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Journal of Autism and Developmental Disorders

, Volume 47, Issue 9, pp 2733–2742 | Cite as

Diagnostic Substitution for Intellectual Disability: A Flawed Explanation for the Rise in Autism

  • Cynthia D. NevisonEmail author
  • Mark Blaxill
Original Paper

Abstract

Time trends in autism spectrum disorder (ASD) and intellectual disability (ID) prevalence from the United States Individuals with Disabilities Education Act data were computed from 2000 to 2011 for each state and each age from 6 to 17. These trends did not support the hypothesis that diagnostic substitution for ID can explain the ASD rise over recent decades, although the hypothesis appeared more plausible when the data were aggregated across all states and ages. Nationwide ID prevalence declined steeply over the last two decades, but the decline was driven mainly by ~15 states accounting for only one-fourth of the U.S. school population. More commonly, including in the most populous states, ID prevalence stayed relatively constant while ASD prevalence rose sharply.

Keywords

Autism spectrum disorder (ASD) Mental retardation Intellectual disability Diagnostic substitution Time trends Individuals with Disabilities Education Act (IDEA) 

Notes

Acknowledgments

We thank the Individuals with Disabilities Education Act for providing the data used in this study.

Funding

CN and MB did not have specific funding for this work.

Author’s Contributions

CN compiled the IDEA data, performed all calculations and wrote the Methods and Results. MB conceived of the study and wrote the Introduction and Discussion.

Compliance with Ethical Standards

Conflict of interest

CN and MB declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical Approval

The ASD and MR counts used in this study involved datasets in which all relevant personal information had been de-identified prior to our activities and in which the data were aggregated by age at the state level. This project therefore did not require institutional review and approval.

Supplementary material

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Supplementary material 1 Figure S1 (DOCX 594 KB)
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Supplementary material 2 Figure S2 (DOCX 467 KB)
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Supplementary material 3 Figure S3 (DOCX 232 KB)
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Supplementary material 4 Figure S4 (DOCX 248 KB)
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Supplementary material 5 Figure S5 (DOCX 574 KB)
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Supplementary material 6 ASD counts (XLSX 147 KB)
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Supplementary material 7 ID counts (XLSX 113 KB)
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Supplementary material 8 SLD counts (XLSX 141 KB)
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Supplementary material 9 DD counts (XLSX 143 KB)
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Supplementary material 10 OHI counts (XLSX 148 KB)
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Supplementary material 11 NCES school populations (XLSX 160 KB)

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Institute for Arctic and Alpine ResearchUniversity of ColoradoBoulderUSA
  2. 2.Health ChoiceCambridgeUSA

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