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Behind the Autism “Spike”: Why Diagnoses Are on the Rise

Last year, the Center for Disease Control and Prevention’s March report demonstrated that there has been a 30% increase in the number of autism spectrum disorders in just the last few years, leading many to wonder if we are actually in the middle of an autism spike, with the condition being more prevalent now than in the past. After all, 1 in 81 children is now diagnosed with autism, nearly double of what that rate was just a couple of decades ago.

As we’ve suggested in this very space in the past, this rise in cases of autism likely has less to do with autism being more pervasive rather than medical professionals have more tools available to them than ever before to diagnose cases that might have in the past flown under the radar.

Now, a new study recently published in the BMJ by a team of Swedish researchers appears to confirm what many of us have long suspected: that the increase in autism cases has less to do with the actual number of autistic children and more to do with the nature of how we diagnose them. In direct contradiction to the apparent rise in ASD diagnoses, the Swedish researchers found far less direct evidence of a rise in the actual number of patients with symptoms of autism.

In discovering this salient discrepancy, the team of researchers used two sets of data that originated in Sweden. The first was part of a comprehensive study that involved nearly 20,000 children, all twins, born in Sweden in the past decade while the second came from a national patient register, which they used to look for diagnosis codes typically associated with autism.

In reviewing the data, the researchers were able to conclusively prove that rather than there being an actual increase in the number of children displaying symptoms of autism being responsible for the increased number of diagnoses, the answer lies more in how our ability and criteria for diagnosing has changed.

This is echoed in a study of Danish children that was conducted earlier this year that found that the rise in diagnoses was due to an increase in previously-unidentified autistic individuals getting an autism diagnosis that experts were unequipped to identify in the past.

The Swedish researchers have been quick to insist that their study should not be interpreted as giving credence to devoting many resources to uncover the source of the perceived rise or focusing too narrowly on one diagnosis instead of investigating and providing other services, especially in the case of those with intellectual or developmental disabilities.

For those who do have an intellectual or developmental disability, being diagnosed with an ASD can open up access to services that might be otherwise unavailable. The criteria used to make the diagnosis of autism have recently been revised, and there is evidence that fewer children may be diagnosed as a result. Some fear that this will mean that children who still need services, regardless of their diagnosis, may not receive them as readily.

In looking forward in the diagnosing and treatment of children with autism, it is clear that there are still new conditions that need to be added to assist in better diagnosing all children with autism—including pertinent racial and gender issues—but that by better understanding why the rate of autism has been on the rise, this will lead to greater awareness of autism in general and more general sensitivity.

In looking forward in the diagnosing and treatment of children with autism, it is clear that there are still new conditions that need to be added to assist in better diagnosing all children with autism.  However, better understanding why the rate of autism has been on the rise, will lead to greater awareness of autism in general and more general sensitivity.