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Autism and Developmental Disabilities Monitoring Network Notice of Funding Opportunity

Centers for Disease Control and Prevention
National Center on Birth Defects and Developmental Disabilities
Division of Congenital and Developmental Disorders
Developmental Disabilities Branch
Notice of Funding Opportunity (NOFO)


This page will be updated regularly to post answers to questions that are received about the Notice of Funding Opportunity

Funding Opportunity Number: CDC-RFA-DD19-1901

Funding Opportunity Title: Enhancing Public Health Surveillance of Autism Spectrum Disorder through the Autism and Developmental Disabilities Monitoring (ADDM) Network

Program Office: National Center on Birth Defects and Developmental Disabilities

Description: The purpose of this NOFO is to implement a population-based, multiple source surveillance program for autism spectrum disorder (ASD). The project will fund sites to participate in the Autism and Developmental Disabilities Monitoring (ADDM) Network and will enhance surveillance activities at both previous and newly participating sites through two funding components. Component A is required for all applicants, while applying for Component B is optional. Component A funds surveillance of autism spectrum disorder (ASD) among 4-year-old and 8-year-old children. Component A activities include:

  • Implementing and adhering to the standardized ADDM Network methodology;
  • Renewing or establishing agreements for access to BOTH health and education data sources (electronic and/or paper records);
  • Training staff and offering continued education;
  • Reporting clean, de-identified data with vital records/census linkages to CDC (as part of public health surveillance);
  • Submitting at least two peer-review manuscripts to scientific journals;
  • Engaging partners and stakeholders in activities aimed at increasing use of ADDM data; and
  • Creating and implementing individual site plans for performance monitoring and evaluation.

Component B funds follow-up of 16-year-old teens who were included in the ADDM surveillance data in years 2010 or 2012 when they were 8 years old. Information to be collected on the 16-year-old teens includes data on ASD behavioral symptoms, co-occurring conditions, limitations in activities, and educational service delivery (including transition planning). These data will inform public health strategies to improve identification of and services for children with ASD.

Application post date: 08/01/2018

Letter of Intent due date (optional): 08/17/2018

Informational Conference Call: 08/16/2018, 1:00pm Eastern, Toll-Free Number: 1-800-779-0645, Participant code: 5270319
DD19-1901_08-16-2018_FNLCLR [PPT – 2 MB] | DD19-1901_08-16-2018_FNLCLR-508 [PDF – 427 KB]

Application due date: 10/01/2018

If interested in applying, please check the website for the full NOFO language and application documents. Under “Basic Search Criteria,” enter the exact letters/numbers that are provided below on the “Funding Opportunity Number” line.

Please direct questions regarding the application process to

Questions and Answers

Question 1:  Who should the letter of intent (LOI) be addressed to and what information should be included?
Answer 1: The LOI must be sent via U.S. express mail, delivery service, fax, or email to:

Anita Washington
CDC, National Center on Birth Defects and Developmental Disabilities
4770 Buford Highway NE, Room 4116.6, MS E-86
Atlanta, GA 30341

Fax: 770-488-1541 | Email:

The LOI should include the following information:

  • Descriptive title of proposed project;
  • Name, address, telephone number, and email address of the Principal Investigator or Project Director, or both;
  • Name, address, telephone number, and email address of the primary contact for writing and submitting this application; and
  • Number and title of this Notice of Funding Opportunity (NOFO).

Question 2:
Do the listed award amounts include both direct and indirect costs? Or direct only?
Answer 2:  The listed award amounts include both direct and indirect costs.

Question 3:  Is the CDC funding 10 additional ADDM Network sites, or will applications for the new NOFO be needed for the current sites?
Answer 3:  The NOFO is open to all current, former, and new sites.

Question 4:  Does the 12,000–25,000 target population include both 4-year-old and 8-year-old children (e.g., 6,000 4-year-olds and 6,000 8-year-olds)?
Answer 4:  No, the total population requirement is separate for the 4-year-old and 8-year-old ASD surveillance areas (e.g., 12,000–25,000 4-year-olds and 12,000–25,000 8-year-olds).

Question 5:  There wasn’t anything in the application that specified what kind of data would be collected from medical and school records. What are some of the data elements that states will be required to abstract for reporting?
Answer 5:  ADDM sites collect a child’s demographics (age, sex, race/ethnicity), ASD diagnosis (including dates), co-occurring conditions, special education exceptionalities, and abstract information (e.g., test type, dates, overall and domain scores, verbatim text of examiner notes, etc.) from all developmental evaluations, adaptive tests, and intelligence quotient tests in the child’s records. These sites also link to birth certificate information and geocode cases in order to obtain socioeconomic status data.

Question 6:  Do the age components require both school and health sources?
Answer 6:  The NOFO is an open competition and applicants will be evaluated according to the scoring criteria outlined in the NOFO. The criteria describe the point values associated with meeting the education and health records requirement.

Question 7:  Would CDC consider funding two applications from one state?
Answer 7:  In order to ensure maximum U.S. coverage, no more than one application per state will be funded. If multiple applicants from the same state apply under this NOFO, only the highest scoring applicant from that particular state will be selected for funding.

Question 8:  On page 41 of the NOFO, it mentions a population guideline of 12,000-25,000 for county and school district boundaries. We have a population of less than 12,000. Does that preclude us from applying, or would the rate of ASD among our population make us eligible for this announcement?
Answer 8:  The NOFO is an open competition and the applicants will be evaluated according to the scoring criteria outlined in the NOFO. The criteria describe the point values associated with meeting the target population size.

