Tag: DSM-5

Why Autism Diagnoses Have Increased

The prevalence of autism spectrum disorders in the U.S. is currently estimated at 1 in 36 children. Factors contributing to this increase include heightened awareness and changes in diagnostic criteria. The article stresses the importance of accurate identification and early screening, which may lead to more effective care and support for individuals with autism.

updated December 22, 2025

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

This information is not intended for diagnosis or treatment. Before making health decisions, discuss with your physician or other qualified healthcare provider to decide what is right for you.

Like other physicians and families of people with autism, I puzzle over the increased number of children and adults diagnosed with autism. And most all of us have theories about why we now believe 1 in 36 children have autism spectrum disorders.

People point out that “when they were children” they never knew of anyone with autism. Some are convinced that the increase of autism followed the introduction of the measles-mumps-rubella vaccine, MMR.

Others implicate genetics, environmental toxins, diet, and intrauterine brain trauma. In 2025, then Secretary of HHS, Robert Kennedy Jr. announced that the “cause” of autism is Tylenol (generic acetaminophen), which President Donald Trump announced in a press conference. No definitive proof was provided and later the claim was softened.

Autism Prevalence in the United States Explained

“The bulk of the increase (in autism rates) stems from a growing awareness of autism and changes to the condition’s diagnostic criteria.”

This article (updated in 2020) was published in Spectrum whose commitment is “to provide accurate and objective coverage of autism research.” Spectrum is funded by the Simons Foundation Autism Research Initiative. Senior News Writer Jessica Wright, Ph.D. in biological sciences from Stanford University, wrote the report. (Scientific American also published the article by permission.)

A diverse group of children smiling as they stand closely together in a circle staring downward. Text overlay reads, “cdc dot gov slash Autism.”
This , @CDC_NCBDDD encourages awareness, inclusion, and connection to support services and one another. Learn more about our work in understanding in children:

Identifying Autism

Let’s consider some terminology. Prevalence is an estimate of how common a disease or condition is in a particular population of people at any given time.

So the prevalence of autism in children would be

the number of children identified as autistic at any given time

divided by the total number of children alive at that time.

The currently accepted rate of autism is 1 in 36 children.

Autism prevalence depends on children being correctly identified as autistic. At any given time, some autistic children may not be identified, and some may be  incorrectly identified.

We do not have any totally objective tests available for autism yet. There is no blood test, scan, culture, imaging study, DNA test, or monitor to definitely conclude that autism is or is not present.

The definition of and criteria for autism have changed substantially since “infantile autism” was first identified by Leo Kanner over 70 years ago. Since 1980, the diagnosis is based on applying the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

In the most recent version, DSM-5, released in 2013, autism, Asperger syndrome, and pervasive developmental disorder, formerly separate, are now a single diagnosis.

Autism Spectrum Disorder is characterized by

  • Persistent deficits in social communication and social interaction across multiple contexts
  • Restricted, repetitive patterns of behavior, interests, or activities
  • Symptoms must be present in the early developmental period (But may not yet be fully expressed or may be modified by learned behavior in later life)
  • Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
  • These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.

Autism spectrum disorder DSM-5 diagnostic criteria: Full text

When the diagnostic criteria for other diseases we diagnose and manage changes, the prevalence also changed. Examples include diabetes, high cholesterol, high blood pressure, migraine, obesity, depression, even some cancers. So autism is not unique in this regard.

The currently accepted rate of autism, 1 in 36, comes from the Autism and Developmental Disabilities Monitoring Network , established by the CDC in 2000. Children are identified by reviewing health and school records of 8-year-olds in selected counties. So possibly some children get missed, and some are assigned incorrectly.

Point of Reference: IDEA

Another major milestone in autism awareness occurred in 1991 when the U.S. Department of Education ruled that autistic children qualify for special education services. This ruling encouraged parents of children with developmental and intellectual disabilities to secure accurate diagnoses, to qualify for services they otherwise might not have access to.

AAP recommends screening

Since 2006, the American Academy of Pediatrics has recommended routine screening of all children for autism at 18 and 24 months old. Many physicians, psychologists, and therapists believe early intervention improves these children’s chances to do well intellectually and socially.

If we could go back and review records of children 10, 20, or 30 years ago, and apply current diagnostic criteria, would we find less autism than we do today? Perhaps. But such records would likely reflect the understanding of autism at the time, so might still fail to recognize autism, even when present by today’s standards.

The apparent increased number of children with autism seems alarming-some call it an epidemic. It may represent our increased awareness, recognition, and knowledge about this disorder. And while this increase should raise concern, it can lead to increased research, treatment options, and more effective care for autistic persons.

