Statewide county-level autism spectrum disorder prevalence estimates—seven U.S. states, 2018

Kelly A. Shaw, Susan Williams, Michelle M. Hughes, Zachary Warren, Amanda V. Bakian, Maureen S. Durkin, Amy Esler, Jennifer A Hall-Lande, Angelica Salinas, Alison Vehorn, Jennifer G. Andrews, Thaer Baroud, Deborah A. Bilder, Adele Dimian, Maureen Galindo, Allison Hudson, Libby Hallas, Maya Lopez, Olivia Pokoski, Sydney PettygroveKatelyn Rossow, Josephine Shenouda, Yvette D. Schwenk, Walter Zahorodny, Anita Washington, Matthew J. Maenner

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Purpose: Autism spectrum disorder (ASD) prevalence information is necessary for identifying community needs such as addressing disparities in identification and services. Methods: Seven Autism and Developmental Disabilities Monitoring (ADDM) Network sites participated in a pilot project to link statewide health and education data to generate statewide and county-level prevalence estimates for a broader age range for their states for the first time. Results: Statewide prevalence of ASD for ages 3–21 years in 2018 ranged from 1.5% in Tennessee and Wisconsin to 2.3% in Arizona. The median county-level prevalence of ASD was 1.4% of residents ages 3–21 years. More boys than girls had ASD at all sites, and prevalence was lower among non-Hispanic Black, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native residents compared to non-Hispanic White residents at most sites. ASD prevalence estimates for children aged 8 years were similar to 2018 ADDM Network estimates that used record review to provide more in-depth information, but showed greater variation for children aged 4 years. Conclusions: Linkage of statewide data sets provides less detailed but actionable local information when more resource-intensive methods are not possible.

Original languageEnglish (US)
Pages (from-to)39-43
Number of pages5
JournalAnnals of epidemiology
StatePublished - Mar 2023

Bibliographical note

Funding Information:
The authors would like to acknowledge the community partners at clinical and educational data sources who shared data that enabled the generation of these estimates, including those who navigated data-sharing agreements and those on the technical side who provided the data. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:

Publisher Copyright:
© 2023


  • Autism
  • Autism spectrum disorder
  • Developmental disabilities
  • Public Health
  • Surveillance


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