New CDC Report Uncovers Significant Changes in Autism Diagnosis Patterns Across U.S. Populations
A recent report from the Centers for Disease Control and Prevention (CDC) has uncovered substantial transformations in autism diagnosis patterns throughout the United States, emphasizing a noteworthy increase in prevalence, particularly among Black children, populations that have previously been underdiagnosed, and low-income communities.
Released last week in the CDC’s biennial Autism and Developmental Disabilities Monitoring (ADDM) Network report, the findings reveal that autism spectrum disorder (ASD) now impacts 1 in 31 children aged 8 in the U.S. — an increase from 1 in 36 according to the CDC’s earlier data in 2020. This represents the fastest rise in prevalence observed in recent times, highlighting advancements in detection methods and possibly escalating environmental and social risk factors.
Changing Demographics: Black Children Leading in Local Prevalence Rates
The report identified a remarkable transformation in race-associated diagnosis trends. Historically, autism has predominantly been diagnosed in white male children, largely due to improved healthcare access and awareness within wealthier demographics. However, the latest data disrupts these long-standing trends.
In Maryland, one of the 16 study sites utilized in the ADDM Network, Black children exhibited the highest autism prevalence rate — 1 in 27 — exceeding other racial demographics, including Asian/Pacific Islander (1 in 32), multiracial (1 in 34), Hispanic (1 in 35), and white children (1 in 52).
“This recent ADDM report, along with the one issued in 2023, illustrates that autism affects individuals of all backgrounds—including females and children from various racial and ethnic groups,” stated Elise Pas, research professor at Johns Hopkins Bloomberg School of Public Health’s Department of Mental Health and co-leader of the Maryland ADDM team.
Regional Disparities: Variations in Access and Diagnosis
Aside from racial differences, the report emphasizes stark regional variations in autism prevalence — varying from as low as 0.97% in Laredo, Texas, to a high of 5.3% in California. These variations are likely due to inconsistent access to diagnostic services, differing local provider practices, and varying levels of awareness among parents and educators.
“Access to developmental screening, early intervention programs, and cultural perceptions surrounding behavioral disorders are all factors that influence how and when children receive diagnoses,” pointed out Christine Ladd-Acosta, associate professor of epidemiology at the Bloomberg School and co-principal investigator at Maryland’s ADDM Network site.
Cognitive Assessments Highlight Disparities in Intellectual Disabilities
A significant area of concern is that among children diagnosed with autism and assessed for cognitive abilities, nearly 40% were concurrently identified with intellectual disability (IQ ≤70). Black children showed the highest rates of co-occurring intellectual disability at 52.8%, compared to just 32.7% among white children. These differences may indicate delays in diagnosis, limited access to early intervention, and various social determinants of health, such as poverty, education, and environmental stressors.
Progress in Early Diagnosis Fuels Demand for Services
Not all information is disheartening. The report provides hopeful insights on early detection. Children born in 2018 are 1.7 times more likely to receive an autism diagnosis by their fourth birthday compared to children born in 2014. Early identification is crucial, allowing families to access necessary therapies and support services during critical developmental stages, which can greatly enhance developmental outcomes.
Christine Ladd-Acosta pointed out the broader significance: “We are identifying children earlier, which should lead to essential supports for children and their families sooner, thereby assisting them in reaching their full potential.”
Narrowing Gender Gap in Diagnoses
The gender gap in autism diagnoses is also decreasing. While boys remain more frequently diagnosed, the male-to-female ratio decreased from 4.2 in 2018 to 3.4 in 2022 — a change attributed to improved identification of autism symptoms in girls, whose manifestations may differ from typical male presentations.
Socioeconomic Shift: Autism Now More Common in Low-Income Communities
For many years, autistic children were predominantly identified in wealthier ZIP codes. This trend has now flipped. The 2022 data indicates higher autism prevalence in lower-income neighborhoods or nonexistent associations between prevalence and income across most evaluated sites. This shift suggests advancements in outreach, screening, and education within underprivileged communities — and possibly heightened severity or clustering of social risk factors impacting development.
Effect on Investment and Innovation
From a healthcare and education market viewpoint, the evolving landscape presents new opportunities. Historically marginalized groups — including Black, Hispanic, and lower-income families — are now emerging as rapidly growing populations in need of diagnostic, therapeutic, and educational services. Innovations—including culturally tailored therapies, localized resources, and scalable platforms for early detection—are expected to experience increased demand.
The market for telehealth platforms also appears primed for growth. While the COVID-19 pandemic temporarily interrupted in-person evaluations in