Trends in Autism Spectrum Disorder Diagnoses: 1994–2007

Abstract

We analyzed predictors of parent-reported initial diagnosis (autistic disorder [AD], pervasive developmental disorder-not otherwise specified [PDD-NOS], pervasive developmental disorder ['PDD'] and autism spectrum disorder ['ASD'], and Asperger syndrome [AS]), among 6,176 individuals with autism spectrum disorders diagnosed from 1994 through 2007. Overall, distribution of diagnoses was influenced by a secular time trend factor; other significant factors included ethnicity, white race, geographic location, urbanicity, and initial evaluator. Since 2001, most initial diagnoses of AD and AS have remained steady while 'PDD' and PDD-NOS have decreased. 'ASD' diagnoses have increased, especially among school-based teams; AS diagnoses also increased uniquely among these evaluators. Findings from this study suggest that current diagnostic guidelines may not be meeting all community evaluator needs.

National Trends in the Mental Health Care of Children, Adolescents, and Adults by Office-Based Physicians

“…19 Increasing awareness of the adverse metabolic effects of second-generation antipsychotic medications 20 is widely thought to have recently slowed the growth in the use of antipsychotic treatment among young people. 1,21 Other changes, such as an increase in the number of children who received a diagnosis of ADHD 3 or autism spectrum disorder, 22 are somewhat more difficult to pin on specific events or changes in the practice environment.…”

Stability of Initial Autism Spectrum Disorder Diagnoses in Community Settings

“…An estimated one in 110 children in the US is diagnosed with an autism spectrum disorder (ASD; Autism andDevelopmental Disabilities Monitoring Network 2006 Principal Investigators 2009;Kogan et al 2009); this figure reflects a 10-fold increase in diagnoses during the past half century (Johnson et al 2007). Given the recent increase in diagnosed prevalence in addition to changing diagnostic criteria and other secular trends, knowledge about stability of ASD diagnoses in community settings is an important avenue for further research (Fombonne 2009;Rosenberg et al 2009). While past studies examining diagnostic stability in research settings have improved our understanding of the natural history of this group of disorders, this paper will focus on community settings to assess how ASD labels have changed within children over time.…”

“…Recent studies have provided some insight into ASD diagnostic practices in community settings (Rosenberg et al 2009;Wiggins et al 2006;Williams et al 2009). A 2006 study examining diagnostic patterns in a population-based sample of 8-year-old children found initial ASD diagnosis to vary by setting; while most children were diagnosed in nonschool settings, children initially diagnosed with autistic disorder and PDD-NOS were less likely to be diagnosed in a non-school setting compared with children initially diagnosed with Asperger's and general ASD (Wiggins et al 2006).…”

“…In a recent study of the classification of ASDs in community settings, initial diagnosis was also found to vary by evaluation setting; when compared to early childhood programs and regional centers, school settings were significantly more likely to diagnose a child as having autism versus other diagnoses on the ASD spectrum (Williams et al 2009). In an examination of trends in ASD diagnoses from 1994 through 2007 using a web-based registry of children with ASD, investigators found that initial ASD diagnosis varied by region, race/ethnicity, initial evaluator and secular time (Rosenberg et al 2009). Specifically, AS was less likely to be diagnosed by developmental pediatricians and more likely to be diagnosed by psychiatrists or clinical psychologists, whereas 'PDD'/'ASD' was less likely to be diagnosed by clinical psychologists (Rosenberg et al 2009).…”

The life and times of 'Asperger's Syndrome': A Bakhtinian analysis of discourses and identities in sociocultural context

“…In addition to increases in the incidence of diagnoses of ASD's, trends within the specific diagnosis of Asperger's Syndrome are equally interesting, especially considering Tomlinson's (2012) argument on the rise of 'the SEN industry', with Rosenberg et al (2009) reporting that ethnicity (white race) and geographic location (urbanicity) are strongly implicated in the likelihood of a diagnosis of AS. Asperger's Syndrome is demonstrably a diagnosis for young, white, affluent, urban males which neatly dovetails with and represents the socioeconomic demographic characteristic of the audience for the products of the AS industry, including, in addition to the special education and other 'therapeutic'…”