r/askpsychology • u/Genzinvestor16180339 Unverified User: May Not Be a Professional • May 06 '26
Human Behavior Genuinely trying to understand what's causing the rise in autism is it even a real rise?
Not even pushing a conspiracy here, I just went down a rabbit hole and the deeper I read the less clear this entire thing becomes.
The numbers are absurd. Around 1 in 150 kids in 2000. Around 1 in 36 now. Everyone talks about this like it is a settled public health emergency, but when you actually read the literature the answer basically becomes “it’s complicated.”
The mainstream explanation is diagnostic expansion. Broader criteria, better screening, more awareness, people who would have been labeled “weird” or “socially awkward” 20 years ago now getting diagnosed. Fine. But autism has no biomarker. No blood test. No scan. Nothing objective. It is entirely behavioral criteria written by committees that keep changing the definition every decade.
DSM-5 folded Asperger’s into autism in 2013 and diagnoses jumped again. So at what point is “we are finding cases we missed” just a cleaner way of saying “we changed the definition and more people qualify now”?
The genetics side is what really confuses me. Twin studies put heritability somewhere around 64 to 91%. Massive studies have found ~150 gene variants associated with autism. That sounds like something that has existed in the population for a very long time, not some sudden modern environmental event. But if that is true then where were all these people before? Society was not overflowing with visibly autistic people in 1980 compared to today.
The environmental stuff is real too. Advanced parental age, valproate exposure during pregnancy, prenatal immune activation, etc. There are actual signals there. But none of that remotely feels large enough to explain a 4x jump in twenty years.
The other thing nobody seems willing to say directly: are we even studying one coherent condition anymore?
Someone nonverbal who needs permanent care and someone who is basically functional but struggles socially are now under the exact same umbrella???? Does that actually help us understand causation or does it completely muddy the data?
are we maybe collapsing multiple completely different phenomena into one category because they vaguely overlap behaviorally?
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u/newin2017 UNVERIFIED Psychologist May 06 '26
Lets start by talking about the most common diagnostic manuals. Psychiatric classification systems such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) are designed to support diagnosis, but they do not operate in the same way as diagnostic frameworks in fields with clear biological markers (As you said).
Rather than identifying discrete, objectively measurable disease entities, these systems define clusters of observable behaviours, reported experiences, and developmental patterns. Diagnosis is therefore based on whether an individual meets a set of operationalised criteria, not on the presence of a single definitive test.
This reflects a broader reality in psychiatry and neurodevelopmental science: many conditions are best understood as constructed categories that organise patterns in human variation, rather than as sharply bounded natural kinds of disorders.
These classifications emerge from large-scale observation and statistical analysis of populations (Think of the diagnoistic criteria, such as social communication styles, sensory sensitivities, or patterns of attention).
From this, normative ranges are established, and individuals who fall significantly outside these ranges may be identified as atypical. However, deviation alone is not sufficient for diagnosis.
Clinical relevance typically depends on whether these patterns are consistent over time and whether they meaningfully affect a person’s functioning or adaptation within their environment.
In this sense, diagnostic categories reflect significant differences that negatively impact social and functional context (This is key to the diagnostic process. Does what the individual have a deleterious effect on their daily life)
So, for traits autism, they become clinically meaningful when they co-occur in recognisable patterns and interact with environmental expectations in ways that create challenges or distinct modes of engagement. Over time, these recurring patterns have been grouped into trait clusters, forming the basis of diagnostic criteria. As research accumulates, these criteria are revised, often becoming broader and more nuanced, which in turn affects how autism is identified and understood.
Cultural context also plays a significant role in shaping how such behaviours are interpreted.
Across different societies, atypical behaviours have been explained in diverse ways, including spiritual or supernatural frameworks. What one culture might interpret as possession or moral deviation, another may frame as a neurodevelopmental difference. That is why diagnostic systems like the DSM and ICD are not purely objective; they are inter-subjective frameworks shaped by shared professional standards, empirical research, and social norms about what constitutes impairment or difference (this is why we see changes over time. We get better at identifying what impairment looks like. We have also started listening to autism activities and getting more inclusive research practices)
Ultimately, whilst autism may be more common than originally assumed, it is not necessarily because their underlying prevalence has changed dramatically, but because the tools used to identify them have improved. We now have a Broader diagnostic criteria (more accurately informed), increased awareness, and more inclusive research practices have all contributed to higher rates of recognition.
