Is the autism epidemic a myth?

Autism diagnoses are way up in recent decades, writes psychologist Adam Omary in a Washington Post op-ed. But there is no "autism epidemic."

Autism diagnoses rose by a factor of five, from 67 to 322 cases per 10,000 children, from 2000 to 2022, reported the Centers for Disease Control and Prevention in April, he notes. But "this dramatic rise may be entirely driven by children with mild or no significant functional impairment," according to a large-scale study based on CDC data, Omary writes. "Between 2000 and 2016, there was a 464 percent increase in diagnoses among children with no significant functional impairment whatsoever," while there was a "20 percent decrease in the prevalence of moderate or severe autism."

Omary believes children who once would have been called "quirky" are now being diagnosed with mild autism.

Many studies use data from parent-reported surveys in counts of "suspected cases" of autism, he writes. One popular survey asks parents if their child questions such as: “Would rather be alone than with others,” “Has difficulty making friends,” and “Is regarded by other children as odd or weird.”

Abigail Shrier argues in her 2024 book, Bad Therapy, that child psychiatry has drifted toward overdiagnosis, Omary writes. "Like the rise in attention-deficit/hyperactivity disorder, anxiety and depression diagnoses among young people, the surge in autism labels may reflect shifting norms, looser diagnostic criteria and excess therapeutic attention directed toward ordinary struggles."

Last year, psychiatrist Allen Frances also blamed the change in diagnosis criteria for the autism surge. He led a task force that updated the Diagnostic and Statistical Manual of Mental Disorders to expand the definition of autism to include "Asperger’s syndrome, which is much milder in severity than classic autism and much more common," he wrote in the Washington Post.

"The resulting explosion in cases included many instances of overdiagnosis — children were labeled with a serious condition for challenges that would better be viewed as a variation of normal," Frances wrote.

The "ever-expanding 'autism spectrum' diagnosis is worse than useless," tweets Steven Pinker. It includes "perfectly functioning Harvard students" and "also teenagers who shriek uncontrollably, self-mutilate, and never look at another person."

The Autism Science Foundation proposes splitting the Autism Spectrum Disorder diagnosis by creating a "profound autism" category for the severely disabled.

Omary and Pinker are misreading the data, tweets Jill Escher, who's the mother of two autistic children and the president of the National Council on Severe Autism. There are "mountains of very clear evidence of a dramatic increase in neurodevelopmental pathology." Growing awareness and changes in diagnostic criteria do not explain the rise in children with autism and intellectual disability, she argues. These aren't just quirky or socially awkward kids.