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Autism rates increase, still great disparities in race and gender

Article

Both the CDC and the AAP stress the need to look at how resources are allocated for autism spectrum disorder.

The number of children diagnosed with some degree of autism spectrum disorder (ASD) continues to increase, according to new estimates from the (CDC), but the number of children with ASD and intellectual disabilities remains in the minority.

About 1 out of every 150 children was diagnosed with autism spectrum disorder between 2000 and 2002, but that number increased to 1 in 54 by 2016, and again to 1 in 44 by 2018. Diagnoses varied by geographical location, gender, race, and socioeconomic status in the past, but newer research suggests that at least racial and ethnic disparities are decreasing. While little variation now remains between white, nonHispanic white, and Black children in terms of overall autism diagnoses, the CDC notes that Black children diagnosed with ASD have higher rates of intellectual disabilities than white children, and their diagnosis is typically made at a more advanced age.1

The American Academy of Pediatrics (AAP) has also released data on autism trends, noting that overall, children with ASD who experience intellectual disabilities are in the minority. About one third of children with ASD have intellectual disabilities, but that proportion is higher among Black and Hispanic children, as well as among children from underserved communities, according to the report.2

The AAP report dove even further into these racial and economically driven disparities at the disability level, highlighting a two-fold increase in children with ASD and intellectual disabilities compared to a five-fold increase in ASD diagnoses without intellectual disabilities. Black children were 30% less likely than white children to be free from intellectual disabilities, the report notes, just as children in more affluent communities were 80% more likely to be diagnosed with ASD but remain free of intellectual disabilities.2

In terms of gender variations, boys had higher rates of ASD diagnosis overall, but male-to-female ratios were lower when comparing the number of children with intellectual disabilities to those without, the report states.2

Both reports stop short of assigning a source of blame for the increase in autism diagnoses, or the likelihood of intellectual disability on any one specific factor. However, both reports stress the need to investigate how the resources are dispersed and what role this plays in both identifying and treating children on the autism spectrum.

References
1. Maenner MJ, Shaw KA, Bakian AV, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. MMWR Surveill Summ. 2021;70(No. SS-11):1–16. doi:10.15585/mmwr.ss7011a1
2. Shenouda J, Barrett E, Davidow AL, et al. Prevalence and disparities in the detection of autism without intellectual disability. Pediatrics. 2023;151(2):e2022056594. doi:10.1542/peds.2022-056594

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