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School-Based Autism Rates by State: An Analysis of Demographics, Political Leanings, and Differential Identification


We reviewed federal special education data to determine school-identified prevalence of Autism Spectrum Disorder (ASD) and other disability categories by U.S. state. We also examined whether state-level policies, demographic factors, and rates of other eligibility categories are predictive of these state ASD rates. Results indicate that overall, 1 of 81 school-aged children are served under an ASD special education eligibility. State-level demographic factors, such as socioeconomic status and political leanings were highly predictive of rates of ASD. States with higher rates of ASD had lower rates of intellectual and learning disabilities, but higher rates of Other Health Impairment (OHI).

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  1. Aiello, R., Ruble, L., & Esler, A. (2017). National study of school psychologists’ use of evidence-based assessment in autism spectrum disorder. Journal of Applied School Psychology, 33(1), 67–88.

    Article  Google Scholar 

  2. Autism Speaks. (2019). Autism Speaks commends Tennessee as it becomes 50th state requiring that insurance plans cover autism. Retrieved from

  3. Barton, E., Harris, B., Leech, N., Stiff, L., Choi, G., & Joel, T. (2016). An analysis of state autism educational assessment practices and requirements. Journal of Autism and Developmental Disorders, 46, 737–748.

    Article  PubMed  Google Scholar 

  4. Brock, S. E. (2006). An examination of the changing rates of autism in special education. The California School Psychologist, 11, 31–40.

    Article  Google Scholar 

  5. Callaghan, T., & Sylvester, S. (2019). Autism spectrum disorder, politics, and the general insurance mandates in the United States. PLoS ONE, 14(5), e0217064.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Daniels, A., & Mandell, D. (2014). Explaining differences in age at autism spectrum disorder diagnosis: A critical review. Autism, 18(5), 583–597.

    Article  PubMed  Google Scholar 

  7. Durkin, M., Maenner, M., Meaney, F., Levy, S., DiGuiseppi, C., Nicholas, J., et al. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: Evidence from a US cross-sectional study. PLoS ONE, 5(7), E11551.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Fountain, C., King, M. D., & Bearman, P. S. (2011). Age of diagnosis for autism: Individual and community factors across 10 birth cohorts. Journal of Epidemiology & Community Health, 65(6), 503–510.

    Article  Google Scholar 

  9. Griffith, M. (2015). A look at funding for students with disabilities. The Progress of Education Reform, 16, 1–6.

    Google Scholar 

  10. Corp, I. B. M. (2016). IBM SPSS statistics, version 24.0. Armonk, NY: IBM Corp.

    Google Scholar 

  11. Individuals with Disabilities Education Act, 20 U.S.C. § 1400 (2004).

  12. Itkonen, T. (2009). Stories of hope and decline: Interest group effectiveness in national special education policy. Educational Policy, 23(1), 43–65.

    Article  Google Scholar 

  13. Johnson, R. A., Danis, M., & Hafner-Eaton, C. (2014). US state variation in autism insurance mandates: Balancing access and fairness. Autism, 18(7), 803–814.

    Article  PubMed  PubMed Central  Google Scholar 

  14. King, M., & Bearman, P. (2011). Socioeconomic status and the increased prevalence of autism in California. American Sociological Review, 76(2), 320–346.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kurth, J. A. (2015). Educational placement of students with autism: The impact of state of residence. Focus on Autism and Other Developmental Disabilities, 30(4), 249–256.

    Article  Google Scholar 

  16. Kurth, J. A., & Mastergeorge, A. M. (2010). Academic and cognitive profiles of students with autism: Implications for classroom practice and placement. International Journal of Special Education, 25(2), 8–14.

    Google Scholar 

  17. Kurth, J. A., Mastergeorge, A. M., & Paschall, K. (2016). Economic and demographic factors impacting placement of students with autism. Education and Training in Autism and Developmental Disabilities, 51(1), 3–12.

    Google Scholar 

  18. Liptak, G., Benzoni, L., Mruzek, D., Nolan, K., Thingvoll, M., Wade, C., et al. (2008). Disparities in diagnosis and access to health services for children with autism: Data from the National Survey of Children's Health. Journal of Developmental & Behavioral Pediatrics, 29(3), 152–160.

    Article  Google Scholar 

  19. Lyons, J., Cappadocia, M. C, & Weiss, J. A. (2011). BRIEF REPORT: Social Characteristics of students with Autism Spectrum Disorders across classroom settings. Journal on Developmental Disabilities, 17(1),77–82.