Question 9:  Do Component A (4- and 8-year-old surveillance) and Component B each get 20 pages for the Project Narrative? That said, will we have a 40-page limit if we submit applications for both Component A and Component B?
Answer 9:  Applicants applying for Component A only will have a maximum of 20 pages for the Project Narrative. Applicants applying for both Component A and Component B will have a maximum of 30 pages for the Project Narrative.

Question 10:  Will CDC provide a recording of the informational call on August 16, 2018?
Answer 10:  The informational call was not recorded, but the slides are available on the ADDM web page. For more information, including frequently asked questions, please visit

Question 11:  Does the need for early intervention sources apply to 4-year-olds only, or should records for 8-year-olds be requested/reviewed at early intervention sources as well?
Answer 11:  Early intervention sources apply to 4-year-old children only.

Question 12:  For 16-year-olds, evaluations previously abstracted will have already been coded by DSM-IV criteria. Will they need to be coded by DSM-IV criteria a second time? Will all new evaluations abstracted need to be coded by DSM-IV criteria as well?
Answer 12:  The 16-year-olds’ records should be coded using DSM-IV and DSM-5 criteria.

Question 13: There are 10 federally funded states in the ADDM Network, and the new request for applications has 10 awardees (Component A). It seems we will be competing against states that are current members of the ADDM Network. Is this correct?
Answer 13: Yes, the NOFO is an open competition, and any state entity is eligible to apply.

Question 14:  Can you explain more about data linkages?
Answer 14:  Sites will link to vital records from state health departments and census data. CDC will provide guidance on performing these linkages.

Question 15: Can you explain why there is a cap of 25,000 per age group?
Answer 15: The labor that goes into surveillance of a population exceeding 50,000 (25,000 4-year-olds and 25,000 8-year-olds) would be too burdensome.

Question 16: What does “health records” mean?
Answer 16: Health records are records on developmental evaluations completed in the community, including early intervention sources, clinics, and hospitals.

Question 17: Do we need to provide separate budgets for Component A and Component B?
Answer 17: Yes.

Question 18: Do the surveillance areas for 4-year-olds and 8-year-olds have to be the same?
Answer 18: We prefer that the areas are the same, but the 4-year-old area could be a subset of the 8-yearold area as long as it meets the minimum population requirement.

Question 19: How do you handle cases in which the child was previously diagnosed, but at age 8, the child has no indication of ASD?
Answer 19: Highly trained ADDM clinicians review all information abstracted from records and assess whether each child meets the case definition of ASD, regardless of the child’s current diagnosis status.

Question 20: How many sites are currently funded?
Answer 20: There are 11 ADDM Network sites (Arkansas, Arizona, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin). For more information about the ADDM Network, please visit

Question 21: Can we use a source in a neighboring state if it serves our state?
Answer 21: Yes, as long as the child lives in the surveillance area.

Question 22: Should indirect costs be included in the budget?
Answer 22: Yes, the budget must include both direct and indirect costs.

Question 23: Are we allowed to have multiple principal investigators (PIs) for the study? If so, is there a maximum number allowed?
Answer 23: Yes, you are allowed multiple PIs for the study, and there is no maximum number.

Question 24: What kind of data, and from what sources, are you anticipating collecting for transition services for 16-year-olds?
Answer 24: We will use the same types of data sources that are used for 4-year-old and 8-year-old surveillance (health and education).  Specific data elements will be discussed and finalized with award recipients.

Question 25: Can you provide clarification regarding the birth years to be examined?  The bottom of slide #15 states: “Surveillance Year 2018: Children born in 2010 and 2014; Surveillance Year 2020: Children born in 2012 and 2016.” Reading previous ADDM papers, it seems like a single birth year was selected, and all 4-year-olds and 8-year-olds were examined from that single birth year, not combined across multiple birth years.  Since the project would start in 2019, wouldn’t that translate into examining records from children born in 2011 and 2015?  Even though it will take several years to examine 2011 and 2015 records, we would still only examine those two birth years, correct?
Answer 25: Although previous 4-year-old and 8-year-old data have been published separately, they were collected together.  This project will begin in 2019, but will estimate a period prevalence for children that were 4 years old and children who were 8 years old in 2018.  The prevalence for 2020 will be based on data collected from children who were 4 years old and children who were 8 years old in 2020.

Question 26: Can you clarify the requirements for option #1 of the site-initiated analyses?  Also, are sites being advised to look at administrative prevalence across the full age range (0-21), or can we select specific age groups, such as looking at characteristics of transition-age students?
Answer 26: Sites selecting option #1 for analysis should use administrative records to estimate ASD prevalence, including by ADDM/non-ADDM area, and at least one other demographic factor (e.g., sex, race/ethnicity, SES, rural/urban residence).  Sites may select a specific age range within 0-21 years that is appropriate for the data and analytic objective.

Question 27:  Are we able to attach optional documents such as CVs, letters of support, etc., as it states on page 51 of 57?
Answer 27: Yes, CVs and letters of support can be included as optional documents.

Question 28: Is ADDM a de-identified surveillance system?  Are participant names and addresses included in the data that surveillance sites submit to CDC?  Or, is participant name and address information simply used to link participant data to birth certificate data and to geocode and geographically aggregate participants into specific geographic boundaries (e.g., zip codes, census tracts)?
Answer 28: CDC only receives de-identified data.

Question 29: For most sites, the populations covered in SY2010 and SY2012 were greater than the recommended maximum for 4-year-old and 8-year old surveillance for SY2018/SY2020.  Is there a recommended target population size for the 16-year-old surveillance?  Is it acceptable for the 16-year-old target population area to be a subset of the 4-year-old and 8-year-old target area?
Answer 29: For 16-year-old surveillance, sites will only follow up on children who were abstracted when they were 8 years old in 2010 or 2012.  Therefore, there is no recommended target population size for this component.