What the Increased Prevalence of Autism in Children Means for Your Family
January 24, 2022
January 24, 2022
The Centers for Disease Control and Prevention (CDC) dropped some news this month: the rate of autism spectrum disorder (ASD) in children aged 8 years old has increased to 1 in 44. The report shows prevalence has grown more than 22% in two years; up from 1 in 54 in 2016.
At first glance, these new statistics may seem shocking to some, so we fielded questions that we feel are important to address.
“Is autism becoming more common?”
“Are some ethnicities more likely to experience autism than others?”
“How will the increase in autism prevalence affect treatment?”
To provide context and break down why these numbers matter to our community, we turned to our Hopebridge team of experts.
The CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network is the tracking system used to provide estimates of the prevalence and characteristics of ASD for this report. It is the largest population-based program to monitor autism and the only autism tracking system that examines health and education records.
First and foremost, it’s significant to note the ADDM derived this information in 2018. We don’t yet know what the numbers are for 2021, although surveillance was also performed in 2020 and we will have more updates in a couple years.
Another aspect to remember about the new CDC report is the “1 in 44” ratio is an estimated rate of autism in the United States, based on the 11 states that were surveyed (diverse communities in Arizona, Arkansas, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, Tennessee, Utah and Wisconsin).
“The ADDM covered more than 200,000 8-year-old children for this study, so the numbers should not be taken lightly,” said Hopebridge Licensed Clinical Psychologist Amaurita Kanai, PhD. “However, the data collected is not nationally representative and does not necessarily reflect the population of the United States as a country. There are wide discrepancies between states.”
Estimates ranged from 1 in 60 in Missouri, to 1 in 26 in California. When comparing the reporting stats, we should not assume California has more people with autism than the others; it is likely the state offers better access to diagnostic services.
What are some of the possible reasons for the increased prevalence? In short, we do not think that autism itself is becoming more prevalent, but rather that our society has become better at identifying it.
“The rate increase was likely due to stronger identification that stems from improved awareness and access to diagnostic services,” said Dr. Kanai. “The heightened presence and efforts of autism organizations, advocates and clinicians have played a significant role in getting information about ASD directly into the hands of the public, putting parents in a better place to request evaluations alongside their pediatricians.”
The increase in rate could mean there is less stigma associated with seeking or receiving a diagnosis, or that services are becoming more accessible than they were in the past.
The CDC also estimates that children were 50% more likely to be diagnosed with autism by age 4 in 2018 than they were in 2014. This is another data point that illustrates that early identification has dramatically improved over recent years, though we believe progress is still necessary to get children the support they need during their key developmental years.
This is especially true within some specific communities, as there were disparities in the prevalence of medical diagnoses between states and ethnic groups. Though autism occurs among all racial, ethnic and socioeconomic groups, the number of Hispanic children with an autism diagnosis was found to be lower than that of White or Black children in several areas. As there is no reason to believe autism prevalence would vary by race or ethnicity, this is evidence that the identification and support efforts may need to be increased so all children receive the care and opportunities they deserve.
The latest shift in intellectual ability could also support improved identification. CDC findings show that while the rate of autism diagnoses increased, the proportion of children with ASD who also have intellectual disabilities decreased. Though there is still variability among racial groups that the CDC intends to address through research (since there was a higher ratio of intellectual disability among Black children than White children), the data across the board suggests that more children with higher IQs are no longer having their diagnoses overlooked, which may have occurred in the past.
In the past, kids were likely referred more often for behavioral and lower functioning challenges, which were easier to identify. Since the recent results show more children with average intelligence are being diagnosed with autism, it could also lead back to improved diagnoses.
“The substantial progress in early identification is good news because the earlier that children are identified with autism, the sooner they can be connected to services and support,” said Karen Remley, M.D., director of CDC’s National Center on Birth Defects and Developmental Disabilities. “Accessing these services at younger ages can help children do better in school and have a better quality of life.”
Hopebridge recommends families learn from and act on this new data by seeking answers around any questions they have related to their children’s development. Parents and caregivers should equip themselves with the signs of autism so their challenges and behaviors can be evaluated through a formal diagnostic assessment, should any concerns arise. Some of the common early symptoms of autism include:
Not only do the CDC reports display the importance of identification, but they underscore the growing need for additional autism services like Applied Behavior Analysis (ABA therapy), speech therapy and occupational therapy to further support these children and their families.
“In many areas across the country, parents wait months to receive a diagnosis for their child, and once they get it, they then must wait even longer to get them into therapy,” said Hopebridge Director of ABA Clinical Quality Assurance Melissa Chevalier. “With the increased prevalence of autism, the need for behavior analysts, speech pathologists and occupational therapists is greater now than ever, so Hopebridge aims to expand access to early intervention services by developing its therapy teams from within.”
In addition to the need for better access to services, providers like Hopebridge also use these reports to understand if and how services should evolve. It’s important we take the IQ data into consideration and adjust our practices to make sure they are inclusive of everyone on the spectrum.
“If you look at Applied Behavior Analysis now versus when I first started working in the field in 2003, you can see how therapy has morphed. In the past, we mostly saw kids with significant delays and behaviors who were older. Now we’re seeing different intellectual abilities in the children we work with and can make adjustments to therapy, as needed, to accommodate them,” said Chevalier.
“We need to be more mindful of how we provide services to those with average or borderline intelligence. They are more likely to be in school and higher functioning, but will still require support,” said Chevalier. “We need to focus more on social skills for them. We should also have better programs in place to be able to transition them into traditional environments and provide added school support, such as ABA therapy.”
We can’t predict what the results for 2020 or future years will say. As we gain more access to diagnostics and awareness of the developmental markers and delays, we may continue to see the rate rise until it finally plateaus. Until then, we must carry on sharing the stories of our kiddos and educate the communities about the disorder and resources available so no one is left out from the care they need.
If your family is touched by autism, or you believe your child could benefit from our services, don’t hesitate to reach out to us. Each child with autism is more than a number to us. With interdisciplinary services and options for center-based or in-home autism therapy in locations across the country, we treat each kiddo like the individual they are, with personalized programs suited for their specific challenges, strengths and goals.
*Informed consent was obtained from the participants in this article. This information should not be captured and reused without express permission from Hopebridge, LLC.
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