    Google Scholar 

  20. MacFarlane, J. R., & Kanaya, T. (2009). What does it mean to be autistic? Inter-state variation in special education criteria for autism services. Journal of Child and Family Studies, 18(6), 662–669.

    Article  Google Scholar 

  21. Maddox, B., Rump, K., Stahmer, A., Suhrheinrich, J., Rieth, S., Nahmias, A., et al. (2019). Concordance between a U.S. educational autism classification and the Autism Diagnostic Observation Schedule. Journal of Clinical Child and Adolescent Psychology.

    Article  PubMed  Google Scholar 

  22. Maenner, M., Shaw, K., Baio, J., Washington, A., Patrick, M., DiRienzo, M., et al. (2020). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites United States, 2016. MMWR Surveillance Summaries, 69(4), 1–12.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Mandell, D. S., Barry, C. L., Marcus, S. C., Xie, M., Shea, K., Mullan, K., et al. (2016). Effects of autism spectrum disorder insurance mandates on the treated prevalence of autism spectrum disorder. JAMA Pediatrics, 170(9), 887–893.

    Article  PubMed  Google Scholar 

  24. Mandell, D. S., & Palmer, R. (2005). Differences among states in the identification of autistic spectrum disorders. Archives of Pediatrics and Adolescent Medicine, 159(3), 266–269.

    Article  PubMed  Google Scholar 

  25. Mandell, D. S., Wiggins, L. D., Carpenter, L. A., Daniels, J., DiGuiseppi, C., Durkin, M. S., et al. (2009). Racial/ethnic disparities in the identification of children with autism spectrum disorders. American Journal of Public Health, 99(3), 493–498.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Marmor, T. R. (2017). The politics of autism: Navigating the contested spectrum. Journal of Health Politics, Policy, and Law, 42(6), 1143–1145.

    Article  Google Scholar 

  27. National Center for Education Statistics. (2017). Children 3 to 21 years old served under Individuals with Disabilities Education Act (IDEA), Part B, by type of disability. Retrieved from

  28. National Center for Education Statistics. (2018). Enrollment in public elementary and secondary schools, by region, state and jurisdiction: Selected years, fall 1990 through fall 2027 [Data file]. Retrieved from

  29. Ong-Dean, C. (2009). Distinguishing disability parent, privilege, and special education. The Chicago, IL: University of Chicago Press

    Book  Google Scholar 

  30. Palmer, R. F., Blanchard, S., Jean, C. R., & Mandell, D. S. (2005). School district resources and identification of children with autistic disorder. American Journal of Public Health, 95(1), 125–130.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Pennington, M., Cullinan, D., & Southern, L. (2014). Defining autism: Variability in state education agency definitions of and evaluations for autism spectrum disorders. Autism Research and Treatment, 2014, 1–8.

    Article  Google Scholar 

  32. R Core Team. (2015). R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing.

    Google Scholar 

  33. Ramsey, E., Kelly-Vance, L., Allen, J. A., Rosol, O., & Yoerger, M. (2016). Autism spectrum disorder prevalence rates in the United States: Methodologies, challenges, and implications for individual states. Journal of Developmental and Physical Disabilities, 28(6), 803–820.

    Article  Google Scholar 

  34. Rzhetsky, A., Bagley, S. C., Wang, K., Lyttle, C. S., Cook, E. H., Altman, R. B., et al. (2014). Environmental and state-level regulatory factors affect the incidence of autism and intellectual disability. PLOS Computational Biology, 10(3), 1–11.

    Article  Google Scholar 

  35. Safer-Lichtenstein, J., & McIntyre, L. L. (2020). Comparing autism symptom severity between children with a medical autism diagnosis and an autism special education eligibility. Focus on Autism and Other Developmental Disabilities, 35(3), 186–192.

    Article  Google Scholar 

  36. Safran, S. P. (2008). Why youngsters with autistic spectrum disorders remain underrepresented in special education. Remedial and Special Education, 29(2), 90–95.

    Article  Google Scholar 

  37. Shattuck, P. T. (2006). The contribution of diagnostic substitution to the growing administrative prevalence of autism in US special education. Pediatrics, 117(4), 1028–1037.

