Objectives: The purpose of this study was to examine educational placement among 4 year old children with ASD.
Methods: The CDC’s ADDM methodology, used for 8 year old children, was applied to 4 year old children in a select region of South Carolina (SC). Additional surveillance sites were added to include preschool programs in early intervention, O-3 year old programs, public school preschool programs (3 and 4 year olds), as well as private and nonprofit programs for preschool children. The surveillance area was narrowed to a 3-county sub region of the larger SC-ADDM surveillance area.
Results: In 2006, in a 3-county sub region of the SC ADDM surveillance area, the total prevalence of ASD in children aged 4 years was 8.0 per 1000 (1:125), higher than for 8 year olds in the same region for each of the previous ADDM study years (2000, 2002, and 2004, respectively). 77% of the 4 year olds with ASD identified by this study had received special education services through the public schools; however only 20 % of these had an educational eligibility of Autism, while 74% of these were identified in the more general category “preschool child with a disability” and hence were not receiving ASD-specific services. Children with documentation in their records of a previous ASD diagnosis (60% of cases) were more likely to receive special education services than those without a community diagnosis. Over half the children with an ASD (54%) had previously been served in an early intervention program (i.e. a state or federally funded program for children under 3 years of age).
Conclusions: Findings suggest that while the prevalence of ASD in 4-year-olds is higher than previous estimates of ASD among school aged children, many of the children in this study were not receiving special education services at all, or were not receiving specialized educational services for children with ASD. Only half of children identified with an ASD in this study had received any state or federally funded services prior to three years of age, suggesting that delays in service provision continue to be common. The surveillance of ASD at an earlier age provides valuable information for the subsequent planning, implementation, and evaluation of resources and interventions for preschool children with ASD. Finally, this study demonstrates that the ADDM methodology can be successfully applied to a younger population.
Funding for this study was provided by Autism Speaks. Methodology for the study was created by the CDC’s ADDM network.