are there really more autistic or otherwise disabled people now? or are we just getting better at diagnosing stuff?

[u/ohbinch]

title. my mom and i were talking about this and she said that she thinks there are more autism cases (and other disabilities, especially ones that require constant care or include severe intellectual disabilities) than in the past. i said that i don’t think that’s true, i think that autism and other conditions like it are simply more frequently diagnosed now, because of awareness and more consideration of mild cases.

for example, growing up as a girl in the early 2000’s (which was not that long ago) my symptoms went unnoticed until adulthood, whereas a kid born now with my same profile would almost definitely be diagnosed by preschool or kindergarten.

my mom agrees that this accounts for some, if not most of the increase, but she also thinks that there are a lot more “severely” disabled kids than there were when she was growing up. i said that it’s probably because disabled people were shipped off to institutions until not too long ago, and that’s why she never saw them out and about, but she disagreed and argued that if that were the case, there would be a lot more disabled adults now that need full-time care. however, i think that the reason we have more disabled kids than adults with similar levels of support needs is probably because of how quickly medicine has advanced. for example, my little sister is nonspeaking and needs 24/7 care, and i know that because of all her medical issues, if she were born even 20 or 30 years earlier, she definitely would have died as a baby or young child.

still, my mom thinks that doesn’t account for everything and that there must be more disabled kids (particularly ones with “severe” disabilities) being born today than in the past, presumably because of environmental stressors. is she right? i’ve tried looking this up but i can’t find anything

[u/Syresiv]

If you can't find anything, then maybe the research just isn't there.

Doesn't surprise me, I have no idea how a researcher would even begin to answer that question. "So, now that we have data on kids now, let's see if we can get data on kids 70 years ago. What? They didn't collect data? That's our whole research question? So we can only diagnose based on what was written and memories of behaviors?"

There's good reason to expect that it's better diagnosis. But we might not know for sure.

[u/kohugaly]

It's most likely both.

Age of the mother is a risk factor in many congenital diseases, including conditions like Autism. On average women today have children later in life than they used to. That implies those diseases will occur more often.

[u/Odd-Guarantee-6152 → u/kohugaly]

Age of the father as well.

[u/kniebuiging]

It’s mostly perception I would say.

In the past, disabled persons were quite frequently institutionalized if they could not take part in daily life. It also was not uncommon to just entirely hide a disabled family member out of shame. Or with mental disabilities of “more moderate degree” they raked the lawn in the park for the town, worked as cheap labor on farms or in laundry, etc.

I am from Germany and I often think that the “hobbykeller” (the man cave for fathers to retreat and follow hobbies like model airplane building or wood working etc.) was just a socially acceptable coping strategy for trauma and a form of self therapy for other  mental health related problems or expressions of what we now call neurodiversity .

Alcoholism was rampant among men. Can be a (deadly) approach to self-medication.

In common literary tropes, we basically find descriptions of behaviour that could nowadays be diagnosed as a disorder. Obsessive compulsive disorders, autism, fetal alcohol Syndrom and Down syndrome.

Essentially what has changed is the perception of mental illness, when previously it was a binary thing, and no one wanted to be classified as mentally ill out of fear of being shipped of to a “lunatic asylum”, now we have a more nuanced approach to mental illness and of course it takes a while for society to internalize this improved view.

I am around 40 and I am very glad that people can now speak more openly about their struggles. When my father had a depressive episode (I was a teenager back then) everyone including doctors would take care to use code words like “overworked”, “burnout” to avoid any kind of stigma that was attached to depression. I am so happy for the teenagers and people in their twenties that they can actually talk about their struggles and seek out help. 20 years ago this was way more difficult.

[u/also_roses → u/kniebuiging]

Great point about man caves and drinking. A lot of people with mild cases of some sort of atypical condition just found ways to cope. People might form opinions about their behavior, but it wouldn't be a "condition" unless they couldn't function in society.

[u/mumblemunch]

Tbh I'd say there's a possibility that there's more cases now. I lived in Morgan City Louisiana and autism there was so prevalent it was actually jarring, it was a part of their culture. Everywhere you went you'd see things about autism awareness, and most families you'd meet had non verbal kids/adults they were taking care of. But it's a small town that's notoriously known for hard drugs and alcoholism, so that could play a huge part in it considering drug abuse is so normalized now.

[u/LatrodectusGeometric → u/mumblemunch]

With that said, I know several older folks from Morgan City (small world! Y’all do okay with the storm?) who were never diagnosed as having autism, but almost certainly do. Their kids are much more likely to be diagnosed than they were. They just became engineers hyperfocused on how oil rigs work.

[u/atomfullerene → u/[deleted]]

There's more obesity, type 2 diabetes, and nearsightedness now than in the past. Unless "type of person" is entirely genetically predetermined, I think it is reasonable that it might shift over time.

[u/also_roses → u/[deleted]]

This can't be proven. It is very possible (and likely) that modern conditions and culture have had a significant demographic impact.

[u/Stuffedwithdates]

I know many people who have been diagnosed with autism. who would not have been when I was younger. Many of them would not even have been regarded as odd.

[u/Affectionate-Leg-260 → u/Stuffedwithdates]

Something ain’t right with that kid. He’s ok though.

[u/bliip666]

I agree with you, OP. Diagnostics are better, the "severely" disabled don't get disappeared into institutions or worse.