    Article  PubMed  Google Scholar 

  38. Shattuck, P. T., Durkin, M., Maenner, M., Newschaffer, C., Mandell, D. S., Wiggins, L., et al. (2009). Timing of identification among children with an autism spectrum disorder: Findings from a population-based surveillance study. Journal of the American Academy of Child and Adolescent Psychiatry, 48(5), 474–483.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Sullivan, A. L. (2013). School-based autism identification: Prevalence, racial disparities, and systemic correlates. School Psychology Review, 42(3), 298–316.

    Article  Google Scholar 

  40. Sullivan, A. L., Sadeh, S., & Houri, A. K. (2019). Are school psychologists’ special education eligibility decisions reliable and unbiased? A multi-study experimental investigation. Journal of School Psychology, 77, 90–109.

    Article  PubMed  Google Scholar 

  41. Szumski, G., & Karwowski, M. (2012). School achievement of children with intellectual disability: The role of socioeconomic status, placement, and parents' engagement. Research in Developmental Disabilities, 33(5), 1615–1625.

    Article  PubMed  Google Scholar 

  42. Thomas, P., Zahorodny, W., Peng, B., Kim, S., Jani, N., Halperin, W., et al. (2011). The association of autism diagnosis with socioeconomic status. Autism, 16(2), 201–213.

    Article  PubMed  Google Scholar 

  43. U.S. Census Bureau. (2018). 2013–2017 American community survey five-year estimates. Retrieved from

  44. U.S. Department of Education, Office of Special Education Programs. (2018). IDEA section 618 data products: State level data files child count 2017. Retrieved from

  45. Vatcheva, K. P., Lee, M., McCormick, J. B., & Rahbar, M. H. (2016). Multicollinearity in regression analyses conducted in epidemiologic studies. Epidemiology, 6(2), 1–9.

    Article  Google Scholar 

  46. Wasserman, D., & Flinn, A. (2017). Introducing the 2017 cook political report partisan voter index. Retrieved from

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Author information




JSL conceived and designed the study. JSL and JH conducted database searches, conducted the literature review, and drafted and edited the manuscript. LLM contributed to study design, analysis, and drafts of the final manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Laura Lee McIntyre.

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Appendix 1

Appendix 1

IDEA Definitions (

  1. 1.

    Autism a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences.

  2. 2.

    Deaf-Blindness concomitant [simultaneous] hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness.

  3. 3.

    Deafness a hearing impairment so severe that a child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child’s educational performance.

  4. 4.

    Emotional Disturbance a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance:

    1. a.

      An inability to learn that cannot be explained by intellectual, sensory, or health factors.

    2. b.

      An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

    3. c.

      Inappropriate types of behavior or feelings under normal circumstances.

    4. d.

      A general pervasive mood of unhappiness or depression.

    5. e.

      A tendency to develop physical symptoms or fears associated with personal or school problems.

  5. 5.

    Hearing Impairment an impairment in hearing, whether permanent or fluctuating, that adversely affects a child’s educational performance but is not included under the definition of “deafness.”

  6. 6.

    Intellectual Disability significantly subaverage general intellectual functioning, existing concurrently [at the same time] with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child’s educational performance.

  7. 7.

    Multiple Disabilities concomitant [simultaneous] impairments (such as intellectual disability-blindness, intellectual disability-orthopedic impairment, etc.), the combination of which causes such severe educational needs that they cannot be accommodated in a special education program solely for one of the impairments. The term does not include deaf-blindness.

  8. 8.

    Orthopedic Impairment a severe orthopedic impairment that adversely affects a child’s educational performance. The term includes impairments caused by a congenital anomaly, impairments caused by disease (e.g., poliomyelitis, bone tuberculosis), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).

  9. 9.

    Other Health Impairment having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that—

    1. a.

      is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and

  10. 10.

    Specific Learning Disability a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations. The term includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. The term does not include learning problems that are primarily the result of visual, hearing, or motor disabilities; of intellectual disability; of emotional disturbance; or of environmental, cultural, or economic disadvantage.

  11. 11.

    Speech or Language Impairment a communication disorder such as stuttering, impaired articulation, a language impairment, or a voice impairment that adversely affects a child’s educational performance.

  12. 12.

    Traumatic Brain Injury an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.

  13. 13.

    Visual Impairment Including Blindness an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness.

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Safer-Lichtenstein, J., Hamilton, J. & McIntyre, L.L. School-Based Autism Rates by State: An Analysis of Demographics, Political Leanings, and Differential Identification. J Autism Dev Disord 51, 2271–2283 (2021).

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  • ASD
  • Socioeconomic status
  • Politics
  • School eligibility/identification