A Profile on Emergency Department Utilization in Adolescents and Young Adults with Autism Spectrum Disorders.

Guodong’s team counted every ER trip made by U.S. teens with autism from 2005 to 2013. They used national hospital billing data and compared rates to same-age kids without autism.

They split the teens by age, sex, and rural versus city ZIP codes to see who was going up the fastest.

Autistic teens landed in the ER four times more often than their typical peers. The gap widened each year, with the steepest jumps in older teens, girls, and kids living in rural counties.

By 2013, an autistic young learners in a rural area was the most likely of any group to visit the emergency department.

Alnahdi et al. (2026) extends these numbers by showing the same teens start using more inpatient and long-term care once they turn 18, while outpatient psychiatry drops. Together the two papers trace a clear arc: heavy ER use in high school gives way to costly hospital stays in early adulthood.

Atladóttir et al. (2012) saw the same pattern earlier in Denmark. Kids with autism had more hospital contacts for almost every reason, hinting that the ER surge Guodong found is part of a broader ‘extra-contact’ effect that crosses countries.

Stephens et al. (2018) adds a why: family adversity delays diagnosis and therapy by months. When outpatient help is late, crises that end in the ER become more likely, tying the rural spike to service gaps rather than autism itself.

If you serve autistic teens, expect the ER to be part of their story—especially for older, rural, or female clients. Use this data to justify front-loading outpatient crisis plans before age 16 and to advocate for telehealth or mobile crisis teams in rural zones. A one-hour prevention call can save a six-hour ER wait.