Is Autism Being Overdiagnosed? (The Status in 2023)

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It is true that there has been an increase in autism diagnoses, but that doesn’t mean it is a bad thing! Countries around the world are now taking steps to assess and analyze overdiagnosis and to ensure it is not negatively impacting their populations by incorporating recent research in their understanding of autism. If your child was diagnosed with autism recently, hopefully this article can provide some insight on any doubts around overdiagnosis.

The Current Diagnosis Criteria for ASD

The current diagnosis criteria for Autism Spectrum Disorder (ASD) are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to the DSM-5 which was published in 2013, ASD is characterized by persistent deficits in social communication and social interaction across multiple contexts. These deficits may include challenges in social-emotional reciprocity, nonverbal communication behaviours, and developing and maintaining relationships.

Additionally, individuals with ASD may exhibit restricted, repetitive patterns of behaviour, interests, or activities. The diagnosis of ASD is made based on direct observations and comprehensive assessments from clinical professionals of an individual’s behaviour and development, considering both their strengths and challenges. The DSM-5 criteria provide a framework for clinicians to assess and diagnose ASD, facilitating early identification and appropriate interventions for individuals on the autism spectrum.

Autism Diagnosis Rates: 2000 to 2020

The diagnosis rates of Autism Spectrum Disorder (ASD) have seen a significant increase from 2000 to 2020. Based on the CDC’s Data and Statistics on Autism Spectrum Disorder, in 2000, 1 in 150 children were diagnosed with autism. In 2020, 1 in 36 children were diagnosed with autism. Therefore, it is true, there has been an increase in children diagnosed with autism.

However, this does not necessary mean autism is being overdiagnosed. There are many external variables and factors that account to the increase in rates. Some of the factors include increased awareness of autism in general, improved diagnostic criteria, and enhanced screening practices. In the past two decades, advancements in research and understanding of ASD have led to improved identification and diagnosis of individuals on the autism spectrum. Changes in societal attitudes and increased access to diagnostic services have also contributed to the rising diagnosis rates. While it is important to acknowledge the increase in diagnosis, it is crucial to ensure accurate assessments and avoid overdiagnosis. Ongoing efforts are being made to refine diagnostic tools and criteria, ensuring that individuals receive appropriate support and interventions based on their unique needs.

What Factors Influence the Diagnosis Rate Gap?

The diagnosis rate gap in Autism Spectrum Disorder (ASD) can be influenced by various factors. One key factor is disparities in access to healthcare and diagnostic services. Socioeconomic factors, including income level, geographic location, and cultural beliefs, can affect individuals’ ability to seek and obtain an accurate diagnosis. Additionally, differences in healthcare provider knowledge, training, and biases can contribute to variations in the diagnosis rates. Another factor is the variability in symptom presentation and expression of ASD across different individuals, which can lead to challenges in recognizing and diagnosing the disorder. Efforts are being made to address these factors and reduce the diagnosis rate gap, including increased awareness, improved access to services, and cultural sensitivity in diagnostic practices.

Another factor that influences the diagnosis rate gap in Autism Spectrum Disorder (ASD) is the evolving understanding of the disorder and changes in diagnostic criteria over time. As diagnostic criteria and guidelines have been refined and expanded, more individuals who previously may not have met the criteria for ASD are now being diagnosed. The DSM is currently at its 5th edition with each edition providing more accuracy than its previous. This shift in diagnostic practices, along with increased awareness and education about ASD among healthcare professionals, has contributed to higher diagnosis rates. Additionally, increased public awareness and advocacy efforts have led to improved recognition of ASD symptoms and greater demand for diagnostic evaluations. Many countries’ public health system has been working on establishing efficient diagnostic policies and resources that are free or affordable. However, it’s important to note that overdiagnosis and misdiagnosis can still occur, highlighting the need for careful and comprehensive assessment by qualified professionals. Ongoing research and collaboration within the medical and scientific communities are crucial in ensuring accurate and appropriate diagnoses for individuals with ASD.

Autism Diagnostic Criteria Have Changed

Over the years, there have been significant changes in the diagnostic criteria for autism, reflecting an evolving understanding of the condition. It has been more than 50 years since Leo Kanner first described his classic autistic syndrome. Before then, symptoms of autism were loosely described, and also described in a negative and problematic connotation. Over the years, thanks to research and clinical work from professionals, we have a better understanding of autism. This includes a clear definition and expanding awareness and voice from the autistic community themselves.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has played a crucial role in shaping these changes. One notable shift occurred with the release of the DSM-5, which introduced a more comprehensive and flexible approach to diagnosing autism spectrum disorder (ASD). The updated criteria now emphasize the importance of considering the individual’s unique strengths, challenges, and support needs, recognizing that autism presents differently in each person. This evolution in diagnostic criteria has allowed for a more nuanced understanding of autism and has contributed to improved accuracy in identifying and supporting individuals with ASD.

Emerging Factor: Cultural Sensitivity in Autism Diagnosis

It is important to address an emerging factor in the diagnosis of Autism Spectrum Disorder (ASD) which is the importance of cultural sensitivity. Cultural factors play a significant role in how ASD is perceived, understood, and diagnosed across different communities and cultural contexts. There is a growing recognition of the need to consider cultural norms, values, beliefs, and language when assessing and diagnosing ASD. Currently, acceptability and understanding of ASD in western and eastern countries still differ greatly. This heavily affects diagnoses rates, funded resources, and family and societal dynamics.

Cultural sensitivity involves understanding and respecting the diverse perspectives and experiences of individuals and families from different cultural backgrounds. It includes adapting assessment tools, diagnostic criteria, and interventions to be culturally appropriate and relevant. We need to take that extra step to promote cultural sensitive actions to ensure it is accounted for. At the end of the day, we want to focus on collaboration rather segregation in the autism community. By promoting cultural sensitivity in autism diagnosis, healthcare professionals can ensure that all individuals, regardless of their cultural background, receive accurate and equitable diagnoses and access to appropriate interventions and support services.


How often is autism overdiagnosed?

The overdiagnosis of autism is a complex and debated topic within the field. While there have been instances of overdiagnosis, it is challenging to determine an exact frequency as it can vary depending on various factors, including diagnostic practices, cultural influences, and individual clinician judgment. Efforts are ongoing to improve diagnostic accuracy and ensure that individuals receive appropriate support and interventions based on their specific needs.

Why are so many people being diagnosed with autism?

The increase in autism diagnoses can be attributed to several factors, including improved awareness and understanding of autism spectrum disorder (ASD) among healthcare professionals and the general public. Changes in diagnostic criteria and expanded screening practices have also contributed to a better identification of individuals with autism, allowing for earlier intervention and support. Additionally, increased research and knowledge about autism have helped reduce stigma and encourage seeking evaluations and diagnoses.

How likely is it to be misdiagnosed with autism?

Misdiagnosis of autism can occur, but the likelihood depends on various factors such as the accuracy of the assessment process, the expertise of the evaluating professionals, and the complexity of the individual’s presentation. While misdiagnosis is a potential concern, comprehensive evaluations conducted by experienced clinicians can help minimize the risk and ensure accurate diagnoses.

Why is autism increasing?

Misdiagnosis of autism can occur, but the likelihood depends on various factors such as the accuracy of the assessment process, the expertise of the evaluating professionals, and the complexity of the individual’s presentation. While misdiagnosis is a potential concern, comprehensive evaluations conducted by multiple experienced clinicians can help minimize the risk and ensure accurate diagnoses.