OSEP has released a new OSEP Fast Facts: Children Identified with Autism

OSEP has released a new OSEP Fast Facts:  Children Identified with Autism [sites.ed.gov], which takes a updated look at our data on children whose primary disability is autism.  We revised and updated our very first (and one of our most popular) OSEP Fast Facts [sites.ed.gov].  

Highlights from 2024 OSEP Fast Fact: Children Identified with Autism [sites.ed.gov]

• In SY 2022-23, the percentage of students with disabilities identified with autism is 12.81%.  States report a range from 5.76% to 17.28% of students with disabilities identified with autism.
• In SY 2021-22, Students with disabilities identified with autism were less likely to be subject to a disciplinary removal than all students with disabilities.  
• In SY 2022-23, States/entities and LEAs were more like to identify males with autism than females when compared to all students with disabilities.
• In SY 2021-22, students identified with autism, ages 14-21, exiting school were less likely to drop out and more likely to receive a certificate than all students with disabilities.  
• In SY 2022-23, States/entities and LEAs are more likely to identify Asian students with autism when compared to all students with disabilities.
• In SY 2022-23, students identified with autism were less likely to be served inside the regular class 80% or more of the day than all students with disabilities. 

Mapping the futures of autistic children

Yet researchers have assembled a rich body of data about how autistic people do over time and can provide certain kinds of nuanced projections. The work points to several broad life trajectories for autistic children — rough sketches of how a child’s adolescence and adulthood may unfold. The data also point to subtle, early behavioral markers of future growth or difficulties in specific areas, as well as genetic variants that affect the arc of a child’s trajectory. Some of the research could help clinicians gauge an autistic child’s risk of having mental health challenges such as anxiety and depression as well. 

Such forecasts can give families a general idea of how to plan for the years ahead. “No matter what the outcome is going to be, that unknown is really challenging for families,” says Anne Arnett, a child psychologist at the University of Washington in Seattle. “When you can take away the unknown, or at least give them some idea of what to expect over time, that can be an intervention in and of itself to help families prepare.” The predictions can also point clinicians to therapies that enable children to build on their strengths as they try to ease the children’s difficulties. “There’s a lot of variability in brain growth, and it’s really worth pursuing early interventions to try to support that brain growth,” Arnett says.

Read more here at Spectrum. 

FDA Authorizes Marketing of Diagnostic Aid for Autism Spectrum Disorder

The Cognoa ASD Diagnosis Aid is a software as a medical device that uses a machine learning algorithm to receive input from parents or caregivers, video analysts and health care providers to assist physicians evaluate a patient at risk of ASD. The device consists of three main components: a mobile app for caregivers and parents to answer questions about behavior problems and to upload videos of their child; a video analysis portal that allows manufacturer-trained and certified specialists to view and analyze uploaded videos of patients; and a health care provider portal that is intended for a health care provider to enter answers to pre-loaded questions about behavior problems, track the information provided by parents or caregivers and review a report of the results. After processing the information provided by parents, caregivers and healthcare providers, the ASD Diagnosis Aid reports a positive or negative diagnosis if there is sufficient information for its algorithm to make a diagnosis. If there is insufficient information to render a “Positive for ASD” or “Negative for ASD” result to help determine a diagnosis, the ASD Diagnosis Aid will report that no result can be generated.

The FDA assessed the safety and effectiveness of the Cognoa ASD Diagnosis Aid in a study of 425 patients aged 18 months through 5 years in 14 different clinical care sites, with an average age of 2.8 years. The study compared the assessments made by the device directly against the assessments made by a panel of clinical experts who used the current standard ASD diagnostic process. The device provided a “Positive for ASD” or “Negative for ASD” result to aid in making a diagnosis in 32% of patients. For those with a “Positive for ASD” or “Negative for ASD” result, the device results matched the panel’s conclusions for 81% of patients who tested positive for ASD by the device and 98% of patients who tested negative for ASD by the device. In addition, the device made an accurate ASD determination in 98.4% of patients with the condition and in 78.9% of patients without the condition.

Source. 

