For years, public health debate has often fixated on a supposed rise in the prevalence of autism. Various culprits have been named, including the well-investigated but unsubstantiated claim that vaccines cause autism. More recently, additional risk factors have been proposed — many by Health Secretary Robert F. Kennedy Jr. — including maternal Tylenol use, food dyes and additives, chemical manufacturing agents and other possible stressors affecting perinatal development. Concerns about autism have been spotlighted within the larger Make America Healthy Again movement, motivated by a well-founded alarm over the nation’s devastatingly high burden of chronic disease and psychiatric illness. But there is a bigger problem with the autism epidemic: It doesn’t exist.
Autism diagnoses have indeed risen dramatically in recent decades. However, diagnostic criteria can change even when the underlying health phenomenon remains unchanged. The most recently released Centers for Disease Control and Prevention report on autism, published last April, revealed a five-fold increase in the prevalence of autism between 2000 and 2022, from 67 to 322 cases per 10,000 children. But a large-scale study published in December, drawing on CDC data from 24,669 8-year-olds across the country, found that this dramatic rise may be entirely driven by children with mild or no significant functional impairment.Between 2000 and 2016, there was a 464 percent increase in diagnoses among children with no significant functional impairment whatsoever. In fact, during the same time period, there was a 20 percent decrease in the prevalence of moderate or severe autism,from 15 to 12 cases per 10,000 children.
There is often a lag of several years before such epidemiological datasets are released, and years more for researchers to perform statistical analyses, publish the findings and enter public policy discussions. We do not yet have data more recent than 2016 breaking down symptoms by severity level while controlling for other psychological factors such as intellectual disability. However, it is likely that the 74 percent increase in cases reported between 2016 and 2022 will reflect a continuation of the previous problem of overrepresentation of children withmild symptoms and no significant functional impairment.
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