A subscriber has asked what I think is behind the dramatic rise in autism since the 1960s.
Great question, especially given that the prevalence of autism in 1970 was generally considered to be 1 child in 10,000, whereas today, according to 2025 CDC data, 1 in 31 children is being identified with autism spectrum disorder (ASD). In the last twenty years, the number of children identified with autism has risen by some 300 percent.
The mental health community attributes that dramatic rise to greatly improved diagnostic criteria and procedures. Let’s examine that claim by delving into the history of the diagnosis and how it is made:
In 1970, my first year in graduate school, the terms autism and autistic were associated with a diagnosis of either childhood schizophrenia or serious cognitive deficiency (then known as “retardation”). The children in question exhibited bizarre behaviors like hand-flapping, avoided eye contact, and were unable to participate in back-and-forth conversation. They were often described as being “completely out of it” and “living in their own world.” It was not until the 1980 publication of the Diagnostic and Statistical Manual (DSM-III) that Infantile Autism would appear as a distinct psychiatric diagnosis. Six diagnostic criteria were required, including appearance before 30 months of age, gross distortions or deficits in language development, and peculiar, sometimes rigid attachments to objects. The DSM-IIIR (1987) changed the title of the diagnosis to Autistic Disorder and described autism as “pervasive lack of responsiveness to other people.”
When DSM-IV was published in 1994, the number of diagnostic criteria for Autism Disorder had increased to sixteen and four subcategories were listed: Asperger’s Disorder, Pervasive Developmental Disorder, Rett’s Disorder, and Childhood Disintegrative Disorder. Asperger’s became synonymous with the term “high-functioning autism,” referring generally to intelligent children who lacked social awareness and interpersonal skills.
In 2013, when the DSM-V appeared, the APA had collapsed the four subcategories into Autism Spectrum Disorder or ASD. The diagnostic criteria for ASD allowed for autism with or without intellectual disability, with or without language impairment, and with severity levels ranging from “requiring support” to “requiring very substantial support.”
As is plain to see, from 1980 (DSM-III) to 2013 (DSM-V), the definition of autism expanded to include just about any child who persistently exhibits any behavior that’s even slightly odd. The diagnosis now captures children who are shy, obsessive, easily frustrated and lacking in emotional control (frequent tantrums), impulsive, and inattentive. In and of themselves, none of those behaviors is pathological. Furthermore, it has been my experience that they can be corrected by simply modifying the parents’ approach to discipline.