Differential Diagnosis in Children with Autistic Symptoms and Subthreshold ADOS Total Score: An Observational Study

Background: Children with autism spectrum disorder (ASD) share some symptoms with children with other neurodevelopmental disorders (ie, intellectual disability or communication disorders or language disorders). These similarities can make difficult to obtain an accurate diagnosis, which is essential to give targeted treatments to the patients. We aim to verify in our study if children with autistic traits who undergo to Autism Diagnostic Observation Schedule had specific clinical diagnosis.
 

Patients and Methods: We selected 73 children tested with ADOS-G or ADOS-2, for the presence of autistic symptoms. The whole sample did not reach the cut-off of ADOS and did not receive the ASD diagnosis, according to DSM-5.
 

Results: Results of this study showed that in order of frequency and early diagnosis, communication disorders (CD), mild intellectual disability (mID) and the attention deficit hyperactivity disorders (ADHD) represent the most common final clinical diagnosis in children with autistic traits.
 

Conclusion: Our results showed as the CD was the common diagnosis of these children and that often associated with younger age. Moreover, analyses of ADOS domains and the difference of individual items between groups did not show the capacity to differentiate between different neurodevelopmental disorders in terms of differential diagnosis, and this confirms the need for integrating multiple sources of information during the diagnostic process.

Read more here. 

A National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorder in Australia

 Developed and published by Autism CRC with the financial support of the National Disability Insurance Agency (NDIA), the Guideline aims to create greater consistency in diagnostic practices across the country to ensure individuals on the autism spectrum and their families can receive the optimal clinical care.

The Guideline also emphasises the importance of listening to individuals and their families about the impact of the behaviours on family life.
The community has been requesting a national and consistent guideline for autism assessment and diagnosis for many years, and we are pleased to release a guideline that responds to this need. The guideline recommendations were approved by Australia’s National Health and Medical Research Council.

 

Register to access the National Guideline

 

Autism prevalence estimates for China, Greece align with global patterns

About 0.7 percent of children in China aged 6 to 12 have autism, suggests the largest study of the country’s autism prevalence to date1. And in Greece, 1.15 percent of 10- and 11-year-olds have the condition, according to the first estimate for that country2.

Both figures fall within the range of autism prevalence estimates reported for children in other nations. The studies also show that autism is about four times as common in boys as it is in girls in both countries, a ratio in line with studiesof children in the United States and elsewhere.

Read more here at Spectrum. 

Popular screen may mistake intellectual disability for autism

A common autism screening tool misses more than 70 percent of autistic toddlers but flags more than 80 percent of non-autistic toddlers who have intellectual disability, a new study of children in Norway reports1.

The study adds to a mounting body of evidence that the tool, the Modified Checklist for Autism in Toddlers (M-CHAT), is not sufficient on its own to identify signs of autism.

Along with previous research in Norway, the results also help clarify which children the M-CHAT flags and which ones it misses, says lead author Roald Øien, professor of special education at UiT – the Arctic University of Norway in Tromsø.

“Basically, we find that screening at 18 months identifies kids with pretty severe delays,” he says, such as a low intelligence quotient (IQ), poor communication skills and prominent autism traits. Conversely, autistic children who fall closer to the typical range of abilities are significantly less likely to be identified by the M-CHAT at 18 months of age.

Read more here at Spectrum. 

The OPI has a New Criteria for Autism

You can see the new criteria here, along with some Frequently Asked Questions. The new criteria checklist is now in the AIM system and on the OPI web page.

If you have questions, please send them to Doug Doty at ddoty@mt.gov. We will update the FAQ questions periodically.

Autism’s relationship to head size, explained

What proportion of people with autism have a large head?
When Leo Kanner first described 11 children with autism in a 1943 paper, he noted many unusual features. “Five had relatively large heads,” he reported, and he said no more on the matter. But the sample size was small.

Many other scientists noted the same link over the following decades. A 1999 review estimated that 20 percent of people with autism have statistically large head size, or ‘macrocephaly’1.

Do autistic children who have a large head also have a large brain?
Yes. Researchers have scanned the brains of autistic people by using technologies such as magnetic resonance imaging (MRI) and have found that those with a large head also tend to have an unusually large brain. However, the link between the two is not entirely straightforward — some autistic children with an enlarged brain don’t have a large head — so it is best for researchers to scan the brain rather than rely on head measurements.

Read more here at Spectrum. 

