SLPCase-ControlAutism research : official journal of the International Society for Autism Research2019

Incidence time trends and socioeconomic factors in the observed incidence of autism spectrum disorder in israel: A nationwide nested case-control study.

Avital Segev, Marc G Weisskopf, Hagai Levine and 2 others

PMID 31365189

WHAT IT FOUND

ASD diagnosis rates in Israel rose until 2009 then flattened.

Minority groups had lower diagnosis rates than the general population. Higher household income was linked to more diagnoses, but this association disappeared once population group and paternal age were accounted for.

Key findings

01Cumulative incidence of ASD for all Israeli-born children at age 8 increased from 0.31% for the 2000 birth cohort to 0.64% for the 2007 birth cohort.

02Incidence rates began to plateau in birth cohorts from 2009–2012, as shown by overlapping lines in the cumulative incidence graphs.

03The association between higher household income and increased ASD incidence became negative after adjusting for population group and paternal age.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study relies on NII benefit claims, so it may miss true ASD cases if families did not file for benefits, or include over-diagnoses if benefits were claimed without strict clinical need. Multiple children from the same family were included, but the researchers could not correct for this dependency because family identification data was not available. The study is based on administrative data, so it lacks detailed clinical information on symptom severity or specific diagnostic criteria beyond the general DSM-IV confirmation.

The easy way to misread this

Do not conclude that higher income causes higher ASD incidence. The apparent association disappeared after adjusting for population group and paternal age, indicating that the initial finding was confounded by these factors.

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