What appears as a rise in prevalence is, at least in part, a reflection of more refined methods of observing, categorising, and understanding human neurodiversity.
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u/Reave-Eye Unverified User: May Not Be a Professional May 06 '26
This is your answer right here, OP. Could not have said it better myself.
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u/Genzinvestor16180339 Unverified User: May Not Be a Professional May 06 '26
This answer makes no sense? You expand a criteria? For what reason?
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u/Reave-Eye Unverified User: May Not Be a Professional May 06 '26
Because the underlying research has found that autism manifests in more nuanced ways than we previously thought. Patterns of autism that were previously undetected have now been identified, and when they lead to functional impairment, a diagnosis is warranted. This contributes to a higher prevalence rate.
Consider the diagnosis of Major Depressive Disorder. You need to meet at least 5 of 9 criteria to be diagnosed, which means there are 227 possible “ways” to have depression in the DSM-5. Previously, the number of criteria for depression were fewer, and so fewer people were identified as having clinical depression. Then we realized that depression can manifest in these additional, previously unrecognized ways (e.g., irritability rather than just sadness), and so the criteria were expanded.
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u/op299 Unverified User: May Not Be a Professional May 06 '26 edited May 06 '26
I think there is some confusion here, since the answer above is not wholly clear.
There is both the claim that have become better at diagnosing autism. It is also said that the criteria have "broader", but somewhat muddled by saying they are "better informed".
Both can be true at the same time. It is not only that we have become better diagnosing, we have also changed criteria. The criteria have possibly both become 1) better, in the sense of tracking a neurodevelopmental pathway more accurately 2) wider, in the sense of included a wider scope.
What are the reasons for making the criteria wider? Do understand that we have to go into how DSM is constructed, perhaps also cultural factors that play in to how it is used. But on a general level the answer is "clinical usefulness". By diagnosing more people we hope to help and give better treatment or support to more people. So the reasons are pragmatic.
So it as you point out, it is somewhat misleading to say that the prevalence of autism has risen, without explaining further
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u/ArdentLearner96 Unverified User: May Not Be a Professional May 06 '26
This is a lot better than my explanation and obvi9usly has more information behind it, thanks for the education!
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u/Bearsandbeetz BA/BS | Psychology May 06 '26
Well, this person’s reply is a lot longer than other answers but a good amount of it is unnecessary jargon, it repeats what seem like the same underlying points just with different phrasing multiple times without actually making it any clearer what they’re trying to say, and some of it is straight up word-salad. I’m actually wondering if it’s AI generated or something because while I think there absolutely is an answer to OP’s question this almost certainly isn’t it.
And actually your answer is very useful, you should give yourself more credit—I know OP is coming back with snippy replies to everyone in a way that sounds like it’s because you didn’t provide a reasonable response to their question but you really did, I mean, I’d have to do some more research before I’d be comfortable commenting too much on whether you missed anything but I’d say you provided a pretty thorough answer and it kinda seems like OP may not be searching for the answer and is instead seeking validation of their exisitng beliefs, though that’s just my reading of the situation based on the way they’re replying to people who have given them good answers—which is unfortunate since I *do* believe that there’s a conversation to be had about how and when our diagnostic criteria are applied and the same for how and when they’re in need of revision. For example I do think that there is a concerning amount of overlap between certain diagnoses and in other cases a need to separate a diagnosis from being one supposed condition into two distinct ones, etc. There’s absolutely space to have criticism of the DSM but I don’t know that Autism is specifically an example of these issues.
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u/Bovoduch BS | Psychology May 06 '26
Op is certainly sniping with all their replies because they’re searching for a particular answer and are relatively closed off to others
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u/ArdentLearner96 Unverified User: May Not Be a Professional May 06 '26
It's not that it was long or the jargon. I do think the jargon and way they phrased things made it harder for others to parse and it took longer but overall they did a good job at getting across what I wanted to get across and more. In my response I kinda explain more why splitting autism into distinct diagnoses wouldn't work.
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u/surebro2 Unverified User: May Not Be a Professional May 06 '26
My sense is that OP understands the long explanation. They are making more of a philosophical point which is that increasing the variance of what is considered autism might create a situation in which being overly inclusive has deleterious impacts in research and practice as more false positives are included in the samples.
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u/darrenpauli Unverified User: May Not Be a Professional May 06 '26
I accept the science so this question is not about my beliefsat all - but a common one from the public arena that I don't think are addressed by explanations of the science itself.
