SafeMinds Interviews Report’s Co-Author Walter M. Zahorodny about New Statistics
SafeMinds had the pleasure of conversing with Walter M. Zahorodny, Ph.D., co-author of the new report, “Prevalence of autism spectrum disorder in a large, diverse metropolitan area: Variation by sociodemographic factors.” He is an Associate Professor of Pediatrics at Rutgers New Jersey Medical School. Dr. Zahorodny is also the Principal Investigator of the New Jersey Autism Developmental Disabilities Monitoring (ADDM) Network. The ADDM Network is a group of programs funded by the CDC to estimate the number of children with autism spectrum disorder (ASD) living in different areas of the United States. These ADDM estimates are released every two years. Dr. Zahorodny answered several questions about this recent New Jersey autism prevalence report. The following is a transcript of our discussion.
Last May you and your research team put out a report titled, “Higher Than Expected ASD Prevalence in Toms River, New Jersey in 2016,” is this new report associated with that previous report?
Yes. The report on ASD prevalence in Toms River was the first information we shared based on a more granular consideration of autism prevalence in our region. The Toms River report was an abstract presented at the 2021 INSAR Meeting. It focused on the prevalence and distribution of ASD in that large suburban town. The paper published last week in Autism Research was broader — more encompassing. In it, we provided a detailed review of variations in autism prevalence by race/ethnicity, wealth (socioeconomic status) and school district size. We also showed that autism prevalence varied at the county level in our region and that children with ASD differed in the extent to which they were diagnosed with ASD and were educated under the Autism (special education) classification.
Can you comment on the racial disparities discovered in this current report?
Our findings indicate that Hispanic children with ASD had lower identified prevalence in three of four counties, compared to white children. That is an important difference and may point to a disparity of identification.
The findings from last May’s report on Toms River, New Jersey showed that ASD prevalence for 8-year-olds including both sexes is 7.4%. But when you factor in the prevalence rate for boys only, that figure swells to 12%. Does this new report also find high prevalence rates such as these in both sexes? What about boys specifically?
Autism disproportionately affects boys. Boys are 4 times more likely to have ASD than girls. It is difficult to accept the fact that as many as 8 -10% (or higher) of all boys in some of our public schools are already affected by ASD. However, the scope of autism is best appreciated by reflecting on that observation. The ‘burden’ of autism on families is very great and the resources required for providing the needed care & resources, over a lifetime, will be substantial. How does our society deal with the reality of autism affecting so many children, affecting so much of our future?
There is a section in the report that showed that mid-socioeconomic status (SES) communities had some of the highest prevalence. Can you shed some light on that finding?
Previous analyses from NJ and the ADDM Network showed a persisting positive SES gradient in autism prevalence. That is, children with ASD were more likely to be from high SES families, in cohorts born between 1992 and 2002. We expected to observe that distribution in this group (born in 2008). To our surprise, the highest autism prevalence in this cohort was in children from middle income (mid SES) families, greater prevalence than in low and high SES families. The observed shift requires additional research. Confirmation of the association over time and change in the distribution of ASD is indicated.
What is the take-away message from this new report?
Autism rates of 5% or higher were identified in one of five New Jersey communities in 2016. Similar levels of ASD prevalence are likely in other US metropolitan areas. The take-away message is that ASD affects significantly more than 2% (the overall CDC ADDM estimate) of the pediatric population in many regions. Planning of educational and health care to children with ASD requires accurate and region-specific information from active population-based monitoring. ASD prevalence is underestimated by approaches based on who was diagnosed (ASD diagnosis) or who was autism classified through 8-years.
