Autism Spectrum Disorder (ASD) is being discussed more than ever as one of the most common neurodevelopmental disorders in the world. In particular, there has been a dramatic increase in the number of diagnoses for ASD within the last 20 years in the United States. Many people are beginning to question whether this increase in diagnosis reflects an actual increase in the prevalence of ASD or if other factors are contributing to the growth of ASD diagnoses.

Currently, there are approximately 1 in 31 children being diagnosed with ASD according to the CDC, this is substantially higher than it has been in previous years.

This article from Allmedscare will outline the actual reasons for the increase in autism prevalence, and will clarify what’s true versus what’s just a myth, and what’s based on research rather than opinion.

Understanding the Rise in Autism Rates

The growth of the number of individuals with related diagnosis has increased at a steady rate for many years; in the year 2000 the prevalence rate was estimated to be 1 in 150 children. Now, in 2021 (or 2022), the estimated prevalence is approximately 1 in 31 children, this is a substantial increase in the last 20 years!

Many professionals are quick to point out that the increase in prevalence does NOT mean more kids are developing autism; rather, the increase in prevalence is representative of a variety of systemic, societal, and medical changes that have occurred over time.

Expanding Diagnostic Criteria

The expansion of the criteria used to diagnose the disorder has been one of the major contributors to the growth of the number of people diagnosed with autism.

When people were first diagnosed with autism, the criteria for diagnosis were generally much more limited. Now, all types of autism are classified within the larger umbrella classification of Autism Spectrum Disorder (ASD), which encompasses many different types and many different degrees of severity.

  • As a consequence of this reclassification process, citizens who previously may have been unaware of having a milder form of autism are now able to seek an evaluation for an autism diagnosis.
  • Previously separated diagnostic categories such as Asperger’s syndrome have now been combined under the ASD classification.

Because of these factors, there has been a significant increase in the number of people being diagnosed with autism.

Increased Parent and Professional Awareness of Autism

Over the years, more people have become aware of autism and its risks. The rate of awareness among parents, teachers, and healthcare providers regarding early indicators, such as:

  • Delayed language development
  • Limited eye contact
  • Repetitive behaviors
  • Socialization difficulties

Because of this increase in awareness, there have been an increasing number of evaluations and diagnoses of children with autism earlier than ever before.

According to studies conducted on the topic of autism. A large part of the reason that more children with autism are being diagnosed, however, is attributed to an increased awareness of and interest in autism among parents, teachers, and healthcare providers.

Development of New Autism Screening and Diagnostic Tools

Modern healthcare has developed screening and diagnostic tools that enable healthcare providers to more accurately screen and diagnose autism.

Some of these tools include:

  • Developmental screening during standard pediatric care visits
  • Behavioral assessment tools
  • Early childhood intervention programs

Using these tools, it is now possible for healthcare providers to provide reliable ASD diagnoses for children as young as 2 years old, whereas previously it could be as late as a child’s fourth or fifth year before a reliable diagnosis was made.

Because of the increased ability of healthcare providers to detect ASD at a much earlier age, there has also been an increase in the number of children diagnosed with ASD.

Improved Access to Healthcare Services

The accessibility of healthcare services has improved exponentially in the U.S., particularly in areas that have been historically underserved.

Some of the key components responsible for improving access to healthcare services are:

  • Increased early intervention services
  • Improved insurance benefits for autism services

Increased numbers of previously underdiagnosed communities, including racial and ethnic minorities, are beginning to receive appropriate diagnoses.

Increased data show increased rates of diagnosis among all communities of color in the U.S. due to improved access and equity.

Earlier and More Regular Screening

Another contributing factor to the increase in prevalence is continuing developmental screenings.

Pediatricians now regularly check kids for autism at:

  • 18 months
  • 24 months

By having a comprehensive approach to screening, there will be earlier identification of autism cases and therefore increase in the overall prevalence of autism.

Increased Diagnosis Among Previously Undiagnosed

Historically, certain populations of children, including:

  • Girls
  • Adults
  • Minority populations

Now, as healthcare systems have made advances, there are now better identification of individuals from these groups:

  • Girls are being diagnosed at an earlier age, although often still missed due to the subtlety of symptoms.
  • Adults are being diagnosed later than children.
  • More minority families are getting access to related services.

The increased identification of individuals from these groups is a major contributor to the overall increase in prevalence rates of autism.

Genetic and Environmental Factors

While the majority of the reasons for the increased prevalence of this disorder can be attributed to improvements in diagnosis, researchers are now conducting research to determine if there are also biological factors at play.

Genetic Factors

There is significant evidence that genetics plays a role in the development, and it is estimated that there is high heritability for autism based upon a variety of studies.

Environmental Factors

Some potential contributing factors include:

  • Advanced age of a parent
  • Premature birth
  • Maternal health during pregnancy

Nonetheless, the general consensus among researchers is that environmental factors play a secondary role when compared to diagnostic advancements.

The Role of Data Collection and Reporting

Data collection has been improved through better data collection systems. For example, the CDC uses advanced surveillance systems to track how many people are diagnosed in many different parts of the country.

  • The total number of regions included in these studies has increased
  • Data is collected more accurately and with greater detail.
  • The way that data is reported has improved

Leading to more precise and usually higher estimates of the number of people diagnosed with autism.

Debunking Common Myths

Myth: Vaccines cause autism

There are no studies that show there’s a relationship between vaccines and autism.

Myth: Autism is a modern disease

There have always been people diagnosed, but the rate of diagnosis has increased because of under diagnosis in the past.

Myth: Rising rates mean an epidemic

When people hear that the number of people diagnosed is going up, they fear there’s a new outbreak of cases when, in fact, the increase is due to better identification and not by more cases being diagnosed than before.

Why the Numbers Continue to Rise?

Raising rates of autism will continue to happen because of:

  • Continued improvements in awareness
  • An expansion of the criteria used to diagnose someone with autism
  • Increased access to healthcare services
  • More inclusive research will lead to even more people being diagnosed.

The recent cultural shift towards being more acceptive of neurodiversity has encouraged more individuals to seek an evaluation and possible diagnosis.

What This Means for Families and Society?

Other implications of the increase in autism diagnosis for families and society.

Positive Outcomes

  • Families will have a better chance at helping their child if they receive early intervention as a result of the increased number of children being diagnosed.
  • Society will be less likely to stigmatize individuals diagnosed as society becomes more aware of autism.
  • Better support systems for families supporting affected children will be in place.

Challenges

  • There will be a greater demand for healthcare services for affected children.
  • There will be a greater need for specialized education programs for affected children.
  • Families will experience a significant financial burden supporting their affected child.

The increase in rates in the United States does not solely indicate an increase in people who are disabled (illness). Rather, the rise reflects a number of factors:

  • Different definitions for diagnosing autism
  • Improved autistic awareness and screening
  • Increased access to health services
  • Enhanced ability to collect and track data

While there may be a role for biological or environmental causes, there is overwhelming evidence that more people have been identified as autistic than ever before and this identification accounts for the majority of the increased number of diagnosed cases.

It is important for the public to understand this difference to develop public opinion about autism, develop public policy for health care, and effectively assist those who are diagnosed as being autistic.

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