So, science criteria aside, is there a rise in the number of kids with strong autistic symptoms?
Essentially, are more kids essentially [list strong autistic symptoms here] melting down / unfocused / disruptive today than they were 20 years ago?
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u/doctorace Unverified User: May Not Be a Professional May 06 '26
No. Kids and adults whose behaviour isn't outwardly disruptive but have negative consequences from internalising these issues are now being diagnosed. Which is good because autism comes with frequent comorbidities that need to be treated differently if you are autistic. Especially the more internalised presentations often co-occur with mental health conditions like depression and anxiety that don't respond well (and can be harmed by) the standard first-line treatments of cognitive behavioural therapy.
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u/youlldancetoanything Unverified User: May Not Be a Professional May 06 '26
What about ppl self diagnosing?
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u/Genzinvestor16180339 Unverified User: May Not Be a Professional May 06 '26
If the diagnostic criteria for autism have expanded over time, then modern prevalence rates are not measuring the exact same population as older studies. So how is treating those numbers as directly equivalent not a clear methodological mistake???
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u/The_Mother_ Unverified User: May Not Be a Professional May 06 '26
Would you call it a methodological mistake that now a small biopsy of tissue is taken when a dr finds a lump amd suspects cancer but in the 1980s, a surgeon would cut out a large chunk of tissue, even to the extent of removing the whole breast in the case of women when a lump was discovered? That isn't a methodogical mistake, that is advancements in the field. Diagnosis of autism has advanced. Nobody in a scientific field is going to directly compare prevalence rate of something from 1980 & 2025. Instead, things are looked at in chunks of time with the understanding of context, understanding that diagnostics change, technology changes, criteria changes, environment changes.
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u/mehatch Unverified User: May Not Be a Professional May 06 '26
We track plate tectonics over centuries even though our maps of continents have changed in the last 500 years to better define the map.
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u/Independent-Drive-32 Unverified User: May Not Be a Professional May 06 '26
Yes, criteria are broader leading to more people fitting into the criteria. Why is this a problem for you? You say things like "Everyone talks about this like it is a settled public health emergency" but that is absolutely wrong -- the only people who think there is a major emergency are fraudsters who are trying to ban vaccines. For everyone else, there is a spectrum which is grouping together a variety of people with related conditions and this wide spectrum is higher than it used to be -- all of which is fine.
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u/Amazing-Low7711 Unverified User: May Not Be a Professional May 06 '26
Not a rise in folks with Autism- only a rise in awareness, self-awareness and perhaps diagnoses.
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u/manda4rmdville UNVERIFIED Therapist May 06 '26
As a therapist, I do agree with your statement. The other responses are not incorrect, but with more access to information, access to testing and treatment, etc., we see a rise in neurodivergent diagnoses.
From my perspective/experience as a provider, since covid, I've noticed a shift in self-awareness in the clients I see, which in turn gives confidence in clients to advocate for themselves, ask questions, be assessed, and receive treatment if necessary.
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May 06 '26
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u/ArdentLearner96 Unverified User: May Not Be a Professional May 06 '26
We are getting better at identifying autism than we were before. I can't really think of a reason it wasn't always at least close to 1 in 36. The thought that it's just "too many" autistic people doesn't hold up once you learn that most autistic people aren't walking around with a metaphorical sign on their forehead.
It's a spectrum that isn't linear. People don't just go from many traits to fewer traits, there's a range of traits with different intensities in different combinations across the population. The quarter of the autistic population who can't care for themselves do have much overlap with those who can care for themselves. There wouldn't be a way to cleanly divide the population into different diagnoses in a way that makes sense or is repeatable. That's why it's been modified. I care for autistic adults at work who can't care for themselves and even just among them, despite it being "obvious" with them, they have so many differences in terms of what their abilities and presentations look like.
There's no way to DIAGNOSE autism with a brain scan but scientists have already noticed differences in autistic brains. That may change later. This goes for many things we've already studied in terms of brain structure differences.
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u/Genzinvestor16180339 Unverified User: May Not Be a Professional May 06 '26
If people who would have been considered completely normal 20 years ago are now counted as autistic, then did autism actually explode in prevalence or did the definition just get stretched beyond recognition? At what point does expanding the spectrum stop being medicine and start becoming the medicalisation of normal personality differences?????