Study: Girls Diagnosed With Autism About 1.5 Years Later Than Boys

A new study reveals that girls with autism receive a diagnosis, on average, nearly 1.5 years later than boys. This is likely because parents and clinicians tend to notice language delays as the first sign of autism, and the girls in the study had more advanced language skills compared to the boys, say the researchers.

Read more here. 

Autism diagnosis test is less reliable than previously assumed, study finds

The standardized test, known as the Autism Diagnostic Observation Schedule (ADOS), assesses communication skills, social interaction and play for children who may have autism or other developmental disorders.

The researchers digitized the test by attaching wearable technology, like an Apple Watch, to two clinicians and 52 children who came in four times and took two different versions of the test.

When researchers looked at the scores of the entire cohort, they found they did not distribute normally - which could mean a chance of false positives inflating the prevalence of autism, among other implications.

Read more here. 

Saliva test for autism hits market

A saliva test designed to quickly diagnose autism in toddlers has hit the market after seven years of research at SUNY Upstate Medical University and Penn State.

The researchers hope the test will help doctors detect autism faster and get children help sooner, when it can be most effective.

Read more here.

A comparison of the ASD experience of low‐SES hispanic and non‐hispanic white parents

This study showed that Hispanic and Non‐Hispanic White children from poor backgrounds got a diagnosis of Autism Spectrum Disorder (ASD) at the same age. Results show differences in religious views, acceptance of diagnosis, knowledge of milestones, and finding resources. This might be because people are more aware of ASD today and Hispanic families were involved with an active parent organization.

Read more here. 

Standard screen misses majority of toddlers with autism

IN BRIEF

• A popular screening tool (M-CHAT) for autism misses more than 60 percent of children with the condition.
• The vast majority of children the screen does flag turn out not to have autism, but most have a related condition.
• Children with autism who screen positive as toddlers are diagnosed more than seven months earlier, on average, than those who are missed.

Read more here at Spectrum. 

Eye tracking reveals early communication problem in autistic children

At 10 months of age, infants later diagnosed with autism rarely draw others’ attention to an object or event, a new study suggests1.

The results hint that early treatments that focus on joint attention — a behavior in which two people focus on the same thing — could ease communication problems in autistic children.

The study is the first to use eye tracking to assess how babies initiate joint attention. It fits with other research over the past few years showing that joint-attention measures may help identify autism before other autism traits emerge, and with long-standing work showing that initiation of joint attention is particularly relevant to autism.

Read more here at Spectrum. 

Diagnostic tests don’t miss girls with autism, study suggests

Boys and girls with autism get virtually identical scores on three commonly used diagnostic tests, suggesting that sex doesn’t affect the scores. With 10,000 autistic children, including nearly 1,500 girls, the unpublished study is the largest of its kind. But some experts are unconvinced, saying the study’s design does not account for girls who go undiagnosed.

The findings are limited, however, because the researchers included only girls already diagnosed with autism, says Kristin Sohl, associate professor of pediatrics at the University of Missouri in Columbia. Tests such as the ADOS miss many girls with the condition, she says, and the new work does not account for this population.

The bigger question, Sohl says, is why diagnostic tests may not spot girls with autism in the first place.

“What is it about those girls that is allowing them to not score [as autistic] on this excellent test?” she says. “It tells me there are probably some adaptations that need to be made to the scoring or how we interpret those scores in the context of gender.”

Bishop acknowledges this possibility but says the team would have seen bigger differences between boys and girls if the tests were inherently biased.

“If we were missing [girls] because they were systematically scoring lower than the boys, we would expect to see larger effects here,” she says.

Read more here at Spectrum.

Autism Data Visualization Tool - CDC

There are several ways to estimate the number of children with ASD. This estimate is referred to as prevalence, a scientific term that describes the number of people with a disease or condition among a defined group (or ‘population’). Prevalence is typically shown as a percent (e.g., 0.1%) or a proportion (e.g., 1 in 1,000).
ASD prevalence estimates from the following four data sources are presented on this webpage:

• Special Education Child Count
• NSCH
• Medicaid
• ADDM Network

 

Prevalence estimates can vary by type of data source because data are collected in different ways.

 

DOUG NOTES:

 

Hence:

 

 

Why does the top graph show a decrease in the number of Montana students with autism from 2010 to 2011, while the bottom graph shows an increase for the same time span?

