Rising Autism Rates: Factors Impacting Diagnosis, Treatment, and Intervention

The Centers for Disease Control and Prevention (CDC) released 2 reports yesterday looking at the rate of children diagnosed with ASD. These findings are based on surveillance data from 11 communities that participate in the CDC’s Autism and Developmental Disabilities Monitoring Network. The data are not nationally representative and vary widely by location – from a prevalence of 1 in 22 children in California to about half as many in Maryland. The CDC says more research is needed to understand this variation.

In 2020, about 1 in 36 children had been diagnosed with autism by age 8, according to the CDC – about 2.8%. That’s up from a prevalence of 1 in 44 children in 2018 and 1 in 150 children in 2000.

Some important findings:

For the first time, diagnosis was more common among Asian, Black and Hispanic children than it was among Caucasian children. The CDC researchers note that this shift “may reflect improved screening, awareness, and access to services among historically underserved groups.” In fact, between 2018 and 2020, autism prevalence rose more than twice as fast among Asian, Black and Hispanic children than it did among Caucasian children.

Still, some trends have stayed consistent.

Autism prevalence is significantly higher among boys than girls – in 2020, there was about a four-fold difference. But it was the first year that more than 1% of 8-year-old girls had been diagnosed with autism.

In recent years, good progress had been made in early detection of autism – an earlier CDC report found that children born in 2014 were 50% more likely to receive an autism diagnosis or special education by age 4 than those born in 2010.

I was very interested to read what if any impact did COVID have on diagnosis. CDC found that there were “sustained lower levels” of evaluations and identification of autism across most of the surveillance network.

In first six months of the pandemic, there were 217 fewer evaluations for every 1,000 children at age 4 than there were four years earlier. There were also nearly three fewer identifications for every 10,000 children, according to the CDC report.

Since we know the impact of Early Intervention, my concern would be that many children did not receive evaluations, did not get a diagnosis and so were unable to start services until a later age…which could have long term impact.

Looking back to 1995 when Ryan was diagnosed by my brother, Dr. Joe Barber, an Erie pediatrician and child neurologist, we have come so far.  My question always is where will we go from here?????

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