The prevalence of autism has increased significantly over the past few years. According to the Centers for Disease Control (CDC), autism was observed in approximately 1 in every 150 children in the United States in the year 2000. By 2023, that number had grown to 1 in every 36 children.
Does this mean that autism is becoming more common? The answer is more complicated than that. As technology has advanced and autism has become less stigmatized, having a child tested for autism has become a more common practice.
We spoke with Dr. Michael Murray, medical director of Autism and Developmental Disabilities at Sheppard Pratt, to discuss what parents should look out for when considering an autism diagnosis, the benefits of being diagnosed and why diagnosis is becoming more common.
Responses have been edited for length and clarity.
Why do you think we’re seeing a rise in autism [diagnoses]?
Over the course of my career, the definition of the autism spectrum has changed. It has grown to be more inclusive and more expansive, because we’ve evolved our understanding of neurodivergence and the strengths and vulnerabilities of autistic individuals. Right now, about 70% of individuals who are diagnosed with autism are considered as having low-support needs.
When I started my career, that 70% wasn’t considered autistic. Part of this growing number is reflecting that our definition of the spectrum has widened considerably, which is leading to a lot of increases in those numbers.
Secondly, we as clinicians are getting better at detecting autism and identifying it in younger kids. Kids are getting diagnosed younger, and the spectrum has widened, which is leading to higher prevalence rates.
What signs should parents look for when determining if their child should be tested for autism?
In toddlers, you see a progression of skills that are kind of occurring in tandem. Speech is coming along with motor skills, which is coming along with social abilities. They should all be increasing and developing at similar rates.
What you might see is a significant delay in one of those. People are fine-tuned to realize if something is off with speech, but there can also be concerns about motor and social skills.
Part of what we focus on is called joint attention. It’s the ability to regulate your attention in concert with somebody else’s for a shared social purpose. It’s like if I am trying to direct your attention to something I need. I’m trying to direct your attention to something I’m enjoying.
So, kids who are on the autism spectrum frequently have difficulty with that. We look at how kids engage with and express their needs to caregivers, and later to their peers.
When kids with autism enter school, the change in environment can also be a stressor.
Parents may have missed signs of autism while their child was a toddler because being at home is a safe environment, but things like sensory issues and emotional dysregulation can become more apparent at school.
Is there any difference in quality of life for people who are diagnosed with autism early vs. people who are diagnosed with it later?
Early intervention is key. We know that kids who receive quality early intervention at an early age have a different developmental trajectory than kids who don’t. It doesn’t mean that people who are diagnosed later, and [who] start receiving services later, don’t have great outcomes and they can’t have good quality of life.
But if you are trying to improve the chances of an autistic individual having the quality of life that they would like for themselves, the earlier you start services and it’s recognized that these are potential needs, the better.
What resources are available for parents whose child may have been recently diagnosed?
I think it’s important for parents to get as much education as they can about autism and what it means, and what it doesn’t mean. At Sheppard Pratt, we feel that our involvement with the family doesn’t end at the time that we give the diagnosis.
We really do want to talk about strengths. And people who are autistic have a lot of strengths, and it’s important to build services and supports around those strengths. That allows [kids] to make the most of them and to utilize them in ways that will be more integrative in how they feel about themselves.
One of the things I always recommend to parents of newly diagnosed kids is to talk to other parents. That parent-to-parent connection is super valuable. People who have lived experience, who have kind of gone through what they are going through now can be an amazing resource in a way that maybe I will never be able to be for them.
So, I always try to get them connected to parent advocacy organizations. I often recommend The Autism Society of Baltimore-Chesapeake (serving Baltimore) and Pathfinders for Autism (serving Maryland).
Sheppard Pratt has schools serving children with developmental disabilities including autism in Frederick, Montgomery, Baltimore and Anne Arundel counties. The Center for Autism is located in Towson, Maryland.
