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Supplementary Online Content Maenner MJ, Rice CE, Arneson CL, et al. Potential impact of DSM-5 criteria on autism spectrum disorder prevalence estimates. JAMA Psych. Published online January 22, 2014. doi:10.1001/jamapsychiatry.2013.3893. etable 1. Proportion of Children Meeting DSM-5 ASD Criteria, Among Children Meeting Current ADDM Network (DSM-IV-TR based) ASD Case Status, by Intellectual Disability Status and History of Developmental Regression etable 2. Proportion of Children Meeting DSM-5 ASD Criteria, Among Children Meeting Current ADDM Network (DSM-IV-TR based) ASD Case Status, by Site and Year etable 3. Frequency of DSM-IV-TR ASD Behavioral Criteria and Other Characteristics for 3 Groups of Children etable 4. Frequency of DSM-5 ASD Criteria for 3 Groups of Children This supplementary material has been provided by the authors to give readers additional information about their work.

etable 1. Proportion of Children Meeting DSM-5 ASD Criteria, Among Children Meeting Current ADDM Network (DSM-IV-TR based) ASD Case Status, by Intellectual Disability Status and History of Developmental Regression History of Developmental Regression % Meeting DSM 5 criteria ID Status N IQ > 70 Yes 416 90 IQ > 70 No 2626 81 IQ<=70 Yes 560 94 IQ<=70 No 1319 83 IQ Unknown Yes 389 82 IQ Unknown No 1267 70

etable 2. Proportion of Children Meeting DSM-5 ASD Criteria, Among Children Meeting Current ADDM Network (DSM-IV-TR based) ASD Case Status, by Site and Year Note that some sites modify their geographic study areas in each year. Arkansas, New Jersey, and Utah contributed data to the 2008 study year only. The previously-reported ASD prevalence estimates for each site and year are also displayed. Reported ADDM ASD prevalence (per 1000) 2006 Study Year 2008 Study Year Reported % ADDM Meeting ASD Number DSM 5 prevalence DSM IV TR ASD (per 1000) ASD cases Number DSM IV TR ASD cases % Meeting DSM 5 ASD Site Alabama 6.0 212 71.6 4.8 174 78.7 Arkansas 10.5 52 88.5 Arizona 12.1 504 78.6 15.6 507 83.6 Colorado 7.5 54 90.7 11.8 91 86.8 Florida 4.2 116 68.1 7.2 211 69.1 Georgia 10.2 474 84.6 11.9 601 86.2 Maryland 9.2 243 62.1 12.4 336 74.1 Missouri 12.1 321 82.2 13.9 357 84.3 New Jersey 20.5 145 88.3 North Carolina 10.4 230 87.8 14.2 525 88.4 Pennsylvania 8.4 150 79.3 13.3 245 80.4 South Carolina 8.6 196 78.6 11.1 264 84.5 Utah 21.2 45 95.6 Wisconsin 7.6 257 76.7 7.8 267 82.0

etable 3. Frequency of DSM-IV-TR ASD Behavioral Criteria and Other Characteristics for 3 Groups of Children Groups included (1) children meeting ADDM Network ASD criteria, but not DSM-5; 2) children meeting ADDM Network ASD criteria and DSM-5 ASD criteria; and 3) children meeting DSM-5 ASD criteria but were not classified as meeting current ADDM Network (DSM-IV-TR) ASD case criteria. Importantly, ALL 304 children in the third group met the behavioral criteria for (DSM-IV-TR) PDD-NOS or Autistic Disorder but were not considered ADDM Network ASD cases, usually because the clinician reviewers concluded that the behaviors were better explained by another disorder. Whether these 304 children would be considered ASD cases under DSM-5 ASD criteria would depend, in part, on the revised criteria for other disorders and their perceived mutual exclusivity. ADDM Network ASD cases; did not meet DSM 5 criteria (n=1238) % with characteristic ADDM Network ASD cases; met DSM 5 Criteria (n=5339) Not ADDM Network ASD cases; met DSM 5 Criteria (n=304) Overall chisquare p value DSM IV TR ASD Criteria 1a (eye gaze) 29.9 100.0 100.0 <0.0001 1b (peer relations) 57.4 78.6 57.9 <0.0001 1c (joint attention) 28.3 57.9 35.2 <0.0001 1d (emotional reciprocity) 74.6 95.3 85.5 <0.0001 2a (spoken language) 83.3 91.9 77.6 <0.0001 2b (hold a conversation) 75.6 90.7 84.2 <0.0001 2c (stereotyped language) 55.9 80.4 66.1 <0.0001 2d (lack of spontaneous play) 31.2 64.5 36.5 <0.0001 3a (restricted interests) 38.5 68.4 45.7 <0.0001 3b (inflexible re: routines) 58.0 92.0 84.2 <0.0001 3c (stereotyped motor) 43.3 75.0 43.8 <0.0001 3d (preoccupation with parts) 34.8 68.0 36.5 <0.0001 Ever Diagnosed or Classified as having an ASD by community professional 61.6 79.5 18.8 <0.0001 Met DSM IV TR behavioral criteria for Autistic Disorder 45.4 97.7 78.0 <0.0001 Male 81.8 83.1 81.3 0.4110

etable 4. Frequency of DSM-5 ASD Criteria for 3 Groups of Children Groups described in etable 3. Note that the DSM-5 ASD criteria requires all 3 criteria in the social communication domain. ADDM Network ASD cases; did not meet DSM 5 criteria (n=1238) % with characteristic ADDM Network ASD cases; met DSM 5 Criteria (n=5339) Not ADDM Network ASD cases; met DSM 5 Criteria (n=304) DSM 5 criterion A1. Social emotional Reciprocity 95.0 100 100 A2. Nonverbal communicative behaviors 29.9 100 100 A3. Developing and maintaining relationships 86.9 100 100 B1. Stereotyped or repetitive behaviors 82.6 99.7 99.7 B2. Excessive adherence to routines 58.1 92.1 84.2 B3. Ristricted, fixated interests 38.5 68.4 45.7 B4. Hyper or hypo reactivity to sensory input 54.7 86.9 60.2