I
105TH CONGRESS
2D SESSION
H. R. 4725
To provide surveillance and research to better understand the prevalence
and pattern of autism and other pervasive developmental disabilities
so that effective treatment and prevention strategies can be implemented.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 7, 1998
Mr. SMITH of New Jersey introduced the following bill; which was referred
to the Committee on Commerce
A BILL
To provide surveillance and research to better understand
the prevalence and pattern of autism and other pervasive
developmental disabilities so that effective treatment and
prevention strategies can be implemented.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Autism Statistics, Sur-
veillance, Research, and Epidemiology Act of 1998 (AS-
SURE)’’.
SEC. 2. FINDINGS.
The Congress makes the following findings:
(1) Autism and other pervasive developmental
disabilities (fragile X syndrome, Rett’s syndrome,
childhood disintegrative disorder, Landau-Kleffner
syndrome, and pervasive developmental disorders not
otherwise 
specified) 
are 
biologically 
based
neurodevelopmental diseases which cause severe im-
pairment in cognition, language, and affective abili-
ties.
(2) Autism and pervasive developmental disabil-
ities are not rare; they may affect as many as one
in every 500 children, and more than 500,000 Amer-
icans.
(3) There is little information on the prevalence
of autism and other pervasive developmental disabil-
ities in the United States. There have never been
any national prevalence studies in the United States,
and the two studies that were conducted in the
1980s examined only selected areas of the country.
Recent studies in Canada, Europe, and Japan sug-
gest that the prevalence of classic autism alone may
be 300 percent to 400 percent higher than pre-
viously estimated.
(4) The cost of caring for individuals with au-
tism and pervasive developmental disabilities is esti-
mated at more than $13,000,000,000 per year for
direct costs only.
(5) Autism is considered by many scientists to
be one of the most heritable of all the developmental
disorders, and the most likely to yield to the latest
scientific advancements in genetics and neurology.
(6) The discovery of effective treatments and a
cure for autism will be greatly enhanced when sci-
entists and epidemiologists have an accurate under-
standing of the prevalence and incidence of autism.
(7) Recent research suggests that environ-
mental factors may contribute to autism. As a re-
sult, contributing causes of autism, if identified, may
be preventable.
(8) Finding the answers to the causes of autism
and related developmental disabilities may help re-
searchers to understand other disorders, ranging
from learning problems, to hyperactivity, to commu-
nications deficits that affect millions of Americans.
SEC. 3. DEVELOPMENTAL DISABILITIES SURVEILLANCE
AND RESEARCH PROGRAMS.
(a) NATIONAL AUTISM AND PERVASIVE DEVELOP-
MENTAL DISABILITIES SURVEILLANCE PROGRAM.—The
Secretary of Health and Human Services (in this Act re-
ferred to as the ‘‘Secretary’’), acting through the Director
of the Centers for Disease Control and Prevention, may
make awards of grants and cooperative agreements for the
collection, analysis, and reporting of data on autism and
pervasive developmental disabilities. An entity may receive
such an award only if the entity is a public or nonprofit
private entity (including health departments of States and
political subdivisions of States, and including universities
and other educational entities). In making such awards,
the Secretary may provide direct technical assistance in
lieu of cash.
(b) CENTERS OF EXCELLENCE IN AUTISM AND PER-
VASIVE
DEVELOPMENTAL
DISABILITIES
EPIDEMIOL-
OGY.—
(1) 
IN
GENERAL.—The 
Secretary, 
acting
through the Director of the Centers for Disease
Control and Prevention, shall (subject to the extent
of amounts made available in appropriations Acts)
establish not less than three, and not more than five,
regional centers of excellence in autism and perva-
sive developmental disabilities epidemiology for the
purpose of collecting and analyzing information on
the number, incidence, correlates, and causes of au-
tism and related developmental disabilities.
(2) RECIPIENTS OF AWARDS FOR ESTABLISH-
MENT OF CENTERS.—Centers under paragraph (1)