The spike in autism diagnoses is finally getting the attention it deserves. Countries around the world are now taking steps to determine if this overdiagnosis trend has negatively impacted their populations and changing policies accordingly. If your child was diagnosed with autism recently, we hope you’ll find our resources helpful as well!
“Is Autism Being Overdiagnosed? (The Status in 2022)” is a question that has been asked by many people. The status of autism will be discussed in the year 2022.
Autism diagnoses have increased in recent years. Some individuals believe that autism in the United States is overdiagnosed.
The greater diagnosis rate is attributed in part to expanded diagnostic criteria and increased public awareness of the illness. If this is the case, it indicates that in 2022, the condition will not be overdiagnosed. Rather, many instances of autism remained undetected in the past.
Because of the rising prevalence of autism, more children are receiving treatment services early. Because early intervention is so important for effective therapy, some argue that overdiagnosis isn’t always a negative thing.
Autism Diagnosis Rates in the United States
What are the autism diagnostic rates?
The Centers for Disease Control and Prevention (CDC) provided their biannual update on the projected incidence of autism spectrum disorder among children in the United States in 2020. The statistics in the update are based on an examination of 8-year-old children’s medical and school data (where available) obtained in 2016 from 11 monitoring sites around the country.
Autism spectrum disorder affects around one out of every 44 children. In 2014, the estimate was 1 in 59, representing a nearly 10% rise.
Autism is far more frequent in males, affecting one out of every 34 boys. The percentage falls to 1 in 144 for females, making boys four times more likely than girls to be diagnosed with autism spectrum disorder. However, this increases the chance that autistic females may go undetected and will not get the treatment and care they need.
While autism is normally diagnosed around the age of two, most children in the United States are not diagnosed until they are older than four. The percentage of children examined for any developmental issue by the age of three has grown from 74% to 84 percent, demonstrating progress toward earlier, more frequent, and consistent screening.
Over 30% of children with autism have an intellectual handicap, defined as having an intelligence quotient of less than 70%. A quarter of children with autism have borderline intelligence (IQs of 71 to 85), whereas 44% have IQs of 85 or above, putting them in the average to above average range.
Diagnosis Rates Gaps
Symptoms of autism spectrum disorder may be observed in people of all races and socioeconomic backgrounds. Minority groups are diagnosed later in life and less often, perhaps due to a lack of knowledge about ASD and access to health care (for reasons of economics or culture).
Even the criteria used by various CDC monitoring locations may vary. Autism was diagnosed at a low prevalence of 1 in 76 in Colorado, but at a high rate of 1 in 32 in New Jersey. Autism is diagnosed and documented in various ways in different societies.
Overall, the CDC research demonstrates that the incidence of autism spectrum disorder in the United States is continuing to rise.
The CDC discovered no difference in the frequency of autism diagnostic rates between Black and white children for the first time, indicating that obstacles to screening and diagnosis may be eroding. However, there is still a disparity in autism prevalence rates among Latinx children, suggesting that this population deserves more screening and intervention. While both Black and white children had equal diagnostic rates, the CDC’s data revealed that Black and Latinx children with autism were examined at a later age than white children, indicating that these groups had less access to screening.
What Factors Influence Diagnosis Rates?
The president and CEO of Autism Speaks, in response to the CDC data, observed that the prevalence of 1 in 54 is a significant improvement above the predicted prevalence rate of 1 in 166 in 2005, when Autism Speaks was created. She believes that this is due to more and improved screening, which reduces the age of diagnosis in minority communities and enhances the likelihood of receiving treatment earlier in life.
While the CDC study was well welcomed, several autism supporters voiced worry that modifying the autism criteria might lead to an increase in autism spectrum disorder diagnoses. Other experts argue that altering the autism diagnostic criteria implies that official diagnosis rates are catching up to the reality of autism happening in more individuals and at a younger age, enabling health care practitioners to start treatment sooner rather than later.
Overextended to a large extent
According to evidence discovered by researchers at the University of Montreal, more people with milder autism symptoms are being diagnosed with autism spectrum disorder. The gap between persons diagnosed with autism and those who do not have autism has narrowed.
One of the authors of the study, (which was published in JAMA Psychiatry), also the chair of cognitive neuroscience in autism at the university, explained that prevalence rates are up by 15 times what they were 50 years ago, concluding that “the autism category has Overextended to a large extent.” In the past, it would not be possible to have both attention deficit hyperactivity disorder and autism; now, that diagnosis can be made. This is the result of a number of neurogenetic and child psychiatry disorders that have “only a loose resemblance with autism” now being folded in under the broader category of an autism spectrum disorder.
This creates a problem for physicians. While an autism diagnosis makes sense in circumstances when both symptoms are present, it muddles the waters when it comes to individuals who have severe ADHD and significant socializing issues. There is fear in the latter situation that these people will be classified as autistic when they are not.
Inclusive & Heterogeneous Population
The study’s results chime in with other voices questioning whether autism would be overdiagnosed in 2022. However, it is possible that early discovery of autistic symptoms has resulted in a greater understanding of how diverse the autism spectrum may be, and that more persons with both milder and more severe forms of autism are being appropriately accounted for.
