Statewide County-level Autism Spectrum Disorder Prevalence Estimates — Seven U.S. States, 2018


Purpose: Autism spectrum disorder (ASD) prevalence information is necessary for identifying community needs such as addressing disparities in identification and services.

Methods: Seven Autism and Developmental Disabilities Monitoring (ADDM) Network sites participated in a pilot project to link statewide health and education data to generate county-level prevalence estimates for a broader age range for their states for the first time.

Results: Statewide prevalence of ASD for ages 3–21 years in 2018 ranged from 1.5% in Tennessee and Wisconsin to 2.3% in Arizona. The median county-level prevalence of ASD was 1.4% of residents ages 3–21 years. More boys than girls had ASD at all sites, and prevalence was lower among non-Hispanic Black (Black), Hispanic, Asian/Pacific Islander (A/PI), and American Indian/Alaska Native (AI/AN) residents compared to non-Hispanic White (White) residents at most sites. ASD prevalence estimates for children aged 8 years were similar to 2018 ADDM Network estimates that used record review to provide more in-depth information, but showed greater variation for children aged 4 years.

Conclusion: Linkage of statewide data sets provides less detailed but actionable local information when more resource-intensive methods are not possible.

Suggested Citation

Shaw, K. A., Williams, S., Hughes, M. M., Warren, Z., Bakian, A. V., Durkin, M. S., Esler, A., Hall-Lande, J., Salinas, A., Vehorn, A., Andrews, J. G., Baroud, T., Bilder, D. A., Dimian, A., Galindo, M., Hudson, A., Hallas, L., Lopez, M., Pokoski, O., … Maenner, M. J. (2023). Statewide county-level autism spectrum disorder prevalence estimates — seven U.S. states, 2018. Annals of Epidemiology.


Peer-Reviewed Article 


  • Specific disability
    • Autism spectrum disorder (ASD)