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Why are autism diagnoses on the rise?

We don’t know for sure, but one major contribution seems to be the increasing recognition of developmental problems in children by professionals like me. The single most frequent referral question I get, as a child psychologist, is: “Is this child autistic?” Often, I see a two-year-old who is head-banging, language delayed, or performing repetitive behaviors. He may already have a speech therapist or other specialist who worries about autism. Or his parents may have heard about autism in the media, and say, “My kid does that!”

When I went to grad school in the 1990s, we learned that autism was a rare, severe, and lifelong disorder of communication and social relatedness. These kids exhibited the most obvious signs of the disorder:

  •   Near complete retreat from communication with others
  •   Hand-flapping and other odd self-stimulatory behaviors
  •   Severe developmental delays and behavioral outbursts

These kids really could not be taught in any regular school setting. They needed support and help in daily living for a lifetime. But as time went on, clinicians started to see less severe forms of these symptoms; we got better at recognizing them in their more subtle forms. As more behavioral healthcare professionals were trained, we had more “eyes” looking for the problem. Parent advocacy and special education laws increased pressure on the school systems to widen the array of services for kids with less severe symptoms. Soon, I had parents and teachers asking me to diagnose autism or a related disorder so the child would qualify for intensive, expensive help that was only available under the autism spectrum range of diagnoses.

The pressure is tremendous; here is a child who has communication and other developmental delays. His parents have few resources. The school will only pay if there is an autism diagnosis. Many clinicians admit that they rationalize labeling the child “autistic” if it helps them get the services they need.
I’m not arguing with the possibility that the actual incidence of autism is increasing. But I am not 100% convinced that that is taking place. And I’m worried about the panic and alarm caused unnecessarily to parents.
William Stillman
Health Education

It is uncertain if autism is actually increasing in its prevalence or if the clarity of standards for identifying it have provided for greater accuracy of diagnosis. In years prior to the 1994 publication of The American Psychiatric Association's Diagnostic and Statistical Manual (which defined autism as a spectrum experience for the first time), individuals with autistic-like symptoms would've likely been diagnosed with mental retardation or childhood schizophrenia.

Personally and professionally speaking, working in the human services field since 1987, I know I have encountered people with one or both of the preceding diagnoses who, in hindsight, were clearly autistic. However, I have also observed that, over that time period, the rate of incidence has indeed expanded and, curiously, is growing worldwide, sometimes at higher rates.

It may remain to be seen if the present rate of one in every 110 children is reflective of a true rise in autism or better-educated diagnoses.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.