Trends in ASD Geographically (United States)

Trends in ASD Geographically (United States)

By Sarah Johnson. 

The United States has its own rules and systems for health care. The Centers for Disease Control and Prevention (CDC) has a major impact on US systems and health data. Looking at autism in the United States, the CDC estimates that 1 in 68 children have autism1. The prevalence is 1 in 42 for boys and 1 in 189 for girls1. These results create a ratio of five boys for every girl. 

In 2015, there were an estimated 3.5 million people with autism in the United States. This number represents about 0.6% of the population. In 2016, it was reported that the rate of diagnosis had increased by 20% since 20104. This increase could be due to better awareness or changes in diagnostic criteria.

In the U.S., the criteria for diagnosing autism are written in the Diagnostic and Statistical Manual of Mental Disorders (DSM). With an ASD diagnosed, there is no blood test, brain scan, or any other objective test that can diagnose autism. There have been many researchers trying to develop such tests. As of now, clinicians rely on observations of a person’s behavior to assess an autism diagnosis. 

Data collecting entities

The Developmental Disabilities Monitoring Network (DDMN) is part of the National Center for Health Statistics, which is part of the CDC. It collects information from states regarding autism prevalence and incidence. NCHS uses this information to estimate national rates and trends. They also report these findings to state-level agencies and organizations. The DDMN reports that in 2014, there were an estimated 2,735,000 people with autism in the U.S. This means that 1 in 88 children has autism. This figure is based on the 2011–2014 data. This number is expected to rise as more people become aware of the condition.

ADDM Network: ADDM stands for Autism and Developmental Disability Monitoring. ADDM is part of the National Institute of Child Health and Human Development. The purpose of ADDM is to monitor the prevalence of autism spectrum disorders among infants and toddlers. ADDM monitors the prevalence of autism spectrum disorder among children aged 8 years and younger. ADDM also monitors the prevalence of intellectual disability and developmental delay among children aged 4 years and younger. 

The National Autism Association is a non-profit organization that provides support to families affected by autism spectrum disorder. Its mission is to provide services and resources to help individuals with autism and their families. They do so through advocacy, education, research, and community outreach. Data collected by the association shows that in 2015, there were approximately 4.4 million Americans living with autism. 

Autism spectrum disorders are characterized by social impairments, communication difficulties, repetitive behaviors, and restricted interests. They affect an estimated one out of every 88 people in the United States. The number of children with autism has increased over time, but not as rapidly as it did before 1990. This increase occurred because more parents were being diagnosed with autism during this period. For example, when a child is interacting with others, they may

  • not follow social cues; they may;
  • repeat themselves over and over again;
  • not respond to their name;
  • be unusually interested in objects;
  • show little interest in toys or games;
  • lack eye contact;
  • engage in repetitive behaviors;
  • be unable to understand what another person wants from them;
  • avoid eye contact;
  • exhibit unusual body movements;
  • use gestures inappropriately;
  • make noises that seem inappropriate;
  • have trouble understanding language; and a host of other behaviors.

Prevalence estimates

The estimated state-level prevalence of ever-diagnosed autism varies from about 1.54% in Texas to 4.88% in Florida. Other states with low prevalence below 2% are Colorado, Alaska, Hawaii, Georgia, Tennessee, Nebraska, North Dakota, South Dakota, and Ohio. Other states with high prevalence above 4% are Rhode Island, Maryland, and Washington D.C. 2. These variations can be contributed to the effects of socioeconomic factors on health care. For example, parents who do not speak English as a first language will find it more difficult to access services. Also, some states have higher rates of Medicaid coverage than others. 

South Carolina has the highest prevalence of autism in the country. Autism affects nearly 5 percent of children in South Carolina compared to approximately 1 percent nationally. According to the National Center for Health Statistics, South Carolina ranks third in the nation for the percentage of children living in poverty. The average annual income per capita in South Carolina is $13,9063 compared to the national average of $55,652. The average family size in South Carolina is 3.7 members compared to the national average which is 2.

