U.S. autism rates reached a record high, with about one in 31 children identified with autism spectrum disorder (ASD) in 2022, new CDC data suggested.
The prevalence of ASD among children 8 years old was higher in 2022 than previous years, reported Kelly Shaw, PhD, of the CDC's National Center on Birth Defects and Developmental Disabilities, in Morbidity and Mortality Weekly Report.
In 2020, an estimated 2.8% of 8-year-old children were identified with ASD (27.6 per 1,000). Prevalence increased from one in 150 in 2000 to one in 36 in 2020, and demographic patterns in identifying ASD changed.
"Differences in prevalence over time and across sites can reflect differing practices in ASD evaluation and identification and availability and requirements that affect accessibility of services (e.g., meeting financial or diagnostic eligibility requirements)," Shaw and co-authors stated.
"As evidence grows of increased access to identification among previously underserved groups, attention might shift to what factors, such as social determinants of health, could lead to higher rates of disability among certain populations," they added.
The findings come from the CDC's Autism and Developmental Disabilities Monitoring (ADDM) network, which tracked autism prevalence in 16 communities nationwide. The ADDM network, which reports biennial ASD estimates in children, expanded from 11 to 16 communities when five additional sites joined in April 2023.
In 2022 -- the most recent information to date -- ASD prevalence was 32.2 per 1,000 8-year-old children across all 16 ADDM sites, ranging from 9.7 in Texas (Laredo) to 53.1 in California. ASD was 3.4 times as prevalent in boys (49.2 per 1,000) than in girls (14.3 per 1,000), the CDC said.
Prevalence was lower among white children (27.7 per 1,000) than among children who were Asian or Pacific Islander (38.2 per 1,000), American Indian or Alaska Native (37.5 per 1,000), non-Hispanic Black or African American (36.6 per 1,000), Hispanic or Latino (33.0 per 1,000), or multiracial (31.9 per 1,000).
The study also looked at ASD rates among 4-year-old children and found a higher rate by 48 months among children born in 2018 compared with children born in 2014.
The cohort of 4-year-olds born in 2018 received more evaluations and ASD identifications than the cohort born in 2014 did during the same age window, Shaw and colleagues pointed out. Disruption was visible in early 2020 at the onset of the COVID-19 pandemic, but a pattern of higher identification re-emerged by the end of 2020.
"Increased identification of autism, particularly among very young children and previously under-identified groups, underscores the increased demand and ongoing need for enhanced planning to provide equitable diagnostic, treatment, and support services for all children with ASD," the CDC researchers wrote.
While there's no single cause of autism, several factors may have fueled rising prevalence numbers over the years, Alison Singer, president of the Autism Science Foundation, told MedPage Today earlier this year.
A redefinition of autism played a role, Singer said at the time. "The five subtypes of autism in DSM-IV, which included classic autism and Asperger's syndrome, collapsed into one overly broad category of autism spectrum disorder," she observed. Societal changes, including advanced maternal and paternal age, may have contributed in part.
Screening, surveillance, and awareness also have changed, said Susan Hyman, MD, of the University of Rochester Medical Center in New York, who co-authored the most recent American Academy of Pediatrics (AAP) report on identifying and managing ASD.
The imperative to screen for ASD was recognized by parents and groups like the AAP when research showed that early intervention could improve functional skills in several developmental domains. "If improved functional outcomes were possible, identifying children who might benefit from them became an important movement," Hyman told MedPage Today in an interview earlier this year.
There's been "a catch-up in diagnoses" among medically underserved populations, Hyman pointed out. "While there continues to be inequity in services provided, gains have been made in recognizing the diagnosis," she said.
Last week, HHS Secretary Robert F. Kennedy Jr. said his agency will undertake a "massive testing and research effort" to determine the cause of autism by September. Both Kennedy and President Donald Trump have suggested that vaccines could be to blame.
HHS also named David Geier -- a man without a medical degree who once was disciplined by the Maryland State Board of Physicians for practicing medicine without a license -- to lead a new study to identify whether a relationship between vaccines and autism exists.
Disclosures
Shaw reported no conflicts of interest.
Primary Source
Morbidity and Mortality Weekly Report
Source Reference: Shaw KA, et al "Prevalence and early identification of autism spectrum disorder among children aged 4 and 8 years -- Autism and Developmental Disabilities Monitoring Network, 16 sites, United States, 2022" MMWR Surveill Summ 2025; DOI: 10.15585/mmwr.ss7402a1.
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