Why Is Autism More Commonly Diagnosed in the US?

The question Why are there so many autistic people in the US? is often asked, leading to discussions about the prevalence and diagnosis rates of autism in the country. Various factors contribute to this perception, including changes in diagnostic criteria and increased testing.

Changes in Diagnostic Criteria

The American Psychiatric Association (APA) broadened the definition of autism in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). This change was made just over a decade ago and made it easier for more individuals to be diagnosed with autism. A systematic review by Sturmey and Dalfernes (2014) found that the application of DSM-5 diagnostic criteria resulted in about a third reduction in the number of individuals diagnosed with autism spectrum disorders. This indicates that while the prevalence is not necessarily increasing, the diagnostic thresholds have changed, leading to more diagnoses.

Societal Factors and Testing Options

Another significant factor is the increased awareness and acceptance of autism in the US. There is a greater emphasis on identifying and addressing the needs of individuals with autism. This has led to more testing and evaluation options, contributing to higher rates of diagnosis. In the United States, there is a robust healthcare system and a culture that encourages seeking medical and psychological help. As a result, more people are being tested for autism, and those who meet the criteria are being diagnosed.

Stereotyping and Conformity

The US has a tradition of valuing conformity, which can also affect how autism is perceived. Those who do not fit the national stereotype may be seen as deviant or problematic. This can lead to a tendency to pathologize people who do not conform. However, it's important to note that the proportion of autistic individuals is not actually higher in the US but may simply be more visible due to improved diagnostic methods and societal acceptance.

Global Comparisons and Sociopolitical Factors

It's worth considering global comparisons when discussing autism prevalence. In developed nations like the US, there are better healthcare systems, more awareness, and stronger protections against discrimination through laws like the Americans with Disabilities Act (ADA). These factors can lead to higher rates of diagnosis and treatment. Contrast this with underdeveloped or authoritarian nations where people with disabilities or mental illnesses may face discrimination, lack of treatment, or even censorship of statistical data. In such environments, the rates of diagnosed autism are likely lower due to multiple factors including societal stigma, lack of access to healthcare, and government control over health data.

Conclusion

The increase in autism diagnoses in the US is not due to a higher prevalence of autism itself but rather to better diagnostic tools, more awareness, and a more inclusive society. While other countries may have lower rates of diagnosis, these are often due to systemic barriers rather than an actual reduction in the number of autistic individuals. It's important to view these trends within the context of global health and social factors.