Facts About CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network

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A photo of a young child sitting on the ground smiling with chalk in their hand as friends in the background play with chalk on pavement.
1 in 36
8-year-old children living in ADDM Network sites* were identified with ASD in 2020

*11 U.S. Communities

CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network is the only collaborative network to track the number and characteristics of children with autism spectrum disorder (ASD) in multiple communities in the United States. CDC encourages partners to use information from ADDM in their local communities and across the country to move forward initiatives, policies, and research that help children and families living with ASD.

What Do ADDM Data Tell Us About ASD?

From 2016 to the beginning of 2020, 4-year-old children had more evaluations and identifications than children aged 8-years (when they were 4) had from 2012 through 2016.

Bar graphs show more evaluations for children born in 2016 during the 6-month period prior to March 2020 compared to followed by a dramatic decrease in evaluations over the following 6-months (March through August) compared to children born in 2012 during a similar time period.

Displayed as 6 months prior and 6 months post-pandemic

  • About 1 in 36 (2.8%) 8-year-old children living in ADDM Network sites were identified with ASD in 2020. This estimate is based on 8-year-old children living in 11 communities who participated in the ADDM Network and does not necessarily represent the entire population of children in the United States.
  • For the first time, the ADDM Network found that the percentage of 8-year-old Black, Hispanic, and Asian or Pacific Islander children identified with ASD was higher than among 8-year-old White children, which was the opposite of previously observed racial and ethnic differences across the ADDM Network.
  • Boys were nearly four times as likely to be identified with ASD as girls among 8-year-olds. However, the percentage of 8-year-old girls with ASD is now more than 1%.
  • Intellectual disability (ID) is often seen in children with ASD and can indicate a type of impairment in intellectual ability. Among 8-year-old children with ASD, about one third (37.9%) also had ID.
  • Overall, children born in 2016 were 1.6 times as likely to receive an ASD diagnosis or special education classification by 4 years (48 months) of age compared with children born in 2012.
  • An analysis comparing the number of evaluations and ASD identifications before and after the onset of the COVID-19 pandemic found that before the pandemic, 4-year-old children were receiving more evaluations and identifications than 8-year-old children did when they were 4 years of age. However, these improvements in evaluation and ASD detection were wiped out beginning in March 2020. Delays in evaluation could have long-lasting effects as a result of delays in identification and initiation of services during the COVID-19 pandemic.

Building the Public Health Infrastructure for ASD

States with ADDM sites year 2020

Find out more about CDC’s ADDM Network sites.

To understand the scope of ASD in the United States, the Children’s Health Act of 2000 authorized CDC to create the ADDM Network to track the number and characteristics of children with ASD and other developmental disabilities using CDC’s Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) as a guide.

ADDM is the largest ongoing ASD tracking system in the United States. There are several major advantages to using the ADDM method for tracking the number and characteristics of children with ASD:

  • The ADDM method is population-based. We study ASD and other developmental disabilities among thousands of children from diverse communities across the country.
  • ADDM tracks how many children have ASD, which groups of children are more likely to be identified with ASD, and at what age they are likely to be diagnosed.
  • ADDM findings reflect real-world community practices. Differences in ASD identification among communities suggests opportunities to more equitably identify and serve children with ASD.

“While typical children are scheduling play dates and extracurricular activities, our children’s lives are about therapies, day after day, year after year, usually 7 days a week. People on the outside cannot grasp the necessary skills that our children require help with. My ultimate hope is that one day soon my children will live in a world where they will be accepted and appreciated, despite their differences. As long as I am here, I try to surround them with people who love and accept them as they navigate this world because autism never takes a day off.”

– Mary Elizabeth, parent of two children with ASD

Moving Forward

CDC will continue to monitor the number and characteristics of children with ASD over time, track progress in the early identification of ASD, and describe health and service needs of adolescents with ASD. States and communities have the potential to turn ADDM Network data into action.

Learn More

Autism and Developmental Disabilities Monitoring Network: www.cdc.gov/addm

CDC’s Learn the Signs. Act Early. Program: www.cdc.gov/actearly

2023 Community Report on Autism. The latest ADDM Network Data