The autism rate among 8-year-olds increased to one in 54 as screening improved, according to a new report from the Centers for Disease Control and Prevention (CDC).
The rate, which is up from one in 59, is the same for white and black children for the first time.
Kristin Sohl, M.D., FAAP, a member of the AAP Council on Children with Disabilities Autism Subcommittee, applauded improvements in screening to reduce disparities and said early diagnosis is “vital for a child’s development.”
“We know the early years, meaning really birth to 5, is where the pivotal time points are to intervene in development,” she said. “That time frame is where the child’s brain is most adaptable so if there are delays, they can learn the most and make the most progress during those ages.”
The AAP recommends developmental screenings at 9, 18 and 30 months and screening for autism at ages 18 and 24 months.
The new autism prevalence rates are based on 2016 data from 11 communities in the CDC’s Autism and Developmental Disabilities Monitoring Network and were published today in Morbidity and Mortality Weekly Report. They ranged from one in 76 children in Colorado to one in 32 children in New Jersey.
As in the past, boys with autism were four times more likely to be identified than girls. Dr. Sohl, associate professor of clinical child health at the University of Missouri, said girls’ social skills may lead to them go unrecognized. Girls who were diagnosed with autism were more likely to have an intellectual disability than boys, according to the report.
While identification of black children caught up to white children, diagnosis of Hispanic children still lagged. Both black and Hispanic children also tend to be diagnosed later than white children.
“We still have work to do to increase access for our underserved populations to evidence-based diagnostics … in order to continue to reduce existing inequalities,” Dr. Sohl said.
Overall, about 44% of 8-year-olds with autism received a comprehensive evaluation by 36 months, an improvement from previous years. The median age at the time of diagnosis was 51 months.
An accompanying report on 4-year-olds with autism was more promising. It found 84% had been evaluated by 36 months up from 74% in 2014.
Dr. Sohl urged pediatricians to continue to follow AAP recommendations for screening and to be especially vigilant with children from underserved populations. Parents should engage with their pediatricians so they can track their child’s developmental milestones.
The AAP recently published an update to its autism guidance that includes discussion of diagnosis, early intervention, genetics, co-occurring medical conditions and lifespan issues. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder is available at https://pediatrics.aappublications.org/content/145/1/e20193447.
