Using records pediatric health clinics, specialized programs for children with developmental disabilities, and special education records along with a review of the abstracted evaluations by trained clinicians using a standardized case definition and method (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) diagnostic criteria) a new Centers for Disease Control and Prevention analysis has found that diagnoses in the sites they used were up 27 percent from 2010 to 2014.

The overall ASD prevalence was 13.4 per 1,000 children aged 4 years in 2010, 15.3 in 2012, and 17.0 in 2014 but in New Jersey, the ASD diagnoses were substantially higher, 19.7, 22.1, and 28.4 per 1,000, for the same years. That's double the diagnoses of what occurred in Missouri, where 8.5, 8.1, and 9.6 per 1,000 for 2010, 2012, and 2014, respectively.

The CDC uses the Autism and Developmental Disabilities Monitoring (ADDM) Network because it does not rely on does not depend on family or professional reporting of an existing ASD diagnosis or classification. The downside is that it does not cover entire states, just participating geographies.

New Jersey says it has excellent clinical and educational services for autism spectrum disorder, so the state's higher rates are likely due to more accurate or complete reporting than in states like Missouri, which it seems New Jersey is suggesting is far less adequate.