Autism Spectrum Disorder Prevalence and Trends

Introduction to Prevalence

The prevalence of autism spectrum disorder in the United States has increased dramatically over the past three decades, rising from approximately 2-4 per 10,000 children to the current estimate of 1 in 59 children, primarily driven by improved awareness, expanded diagnostic criteria, and better screening practices 1, 2, 3

The 2018 CDC estimates indicate that 2.3% of 8-year-old children (1 in 59 overall; 1 in 36 boys) have autism spectrum disorder, representing more than a 10-fold increase in identified prevalence over the 30-year period 1, 2, 3

The evidence strongly indicates that the increase is not primarily a true epidemic but rather reflects multiple methodological and societal changes, including broader diagnostic criteria, diagnostic substitution, and recognition of milder presentations 3, 4
Universal screening recommendations, earlier detection, and public awareness have also contributed to the increase in identified prevalence 1, 2, 4

Advanced parental age correlates with increased autism spectrum disorder risk 3, 4
Prematurity may contribute to prevalence increases due to higher survival rates of extremely premature infants who have elevated autism spectrum disorder risk 3, 4
Strong genetic heritability, with approximately 90% heritability and 2-10% sibling recurrence risk, is also a contributing factor 4, 5

The individual lifetime costs for autism spectrum disorder are $1.4 million without intellectual disability and $2.4 million with intellectual disability 2, 3, 6
The annual U.S. economic impact of autism spectrum disorder is at least $268 billion 2, 3
More than 50% of young adults with autism spectrum disorder have no participation in postsecondary education or employment 2 years after high school 2, 3
Earlier identification and effective interventions, such as early intensive behavioral interventions, can improve outcomes for individuals with autism spectrum disorder 1, 2, 4
Genetic evaluation can identify specific etiologies in 30-40% of cases, providing families with recurrence risk counseling 4