The purpose of this project is to enhance capacity for ongoing public health surveillance of autism
spectrum disorder (ASD) in the United States by participation in surveillance years 2022 and 2024
of the Wisconsin site of the Center for Disease Control and Prevention Autism and
Developmental Disability Monitoring (ADDM) Network. As part of the ADDM Network, our site,
the Wisconsin Surveillance of Autism and Other Developmental Disabilities System (WISADDS),
has monitored the prevalence or outcomes of ASD among 8-year-old children in southeast
Wisconsin since 2002, among 4-year-old children since 2010 and among 16-year-old children
since 2018. The proposed project includes two components: (A) multi-source, active ASD
surveillance at ages 4 and 8 years (birth years 2018 and 2020 for 4-year-olds and 2014 and 2016
for 8-year-olds); and (B) follow-up collection of data on functioning, educational status and
transition planning at age 16 years of 1,550 Wisconsin children whose records we abstracted for
ASD surveillance at age 8 years in 2014 and 2016 (birth years 2006 and 2008). For both
components, the target population will consist of a contiguous 4-county area with a diverse
population selected to adhere to funding opportunity CDC-RFA-DD23-2301 (Enhancing public
health surveillance of ASD through the ADDM Network) requirements and guidelines. In 2020,
this population included 24,263 4-year-old and 24,154 8-year-old children, of whom
approximately 53% were White non-Hispanic, 22% were Black non-Hispanic, 18% were Hispanic,
6% were Asian or Pacific Islanders, and 1% were American Indian. We propose to collect data
from health and school sources within the surveillance area and perform ASD surveillance in
accordance with the ADDM Network protocol. We will also continue surveillance of cerebral palsy
among 8-year-old children in the surveillance area following the ADDM Network protocol. We
will continue to conduct and expand our community engagement and outreach activities with
the goals of strengthening existing relationships and initiating new relationships as needed with
schools, pediatric and developmental service providers, state agencies and autism and
developmental disabilities advocacy organizations in Wisconsin. We will produce innovative
community reports of surveillance data using multiple modalities, and collaborate with ADDM
Network scientists in analyzing and disseminating the results at local and national levels.
Additional outcomes of this project will include: strengthening of public health surveillance at
age 4 years to allow monitoring of progress in early identification of ASD and equitable access to
interventions; improved understanding of differences in ASD characteristics by age through
comparisons of children aged 4 years, 8 years, and 16 years; ongoing quality improvement to
increase the reliability and efficiency of ADDM surveillance; information to support effective
public health planning and policies to improve services and outcomes for individuals with ASD;
and improved knowledge of trends and disparities in ASD prevalence over time and over the life
course between early childhood and adolescence.