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News and Notes from The Johnson Center

Autism in the News: How do they know it is 1 in 88?

JCCHD | Mon, April 09, 2012 | [Assessment Corner][News]

Last week, the Center for Disease Control and Prevention (CDC) released its most recent update on the rates of autism in the United States.  The numbers are staggering, indicating a rate of 1 out of 88 eight-year-old children (1 out of 54 of boys and 1 out of 252 of girls). Review of rates over the past several years indicates a skyrocketing increase—the CDC data shows an increase of 78% in autism rates from 2002 to 2008. While unanswered questions remain regarding the cause of this increase, one thing is very clear: public health action is needed to help children and families dealing with autism.

How were these numbers determined? The CDC developed the Autism and Developmental Disabilities Monitoring Network (ADDM) in the year 2000 to monitor the prevalence of autism and developmental disabilities in the United States.  The recent rates are for the 2008 surveillance year; fourteen sites within the United States participated. The ADDM focuses on eight-year-old children because of previous studies that suggest this is the age of identified peak prevalence (younger children often fail to get an accurate diagnosis).  The ADDM determines cases of autism through a two-step procedure.  The first step involves collecting and screening records at multiple settings, including educational and health settings.  The second step involves a rigorous review of all records by trained clinicians to determine ASD case status according to the DSM-IV-TR diagnostic criteria.  Cases are included if there is documented display of behaviors that meet the ADDM surveillance criteria for an ASD diagnosis anytime from birth to age eight years.  For specific information regarding the ADDM’s 2008 surveillance and overall findings follow the link:

http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6103a1.htm?s_cid=ss6103a1_e

The current autism rates released by the CDC are based on the DSM-IV-TR, the current diagnostic manual used by clinicians to diagnosis autism. A new edition, the DSM-V, is expected to be released in 2013, with proposed changes to diagnostic criteria for autism and developmental disorders. These proposed changes are significantly different from current criteria and will likely impact diagnoses received as well as access to services. Stay tuned for more information on these proposed changes and potential consequences.