Intended for healthcare professionals


Is the prevalence of autism increasing in the United States?

BMJ 2014; 348 doi: (Published 09 May 2014) Cite this as: BMJ 2014;348:g3088
  1. Stephanie Blenner, assistant professor of pediatrics,
  2. Marilyn Augustyn, professor of pediatrics
  1. 1Division of Developmental Behavioral Pediatrics, Boston University School of Medicine, Boston, MA 02118, USA
  1. Stephanie.Blenner{at}

A consistent approach to identification and studies in a stable representative population are needed to decide

Few reports from the Centers for Disease Control and Prevention (CDC) garner as much media attention as the periodic updates from the United States Autism and Developmental Disabilities Monitoring (ADDM) network.1 Perhaps this reflects the reported increases in the prevalence of autism, which are worrying to all those who care for affected children and their families.

Considering the ADDM’s findings, an understanding of its methodology is important. This multistate autism surveillance network was established in 2000 by congressional mandate and the CDC. The study sample comes from states selected through a competitive grant, so participating states vary over time, and it is not representative of the US population. The most recent report from March 2014 is based on data from 11 sites in the 2010 surveillance year.2 Data derive from a two phase approach to identifying 8 year olds with autism spectrum disorder. The first phase involves abstraction of medical and educational (if available) evaluations. The second phase is identification of children who on review of the abstracted records by trained clinicians meet criteria for any of the following DSM-IV-TR (Diagnostic …

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