Temporal and Geographical Variability of Prevalence and Incidence of Autism Spectrum Disorder Diagnoses in Children in Catalonia, Spain.
Laura Pérez-Crespo, Albert Prats-Uribe, Aurelio Tobias and 4 others
PMID 31317678WHAT IT FOUND
In Catalonia, autism diagnoses in children rose threefold between 2009 and 2017.
Prevalence reached 1.23% in 2017, with boys diagnosed 4.5 times more often than girls. The median age at diagnosis was 8 years, indicating significant delays in identifying cases.
Key findings
01The overall prevalence of autism spectrum disorder in children aged 2 to 17 was 1.23% in 2017.
02The incidence of new autism diagnoses increased significantly from 0.07% in 2009 to 0.23% in 2017.
03The median age at autism diagnosis was 8 years, with the highest prevalence found in the 11 to 17 age group.
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 administrative registers, which only capture children who accessed public healthcare services. Children diagnosed in private clinics or educational settings may be undercounted. Diagnosis was not verified by the researchers. Diagnostic practices varied across healthcare areas, with some clinicians using standardized tools and others relying on brief clinical assessments. The increase in diagnoses may reflect better awareness and changes in diagnostic criteria rather than a true rise in the condition's occurrence. Prevalence and incidence rates are estimates based on registered cases and may underestimate the true burden in the population.
Declared interests
One author is the father of a child with autism and a member of two patient advocacy associations. The study was funded by the Health Effects Institute and the Medical Research Council.
The easy way to misread this
Do not interpret the threefold increase in diagnoses as evidence that autism is becoming more common biologically. The authors state this rise is likely due to changes in diagnostic definitions, increased awareness, and improved detection methods rather than a change in the underlying condition.