The prevalence of children with autism spectrum disorder (ASD) has grown to one in 36 (2.8%) 8-year-olds, according to a new report. For the first time, rates are lower for White children than for other races.
The overall rate reported Thursday in the Morbidity and Mortality Weekly Report is up from one in 44 8-year-olds two years prior.
“We can’t say for sure, but we suspect this is due to increased awareness leading to more children being identified with autism,” Karen Remley, M.D., M.B.A., M.P.H., FAAP, director of the Centers for Disease Control and Prevention’s (CDC’s) National Center on Birth Defects and Developmental Disabilities, said in a press conference.
The CDC’s findings are based on 2020 data from its Autism and Developmental Disabilities Monitoring Network, which spans 11 sites — Arizona, Arkansas, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, Tennessee, Utah and Wisconsin. While reports from the network may not be nationally representative, they commonly are used as an indicator of autism prevalence. ASD rates ranged from one in 43 in Maryland to one in 22 in California.
Historically, White children have had higher rates of being identified with ASD than children of other races/ethnicities, although they were similar in recent years. In 2020, rates were lowest for White children at 2.4% followed by 2.9% of Black children, 3.2% of Hispanic children and 3.3% of Asian/Pacific Islander children. Dr. Remley again attributed this finding to better identification.
“These data indicate that ASD is common across all groups of children and underscore the considerable need for equitable and accessible screening, services, and supports for all children,” authors wrote in the report.
About 38% of children with autism who had data available on their cognitive ability had an intellectual disability, according to the report. Rates were higher among Black children than White children.
“And while more research is needed to understand this difference, it could relate in part to less access to services that diagnose and support children with autism,” Dr. Remley said.
ASD prevalence for girls was slightly over 1% for the first time but still was nearly four times higher for boys.
The AAP recommends developmental screenings at 9, 18 and 30 months and screening for autism at ages 18 and 24 months. AAP President Sandy L. Chung, M.D., FAAP, said pediatricians are eager to discuss developmental or behavioral challenges with parents who have questions.
CDC researchers found about 49% of 8-year-olds with ASD and a recorded evaluation had been evaluated by 36 months, up from 47% two years prior. However, an accompanying report on early identification among 4-year-olds found that upward trends in evaluating and identifying children reversed once the COVID-19 pandemic began in early 2020.
“We all need to work together to catch up to the progress we have been making to identify children with autism early, which is when we know interventions have the greatest likelihood of success,” Dr. Chung said. “We also want parents to understand it’s never too late. If you are noticing something concerning with your child’s development at any stage, please reach out to your child’s doctor so we can begin that conversation.”