 

Because in 2011, the federal government changed the order of "primary" disabilities in how they rank the "order" of disabilities in child count. The ACTUAL number of students with autism didn't decrease, just those who had a primary disability of autism in 2010, but not in 2011. So the same kid with autism might be counted (or not counted) differently from 2010 to 2011, even though their autism and autism identification did not change, because they no longer had a "primary" disability of autism.

 

Graphs from the OPI Montana Autism Education Project show ALL public school students with autism, not just those who have a "primary" disability of autism. We think that is the truest way to show the number of students with autism.

 

Like Abraham Lincoln said to Mark Twain, "There are three types of lies: lies, damned lies and statistics."

 

You can view and play with the Visualization Tool here.  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AKA - The CDC report finding 1/59 children had autism in 2014.

Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 4 Years — Early Autism and Developmental Disabilities Monitoring Network, Seven Sites, United States, 2010, 2012, and 2014

New autism prevalence stats spotlight challenge of early diagnosis

The prevalence of autism in 4-year-old children in the United States has increased — from about 1 in 75 children in 2010 to 1 in 59 in 2014 — to match a previously reported rise in 8-year-old children, according to data released last week by the Centers for Disease Control and Prevention (CDC)¹.

But children are still being evaluated for autism or other developmental conditions later than is ideal, the data suggest.

The trend highlights how difficult it is to diagnose autism in young children, experts say; early diagnosis is important so that children can be treated early.

The autism prevalence they identified among 4-year-olds in 2014 matches the prevalence among 8-year-olds that same year. (The two groups are not directly comparable, however, because the sites in the two studies don’t match up.)

The new study also shows some of the trends in variability among sites: the Missouri site has the lowest prevalence for 2014, at about 1 in 104 children, and the New Jersey site has the highest, at 1 in 35.

The prevalence in New Jersey increased significantly from 2010 to 2014, whereas the numbers remained stable in Arizona and Missouri.

There is no biological reason for the prevalence to vary so dramatically across the U.S., says Walter Zahorodny, associate professor of pediatrics at Rutgers New Jersey Medical School, who led the analysis for New Jersey.

Read more here at Spectrum.

Information About Extending Developmental Delay Eligibility through Age 9 // The Special Education Reevaluation Process

Greetings,

When the rules for the proposed new criteria for Developmental Delay, Autism and Visual Impairment  go into effect on July 1, 2019, students who were previously identified in those disability categories WILL NOT need to meet the new disability criteria. The new criteria will only apply to students who are identified in those categories of disability after July 1, 2019. 

How does the proposed change to allow students to have a label of Developmental Delay until age nine affect students who are currently identified as DD and turn six after July 1st, 2019?

The student would then be a six-year-old with Developmental Delay, which is allowed under the new rule.

To clarify the reevaluation process:

The IEP Team must consider the need for a reevaluation every three years. The IEP team can choose not to reevaluate the student.

A reevaluation is not necessary if the IEP team determines that the student continues to be a student with a disability, and because of that disability needs special education and related services; and additions or modifications to enable the student to meet the measurable annual goals of the IEP and to participate, as appropriate, in the general education curriculum are not needed. This determination is documented on the IEP form.

If the IEP Team determines that a reevaluation is needed, the ER team does not have to consider the initial disability criteria to determine that a student continues to have a disability. The purpose of the reevaluation is to determine that the student continues to have a disability and needs special education and related services.

We hope this clarifies the reevaluation process. Please see the previously published information from the OPI Guide below: 


22. When are reevaluations required?


Reevaluations must occur at least once every three years, unless the parent and the district agree that a reevaluation is unnecessary. 

A reevaluation is not necessary if the IEP team determines that the student continues to be a student with a disability, and because of that disability needs special education and related services; and additions or modifications to enable the student to meet the measurable annual goals of the IEP and to participate, as appropriate, in the general education curriculum are not needed. This determination is documented on the IEP form.
34 CFR 300.303 Reevaluations

27. When a student is reevaluated must he or she meet the criteria required for initial determination of eligibility for special education and related services?

The team does not have to consider the initial criteria to determine that a student continues to have a disability. The purpose of the reevaluation is to determine that the student continues to have a disability and needs special education and related services.
34 CFR 300.305 Additional requirements for evaluations and reevaluations