TRENDS IN DOCUMENTED AUTISM SPECTRUM DISORDER CO-OCCURING CONDITIONS AND SPECIAL EDUCATION EXCEPTIONALITY IN CHILDREN WITH AUTISM SPECTRUM DISORDER IDENTIFIED BY THE AUTISM AND DEVELOPMENTAL DISABILITY MONITORING NETWORK, 2002, 2006, AND 2008
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Autism spectrum disorder (ASD), an impairment of social communication and interaction, affects 1 in 68 eight-year-olds. The Autism and Developmental Monitoring Network (ADDM) found prevalence increased 78% from 2002 to 2008. Part one assesses documented ASD co-occurring conditions (DACCs) for eight-year-olds with ASD identified by ADDM in 2002, 2006, and 2008. Children were included if they were identified by an ADDM site that abstracted medical records and collected IQ data on greater than 85% of children and the child lived in an area that participated in all three surveillance years. Negative binomial regression and rare events logistic regression were used to test for trends in count and by categorized and individual DACCs. The same approach was used examine the multiplicative effects of prior documentation of ASD on the child’s records and intellectual disability (ID). Number of DACCs significantly increased for children with ID and all children with prior documentation of ASD. Increasing DACCs were mainly specific developmental delays (SDD); this may be a result of increased early developmental screening. SDDs that increased differed within the subgroups. In part two, trends in special education exceptionality from 2002, 2006, and 2008 in the ADDM network were assessed. Special education exceptionality is a US government mandated classification system for children who meet criteria for special education services. Children were included if they had exceptionality, identified as having ASD by a site in the ADDM network, had abstracted school records, and lived in the surveillance area for all three surveillance years, Rare events logistic regressions were conducted to test trend. Trends in exceptionality type stratified by sex and race/ethnicity were assessed to evaluate possible disparities. Results were compared to Individuals with Disabilities in Education Act (IDEA) data. Autism exceptionality remained constant for the total sample and in all subgroups but females. ID classification significantly decreased for both sexes and white and black children and differed significantly among sexes and race/ethnicity. Developmental disability exceptionality increased for all subgroups but did not differ and may be partially attributable to the increase in early developmental screening. Comparing to national data, exceptionality classification for children with ASD is not increasing with increased ASD prevalence. Better understanding classification patterns will help better service allocation for children with ASD.