Updated Numbers: Autism affects 1 in 31 8-year-olds

Autism Spectrum Disorder (ASD) is a developmental condition that affects communication, behavior, and social interaction. In recent years, it has been identified earlier and in more children, especially among groups that previously had less access to diagnosis, such as black and Hispanic children. In 2022, according to the Autism and Developmental Disabilities Monitoring Network (ADDM), 1 in 31 8-year-olds in the United States was diagnosed with autism. Identifying ASD early is important so that the child receives support and treatment as soon as possible, helping their development.

Autism Spectrum Disorder, known as ASD, is a developmental condition that primarily affects the way a person communicates, interacts socially, and behaves. People with ASD may have very specific interests, repeat certain behaviors frequently, and have difficulty relating to others.

This condition is very varied: some people need more support in their daily lives, while others are able to live more independently. Therefore, the signs and severity of Autism Spectrum Disorder can vary greatly from person to person.

Doctors recommend that all children undergo a specific assessment to identify signs of autism at 18 to 24 months of age. This is because the earlier autism is identified, the sooner the child can begin to receive the support needed to develop better.

In some cases, additional assessments are necessary, especially if the child is at higher risk of Autism Spectrum Disorder or is already showing worrying behaviors.

In the United States, there is a program called the Autism and Developmental Disabilities Monitoring Network (ADDM), which has been tracking data on autism since 2000. This program monitors how many children are diagnosed with Autism Spectrum Disorder and how this changes over time.

In 2000, it was estimated that 1 in 150 children had ASD. By 2020, that number had risen to 1 in 36 children. Initially, autism was more commonly found in white children and in families with higher incomes. But in recent years, it has become more common among black, Hispanic, and underserved groups.

The Autism and Developmental Disabilities Monitoring Network has also started tracking children as young as 4 years old to see if autism is being diagnosed earlier. Although the prevalence is still highest among 8-year-olds, data shows that among younger children, diagnoses are occurring at younger ages than before.

This is positive, as it shows that health and education professionals are being able to recognize the signs earlier. However, the COVID-19 pandemic hampered this progress in 2020, making it difficult to access screenings during that period.

In 2022, the monitoring network expanded its reach to include 4- and 8-year-olds in 16 U.S. states and territories. Children were considered to have ASD if they had a formal diagnosis, were eligible for specific educational support, or had an autism code recorded on their medical exam.

For 4-year-olds, those who did not yet have a full diagnosis but showed strong signs were considered to have autism.

Among 8-year-olds monitored in 2022, 1 in 31 were identified as having ASD. This proportion varied greatly by location, ranging from 1 in 103 in Texas (Laredo) to 1 in 19 in California.

Boys were diagnosed with ASD far more often than girls, by a ratio of more than 3 to 1. Furthermore, the condition was more commonly found in Black, Hispanic, Native American, and Asian children than in White children. Of those children with ASD, many also had intellectual disabilities, or cognitive difficulties beyond those related to autism.

This was more common among Black, Native American, and Hispanic children. The average age of first diagnosis was 47 months (almost 4 years), but this also varied widely: in California, the diagnosis occurred around age 3, while in Laredo, Texas, it was almost 6 years.

When comparing children born in 2014 to those born in 2018, it was seen that the youngest children (who would have been 4 years old in 2022) were being diagnosed earlier than the oldest children.

On average, there was a 70% increase in the number of diagnoses made by age 4, which shows a significant advance in early detection. However, the COVID-19 pandemic caused this progress to pause for a while.

Prevalence of autism spectrum disorder among 8-year-old children, by type of identification and location, Autism and Developmental Disabilities Monitoring Network, 16 sites, United States, 2022. Horizontal line is the overall prevalence of autism and developmental disabilities of 32.2 per 1,000 8-year-old children. Abbreviations: ASD = autism spectrum disorder; ICD = International Classification of Diseases.

Most 8-year-old children with autism spectrum disorder had received at least one specific test for autism, although this also varied greatly by location. The most commonly used tests included methods such as detailed observations of the child’s behavior and rating scales completed by professionals.

In summary, the number of autism diagnoses has increased, particularly among young children and among groups that were previously underdiagnosed. This shows that the system is evolving, but also highlights the need for more planning and resources to ensure that all children with ASD receive support fairly and as early as possible. Differences between regions show that there is still room for improvement in the way diagnosis is made in each community.

READ MORE:

Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years — Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022. 

Shaw KA, Williams S, Patrick ME, et al.

MMWR Surveill Summ 2025; 74 (No. SS-2): 1–22. 

DOI: http://dx.doi.org/10.15585/mmwr.ss7402a1

Abstract

The Autism and Developmental Disabilities Monitoring Network is an active surveillance program that estimates prevalence and characteristics of ASD and monitors timing of ASD identification among children aged 4 and 8 years. In 2022, a total of 16 sites (located in Arizona, Arkansas, California, Georgia, Indiana, Maryland, Minnesota, Missouri, New Jersey, Pennsylvania, Puerto Rico, Tennessee, Texas [two sites: Austin and Laredo], Utah, and Wisconsin) conducted surveillance for ASD among children aged 4 and 8 years and suspected ASD among children aged 4 years. Surveillance included children who lived in the surveillance area at any time during 2022. Children were classified as having ASD if they ever received 1) an ASD diagnostic statement in a comprehensive developmental evaluation, 2) autism special education eligibility, or 3) an ASD International Classification of Diseases, Ninth Revision (ICD-9) code in the 299 range or International Classification of Diseases, Tenth Revision (ICD-10) code of F84.0, F84.3, F84.5, F84.8, or F84.9. Children aged 4 years were classified as having suspected ASD if they did not meet the case definition for ASD but had an evaluator’s suspicion of ASD documented in a comprehensive developmental evaluation. Among children aged 8 years in 2022, ASD prevalence was 32.2 per 1,000 children (one in 31) across the 16 sites, ranging from 9.7 in Texas (Laredo) to 53.1 in California. The overall observed prevalence estimate was similar to estimates calculated using Bayesian hierarchical and random effects models. ASD was 3.4 times as prevalent among boys (49.2) than girls (14.3). Overall, ASD prevalence was lower among non-Hispanic White (White) children (27.7) than among Asian or Pacific Islander (A/PI) (38.2), American Indian or Alaska Native (AI/AN) (37.5), non-Hispanic Black or African American (Black) (36.6), Hispanic or Latino (Hispanic) (33.0), and multiracial children (31.9). No association was observed between ASD prevalence and neighborhood median household income (MHI) at 11 sites; higher ASD prevalence was associated with lower neighborhood MHI at five sites.