As a spectrum disorder, autism affects everyone differently. With increasing awareness and improved diagnostic criteria, it’s crucial to explore the various facets of autism, including its prevalence, impact on individuals, co-occurring conditions, and available care options.
In this article, we will delve into the statistics, challenges, and support mechanisms surrounding autism, and uncover valuable insights for parents, educators, healthcare professionals, and the general public.
Before we start, here are a few key findings:
- Rise in autism prevalence: The rate of autism continues to surge from 0.65% in 2000 to 2.8% in 2020, stressing the need for increased awareness and support (as reported by the CDC in March 2023*).
- The gender gap continues: Boys are 3.8 times more likely to be diagnosed with autism than girls.
- Shift in demographics: For the first time, reported rates of autism are now lower among white children compared to other racial groups, such as blacks and Hispanics.
- Stark regional differences: Florida leads with the highest autism prevalence at 4.8%, while Texas reports the lowest at just 1.4%
- Communication barriers: About 25-30% of autistic children are non-speaking or minimally verbal, spotlighting the importance of innovative therapies and strategies.
- Disturbing safety concerns: Autistic individuals face a 28% risk of death from accidental injury, compared to just 6.5% in the general population.
- Complex health challenges: An overwhelming 95% prevalence of co-occurring conditions in autism, including intellectual disabilities, epilepsy, sleep disorders, gastrointestinal disorders, anxiety, depression, and ADHD, complicates care and treatment.
- Economic burden on families: 57% of parents with autistic children have had to reduce or cease employment to meet caregiving demands, incurring additional healthcare costs and productivity losses.
* Note the considerable lapse in time between autism prevalence being surveyed and reported.
Join us on this journey through the multifaceted world of autism, as we strive to create a more inclusive and compassionate society for everyone touched by this condition.
Table of Contents
How Many People Have Autism in the US?
The CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network collects and publishes data related to autism spectrum disorder and other developmental disabilities.
The ADDM started collecting data in the year 2000. In 2000, 1 in 150 kids were identified as having autism (0.67% of the population).
The most recently published update from the CDC was 2020 data, listing the current prevalence as 1 in 36 kids (2.8% of the population).2
Is Autism Prevalence Increasing? Rates by Year
The CDC updates prevalence data every two years. In every update since 2012, the prevalence has increased.
| Year | Prevalence of Autism in the US |
|---|---|
| 2000 | 0.67% |
| 2002 | 0.66% |
| 2004 | 0.8% |
| 2006 | 0.9% |
| 2008 | 1.13% |
| 2010 | 1.47% |
| 2012 | 1.45% |
| 2014 | 1.68% |
| 2016 | 1.85% |
| 2018 | 2.30% |
| 2020 | 2.76% |
There has been much debate regarding the increase in autism diagnoses over the last 20 years. Many have questioned whether environmental factors may be contributing to increased prevalence.
However, the general consensus among medical professionals and researchers is that the prevalence is not actually increasing. Rather, we are becoming better equipped to identify and diagnose autism.
Over the last several years, we have increased routine autism screenings to catch developmental concerns early on. Additionally, improved diagnostic criteria and general autism awareness have contributed to more individuals being diagnosed with autism who may have otherwise been missed.
From 2010-2016, the prevalence of autism appeared to be stabilizing. The rates of autism increased only slightly, from 1 in 68 in 2010 (1.5% of the population) to 1 in 54 (1.9% of the population) in 2016. Many researchers and professionals believed that rates were stabilizing.
However, 2020’s prevalence has shown us that may not be the case, having increased from 2.3% of the population to 2.8% of the population in just two years.
The American Academy of Pediatrics (AAP) recommends all children be screened for developmental delays during regular checkups with their pediatrician. These are strongly recommended at ages 9 months, 18 months, and 30 months. Additionally, children should receive ASD-specific screenings at both their 18 and 24-month checkups.
| Age | Recommended Screening |
|---|---|
| 9 months | Developmental delays |
| 18 months | Developmental delays and ASD-specific |
| 24 months | ASD-specific |
| 30 months | Developmental delays |
When a child is at an increased risk for autism, additional screenings may be recommended.28
Note: The prevalence rates consider children at the age of 8, as the majority of those with autism are diagnosed by this age.
Sources:
https://www.cdc.gov/ncbddd/autism/data.html
https://www.cdc.gov/ncbddd/autism/hcp-screening.html
How Many People Have Autism in the World?
As of March 2022, the global prevalence of autism spectrum disorder was estimated at 1 in 100 children.
Worldwide, males are 4.2 as likely as females to be diagnosed with autism.
