Autism in U.S. Children: 2022

Date: April 17, 2025

Publication: CDC Morbidity and Mortality Weekly Report

Executive Summary

This CDC report presents updated findings from the Autism and Developmental Disabilities Monitoring (ADDM) Network on the prevalence and early identification of autism spectrum disorder (ASD) among U.S. children aged 4 and 8 years during 2022. It covers data collected from 16 sites and compares trends across age groups, race and ethnicity, sex, and socioeconomic status.

The report highlights a continued increase in ASD identification, with earlier diagnoses becoming more common, particularly in underrepresented groups.

Key Provisions

• Introduction

• ASD is a developmental disability marked by social communication challenges and repetitive behaviors. Early diagnosis is essential for accessing support services. The ADDM Network has tracked ASD since 2000 and began monitoring children aged 4 in 2010 (pg. 2, para. 1–3).

• Results

• Prevalence Among 8-Year-Olds
• National average ASD prevalence: 32.2 per 1,000 children (1 in 31).
• Site range: 9.7 per 1,000 in Laredo, Texas to 53.1 in California.
• Boys were 3.4 times more likely than girls to have ASD (49.2 vs. 14.3 per 1,000).
• Prevalence was higher among Asian/Pacific Islander (38.2), Black (36.6), and Hispanic (33.0) children than White children (27.7) (pg. 5, para. 1–3).
• Diagnosis and Record Documentation
• Among 8,613 children aged 8 with ASD:
• 68.4% had a documented diagnosis,
• 67.3% had special education eligibility,
• 68.9% had ICD codes.
• 34.6% had all three indicators (pg. 6, para. 1–2).
• Cognitive Ability
• 39.6% of children with cognitive data had an intellectual disability (IQ ≤70).
• Black children had the highest proportion of co-occurring intellectual disability (52.8%) (pg. 7, para. 1–2).
• Age at Diagnosis
• Median age at diagnosis: 47 months.
• Children with intellectual disability were diagnosed earlier (median 43 months) than those without (49 months) (pg. 7, para. 3).
• Prevalence Among 4-Year-Olds
• Overall prevalence: 29.3 per 1,000.
• ASD was suspected in an additional 3.1 per 1,000.
• Children born in 2018 (age 4 in 2022) were 1.7 times more likely to be identified by 48 months than children born in 2014 (age 8 in 2022) (pg. 8–9).

• Conclusion

• ASD prevalence among children aged 8 years increased from 2020 to 2022, with wide differences across the 16 sites. These differences may reflect variations in local diagnostic practices and access to services rather than actual differences in ASD occurrence (pg. 15, para. 1).
• Children from historically underserved racial and ethnic groups (Asian/Pacific Islander, Black, Hispanic, and multiracial) continued to show higher rates of ASD than White children, reinforcing a pattern first noted in 2020 (pg. 15, para. 1).
• In five of the 16 sites, children living in lower-income or more socially vulnerable neighborhoods had higher ASD prevalence than those in more advantaged areas, suggesting that access to diagnosis is improving across income levels but still uneven (pg. 15, para. 1).

• Researcher's Opinions

• Significant differences in ASD prevalence across the 16 sites were likely due to variation in community practices, such as how and where children are identified (e.g., health vs. education settings), rather than actual differences in ASD occurrence (pg. 10, para. 1).
• Some areas, like California and Pennsylvania, showed higher prevalence possibly due to robust early screening initiatives and inclusive Medicaid policies that expand access to diagnostic services (pg. 10, para. 2).
• Higher rates of intellectual disability among children from certain racial and ethnic groups may reflect the impact of social determinants of health—such as access to prenatal care, nutrition, and environmental risks—on developmental outcomes (pg. 13, para. 1–2).
• Although early ASD identification has improved overall, disparities in service access and diagnostic tools still exist. Differences in insurance coverage, state policies, and provider training contribute to uneven identification across communities (pg. 12–13).

• Methods

• Surveillance was conducted at 16 sites across 15 states and Puerto Rico. Data were collected from medical and educational records. Children were counted as having ASD if they had an ASD diagnosis, special education eligibility, or qualifying ICD codes. Cognitive ability and diagnostic test data were also abstracted (pg. 3–4).

• Impact of COVID-19

• Identification slowed briefly in early 2020 but rebounded by mid-year.
• Children born in 2018 still had more evaluations and diagnoses by age 4 than those born in 2014 had by the same age (pg. 9, para. 1–2).

• Limitations

• Data are not nationally representative.
• Variability in data quality and access across sites.
• Demographic categories might not reflect individual identities or Census standards.
• Intellectual disability estimates may not align with clinical diagnoses (pg. 14, para. 1).

Source: https://www.cdc.gov/autism/data-research/index.html