Rates of autism diagnosis in children are at an all time high, CDC report suggests

The prevalence of ASD is higher among Asian, Black and Hispanic children than among white children, who have historically had better access to diagnostic services.  (Image credit: Shutterstock)

The rate of autism spectrum disorder (ASD) in the United States has reached an all time high, a new report from the Centers for Disease Control and Prevention (CDC) has revealed. However, the sky-high rate is likely due to improved screening and diagnosis, not an epidemic of new cases, the study suggests.

One in 36 children had an ASD diagnosis in 2020 compared to one in 44 in 2018, according to data collected across 11 states by the Autism and Developmental Disabilities Monitoring (ADDM) Network. Wisconsin recorded the largest relative change between 2018 and 2020, with a 49.5% increase in the overall prevalence of ASD.

For the first time in 20 years of monitoring, the percentage of 8-year-old girls with ASD rose above 1%, while it remained around 4% for boys.

The report, published on March 24, also found for the first time that the prevalence of ASD in Black, Hispanic, Asian and Pacific Islander children has overtaken the prevalence in white children, who have historically had better access to screening and diagnosis.

While ASD prevalence in white children rose 14.6% from 2018 to  2020, it increased by more than 30% in Asian, Black and Hispanic 8-year-olds. The staggering increase in those groups is due to improved screening, awareness and access since 2018, the report suggests.

Related: Brain differences tied to autism can be detected in the womb 

ASD is a developmental disorder that affects the brain and impacts how people interact with others, communicate, learn and behave, according to the National Institute of Mental Health.

To estimate how many children have ASD, the ADDM Network counted 8-year-old children with either an ASD diagnosis from a qualified professional, a special education classification of autism in public school or an administrative record of ASD using the World Health Organization's International Classification of Diseases.

ASD prevalence among children has increased markedly over the last 20 years. The ADDM Network notes that while just 6.7 kids per 1,000 met criteria for an ASD diagnosis; that number rose to 23 in 2018 and 27.6 in the current report.

Black children with ASD were more likely to have additional intellectual disabilities, such as those related to genetic conditions or birth defects, than their white counterparts.

The current prevalence could be an underestimate, the report suggests. COVID-19 and successive lockdowns blocked access to some services, which may have led to fewer records of ASD being documented.

"In the early months of the pandemic, 4-year-old children were less likely to have an evaluation or be identified with ASD than 8-year-old children when they were the same age. This coincides with the interruptions in childcare and healthcare services during the COVID-19 pandemic," CDC officials wrote in a statement

Sascha Pare
Trainee staff writer

Sascha is a U.K.-based trainee staff writer at Live Science. She holds a bachelor’s degree in biology from the University of Southampton in England and a master’s degree in science communication from Imperial College London. Her work has appeared in The Guardian and the health website Zoe. Besides writing, she enjoys playing tennis, bread-making and browsing second-hand shops for hidden gems.

  • NerillDP
    Having zero professional standing in the subject area, suggest that you take my comments as only those from a curious bystander. However, I do have education and experience in statistical analyses.

    With above in mind, one has to wonder at what percentage of a trait, is something considered as "normal" albeit but not a large number. With up to 4% of boys on the "autism" scale, which, I assume, includes those with "high-functioning Asperger's," one must ask if we are diagnosing a normal characteristic as some type of disfunction that demands intervention which results in so much unnecessary consternation just because an otherwise well functioning person is being labeled for having a personality that was once considered at most eccentric.

    For example, those who have "ginger" characteristics amount to between 2 & 6 percent of the population, and often have adverse health issues like problems with exposure to the sun, pain sensitivity, endometriosis, Parkinson's disease, decreased platelet function and, perhaps, defects in the immune system, but they are not considered to be abnormal and therefore deserving of a similar diagnosis with the related stigma.

    Are we over diagnosing what really should be in the spectrum of "normal?" Notwithstanding those with a level of autism that truly requires intervention to protect them and those around them. I fear so much unnecessary, but well meaning, damage is being caused by overzealousness.
  • Yvonne F
    I hope that the editors of this section on autism will update their knowledge, including updating it from such sources as adults in the autistic community (autistic people) as well as peer-reviewed sources that include autistic and non-autistic researchers (such as https://home.liebertpub.com/publications/autism-in-adulthood/646).

    Most autistic people are adults, not children - whether or not we got diagnosed.

    The CDC admits that the increases in diagnosis among children are most likely due to changes in ability to diagnose, not actual prevalence increases. There is no good evidence of true prevalence differences between racial and ethnic groups, that I have seen.

    Humans spend most of our lives as adults (if we are fortunate enough to live long enough, which most are.)

    Most of autistic humanity is therefore not an 8-year-old white boy, in spite of the all-too-common stereotypical photo I see today, heading your category.

    As a female white person who "masks" quite well, has degrees, works, volunteers, etc., I realized I was autistic on my own, sought and received the diagnosis officially, and have had to puzzle out the effects on my life plus how to help myself better than the one-neurotype-fits-all approach of modern therapy theory... I would love to see Livescience catch up to the state of our lives, not just some scientists stuck in circular thinking based upon incorrect stuff from 50 years ago...

    Forcing autistic kids to act more "normal" with more behaviorist training hours than you'd subject a dog to, ignoring our internal lives, looking at all our differences as deficits down to the level of genes... this was done to the LBGTQ+ community too, 70 years ago, with so much harm resulting.
  • SHaines
    Yvonne F said:
    I hope that the editors of this section on autism will update their knowledge, including updating it from such sources as adults in the autistic community (autistic people) as well as peer-reviewed sources that include autistic and non-autistic researchers (such as https://home.liebertpub.com/publications/autism-in-adulthood/646).

    If there are specific articles with specific areas of concern, please share those so they can be investigated. While the headline above mentions 8 year old children explicitly, that's because the study referenced them. The article, beyond the headline, is very clear in how the results shouldn't be used to conclude anything about this being an example of anything other than better tools for diagnosis.