As with the prevalence of autism in the United States, the global autism rate has increased. In the 2012 global prevalence report, researchers found a global rate of 1 in 161 children.29
Autism Demographics
An examination of autism demographics reveals critical insights, such as the significant differences in autism prevalence between boys and girls, and the intriguing variations in diagnosis rates among racial groups.
Is Autism More Common in Males or Females?
According to the CDC’s 2020 data, autism is about 3.8 times as prevalent in boys as it is in girls. 1 in 87 girls is diagnosed with an autism spectrum disorder (1.1% of the population), compared to 1 in 23 boys (4.3% of the population).27
Some believe that these statistics may be skewed due to females being more challenging to diagnose. Studies have suggested that there are often fewer repetitive and restrictive behaviors observed in autistic girls.
With a more subtle presentation of signs of autism, it may be less obvious to teachers, caregivers, and medical professionals, thus missing the diagnosis.
One 2021 meta-analysis found that females, on average, are evaluated for ASD two years later than males.3
Sources:
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.539835/full
https://www.cdc.gov/mmwr/volumes/72/ss/ss7202a1.htm?s_cid=ss7202a1_w
Autism Demographics by Race
Historically, the rates of autism were higher among white children compared to other racial groups. However, researchers have found significant disparities in diagnosing autism in black and Hispanic children, which were believed to be a contributing factor to lower reported rates of autism in these groups.
Disparities in diagnosing black and Hispanic children were due to a combination of stigma, lack of access to quality healthcare services, and language barriers.8
Based on the CDC’s 2020 data, for the first time, reported rates of autism in white children have been lower than in other racial groups.
Children of 2 or more races had the lowest prevalence of autism with a rate of 1 in 44. White children were diagnosed with autism at a rate of 1 in 41. American Indian and Alaska Native children were diagnosed at a rate of 1 in 38. Black children were diagnosed at a rate of 1 in 34. Hispanic children were diagnosed at a rate of 1 in 32. And lastly, Asian or Pacific Islander children were diagnosed at a rate of 1 in 30.27
Below are the numbers translated into percentages
| Race | Prevalence |
|---|---|
| Children of multiple races | 2.27% |
| White | 2.44% |
| American Indian and Alaska Native | 2.63% |
| Black | 2.94% |
| Hispanic | 3.12% |
| Asian | 3.33% |
| Pacific Islander | 3.33% |
Sources:
https://www.cdc.gov/ncbddd/autism/addm-community-report/differences-in-children.html
https://www.cdc.gov/mmwr/volumes/72/ss/ss7202a1.htm?s_cid=ss7202a1_w
Which State Has the Highest Prevalence of Autism? Which Has the Lowest?
Research on the prevalence of autism within each state shows us a great deal of variation.
The CDC’s 2018 report found that Florida has the highest prevalence of autism, with 4.88% of children diagnosed with autism.
Texas has the lowest prevalence of autism with 1.54% of the population diagnosed.7 Additional research is needed to further explore the reasons for this disparity. However, awareness of autism and access to healthcare providers may play a part.
In addition to Texas, 9 other states including Alaska, Georgia, and North Dakota all have prevalence rates below 2%.
On the opposite end, 3 states in addition to Florida have prevalence rates above 4%. These include Rhode Island, Maryland, and DC.
17 states have a prevalence between 3.0-3.9%. 20 states have a prevalence rate between 2.0-2.9, which is within the average range.7
| State | Prevalence of Autism |
|---|---|
| Florida | 4.88% |
| National Average | 2.7% |
| Texas | 1.54% |
Sources:
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2716402
What is the Average Age at First Evaluation and Diagnosis?
According to the CDC, 49% of children with an ASD diagnosis were first evaluated by the age of 36 months.
Children with a co-occurring intellectual disability were more likely to be evaluated at a younger age. 61.8% of children who would be diagnosed with autism and a co-occurring intellectual disability were diagnosed by 36 months.
Children who would be diagnosed with autism, but did not have an intellectual disability were evaluated by 36 months in 46% of cases.27
| With intellectual disability | 61.8% |
| Without intellectual disability | 46% |
Sources:
https://www.cdc.gov/mmwr/volumes/72/ss/ss7202a1.htm?s_cid=ss7202a1_w
What is the Potential Effect of Autism on Day-to-Day Life?
As a spectrum disorder, autism impacts each individual differently. Some children are more severely impacted and require more substantial support. Others are able to communicate and complete daily tasks with minimal support.
