Summary
There has been a remarkable increase in the reported prevalence of autism, but the evidence does not bear out that we are in the midst of an autism ‘epidemic.’
What we know
- The latest survey from the U.S. Centers for Disease Control and Prevention (CDC) indicates that the prevalence of autism is 1 in 68 children in the U.S.
- The distribution in the U.S. is uneven, with a threefold variation among states.
- According to the CDC, prevalence more than doubled between 2002 and 2008 and increased tenfold over the past 20 years.
- Much of the reported increase in prevalence reflects the application of broader diagnostic criteria, greater availability of services and reduction in stigma associated with the diagnosis.
- Autism, across the entire spectrum, is four to five times more common in boys than in girls. The gender ratio is close to 1:1 in individuals with low intelligence quotients and 8:1 for high-functioning individuals.
- The incidence of autism increases with paternal age.
- Current evidence for specific environmental triggers is weak.
What is next?
- Do pockets of increased prevalence exist in certain communities?
- Is the prevalence of autism the same worldwide?
- Is autism underdiagnosed in girls?
- What accounts for the gender gap? Genetics? Environment?
- What social determinants influence the prevalence of autism?
- Do environmental risk factors influence the expression of autism risk genes?