Rising Autism Diagnoses: Key Facts to Understand

Modern Conversations about Autism: Unraveling the Questions

There's been a lot of chatter these days regarding autism diagnoses, fueled by social media users sharing their experiences and raising awareness. Yet, amidst this buzz, there's a debate unfolding around an alleged surge in autism cases, particularly in the United States.

Robert F. Kennedy Jr., the US Federal Health Secretary, has made bold claims about this apparent increase, branding autism as an "epidemic." But, how valid are these statements concerning autism and its supposed escalation?

To clarify, Medical News Today enlisted the help of one of our carefully selected experts, David Cutler, a certified family medicine physician at Providence Saint John's Health Center in Santa Monica, CA.

Is there an autism 'epidemic'?

During his April 16, 2025 press conference, emphasizing a recent CDC report, Kennedy described autism as an "epidemic" and suggested that the condition was on a rapid rise. In fact, the report indicated that one out of every 36 children in the U.S. has now been diagnosed with autism, compared to one in 44 in 2021.

Undeniably, the statistic having jumped six points is concerning. But, as Cutler explained, the actual progression of autism diagnoses is primarily due to heightened awareness, widened diagnostic criteria, and refined screening strategies, rather than a genuine upsurge in prevalence.

He highlighted the following factors as the chief contributors to the observed rise:

Expanded definition of autism: In 2013, with the introduction of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), conditions such as Asperger's syndrome and pervasive developmental disorder - not otherwise specified were grouped under the umbrella term 'Autism Spectrum Disorder' (ASD), leading to more diagnoses, especially among those with less severe symptoms.
Improved screening and earlier diagnosis: The American Academy of Pediatrics recommended routine autism screening at 18 and 24 months of age starting in 2006. This proactive approach has led to earlier identification of children with autism, including those with milder symptoms, thus raising the number of diagnoses.
Increased awareness and advocacy: Better understanding among parents, educators, and healthcare providers has resulted in more children being evaluated and diagnosed. This is particularly noticeable in historically underrepresented groups like females and racial minorities.

Are environmental factors more crucial than genetics in autism?

On his press release, Kennedy suggested that autism must be caused by environmental exposure to toxins, downplaying the role of genetic heritability. Although environmental factors may have a part, their significance shouldn't overshadow the role of genetics.

In reality, genetics play a significant role in autism, with multiple large-scale studies demonstrating that in many instances, autism tends to run in families. For instance, a meta-analysis of seven twin studies (published in December 2015) indicated that genetics are the primary risk factor for autism.

Nevertheless, the notion that environmental factors do not play a role in autism is misleading. Certain studies indicate that environmental influences during pregnancy and early childhood may contribute to the risk, such as maternal age, exposure to specific chemicals, and complications during birth.

In essence, while there's an uptick in autism diagnoses, the primary reasons are improvements in official diagnostic criteria, heightened awareness among healthcare professionals, and enhanced advocacy among frequently overlooked populations.

Environmental factors, while they may play a role in autism, are not the main drivers. In reality, the apparent surge in autism diagnoses stems from advancements in our understanding, diagnosis, and recognition of autism across diverse communities.

- David Cutler, MD

The interpretation of an 'autism epidemic' is questionable, as the rise in diagnoses can be attributed primarily to heightened awareness, widened diagnostic criteria, and refined screening strategies.
Genetics play a significant role in autism, with multiple studies demonstrating that in many instances, autism tends to run in families.
Environmental factors may contribute to the risk of autism, but their significance should not overshadow the role of genetics, as some studies suggest.
The apparent rise in autism diagnoses is due to advancements in our understanding, diagnosis, and recognition of autism across diverse communities, including underrepresented groups.
Factors such as the expanded definition of autism, improved screening, and increased awareness are the dominant reasons behind the increase in autism diagnoses, not a genuine upsurge in prevalence.