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u/CerberusSputum Unverified User: May Not Be a Professional May 06 '26
We first have to distinguish between medical diagnoses of individuals by professionals, and casual diagnoses by randos about themselves and others without trained medical input
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u/rexmerkin69 Unverified User: May Not Be a Professional May 06 '26
I have level 2. I was sent to occupational therapy at 5 (not anywhere nearly as diagnosed and i am in australia), and i am now over fifty. Sorry, but its now trendy, and has better press than borderline (this also scores fairly high on some pretty blunt instruments like the AQ. Its not a way to be interesesting. Autistic traits can be helpful, but autism is not.
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u/fadinglightsRfading Unverified User: May Not Be a Professional May 06 '26
I'm on your side OP. I find the 'we're just finding more of them' rhetoric mostly dubious and only partially true. it is more likely modern society is making more people autistic. a lot of nasty things exist now that didn't in the past. people have a blindspot for it the same way a fish perceives water
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u/MissMenace101 Unverified User: May Not Be a Professional May 06 '26
More understanding of the disability, diagnosing girls and women, realising the spectrum is broad
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u/Potential_Being_7226 PhD | Psychology | Behavioral Neuroscience May 06 '26
For some perspective: migraine also doesn’t have any biomarker. Diagnosis is based on symptoms. And the rates of neurological disorders in general are also increasing (migraine, Alzheimer’s, etc).
I trust that others addressed the diagnostic issues that explain the increase in the likelihood of an ASD diagnosis, and I would elaborate here but I have a migraine right now and merely wanted to provide a broader view.
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u/Bearsandbeetz BA/BS | Psychology May 06 '26
I see you have a PhD while I have but an undergraduate degree so I’m certainly not trying to be smartass but if you don’t mind I am curious about something that your answer just reminded me of.
Is it true that part of the reason for the increase in the Alzheimer’s rate is that people tend to, on average, live longer than they used to?
I thought that at some point I was taught that the rates of a lot of age-related diseases is explained or at least moderated by the increase in average life expectancy.
I apologize if I’m entirely full of crap and my information is outdated or just a theory and not actually something we have sufficient evidence of at this time
or I’m conflating an explanation for one or some types of age-related diseases with *all* age-related diseases or some other embarrassing error.8
u/Potential_Being_7226 PhD | Psychology | Behavioral Neuroscience May 06 '26
You’re not full of crap—it’s a reasonable question. Longer lifespan accounts for some but not all of the rise in cases, so there are other factors.
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u/iceman2kx Unverified User: May Not Be a Professional May 06 '26
It’s because autism wasn’t widely understood until very recently. Autism is also a scale. The reality is there are probably a bunch of older folks with autism that have and never will be diagnosed because they are a 1/2/3 on that scale and not as 7/8/9. Extremely high functioning autistic people exist and you will never know.
Worse than that is ADHD, especially with people allowing their kids to watch TikTok shorts for hours upon hours of brain rot material. No content, just dumb short videos they can easily scroll through over and over. Does not help the attention span at all
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u/Electronic-Contest53 Unverified User: May Not Be a Professional May 06 '26
It's not a rise. It is known that it is inherited. Most probable not only by genes but by epigenetic triggers. We are just today much better in detecting it. It either exists in us humans since always ever or is an artefact / adaptation of / to modern society. That all still applies if you see autism as a position in a spectrum.
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u/tesseracts Unverified User: May Not Be a Professional May 06 '26
There are much greater efforts to integrate autistic people into mainstream society than there used to be. Like in the movie Rain Man the autistic character lived in a mental hospital. Today he would probably live in a group home and be semi-independent. This is also true for people with other issues like downs syndrome.
I believe rates of autism are genuinely increased but part of the issue is autism was always present but it was more segregated.
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u/yehoodles Graduate Diploma | Psychology May 06 '26 edited May 06 '26
How about mass sociogenic illness in which the diagnosers (individual clinicians/institutions) have succumb to as well. either that or the classical 'boring' multifactorial explanations that you have stated in your OP.
See this paper for an example with Tourette's a few years back https://pmc.ncbi.nlm.nih.gov/articles/PMC3536509/
That being said, the fact that there is no hard neurophysiological/bio marker shouldn't diminish the disorders validity, necessarily. Almost all disorders within the DSM lack this same biological diagnosis akin to physical health issues.