Percentage of Non-Speaking and Minimally Verbal Autism
An estimated 25-30% of children with autism are non-speaking or minimally verbal. However, many children who are considered non-speaking as toddlers or young children do develop functional speech. For those who do not develop the ability to speak, there are a number of augmentative and alternative communication (AAC) options that allow non-speaking children to have a voice.12
An ability to effectively communicate is vital for all aspects of an individual’s life. While vocal speech is not the only way to communicate, non-speaking children can face increased challenges, as vocal speech is the primary means of communication for the majority of the population.
Source: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012324.pub2/full
Tendency to Wander or Elope
Roughly 60% of children with autism are reported to wander or elope.13 Wandering can be incredibly dangerous for any child, but even more so for children with autism, who may not be able to communicate important information like their name or other identifying information.
Source:
https://pubmed.ncbi.nlm.nih.gov/31977588/
Risk of Accidental Injuries and Drowning
Accidental injuries such as suffocation, asphyxiation, and drowning are the leading causes of death in people with autism. 28% of deaths in people with autism are caused by accidental injury.14
This is significantly higher than the general population. 6.5% of deaths in the general population are caused by accidental injury.15 With such higher rates of accidental deaths, people with autism have a notably lower life expectancy.
The mean age at death for individuals with autism is about half that of the general population, 36.2 years of age.14
With such a high risk of drowning, experts strongly urge families of children with autism to register their children for swimming lessons to teach safety near water. Additionally, take extra precautions to evaluate home conditions to eliminate potential household dangers.
Source:
https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2017.303696
Self-Injurious Behaviors
Around 28% of children with autism exhibit self-injurious behaviors. These can include behaviors like head banging, hair pulling, arm biting, eye poking, and skin scratching. Self-injurious behaviors increase the risk of serious health consequences and injury.16
Source:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392775/
What is the Prevalence of Co-occurring Conditions With Autism?
Comorbidities or co-occurring conditions are highly prevalent in those with autism. 95% of autistic children experience one or more comorbid challenges.5 Comorbidities may include medical and/or mental health conditions.
Autism and Intellectual Disability
31% of people with autism also have an intellectual disability, with an IQ of 70 or less. 24% of people with autism score within the borderline range in intellectual abilities, with an IQ between 71 and 85. Furthermore, 44% of people with autism have an average or above average IQ.17
Roughly 1% of the general population has an IQ of 70 or less.99
Autism and Epilepsy
Research varies on the rate of epilepsy in children with autism. Reports range from 5% to 38%. Only about 1% of the general population has epilepsy, so even on the lower end of the estimated range, epilepsy is much more common in those with autism.6
Autism and Sleep Disorders
Sleep challenges affect up to 80% of people with autism, compared to 30-40% of the general population.
Sleep disruptions can have a significant impact on individuals and their families.
50-80% of children with autism experience insomnia, compared to 19.3% of the general population.
Other sleep challenges may include sleep apnea, nighttime wakefulness, bedtime resistance, sleep onset delay, and reduced REM sleep.18
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5919599/
https://www.psychiatry.org/patients-families/intellectual-disability/what-is-intellectual-disability
Autism and Gastrointestinal Disorders
46-84% of children with autism experience gastrointestinal challenges, compared to 21.8% in the general population.
The common GI disorders most reported include chronic diarrhea, chronic constipation, reflux, nausea and/or vomiting, food intolerance, ulcers, and inflammatory bowel disorder.
Compared to 5-8% of the general population, 20-25% of children with autism experience food allergies.19
Autism, Anxiety and Depression
Approximately 40% of people with autism experience one or more anxiety disorders, compared to 28.4% in the general population. Anxiety can heighten the challenges people with autism experience including social communication difficulties, resistance to change, and repetitive behaviors.
Specific phobias, social phobia, generalized anxiety disorder, separation anxiety disorder, and obsessive-compulsive disorder are common comorbid anxiety disorders.20
People with autism are also 4x more likely to experience a depressive disorder, compared to the general population.21
Autism and ADHD
Attention deficit hyperactivity disorder (ADHD) has a high degree of comorbidity with autism. An estimated 60% of children with autism also qualify for an ADHD diagnosis.
This overlap may result in challenges with differentiating between diagnoses and therefore accurately diagnosing a child with autism, ADHD, or both.22
In comparison, 10% of children in the general population are diagnosed with ADHD.
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5919599/
https://www.psychiatry.org/patients-families/intellectual-disability/what-is-intellectual-disability
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085719/
https://www.ajmc.com/view/insomnia-overview-epidemiology-pathophysiology-diagnosis-and-monitoring-and-nonpharmacologic-therapy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912735/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085719/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8585107/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772195/
https://pubmed.ncbi.nlm.nih.gov/29497980/
https://www.sciencedirect.com/science/article/abs/pii/S1750946719301564
https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm
https://www.cdc.gov/ncbddd/adhd/data.html
How Many Children With Autism Receive Behavior Treatment Vs. Medication Treatment?
