At the height of the fear and confusion associated with the declaration of a coronavirus pandemic public health emergency and strict social distancing regulations in the spring of 2020, U.S. health officials published a report that, in 2016, autism spectrum disorder (ASD) was estimated to affect one in 54 eight-year old children in the U.S., with one in 34 boys (2.97 percent) and one in 145 girls (.69 percent) having the developmental disorder.1 2
Those 2016 prevalence statistics represent a 10 percent rise in ASD among American children compared to a similar 2018 report that estimated one in 59 children in 2014 had ASD, the highest prevalence rate since the U.S. Centers for Disease Control and Prevention (CDC) began tracking the development of autism in children in 11 states in 2000. According to the CDC’s data, the ASD prevalence rate has nearly tripled since 2000 and, by 2016, nearly two percent of eight-year old children in the U.S. were estimated to have ASD.3
A recent report by public health officials in Northern Ireland found an ASD prevalence rate of almost one in 20 school aged children (4.5 percent), which is a 3.3 percent increase since 2009. Thousands of children are waiting for an autism assessment in northern Ireland and public health officials say the prevalence rate may be higher.4
A Need to Prepare for the Future
The latest ASD prevalence report published by the U.S. Center for Disease Control and Prevention (CDC) in 2020 is based on active surveillance conducted by the Autism and Developmental Disabilities Monitoring (ADDM) Network tracking children in 11 states (AZ, AK, CO, GA, MD, MN, MO, NJ, NC, TN WI). The ASD prevalence rate among eight year old boys living in New Jersey in 2016 was estimated to be 1 in 20—the highest among the 11 states.5 The report’s authors stated, “The ADDM Network reported higher ASD prevalence among more socioeconomically advantaged groups and among children classified as non-Hispanic white (white) than among other groups.”
This is the seventh report by the ADDM Network. The first report estimated that, based on 2000-2002 data, one in 150 eight year old children living in the U.S. in 2007 were affected by ASD. In a Mar. 26, 2020 press release, an epidemiologist with the Johns Hopkins Bloomberg School of Public Health, Li-Ching Lee, PhD, commented on the latest ASD prevalence estimates for Maryland, which are one in 33 for boys and one in 128 for girls and stated:
We need to know how many children have ASD in order to prepare our communities and services systems. An ongoing and accurate estimate will help to develop realistic plans to support these children now, and later into their adolescence and adulthood.
2019 Report: Overall Significant Increases in Prevalence of Any Developmental Disability in U.S. Children
In late 2019, federal officials at the National Center for Health Statistics (NSHS) published data on diagnoses by health care professionals of attention deficit/hyperactivity disorder, autism spectrum disorder, blindness, cerebral palsy, moderate to profound hearing loss, learning disability, intellectual disability, seizures, stuttering or stammering and other developmental delays in a nationally representative survey of the civilian noninstitutionalized population in the U.S. Known as the National Health Interview Survey (NHIS), the 2019 published analysis concluded that among U.S. children aged 3 to 17 years:
The prevalence of developmental disability among U.S. children aged 3 to 17 years increased between 2009 and 2017.” From 2009 to 2011 and 2015 to 2017, there were overall significant increases in the prevalence of any developmental disability, attention deficit/hyperactivity disorder, autism spectrum disorder and intellectual disability, but a significant decrease for any other developmental delay.6
The 2019 NHIS-based prevalence estimate for any developmental disability among U.S. children ages 3 to 17 between 2015 and 2017 increased to about 17 percent (an increase of 9.5 percent) compared to the years 2009 to 2011, and the CDC now states that one in six children in the U.S. have a developmental disability.7 8 At the same time, the 2019 NHIS report found that ADHD increased more than 12 percent; intellectual disability increased more than 25 percent and ASD increased more than 122 percent.9 Boys were more likely than girls to be diagnosed with any developmental disability.
