By Casey-Lee Flood, RN, HWNC-BC, NC-BC
Autism diagnosis rates are increasing across all age groups, but it isn't an epidemic — it's a sign of progress. There have been so many positive changes over the last 2 decades regarding awareness, access, and how society is finally recognizing the full autism spectrum.
Autism has become a frequent topic of discussion across social media, in healthcare conversations, and even in mainstream news. The increase in visibility can make it seem like autism spectrum disorder (ASD) has suddenly become more common or even trendy.
While prevalence numbers have increased in recent decades, research shows that this trend reflects how autism diagnosis has become more inclusive, accessible, and better understood—not that there's a sudden surge in autism itself. Medical professionals are “seeing” more Autistic people now than ever before. Better tools and fewer poor assumptions are making it possible for more people to get the support they need.
Bias has historically prevented diagnosis of non-white non-males
Some feel that autism has always existed within human populations, long before there was a name to describe them. Some even speculate that great minds like Albert Einstein could have been, in fact, Autistic. We will never know, of course, but it is fun to look for other Autistics in history.
While people of all kinds are Autistic, for many years, autism was socially seen through a narrow lens that centered on young, white boys, leaving adults, women, and non-white individuals largely undiagnosed and therefore not reported in the diagnosis rates.
Gender bias plays a significant role in underdiagnosis. Historically, most autism research studies focused on male subjects, leading clinicians to overlook how autism can appear differently in women and AFAB (assigned female at birth) individuals. Many AFAB individuals learned to "mask" or camouflage social differences at very young ages, delaying or preventing accurate identification until adulthood.
There is a racial bias within medicine regarding ASD diagnosis as well. In a study in which researchers reviewed the charts of 406 children on Medicaid, they found that a diagnosis of ASD for black children on average was delayed 1.4 years compared to white children. Also, black children spent on average 8 more months under mental health care before getting diagnosed than white children. The same study also showed that black children were 5.1 times more likely to receive a diagnosis of adjustment disorder than ADHD when compared to white children.
Better tools, broader awareness lead to more diagnoses
Changes to the diagnostic process are being made to help improve accurate diagnosis of black and Latino people in the U.S. Some providers have begun using the Criteria Diagnostic Interview (CRIDI-ASD/DSM-5), which was specifically created by researchers in Mexico (led by Lilia Albores-Gallo, PhD) to interview Latino families seeking an ASD diagnosis. This diagnostic tool utilizes Spanish language and incorporates cultural differences from US Anglo culture.
In the past decade, especially, there have been public campaigns and news programs further highlighting the barriers black and brown children face and increasing knowledge about ASD amongst the general population. Armed with culturally relevant information about autism, parents may find it easier to recognize Autistic traits in their children, and ask for testing and ongoing support.
Medical care providers are still in the early days of truly identifying and removing all the cultural barriers preventing proper autism diagnosis and care, but even in these humble beginnings, improvements are being made.
At a grassroots level, a recent decrease in the stigma around an autism diagnosis may have also played a role in increasing diagnoses for lower support needs individuals. The neurodiversity movement, guided by the principle "Nothing about us without us," has amplified Autistic self-advocacy. This movement challenges outdated stereotypes and emphasizes that autism is not a deficit but a difference in human cognition. This change may be increasing the demand for an official autism diagnosis for both children and adults with lower support needs.
Improved awareness amongst practitioners and the public isn't the only reason for seemingly increasing amounts of autism. Access to diagnosis has also expanded in general. The rise of telehealth autism assessments has made it easier for people in rural areas, disabled adults, and those seeking late-life evaluations to connect with qualified clinicians (click here for an example).
Changes to the DSM-5
When the DSM-5 redefined autism spectrum disorder in 2013, it unified several older terms—like Asperger's syndrome and Pervasive Developmental Disorder-Not Otherwise Specified—under one broader “autism spectrum” diagnosis.
This shift acknowledged the overlap of many symptoms within the multiple conditions. These had caused confusion and possibly a barrier to proper diagnosis in the past
Another development that increased the availability of diagnosis with the DSM changes was allowing the dual diagnosis of ASD and ADHD. Prior to this change, many who were actually neurodivergent in multiple ways may not have been diagnosed with ASD.
A meta analysis of various studies has shown that about 40% of Autistic individuals also have ADHD, confirming a strong overlap between the two conditions. If these individuals were diagnosed with ADHD prior to 2013, even if they were Autistic, they would not have been assessed or diagnosed.
There are multiple and complex reasons that there are more people being diagnosed as Autistic. None of which are toxins or certain over the counter pain medications.