There are also differences between urban and rural areas. In general, rural areas tend to have lower rates of autism. However, this is not always true. Some studies show that rural areas have higher rates of autism than urban areas. This difference is likely due to different cultural factors. For example, rural communities often have fewer resources available to families. Rural communities also have less access to medical professionals. Therefore, these communities must rely on each other for help. This creates a sense of community among residents. It is important to note that all communities have unique cultures and environments. 

There are also differences within urban areas. Urban areas with higher rates of autism include New York City, Los Angeles County, Chicago, Houston, San Francisco Bay Area, and Boston. The reasons behind this variation are unknown. One explanation is that these cities have larger populations. Another reason might be that these cities have large numbers of immigrants. Immigrants often come from countries where autism is common. They bring the culture of those countries with them. When they settle into new homes, they encounter children who already have autism. This causes them to feel like they are “different” and therefore seek out support groups. 

Geographic variability

A study conducted by the CDC showed that there were significant geographic differences in the prevalence of autism spectrum disorders. The highest rate was found in the Midwest at 3.6%, followed by the Northeast at 3.1%. The lowest rate was found in the West at 2.0%. The overall national average was 2.8%.

One study found that the prevalence of autism among African Americans is higher than Caucasians. It is unclear why this occurs but one hypothesis is that African Americans are more likely to receive a diagnosis of intellectual disability rather than autism because of the lower cutoff scores used to identify an intellectual disability. Another reason is that parents of African American children may be less aware of the symptoms of autism. The lack of awareness could lead to delayed diagnosis and treatment, which can have a negative impact on child development.

A third factor is a perception that autism is not a serious condition. This belief has been shown to affect how people respond to an autistic person. For example, when people believe that autism is not a real problem, they are more likely to ignore or even mock an autistic individual. The result is that many autistic individuals do not receive the help they need.

Race /ethnicity

The racial and ethnic distribution of autism varies across the United States. White children make up about 70% of cases while black children account for 11% of cases. Asian children represent 6% of cases and Hispanic children 4%. These percentages vary slightly depending on what part of the country you are looking at.

Racial disparities exist in terms of access to services. Black children are less likely to receive early intervention services compared to their white counterparts.

Hispanic children have a much higher incidence of autistic Disorder than non-Hispanic whites. Hispanic children are four times as likely to have autism as white children. There are several possible explanations for this. First, Hispanics are more likely to live in poverty. Poverty increases the risk of having an autistic child. Second, Hispanic children are more likely to grow up in single-parent households. Third, Hispanic children are more prone to health problems such as asthma, diabetes, seizures, and heart disease. 

Access to services

There are also regional differences in rates of autism. The rate is highest in the Northeast, and lowest in the West. The most common type of autism is Asperger's syndrome, which affects about 1 percent of children. It often has a milder form than classic autism, but it can be difficult to tell them apart.

A study conducted by the Centers for Disease Control and Prevention found that only one-third of people with autism were receiving early intervention services. This means that most autistic individuals receive no formal education until they enter school. Many schools lack trained teachers who know how to teach students with special needs. Even if schools provide training, they usually lack the necessary materials.

Another problem is that parents often do not recognize the signs of autism. This makes it hard for them to get proper treatment. Parents may think their child has attention deficit hyperactivity disorder (ADHD) or another disorder instead of autism. As a result, they may put off getting help.

Since the United States has different laws and regulations state-by-state, health plans for ASD vary. For example, each state has its own regulations on state insurance mandates for autism. These mandates require certain insurers to provide coverage for autism spectrum disorder. To learn more about states and insurance involving ASD visit the ASHA website.

1 Centers for Disease Control and Prevention. CDC estimates 1 in 68 school-aged children have autism; no change from the previous estimate (March 31, 2016). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.,Report%20(MMWR)%20Surveillance%20Summary.

2Xu G, Strathearn L, Liu B, et al. Prevalence and Treatment Patterns of Autism Spectrum Disorder in the United States, 2016. JAMA Pediatr. 2019;173(2):153–159. doi:10.1001/jamapediatrics.2018.4208


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