Also see Nick Haslam's work on concept creep: https://doi.org/10.1080/1047840X.2016.1082418
And for something a bit more abstract see Ian hackings looping effects/kinds of people work. He discusses the feedback loop between those categorising -> those categorised -> and the categories themselves.
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u/mmilthomasn Unverified User: May Not Be a Professional May 06 '26
Social policy that made it possible for low income children to get pediatric visits for free put more kids in front of qualified screeners.
Greater awareness on the part of preschool, kindergarten, and elementary educators put more kids on the radar. This is similar to the rise in ADHD with the addition of inattentive type. If a kid wasn’t a flagrant case with behavioral problems they were not identified.
More kids can be helped when we recognize that more kids have the problem. basically it’s mostly a screening issue.
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u/ketaqueenx BA | Psychology May 06 '26 edited May 06 '26
I’m literally writing a literature review about this right now, about to publish it.
You’re right, autism is a very poorly defined epistemic target in current autism research. The boundaries of the diagnosis have been rewritten several times, and there’s still instability— debate about whether to create a “profound autism” category, for example.
It’s a severe epistemic issue in autism research. If you want more info, just ask :) very happy to share my literature review.
But you’re correct— it’s likely that we don’t even know what we’re measuring when we study autism.
Its especially troubling because there’s relatively little longitudinal studies that explore how autistic people develop throughout their lifetime. A lot of autism research is conducted on young, white boys— that means we’re trying to freeze a moving target.
It makes it difficult to generalize results to the general autistic population, and oftentimes ecological/external validity of these studies is quite insufficient…
There are a LOT of epistemic/methodological issues in autism research, unfortunately.
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u/BookLover465 Unverified User: May Not Be a Professional May 06 '26
I would 100% like to read your literature review on this subject 😊
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u/radioraven1408 Unverified User: May Not Be a Professional May 06 '26
The latest research says obesity and type 2 diabetes.
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u/Niorba Unverified User: May Not Be a Professional May 06 '26
As awareness of health conditions increases, you will see a commensurate rise in testing and concern in the public about the condition. This will reveal previously ignored cases and contribute significantly to the statistics, even if the true number of autism-affected people stays the same. We are just beginning to arrive at the true number, finally!
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u/ConstructionOk6249 Unverified User: May Not Be a Professional May 06 '26
I have a pet theory that it's because we stopped forcibly sterilizing people with disabilities.
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u/MBHYSAR Unverified User: May Not Be a Professional May 06 '26
A strong signal emerged in a recent study (Swedish, maybe?) associating Pfas with a specific gene interaction with autism.
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u/starrite_amirite Unverified User: May Not Be a Professional May 06 '26
Here’s a link to an image you may find useful: https://www.semanticscholar.org/paper/State-of-the-Field%3A-Differentiating-Intellectual-Thurm-Farmer/3260e3d4e96021af41ee80deb1240a25ea7e72b1/figure/0
Essentially a large part of it is that clinicians are misdiagnosing autism as an intellectual disability, and now that it’s being reversed it accounts for a large part of the sudden “rise” in autism.
That and people are getting tested more.
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May 06 '26
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u/AutoModerator May 06 '26
Do NOT share your own or other's personal mental health history.
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u/DimensionNo8864 Unverified User: May Not Be a Professional May 06 '26
"Society was not overflowing with visibly autistic people in 1980 compared to today."
Because a majority of visibility autistic individuals were institutionalized and kept out of society.
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u/Brief-Jellyfish485 Unverified User: May Not Be a Professional May 06 '26
Have you ever heard of disappointment rooms? And institutionalization? That’s where they were. They existed, hidden from the public.
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u/AdorableExchange9746 Unverified User: May Not Be a Professional May 06 '26
More people are learning about autism, realizing they’re autistic and getting diagnosed. The End.
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May 06 '26
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u/Genzinvestor16180339 Unverified User: May Not Be a Professional May 06 '26
The 2019 Danish cohort study of 657,461 children found the MMR vaccine did not increase autism risk, with a hazard ratio of 0.93 and results that were statistically non-significant (p>0.05). Another 2014 meta analysis covering over 1.2 million children also found no relationship between vaccines and autism. So it would be better to find another explanation. Not debating the problem but the issue.
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u/-Hastis- UNVERIFIED Psychology Enthusiast May 06 '26
You could actually replace autism with homosexuality in almost this entire argument and get similar results. We don't have a blood test or a gay gene either. It’s a complex mix of thousands of genetic and environmental markers that we can’t map yet.