Autism Prevalence  in USA

• • In 2020, the CDC reported that approximately 1 in 54 children in the U.S. is diagnosed with an autism spectrum disorder (ASD), according to 2016 data.

– 1 in 34 boys identified with autism
– 1 in 144 girls identified with autism

• Boys are four times more likely to be diagnosed with autism than girls.
• Most children were still being diagnosed after age 4, though autism can be reliably diagnosed as early as age 2.
• 31% of children with ASD have an intellectual disability (intelligence quotient [IQ] <70), 25% are in the borderline range (IQ 71–85), and 44% have IQ scores in the average to above average range (i.e., IQ >85).
• Autism affects all ethnic and socioeconomic groups.
• Minority groups tend to be diagnosed later and less often.
• Early intervention affords the best opportunity to support healthy development and deliver benefits across the lifespan.
• There is no medical detection for autism.

• Intervention and Supports 

• Early intervention can improve learning, communication and social skills, as well as underlying brain development.  
• Applied behavior analysis (ABA) and therapies based on its principles are the most researched and commonly used behavioral interventions for autism. 
• Many children affected by autism also benefit from other interventions such as speech and occupational therapy.

  Developmental regression, or loss of skills, such as language and social interests, affects around 1 in 5 children who will go on to be diagnosed with autism and typically occurs between ages 1 and 3. 

• Associated Challenges 

• An estimated 40 percent of people with autism are nonverbal.  
• 31% of children with ASD have an intellectual disability (intelligence quotient [IQ] <70) with significant challenges in daily function, 25% are in the borderline range (IQ 71–85). 
• Nearly half of those with autism wander or bolt from safety.  
• Nearly two-thirds of children with autism between the ages of 6 and 15 have been bullied. 
• Nearly 28 percent of 8-year-olds with ASD have self-injurious behaviors. Head banging, arm biting and skin scratching are among the most common. 
• Drowning remains a leading cause of death for children with autism and accounts for approximately 90 percent of deaths associated with wandering or bolting by those age 14 and younger.

• Associated Medical & Mental Health Conditions 

• Autism can affect the whole body. 
• Attention Deficient Hyperactivity Disorder (ADHD) affects an estimated 30 to 61 percent of children with autism. 
• More than half of children with autism have one or more chronic sleep problems. 
• Anxiety disorders affect an estimated 11 to 40 percent of children and teens on the autism spectrum. 
• Depression affects an estimated 7% of children and 26% of adults with autism. 
• Children with autism are nearly eight times more likely to suffer from one or more chronic gastrointestinal disorders than are other children. 
• As many as one-third of people with autism have epilepsy (seizure disorder). 
• Studies suggest that schizophrenia affects between 4 and 35 percent of adults with autism. By contrast, schizophrenia affects an estimated 1.1 percent of the general population. 
• Autism-associated health problems extend across the life span – from young children to senior citizens. Nearly a third (32 percent) of 2 to 5 year oldswith autism are overweight and 16 percent are obese. By contrast, less than a quarter (23 percent) of 2 to 5 year oldsin the general population are overweight and only 10 percent are medically obese. 
• Risperidone and aripiprazole, the only FDA-approved medications for autism-associated agitation and irritability. 

• Caregivers & Families  

• On average, autism costs an estimated $60,000 a year through childhood, with the bulk of the costs in special services and lost wages related to increased demands on one or both parents. Costs increase with the occurrence of intellectual disability. 
• Mothers of children with ASD, who tend to serve as the child’s case manager and advocate, are less likely to work outside the home. On average, they work fewer hours per week and earn 56 percent less than mothers of children with no health limitations and 35 percent less than mothers of children with other disabilities or disorders. 

• Autism In Adulthood  

• Over the next decade, an estimated 707,000 to 1,116,000 teens (70,700 to 111,600 each year) will enter adulthood and age out of school based autism services. 
• Teens with autism receive healthcare transition services half as often as those with other special healthcare needs. Young people whose autism is coupled with associated medical problems are even less likely to receive transition support. 
• Many young adults with autism do not receive any healthcare for years after they stop seeing a pediatrician. 
• More than half of young adults with autism remain unemployed and unenrolled in higher education in the two years after high school. This is a lower rate than that of young adults in other disability categories, including learning disabilities, intellectual disability or speech-language impairment. 
• Of the nearly 18,000 people with autism who used state-funded vocational rehabilitation programs in 2014, only 60 percent left the program with a job. Of these, 80 percent worked part-time at a median weekly rate of $160, putting them well below the poverty level. 
• Nearly half of 25-year-olds with autism have never held a paying job. 
• Research demonstrates that job activities that encourage independence reduce autism symptoms and increase daily living skills. 

• Economic Costs 

• The cost of caring for Americans with autism had reached $268 billion in 2015 and would rise to $461 billion by 2025 in the absence of more-effective interventions and support across the life span. 
• The majority of autism’s costs in the U.S. are for adult services – an estimated $175 to $196 billion a year, compared to $61 to $66 billion a year for children. 
• On average, medical expenditures for children and adolescents with ASD were 4.1 to 6.2 times greater than for those without autism.   
• Passage of the 2014 Achieving a Better Life Experience (ABLE) Act allows tax-preferred savings accounts for people with disabilities, including autism, to be established by states.  
• Passage of autism insurance legislation in all 50 states is providing access to medical treatment and therapies. 

Prevalence in Europe

ASD affects approximately 0.62–0.70% of the population, although estimates of 1–2% have been made in the latest large-scale surveys. Over the past 30 years, the number of reported cases of ASD has been increasing rapidly. This increase of ASD cases has been partly explained as a result of changes in diagnosis and classification criteria, early diagnosis, the better awareness and recognition, the type of areas studied (rural vs urban areas) and also possible differences across countries. However, it has not been possible to rule out an increase of the ASD incidence due to the influence of some environmental risk factors.

In addition, irrespective of the causes of the increasing prevalence, it is a reality that there are now more ASD cases diagnosed during childhood and adolescence that need care, attention and treatment. Moreover, if an increasing prevalence is a reality, incidence would have been rising during previous years, and a real concern about improving research for environmental causes should be incorporated into autism research policy decisions.

The lack of mechanisms to obtain consistent and reliable information about ASD trends at the European level is an important obstacle for the development of better and more equitable services. Hence, prevalence estimation across Europe and the development of a standardized strategy to be used for future surveillance of the ASD figures constitute important pieces of the puzzle of autism in the European Union.