Also on this Blog

Aching Joy- a book review

Jason Hague’s memoir “Aching Joy” explores faith, fatherhood, and autism through the lens of his son’s diagnosis. Despite initial denial and shaken faith, Hague finds solace in trusting a higher power. The book is a powerful journey through grief, hope, and ultimately, faith in the face of unexpected challenges.

Keep reading
a book cover- Aching Joy

A Different Way of Seeing Autism- a book review

“Uniquely Human: A Different Way of Seeing Autism” by Barry M. Prizant, PhD, CCC-SLP offers insights into understanding and living with autism. The book promotes a person-centered approach, emphasizing the importance of engaging, building self-esteem, and fostering joyful experiences for individuals with autism. Dr. Prizant advocates for working with their strengths rather than focusing on…

Keep reading
UNIQUELY HUMAN- A DIFFERENT WAY OF SEEING AUTISM, a book by Barry Prizant, Ph.D.

Exploring the HEART of Health

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Why are we obsessed with OCD?

It seems that everyone is obsessive compulsive these days and sports a tee shirt or posts a social media message to prove it.

We are obsessed with a variety of things most of them generally benign or even good- cooking, reading, sewing, running, dancing, decluttering, work- you name it and there seems to be an obsession for it. But do these make it a disorder?

Probably not. And that is why I’m concerned that people throw around the term OCD, acronym for obsessive-compulsive disorder, minimizing the seriousness of the disorder for the people who do suffer from it.

MRI OF THE BRAIN
an MRI image of the human brain ; there is still much we do not understand about how the brain works and why problems develop (photo from Pixabay)

 

 

Maybe I’m sensitive about this because as a physician I deal with people who have all kinds of disorders which are disabling and disturbing and because I deal with neuropsychiatric disorders in my family.

My late mother suffered from severe dementia for several years; early on the main symptom was poor memory; some people thought it was no big deal, not considering that forgetting important things like where you live has serious consequences.

Many years after a tour of duty in Vietnam, my veteran husband still works on managing  depression and PTSD (post-traumatic stress disorder).

And my grandson is on the autism spectrum, affecting his social and verbal development.

 

A disorder causes distress and affects functioning; these conditions as well as OCD fit that criteria.

Obsessive compulsive disorder , OCD, is a distinct neuropsychiatric disorder

with characteristic and diagnostic features. These are

  • Recurrent distressing thoughts such as contamination, aggression, superstition, exactness, doubt

  • Repetitive behaviors or mental rituals such as handwashing, checking, counting, ordering,

 

These behaviors are

  • performed to relieve anxiety

  • consume an unreasonable amount of time, and

  • impair  social interaction and work.

Those affected may feel shame and secrecy.

The exact criteria for a diagnosis of obsessive-compulsive disorder are outlined in the recently updated Diagnostic and Statistical Manual of Mental Disorders, aka DSM-5.

 

 

OCD can be mistaken for other disorders including

  • ADHD- attention-deficit hyperactivity disorder,
  • anxiety,
  • autism,
  • depression,
  • psychosis
  • Tourette syndrome

(Read information about these and other neuropsychiatric conditions at this link. )

 

 

 

I think some people who claim OCD may  have obsessive compulsive personality disorder. Their behavior emphasizes organization, perfectionism and a sense of control but they are not disabled  by it.

Most people who like things to be neat, orderly, organized and perfect do not have OCD.

 

 

OCD can be difficult to diagnose,because patients  do not seek help, or are too embarrassed to report their symptoms in detail.

But with treatment much of the distress can be eliminated or at least minimized so no one needs to hesitate to seek help.

So, if you think you or someone you love may have OCD, see your physician. Many primary care physicians can and do diagnose and treat this disorder, or will  refer patients to a psychiatrist (M.D.or D.O.) or other mental health professional.

 

 

 

Available treatments include

CBT, cognitive behavior therapy, using exposure to anxiety producing stimuli and  and learning response prevention( not performing the compulsive behaviors),  administered by a trained health care professional in an individual or group format.

Some patients choose medication; Several medications are effective and should be continued for at least 1-2 years, if not indefinitely, as there is a fairly high rate of recurrence.

If either treatment alone lacks effective relief, they can be used together.

Deep brain stimulation is approved by the FDA as a last resort only for severe cases which don’t respond to the approved medications and CBT. So far it has been used in only a few patients.

 

Follow this link to a printable article about OCD from FamilyDoctor.org .

Find more information at this link from the American Psychiatric Association .

 

The Mighty,a website that reports on disability, mental illness and chronic disease, posted a story about OCD; they asked “people with OCD” to share their symptoms. I don’t know whether  these people had professionally diagnosed  OCD, the descriptions shared in this article sound compatible with true disabling obsessions and compulsions.

And please review a previous watercress words post on mental illness.