What the data really show about the “epidemic of autism”
A 2024 study published in JAMA Network’s OPEN journal found that autism diagnosis among U.S. children and adults increased steadily from 2011 to 2022. The results included notable rises in adult evaluations as more clinicians learned to recognize late-identified autism in recent years.
Findings from the CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network echo these results: that though imperfect, progress has been made in identifying autism in a variety of people. They documented that children with ASD born in 2018 had more assessments and identification between ages 0-4 than children born in 2014. The trend of increased early diagnosis was documented consistently except in 2020 during the pandemic.
In 2022, an average 1 in 31 children aged 8 years (32.2 per 1,000) were identified as Autistic across 16 U.S. sites. California had the highest average at 53.1 and a site in Texas had the lowest at 9.7 eight-year-old kids diagnosed per 1,000, showing how early identification can vary widely based upon the availability of diagnostic and other support services. The CDC authors of this study say it best really: “The substantial variability in ASD identification across sites suggests opportunities to identify and implement successful strategies and practices in communities to ensure all children with ASD reach their potential.”
These findings make one thing clear: autism isn't spreading. Our understanding and recognition are expanding.
Persistent barriers to diagnosis still remain
There have been many positive changes in how professionals and society view autism in recent decades that have led to more diagnoses, more support for those who need it, and less stigma. Yet it would be negligent of me to not specifically point out a few of the many remaining barriers to diagnosis, care, and resources.
- Economic inequality: high evaluation costs limit access for many families.
- Racial disparities: BIPOC individuals are still diagnosed later or misdiagnosed.
- Gender and cultural bias: Stereotypes about how autism "looks" persist, particularly for women and LGBTQ+ people.
- Stigma: The diagnosis still carries a stigma, and parents still might not want to label their child as Autistic.
- Lack of access to healthcare: Not everyone lives near and/or can get to a facility for a diagnosis.
Some Autistic individuals are leaning into “self-diagnosis”/ “self-identification” because they lack equitable access to diagnosis. Self-identification allows individuals to honor their lived experience, engage with autism support groups, and build community without waiting for professional validation. The autism acceptance movement affirms that you don't need paperwork to belong—your experience is what matters.
However, growing access to inclusive, neurodiversity-affirming healthcare, as well as growing a neurodiversity-affirming culture is important for all Autistic people to thrive.
Are you considering a formal autism assessment?
If you are here because you wonder if someone you care about or you yourself may be Autistic, here are a few tips that can make getting assessed a little more accessible for both adults and children.
- Document day to day experiences. Track sensory sensitivities, social patterns, and daily challenges over time.
- Gather collateral insights. Feedback from family, friends, or caregivers can help providers see lifelong traits.
- Seek affirming professionals. Look for providers trained in adult autism diagnosis (as applicable), neurodivergent-affirming care, and/or intersectional populations (women, nonbinary, and BIPOC clients etc.).
- Avoid free autism quizzes. Instead, use well-documented tools. Something an adult can fill out is the Autism Spectrum Quotient. This is an official self-screening assessment. It can provide valuable information to bring to an assessment.
- Find support. Support and advocacy groups both locally and nationally can also be sources of information regarding getting diagnosed. If you feel stuck, I suggest looking into these groups.
For more details regarding assessment, diagnosis, and the benefits of receiving a formal diagnosis, you can read my blog about late diagnosis and if it is worth it.
Rising autism diagnosis rates suggest progress, not a crisis
You may have read that the steady rise in autism diagnosis rates reflects more people being Autistic than in the past and a growing public health concern.
What is clearly rising is visibility. With better awareness, inclusive screening practices, and telehealth accessibility, more people across all backgrounds are finally being recognized for who they are.
The increase reflects progress in public health and inclusion. Autism has always been part of the human experience. What's changing is our ability to recognize neurodiversity and create systems that honor and support it regardless of gender, race, or age.
The growing number of autism diagnoses should be viewed as a sign of understanding, not alarm. Each diagnosis—or self-identification—represents someone gaining the language and support they need to live authentically.
So whether you're a caregiver of an Autistic person, or an Autistic who is formally diagnosed, self-identified, or still exploring where you fit, know this: You are valid. You belong here. And the world is better when all kinds of minds are supported.
About the author
Casey-Lee Flood, The Radical RN Advocate, AuDHDer, and disabled writer is passionate about making healthcare and autism education more inclusive. Drawing on 14 years of nursing experience and her own lived experience with multiple invisible disabilities, Casey-Lee’s mission is to empower others through knowledge and practical resources.
Recommended reading:
Why Is Autism a “Spectrum?” - The Autism Color Wheel
What Happened to Asperger’s Syndrome?
Autism Comorbidities: What You Need to Know
