Investigation of Shifts in Autism Reporting in the California Department of Developmental Services
Abstract
We investigated if shifts in the coding of qualifying conditions in the California Department of Developmental Services (DDS) have contributed to the increase in California children with autism observed in recent years. Qualifying condition codes for mental retardation (MR) and autism in DDS electronic files were compared to hard-copy records for samples of children born 1987, 1990, 1994, and 1997. Contrary to expectations, we did not find evidence of a coding shift from "MR only" to "both MR and autism" or an increase in the proportion of children with coded autism who lacked supportive diagnostic documentation in records (possible "misclassifications"). These results indicate that changes in DDS coding practices are unlikely to explain the increase in DDS clients with autism.
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Independent studies have concluded that the increasing incidence of ASD cannot be explained entirely by increased awareness, broadening of diagnostic criteria, or improved detection.
“Independent studies have reached the common conclusion that this trend cannot be explained in its entirety by increased awareness, broadening of diagnostic criteria, or improved detection of ASD [ 5–8 ].”
From DNA methylation: a mechanism linking environmental chemical exposures to risk of autism spectrum disorders? (2016) · cites this paper as [5]
Factors other than diagnostic drift likely account for more than one-half of new ASD cases.
“In fact, these studies suggest that factors other than diagnostic drift likely account for more than one-half of new cases.”
From DNA methylation: a mechanism linking environmental chemical exposures to risk of autism spectrum disorders? (2016) · cites this paper as [5]
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- Authors
- Grether, J. K., Rosen, N. J., Smith, K. S., & Croen, L. A.
- Affiliations
- California Department of Public Health (US)
- Kaiser Permanente (US)
- Corresponding author
- Grether, Judith K.
- ORCID
- Croen, Lisa A.
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2009-05-29
- Volume
- 39
- Issue
- 10
- Pages
- 1412-1419
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- OpenAlex
- W2071639186
- Cited by
- 45
- References
- 26
- Citations by year
- 2023: 2 · 2022: 4 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 5 · 2016: 2 · 2015: 4 · 2014: 3 · 2013: 3 · 2012: 5
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Autism Speaks (AS1758)
- California Department of Public Health
- U.S. Public Health Service (U10/CCU920392)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Keywords
- autism spectrum disorder, intellectual disability, diagnostic misclassification, electronic health records, developmental disabilities services
- MeSH terms
- Adolescent, Autistic Disorder, California, Child, Child Health Services, Forms and Records Control, Government Agencies, Humans, Young Adult
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