Autism does not inherently require treatment. Many people with autism are able to live a fulfilled life with only minimal support.
However, 70.5% of children with autism receive one or more types of treatment to care for and support their unique needs.7
According to a 2016 study, 43.3% of children with autism received behavioral treatment only such as applied behavior analysis (ABA) therapy. 6.9% received medication treatment only, while 20.3% received a combination of behavioral and medication treatment.
29.5% of children with autism were not receiving any treatment.7
Younger children are significantly more likely to receive behavioral treatment only, while older children are more likely to receive medication treatment only.
In children aged 3-5, 74.1% received behavioral treatment, compared to 54.4% of children aged 12-17. 8.4% of children aged 3-5 received medication treatment only, compared with 32.8% of children in the 12-17 age group.7
Source:
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2716402
What Are the Economic Impacts of Autism?
A 2015 study reported that the cost to care for people with autism in the United States had risen to $268 billion. It was estimated at that time that the costs would rise to $461 billion by 2025.24
| Cost to care for people with autism in the US | |
|---|---|
| 2015 | $268 billion |
| 2025 forecast | $461 billion |
The cost of caring for adults with autism is significantly higher than the cost of caring for children with autism, highlighting a need for more research and better methods of early identification and intervention.
Source:
https://pubmed.ncbi.nlm.nih.gov/26183723/
Healthcare Costs
The average annual medical expenditures for children with autism exceed the costs of neurotypical children by $4,110-$6,200/year.26
One of the most significant costs associated with autism is behavioral therapies. Intensive behavioral therapies cost roughly $40,000-$60,000 annually. Education costs for children with autism are estimated to be 70-175% more expensive than for the general education population. The wide range is due to the variation in severity levels and unique needs.25
https://link.springer.com/article/10.1007/s10803-019-04014-z
https://www.ncsl.org/health/autism-and-insurance-coverage-state-laws
Parental Loss of Employment & Productivity
Autism can have a significant financial impact on families beyond healthcare costs. One study found that 57% of families caring for a child with autism had a parent who had to reduce or stop employment to care for their child’s needs.25
How Much Federal Funding Does Autism Research Receive?
Federal funding for autism research was $288 million in 2021. For comparison, funding for breast cancer research was $731 million, Alzheimer’s research received $3.1 billion, $373 million for hepatitis, $3.1 billion for HIV/AIDS, $1.1 billion for obesity research, and $936 million for research on opioids.23
References
- https://www.nimh.nih.gov/health/statistics/autism-spectrum-disorder-asd
- https://www.cdc.gov/ncbddd/autism/data.html
- https://www.frontiersin.org/articles/10.3389/fpsyt.2021.539835/full
- https://www.verywellhealth.com/is-there-a-real-increase-in-the-incidence-of-autism-260133
- https://www.researchgate.net/publication/323665731_Prevalence_of_Co-occurring_Medical_and_Behavioral_ConditionsSymptoms_Among_4-_and_8-Year-Old_Children_with_Autism_Spectrum_Disorder_in_Selected_Areas_of_the_United_States_in_2010
- https://www.epilepsybehavior.com/article/S1525-5050(14)00412-0/fulltext
- https://jamanetwork.com/journals/jamapediatrics/fullarticle/2716402
- https://www.cdc.gov/ncbddd/autism/addm-community-report/differences-in-children.html
- https://www.autismspeaks.org/sites/default/files/2018-09/autism-and-health-report.pdf
- https://www.cdc.gov/ncbddd/autism/facts.html
- https://www.cdc.gov/mmwr/volumes/69/ss/ss6904a1.htm?s_cid=ss6904a1_w
- https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012324.pub2/full
- https://pubmed.ncbi.nlm.nih.gov/31977588/
- https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2017.303696
- https://www.statista.com/statistics/248619/leading-causes-of-death-in-the-us/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392775/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5919599/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085719/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085719/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772195/
- https://pubmed.ncbi.nlm.nih.gov/29497980/
- https://www.sciencedirect.com/science/article/abs/pii/S1750946719301564
- https://report.nih.gov/funding/categorical-spending#/
- https://pubmed.ncbi.nlm.nih.gov/26183723/
- https://link.springer.com/article/10.1007/s10803-019-04014-z
- https://www.ncsl.org/health/autism-and-insurance-coverage-state-laws
- https://www.cdc.gov/mmwr/volumes/72/ss/ss7202a1.htm?s_cid=ss7202a1_w
- https://www.cdc.gov/ncbddd/autism/hcp-screening.html
- https://onlinelibrary.wiley.com/doi/full/10.1002/aur.2696
