Diagnostic shifts explain increases in autism, ADHD, and intellectual disability

  • Pediatrics

  • Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • From 2009 to 2017, about 1 in 6 US children were diagnosed with a developmental disability.
  • Increases in rates of autism, ADHD, and intellectual disability were accompanied by decreases in prevalence of nonspecified developmental delay.
  • Demographic and socioeconomic disparities in diagnoses persist. 

Why this matters

  • These data from the National Health Interview Survey can guide clinicians in being mindful in particular of biases related to socioeconomic and demographic factors in making screening and referral choices.

Key results

  • From 2009-2011 to 2015-2017, prevalence of “any disability” increased (16.2%-17.8%; P<.001 as did:>
  • ADHD: 8.5%-9.5% (P<.01>
  • Autism: 1.1%-2.5% (P<.001>
  • Intellectual disability: 0.9%-1.2% (P<.05>
  • But values for "any other developmental delay" decreased during that same period: 4.7%-4.1% (P<.05>
  • Non-Hispanic black children were most likely to be diagnosed with learning disabilities or stuttering/stammering.
  • Children with private health insurance were less likely to be diagnosed with learning disabilities, but more likely to receive an autism or ADHD diagnosis.
  • Study design

    • Data from 2009-2017 National Health Interview Survey, with parent-reported diagnoses.
    • Funding: No external funding.

    Limitations

    • Parent report carries limitations.