The latest report from the CDC reveals that the prevalence of autism among American children has risen from 1 in 44 children in 2021 to 1 in 36 children today. This data change has drawn public attention. Federal Health Secretary Robert Kennedy Jr. recently claimed at a press conference that autism has become an “epidemic” and emphasized that it is “increasing at an alarming rate,” pointing the finger at exposure to environmental toxins, while downplaying the role of genetic factors. This statement has sparked discussions on social media and in the medical field: Is the increase in diagnosis rates a real outbreak of the disease, or is it the result of advancements in medical cognition and social screening systems? Dr. David Carter, a board-certified family physician at the Santa Monica Providence St. John Health Center, clarified the scientific logic behind the data by breaking down key factors.
Dr. Carter pointed out that the release of the “Diagnostic and Statistical Manual of Mental Disorders (5th Edition)” in 2013 was a key turning point – previously separately classified Asperger syndrome, unspecified pervasive developmental disorders, etc. were unified under the “Autism Spectrum Disorder” (ASD) category, this adjustment enabled individuals with milder symptoms to be included in the diagnostic framework for the first time. “In the past, only those with severe functional impairments would be diagnosed, now the boundaries of the spectrum have expanded, and more high-functioning groups can be identified.” He explained. At the same time, the American Academy of Pediatrics’ routine autism screening mechanism for children aged 18 to 24 months since 2006 has captured more atypical cases through early intervention programs, especially those with subtle symptoms in young children. “This proactive screening has allowed children who might have been overlooked due to being ‘seemingly normal’ to receive a diagnosis, such as children with mild language development delays but subtle social interaction disorders.”
What is more noteworthy is the correction of group diagnostic bias: Historically, women and minority groups have long been underdiagnosed due to differences in symptom manifestations (such as women being more likely to exhibit social imitation abilities) and issues with access to medical resources. Carter mentioned that in recent years, with the application of gender-sensitive assessment tools, the diagnosis rate of female autism patients is gradually approaching the actual prevalence rate, “This is not a sudden increase in incidence, but a breaking of the ‘autism = male disease’ cognitive bias.” Additionally, the “diagnostic substitution” phenomenon cannot be ignored – children previously classified as learning disorders or intellectual disabilities have been re-diagnosed due to the deepening understanding of the autism spectrum, and this classification adjustment directly affects the longitudinal comparison of statistics.
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