Is Autism Really on the Rise?

In today’s New York Times, Dr. Allen Frances suggests in a guest essay a reason why autism is on the rise. Dr. Frances is part of the task force overseeing the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) that defines mental disorders, and he believes the increase may not only be due to more kids (and adults) having autism, but also due to improvements and increases in diagnoses.

If you’re the parent of a child with autism, you’re probably wondering: is autism truly becoming more common, or are we simply getting better at recognizing it?

The answer is both reassuring and complex. Most experts like Dr. Frances agree that the rise in autism diagnoses is largely due to better awareness, improved screening, and changes in how we define autism, though some still explore the possibility of an actual but smaller increase. Here’s what parents should know, based on research from the Centers for Disease Control (CDC), National Institutes of Health (NIH), and other reputable sources.

What do the Experts Say?

According to the CDC, 1 in 36 children in the U.S. was identified with autism in 2020. That’s a dramatic increase from 1 in 150 children in 2000. While this statistic may sound alarming, it’s important to understand why this number has changed.

One of the biggest reasons for the increase is that doctors are getting better at spotting autism early. Pediatricians now routinely screen children for autism at their 18- and 24-month checkups, which wasn’t always the case.

Also, the way autism is diagnosed has evolved. The latest version of the DSM broadened the definition of autism to include conditions like Asperger’s syndrome and other developmental differences under the larger umbrella of Autism Spectrum Disorder (ASD). This means that children who might not have qualified for a diagnosis 20 years ago are now correctly recognized and supported.

Thanks to increased public awareness and education, parents, teachers, and doctors are more likely to recognize early signs of autism (such as delayed speech, sensory sensitivities, or difficulties with social interactions) and seek out evaluations sooner. This is especially true for children who were previously overlooked, including girls, children of color, and those with milder or different presentations of autism.

Some researchers have explored environmental or biological factors, such as parental age or prenatal exposures, to explain a possible real increase in autism. But so far, there is no strong evidence that these are driving the rise. Most scientists, including Dr. Frances, agree that better detection and changes in diagnostic practices are the main reasons behind the increase.

It’s Not Just Children

More adults are being diagnosed with autism now than ever before, often after years or even decades of wondering why social or emotional challenges have followed them throughout life.
Studies have shown that many autistic adults, especially women or those with strong masking skills, were missed in childhood due to outdated criteria or a lack of awareness. Today, more adults are seeking and receiving diagnoses, often as a result of their children’s evaluations or after learning more about autism online.

One U.K. study published in The Lancet found that autism diagnoses in adults tripled over 20 years. In the U.S., the CDC estimates that over 2% of adults are on the autism spectrum, and many don’t know until later in life.

Are More Diagnoses Good or Bad?

Dr. Frances cautions that childhood or adult diagnoses shouldn’t be overstated simply to explain away social awkwardness or other personality traits. “Overdiagnosing autism,” he writes, “often misallocates very scarce resources away from the more severely impaired people who most need them.”

Still, it’s probably good news that there’s an increase in diagnoses. Kids with autism have always been here; we’re just better at recognizing and supporting them now. Earlier and more accurate diagnoses mean:

• Kids get services and support sooner
• Parents are less likely to feel alone
• Schools and communities are adapting to meet kids’ needs
• Adults who were previously overlooked can finally understand themselves

Here are some additional resources if you’re interested in learning more.

• CDC Autism Data
• NIH: What Is Autism?
• AAP Screening Recommendations
• Lancet Study on Adult Diagnoses