Changes over time in how autism is defined as well as improved access to diagnosis are the most likely reasons why autism diagnoses have jumped in recent years, according to Harvard T.H. Chan School of Public Health’s Ari Ne’eman.
Ne’eman, assistant professor of health policy and management and an expert on autism and disability policy, shed light on the issue in a Sept. 30 opinion piece for STAT, written in the wake of Health and Human Services Secretary Robert F. Kennedy Jr.’s assertion that there is an autism “epidemic.”
According to the most recent CDC estimate, one in 31 eight-year-old children in the U.S. had autism spectrum disorder in 2022, up from one in 150 in 2000. But Ne’eman pointed out that changes in how mental disabilities were diagnosed have played a big role in that increase. Decades ago, he wrote, many people who would today be diagnosed with autism received other diagnoses, such as “intellectual disability.” But as researchers learned more about such disabilities, many individuals were shifted into other categories—notably, autism—as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a handbook published by the American Psychiatric Association that provides a common language for diagnosing mental health conditions.
Ne’eman also noted that, as autism diagnoses have increased in recent years, there have been corresponding declines in other diagnoses, such as “intellectual disability” and “learning disability”—which suggests “that a process of diagnostic substitution was taking place rather than a real increase in autism prevalence,” he wrote.
Another factor in the increase in autism prevalence has been improved access to diagnosis, particularly among racial and ethnic minority groups and among households of lower socioeconomic status, according to Ne’eman.
In addition to mischaracterizing the prevalence of autism, the Trump administration is making matters worse with plans to cut federal funds and programs that support people with autism and other disabilities, he added.
Read Ne’eman’s STAT article: The Trump administration’s Soviet approach to autism policy
Learn more
A research agenda to improve the lives of autistic people (Harvard Chan School news)
