As many of you know, last week the Centers for Disease Control (CDC) revealed their newest research which suggests the autism prevalence rate in the U.S. is currently 1 in 88 children. This is a huge increase from their last report of 1 in 110 children. Why do the numbers keep rising you ask? Researchers believe that the increased prevalence is related to better identification and reporting of concerns; however, the possibility of an environmental link has not been ruled out.
Although the CDC has estimated a 1 in 88 prevalence rate in the U.S., international studies have identified prevalence rates between 0.6% to above 1%. One population-based sample study conducted in South Korea estimated a prevalence rate among school age children of 2.6%. This suggests that while general diagnosis and prevalence rates are increasing in the U.S., a portion of children are still going unidentified, as compared to a total population sample prevalence rate.
Despite autism symptoms being identifiable in the first 3 years of life, children are more often diagnosed between the ages of 7 to 9 years. This suggests that young children with autism are delayed in receiving crucial early intervention services. The median age of diagnosis for children is still between 4 and 5 years of age. This lags significantly behind the latest research that has demonstrated that early signs of autism spectrum disorders can be identified in children as young as 12 months of age. Experienced clinicians have also been accurately diagnosing children between 18 months and 2 years of age for some time with diagnoses that tend to be fairly stable.
Children who are diagnosed later also seem to fall in the “higher functioning” range of the broader autism spectrum. The same South Korean study found that two-thirds of positive ASD screens in a general school-age (6 and older) population sample were children who had never been diagnosed or received treatment. 12% of the same population sample was found to have superior (gifted) intelligence quotients (IQ’s). This lends support to the possibility that higher functioning children are identified in later years or not at all. It is likely that under diagnosis is related to these children’s high intelligence and good verbal skills. This is unfortunate, as research indicates that this “high functioning” group of children on the autism spectrum may show the most improvement following early intervention.
There is no doubt that we have made improvements in recognizing autism and connecting diagnosed children with services, as indicated by the higher CDC reported prevalence rate. In spite of this improvement, though, it is likely that many children are still going unrecognized or identified late. What can we do as parents, professionals, and educators to recognize the suffering of these children and get them the help they so need?
As parents, have you educated yourself on the red flags of autism in young children? Educators, have you sought training on autism symptoms and do you consistently refer children who present with concerning behaviors? Pediatricians, are you consistently following the American Academy of Pediatrics guidelines for routine screening? On today, World Autism Awareness Day, I challenge us all to learn more and do more to support early identification in our communities.