At a glance
Findings from ÐÇ¿ÕÓéÀÖ¹ÙÍø's Autism and Developmental Disabilities Monitoring (ADDM) Network show that autism spectrum disorder (ASD) prevalence varies across communities in the United States. This variability is likely due to several factors, including how communities identify children with autism. Communities can learn from successful ASD identification strategies to help children receive the diagnostic and support services they need as early as possible.
ASD prevalence numbers varied
Across the ADDM Network's 16 sites, the overall ASD prevalence, or the number of 8-year-old children identified with ASD in 2022, was 1 in 31, but there was wide variability by site. The prevalence ranged from 1 in 103 in Texas-Laredo to 1 in 19 in California.
Fact
About 1 in 31 (3.2%) children were identified with autism spectrum disorder among a 2022 sample of 8-year-olds from 16 US communities in ÐÇ¿ÕÓéÀÖ¹ÙÍø's ADDM Network.1
Important
Currently, research does not show that living in certain communities puts children at greater risk for developing ASD. Find out how ÐÇ¿ÕÓéÀÖ¹ÙÍø collected data from ADDM Network sites.
Evaluation and testing practices
Across the ADDM Network, 66.5% of children aged 8 years with ASD had a documented autism test, ranging from 24.7% in New Jersey to 93.5% in Puerto Rico. The most common ASD tests documented for this age group included the Autism Diagnostic Observation Schedule (ADOS), Autism Spectrum Rating Scales (ASRS), Childhood Autism Rating Scale (CARS), Gilliam Autism Rating Scale (GARS), and Social Responsiveness Scale (SRS).
In addition, intelligence quotient (IQ) scores were available for 61.4% of children aged 8 years with ASD, ranging from 21.3% in Texas-Laredo to 90.2% in Arkansas. Among 8-year-old children identified with ASD and an available IQ score, more than one third (39.6%) had an intellectual disability (IQ scores equal to or less than 70). The number of 8-year-old children with ASD who had IQ scores available and were classified as having intellectual disability also varied among communities, ranging from 24.8% in Puerto Rico to 80% in Texas (Laredo). These findings suggest that in some communities, children may be less likely to be tested for intellectual disability.
ÐÇ¿ÕÓéÀÖ¹ÙÍø's ADDM Network sites also showed variability in where children were identified with ASD, for example, in an education setting (such as through special education services at school) or in a healthcare setting (such as by a healthcare provider).
Differences in where and when a child is identified with ASD could impact how soon a child may receive support services. ADDM Network sites provide an opportunity for us to learn from different strategies to ensure children in all communities receive the evaluation, testing, and care they need as early as possible.
ASD prevalence and early identification
Some other patterns remained mostly consistent throughout communities. Certain 8-year-old children were more likely to be identified with ASD, including:
- Boys were more than 3 times as likely as girls to be identified with ASD
- Asian or Pacific Islander, American Indian or Alaska Native, Black, Hispanic, and Multiracial children were more likely to be identified with ASD compared with White children
- Higher socioeconomic status was not related to higher identification of ASD
Community approaches
Findings from ÐÇ¿ÕÓéÀÖ¹ÙÍø's ADDM Network provide an opportunity to understand the factors that may lead to variations in ASD prevalence across different communities. Variability in ASD prevalence could reflect differences in availability of services for early detection and evaluation, as well as differences in diagnostic practices by providers and educators within communities. Variability in the identification of autism could impact the timely receipt of support services.
There are opportunities to learn from successful identification and diagnostic strategies to help ensure children in all communities receive the diagnostic and support services they need as early as possible. Examples of approaches found across ADDM communities include:
- California: The Get SET Early model has been used to train hundreds of local pediatricians to screen and refer children for assessment as early as possible. provide evaluations and service coordination for people with disabilities and their families. Since the state joined the ADDM Network in 2018, identification of ASD in children aged 4 and 8 years has been highest in California compared with other ADDM sites.
- Pennsylvania: The state provides Medicaid for children with physical, developmental, mental health, or intellectual disabilities regardless of parents' income. In 2022, identification of ASD in children aged 8 years was second highest in Pennsylvania compared with other ADDM sites.
- Puerto Rico: Title V (CSHCNP) and the Act Early Ambassador have worked together to develop and share clinical protocols for early identification and diagnosis of ASD across Puerto Rico. This effort has led to increasing access to diagnostic evaluations at the CSHCNP Autism and Pediatric Centers for children aged 3 or younger and to provision of a guide including information about developmental milestones and early ASD signs to all parents of newborns. Identification of ASD in children aged 4 years was second highest in Puerto Rico compared with other ADDM sites.
Data impact and future directions
Service providers (such as healthcare organizations and school systems), community leaders, and researchers can use ADDM Network data to:
- Support planning for services
- Inform systems and policies that promote improved outcomes in health care and education
- Guide research on risk and protective factors for ASD
- Promote interventions that can help children with ASD succeed
Data from ÐÇ¿ÕÓéÀÖ¹ÙÍø's ADDM Network can provide early awareness of important public health trends across different communities:
Early identification is one of the most important tools that can make a difference in the lives of children with ASD and their families. ÐÇ¿ÕÓéÀÖ¹ÙÍø will continue to track the number and characteristics of children identified with ASD and work to understand factors associated with outcomes among children and adolescents with ASD throughout their adult life.
ADDM Network findings on age at ASD diagnosis of ASD support ÐÇ¿ÕÓéÀÖ¹ÙÍø's "Learn the Signs. Act Early." program, that aims to improve early identification of developmental delays and disabilities by promoting early childhood developmental monitoring by families, child care providers, healthcare providers, and others.
Resources for families and providers
Families know their children best. If a family has concerns about their child's development, it is best to act early to help the child get the services and support they might need.
Resources are available for families that suspect their child might have ASD.
Families can Act Early by:
- Tracking their child's development using ÐÇ¿ÕÓéÀÖ¹ÙÍø's FREE Milestone Tracker app, available in both English and Spanish in the and on
- Talking with their child's doctor and asking for developmental screening
- Contacting a local early intervention program for a free or low-cost evaluation (children under age 3) or school system for a free evaluation (children 3 years or older)
Early intervention (before school age) can have a significant impact on a child's ability to learn new skills and may also reduce the need for costly interventions over time. Families should remember that it's never too late to get help for their child. An ASD diagnosis from a doctor is not necessary for a child to begin receiving services.
For more tips on what families and others can do when there is a concern, visit .
- Shaw KA, Williams S, Patrick ME, et al. Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years — Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022. MMWR Surveill Summ 2025;74(No. SS-2):1–22.