About one in 40 children has been diagnosed with autism, according to a national survey of parents.
Researchers called on pediatricians to help those who are struggling to access the health care services they need.
The Academy recommends asking about concerns at every well-child visit and screen all children at 18 and 24 months.
Increases in awareness, screening and risk factors have contributed to rising autism rates over the last several decades. The latest prevalence data come from a study led by researchers from the Health Resources and Services Administration’s Maternal and Child Health Bureau (MCHB). The team analyzed parent survey data for about 43,000 children ages 3-17 from the 2016 National Survey of Children’s Health (NSCH).
It found 2.5% of parents reported their child received an autism diagnosis and still had the disorder, translating to about 1.5 million children nationwide. However, changes in the survey make it difficult to compare the findings to data from previous years, according to “The Prevalence of Parent-Reported Autism Spectrum Disorder Among U.S. Children” (Kogan MD, et al. Pediatrics. Nov. 26, 2018, http://pediatrics.aappublications.org/content/early/2018/11/21/peds.2017-4161).
Boys were about 3.5 times more likely to be diagnosed with autism than girls. Overall rates were higher among low-income families than wealthy families and among children who were born preterm compared to those who were not.
Among all children with a diagnosis, 27% used medication to ease the symptoms, while 64% had received behavioral therapy in the past 12 months, according to the study.
Children with autism were more likely than those with other emotional, behavioral or developmental conditions to have seen a specialist, received mental health counseling or have a special education or early intervention plan. However, they also reported being 44% more likely to have trouble getting mental health treatment, 23% less likely to have a medical home and 24% less likely to receive care coordination.
“We found that the families of children with autism face a number of unique challenges in getting health care services and we believe that pediatricians can play a key role in helping them whether it’s achieving a medical home or facilitating needed care coordination,” Michael D. Kogan, Ph.D., director of the Office of Epidemiology and Research at MCHB, said in an AAP video summarizing the study.
The NSCH is one of several surveys that have been used to estimate autism rates. The National Health Interview Survey has reported similar rates. Data from the Autism and Developmental Disabilities Monitoring Network, which relies on review of health and education records, reported a rate of 1.7%, but used 2014 data on 8-year-olds from 11 communities.
Authors of a related commentary noted the NSCH data would be more useful if it showed the vast differences in rates that can exist from state to state.
“Ideally, increased awareness of heterogeneity will facilitate conversation about the meaning of national estimates of prevalence,” they wrote, “in particular how they conceal underlying heterogeneity that may reflect important differences in policies, educational and medical practices, and/or causal environmental exposures at the local level.”