The Value of State Differences in Autism When Compared to a National Prevalence Estimate.

Abstract

* Abbreviations: ADDM — : Autism and Developmental Disabilities Monitoring ASD — : autism spectrum disorder NSCH — : National Survey of Children’s Health This issue’s article, “The Prevalence of Parent-Reported Autism Spectrum Disorder Among US Children,” revealed that the parent-reported prevalence of autism spectrum disorder (ASD) in the National Survey of Children’s Health (NSCH) is now 1 in 40, representing 2.50% of US children ages 3 to 17 years.1 This estimate represents the latest point data on an ever-increasing trend of ASD prevalence in recent years. But what does this new estimate mean? As an average value representing the entire United States, perhaps not as much as one might think. Studies from the Autism and Developmental Disabilities Monitoring (ADDM) Network have consistently documented considerable heterogeneity in ASD prevalences across states. The most recent data from 2014 revealed prevalence estimates ranging from 13.1 per 1000 children in Arkansas to 29.3 per 1000 children in New Jersey, which is more than a twofold difference. Moreover, the range of state-level prevalence estimates was many times larger than the 95% confidence interval around the mean prevalence rate (16.4–17.3 per 1000 children), with only 1 state-level estimate falling within that 95% confidence interval.2 Already large, differences in state-level estimates of ASD prevalence appear … Address correspondence to Sarabeth Broder-Fingert, MD, MPH, Department of Pediatrics, School of Medicine, Boston University, Boston Medical Center, Vose Hall, Room 318a, 850 Harrison Ave, Boston, MA 02118. E-mail: sarabeth.broder-fingert{at}bmc.org