According to the research, extending the definition of autism “toward an inclusive and heterogeneous population” risks limiting the possibility to develop effective and practical models for better understanding the real nature of autism and developing suitable treatments.
There’s also a chance that expanding the diagnosis of autism and classifying more persons with ASD may put a strain on present autism treatment programs.
Overdiagnosis vs. a More Accurate Diagnosis
Even as proponents of expanding the scope of autism diagnosis acknowledge that this will alter the autism landscape in the United States, they argue that as more people become aware of ASD and more research is conducted into the condition, more autistic people will be identified and receive the treatment they require. They claim that it is not so much a matter of overdiagnosis as it is a case of improved diagnosis.
If the concept of autism stays strictly restricted and confined, educating people, parents, and communities about the early warning signals of autism will be futile. More individuals will benefit from early intervention and diagnosis than from the opposite.
Others argue that the essential traits of autism, such as repetitive behavior and socio-emotional and linguistic impairments, haven’t altered, and that autism isn’t being overdiagnosed as a result. Instead, care providers are identifying milder forms of autism spectrum disorder and ensuring that patients with these forms of autism continue to get therapy.
Conditions that are distinct but related
According to some experts, recent revisions to the diagnostic criteria for autism have not diminished the concept of autism. Instead, the modifications have helped health care practitioners to get a better understanding of the underlying mechanisms for a variety of illnesses with similar symptoms to autism. This allows them to have a better knowledge of the many forms of autism as well as other illnesses that overlap.
Even while the prevalence of autism diagnoses has risen, more individuals are receiving more accurate diagnoses earlier in life, which means that more people with autism are receiving the essential intervention and treatment to manage their illness.
Autism Diagnostic Criteria Have Changed
What has changed in autism diagnostic criteria? The autism prevalence rate climbed from less than 0.05 percent at age 8 to 1.47 percent between 1966 and 2019, and it is anticipated to continue to grow.
The American Psychiatric Association’s 2013 revision of the Diagnostic and Statistical Manual of Mental Disorders merged previously separate diagnoses of autistic disorder, Asperger’s syndrome, childhood disintegrative disorder, and pervasive developmental disorder – not otherwise specified – into the widely used title of autism spectrum disorder. This “maximizes diagnostic sensitivity and specificity [of autism] in preschool children,” according to the journal Social Psychiatry and Psychiatric Epidemiology.
This is particularly true in communities where autism is often misdiagnosed. Many people assume that females cannot have autism, however the widening definition of autism may persuade autistic girls’ parents to reconsider.
Because of the stigma connected with mental health issues in general, minorities may be resistant to the idea of a member of their culture or community being autistic (leading to “wide underrepresentation”). Autism symptoms may go unnoticed by those living in low-income areas. Indeed, “the prevalence of ASD […] is more likely to be greater in places with the greatest degree of [socioeconomic] hardship,” according to the PLOS ONE publication.
Opening the diagnostic door in each of these situations might lead to a greater understanding of what autism is and how pervasive it can be.
However, the pendulum swings in both directions. A study published in the Autism journal in 2016 by researchers at the University of Washington looked at a group of persons who had been diagnosed with autism. The researchers discovered that 9% of those persons had been misdiagnosed.
The researchers concluded that if the criteria for autism are growing, so should the criteria for reanalysis and reevaluation.
Is It True That Autism Is Overdiagnosed?
According to Psych Central, the topic is contentious. Autism is a complex medical disorder that has eluded treatment in the past. Other diseases, such as attention deficit hyperactivity disorder, are treated with well-established pharmaceutical therapy; autism is not one of them. Furthermore, due to the expanding of the autism spectrum, a person with a lesser type of autism may have symptoms that are quite different from a nonverbal and nonresponsive individual.
As a result, anti-vaccination campaigners allege that children’s obligatory vaccinations have caused a “epidemic” of autism diagnoses, a claim that has been largely debunked by health care experts. Despite the fact that studies have consistently refuted this hypothesis, it continues to circulate on social media.
There are still concerns and critiques. According to an opinion article published in The Guardian, the autism rights movement to increase awareness for neurodiversity “ignores people with crippling severe autism,” making the diagnostic word “autism” meaningless.
However, as Scientific American points out, since the word “autism” was first used to characterize the disorder in 1943, our knowledge of the condition has been constantly evolving. Since then, as more is learned about the condition — and new issues are raised — researchers and specialists have altered the diagnostic criteria on a regular basis.
In that perspective, the most recent reevaluation of those criteria is unsurprising. The response and worry over overdiagnosing, on the other hand, may reflect the sensationalism, politicization, and ongoing reconsideration of autism’s genuine nature.
The “are doctors diagnosing autism too readily” is a question that many people are asking. The issue of whether or not autism is being overdiagnosed has been debated for years. In 2022, the status of this question will be revealed.
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Janice is a Board Certified Behavior Analyst. She graduated from the University of British Columbia with a Bachelor of Arts in Psychology and Special Education. She also holds a Master of Science in Applied Behaviour Analysis (ABA) from Queen’s University, Belfast. She has worked with and case managed children and youth with autism and other intellectual and/or developmental disabilities in home and residential setting since 2013.