J Adolesc Health

PurposeThe objectives of this study were to describe child characteristics associated with later autism spectrum disorder (ASD) identification and the health status and educational transition plans of adolescents with ASD.MethodsLongitudinal population-based surveillance cohort from the Autism Developmental Disabilities Monitoring Network during 2002\u20132018 in 5 catchment areas in the United States. Participants included 3,148 children born in 2002 whose records were first reviewed for ASD surveillance in 2010.ResultsOf the 1,846 children identified in the community as an ASD case; 11.6% were first identified after age 8 years. Children were more likely to have ASD identified at older ages who were Hispanic; were born low birth weight; were verbal; had high intelligence quotient or adaptive scores; or had certain co-occurring neuropsychological conditions by age 8 years. By age 16 years, neuropsychological conditions were common with more than half of children with ASD having a diagnosis of attention-deficit/hyperactivity disorder or anxiety. Intellectual disability (ID) status was unchanged for the majority (>80%) of children from ages 8 to 16 years. A transition plan was completed for over 94% of children, but disparities were observed in planning by ID status.ConclusionA high percentage of adolescents with ASD have co-occurring neuropsychological conditions, markedly higher than at age 8. While most adolescents had transition planning, this occurred less often for those with ID. Ensuring access to services for all people with ASD during adolescence and transition to adulthood may help to promote overall health and quality of life.CC999999/ImCDC/Intramural CDC HHSUnited States/CC/CDC HHSUnited States