2018 Report: Parent-Reported Autism in U.S. Children
The 2016 National Survey of Children’s Health (NSCH) study that was published in 2018 was designed by federal officials at the Health Resources Services Administration (HRSA) and conducted by the U.S. Census Bureau.10 It is a nationally and state-representative survey of 50, 212 U.S. children, ages 0 to 17 years. Describing the survey results, authors concluded that 1 in 40 children in the U.S. have a parent-reported diagnosis of ASD. They stated:
Previous studies over the last 20 years have shown an increasing prevalence of autism spectrum disorder (ASD) among US children. Moreover, families of children with ASD have reported greater health care needs and challenges compared with children with other emotional or behavioral conditions. In this study, we present new nationally representative data on the prevalence of ASD, reported health care challenges, and estimates on ASD-specific behavioral and medication treatments. The estimated prevalence of US children with parent-reported diagnosis of ASD is now 1 in 40.
New Autism Data in Ireland: One in 20 School Aged Children
According to new data published by the Department of Health in the United Kingdom, almost one in every twenty school-age children in Northern Ireland has been diagnosed with autism spectrum disorder (ASD)11 12 The report estimates that more than 13,000 children between the ages of four to fifteen have a diagnosis of autism, an estimated 4.5 percent of the school-aged population.13
The rate of children with ASD and Asperger’s Syndrome in Northern Ireland has increased by 3.3 percent since 2009. In 2009, the rate of ASD and Asperger’s Syndrome was 1.2 percent of all children aged 4 to fifteen. In 2020, the rate has jumped to 4.5 percent, an increase of 3.3 percent.14 In response to the increased in ASD rates, the Department of Health in Northern Ireland warned against against direct comparison between years as a result of changes in the ways autism data is collected.15
Almost 4,500 children in Northern Ireland are on the waiting list for an autism assessment and public health officials are saying there could be more.16 Health Minister Robin Swann responded to this issue saying that he will create a new longer-term strategy, which will include a reduction in waiting times for assessments, giving parents a chance of early intervention.
Boys Living in Urban Areas More Likely to Be Diagnosed with ASD
The Department of Health report highlighted that boys were three times more likely than girls to be diagnosed with ASD. There was also a statistically significant higher prevalence rate of autism in urban areas than the rural areas.17
The Northern Ireland School Census showed that 6.7 per cent of males were identified with ASD compared to 2.2 per cent of females. The data also showed that highest prevalence autism rate recorded was 5.8 per cent for those in Year 8 (children aged 11-12), while the lowest was 1.8 per cent, for those in Year 1 Nursery (children aged 4-5).18
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1 Maenner MJ, Shaw KA, Baio J et al. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years – Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016. MMWR Mar. 27, 2020.
2 Johns Hopkins Bloomberg School of Public Health. U.S. Autism Rates Up 10 Percent in New CDC Report: Since 2000, Prevalence Rate Has Nearly Tripled, from 0.6 to 1.85 Percent. Press Release: Mar. 26, 2020.
4 Department of Health. Prevalence of Autism (including Asperger Syndrome) in School Age Children in Northern Ireland. Health-no.gov.uk 2021.
5 Maenner MJ, Shaw KA, Baio J et al. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years – Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016 (Table 1). MMWR Mar. 27, 2020.
6 Zablotsky B, Black LI, Maenner MJ et al. Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009-2017. Pediatrics 2019; 144(4).
7 U.S. Centers for Disease Control and Prevention. Increase in Developmental Disabilities Among Children in the United States. Sept. 26, 2019.
8 CDC. Data & Statistics on Autism Spectrum Disorder: Prevalence. Sept. 25, 2020.
9 Zablotsky B, Black LI, Maenner MJ et al. Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009-2017. Pediatrics 2019; 144(4).
10 Kogan MD, Vladutiu CJ, Schieve LA et al. The Prevalence of Parent-Reported Autism Spectrum Disorder Among US Children. Pediatrics 2018; 142(6).
11 Department of Health. Prevalence of Autism (including Asperger Syndrome) in School Age Children in Northern Ireland. Health-no.gov.uk 2021.
12 Meredith R. Autism: Almost one in 20 NI schoolchildren have diagnosis. BBC May. 20, 2021.
16 Beattie J. Autism assessment waiting list hits 4,500 in Northern Ireland. BelfastLive.co.uk May. 12, 2021.
17 McConville ML. New report shows boys in Northern Ireland are three times more likely to be diagnosed with autism. Irish News May. 21, 2021.