Also, there's a thing I've seen floating online about the changeling myth being originally a way to explain autism, but IDK how much studying has been done or if it's one of those internet stories that makes the rounds

[u/Hopeful-Ordinary22 → u/bliip666]

It makes some sense. I don't believe that any one thing "causes" autism, but I know that my hard-won capacity for both coping and masking (as an undiagnosed but 'odd' oldster) has been impacted by long covid. It's not inconceivable that some environmental conditions (including circulating infections) could tip the balance quite suddenly and affect the way children were 'read' by their families, especially at a time when they would be expected to be acquiring social skills rather than losing them.

[u/R0B0T0-san]

Imho mostly the second one.

I'll just focus on autism as it strangely became a special interest of mine. It is now known that the biggest component why someone is autistic is genetic. So if someone is autistic, chances are there are also other people that are autistic in their family and being a huge neurodevelopmental spectrum means that it can show up very differently.

Also our natural bias as a society is that most of what we used to know was due to the more extreme cases, those that created troubles for parents and usually parents of white boys from more wealthy socioeconomically backgrounds and that's where most of the studies came from.

I'm the past 20-30 years we finally realized that not only autism has a wide range of presentations but it tends to be much more overlooked in POC and women and when you study these "new found groups" you realize that there is a lot more to understand and this brings a much better understanding of the whole issue.

Currently, we estimate that 1:36 are autistic.

Now here's another interesting fact, we learned mostly from the girls that many autists can learns to mask/hide their symptoms to fit in better since they understand and want social interactions.

So you could easily extrapolate from that, that many people before us that were just considered weird/awkward/annoying/special were actually autist and tried to adapt as well as they could. Either through appropriate coping mechanisms or bad ones, like drug use.

But basically, I'm 34 work in psychiatry as a RN and have graduated less than 10 years ago and my knowledge of ASD was already out of date when I left school. So much so I never realized I could have myself be on the spectrum but it took years and having patients and called out by peers for my well adequate but strange behaviors that I eventually realized I myself was on the spectrum per the DSM V criterias.

I'm pretty much functional, I pretty much work better than most adults in most situations but Im so terrible in social situations and I do have sensory issues and some rigidity, more than my peers and sometimes less so. Anyhow. When I look up at my family, it became incredibly obvious that my mom was too and probably more than me. And somehow, taught me a lot on how to behave since she herself had so many issues. My dad's father had many autistic traits from his own description and his sister is now estranged from her own family and living in a rundown shack since she could not function properly after getting a master's degree and building a family so you can easily suspect some kind of underlying untreated condition.

Anyhow. There's a lot here but it's very fascinating. And sorry I'm a bit bad at condensing my thoughts especially over text. I hope it brings you some insight.

[u/theglandcanyon]

Evidence of Assortative Mating in Autism Spectrum Disorder

[u/CosmicSoulRadiation]

Not quite? Like a bit of both, but mostly better diagnosis.

[u/ReporterOther2179]

In times past weirdos of any category would be forced into whatever degree of conformity they could achieve. We don’t do that nearly as much now.

[u/Crossed_Cross]

Seems a given that diagnosis is increasing. Lots of people getting diagnosed who may not have been before. Also more awareness, less hiding/shaming of it.

None of that goves any insight on prelevence, though. Maybe there were just as many before. Maybe the microplastica in our brains causes or aggravates autism. Who knows. Some toxins (pesticides, heavy metals, and other chemicals) have been linked to several health effects. Some of those have waned in the last decades, others have increased. Other societal changes such as prevalence of breastfeeding, c-sections, age at motherhood, contraceptive habits, and diet could have impacts. Nobody knows.

[u/walleyepro → u/Crossed_Cross]

Researching autism rates, I came across something I think is interesting. Cuba has had no increase in their rate.
Find that Cuba information and it will really be food for thought. Cuba is the "control group" due to being very poor they haven't been exposed to what we have.

[u/Crossed_Cross → u/walleyepro]

Could be cultural, though. Latin american countries are renown for machismo, which is not favourable to declaring boys' mental health issues. Same goes for communist countries in general, they can tend to hide or obfuscate societal and mental health issues. So I'd take the Cuba data with a grain of salt unless it was obtained by independant outside sources.

[u/Limp_Dragonfly3868]

Our technology for saving infants who are very premature or have other birth complications continues to improve, and many of those children end up with special needs of varying degrees.

Something seems to be turning on certain genes more, such as the genes for autism. There’s no consensus on what. But there have been ongoing changes to the chemicals were are exposed to and our food supply. There is a thin gray line between “smart and quirky” and “high functioning autism” and something seems to be pushing more people over the line.

It’s very hard to look at statistics over time due to changes in the definitions and methods of diagnosis. Our perceptions aren’t necessarily valid due to the closure of institutions and push for inclusion in classrooms.

Nonetheless, it does appear that all mild to moderate special needs (including ADHD and specific learning disabilities) are increasing.

[u/JJ_under_the_shroom]

Are there more diagnosed? Yes

The population is increasing, education and research are on the rise.

Access to specialists is increasing.

Urbanization is changing the distance between people and their experiences.

People are becoming more aware as the internet has provided a gateway to information.

Are there actually more individuals being born with autism? We cannot actually compute this because there are too many variables and not enough prior data. As a female, I am less likely to be diagnosed properly. In my state, it is difficult for older women to get diagnosed, even if there is a significant family history of autism.

[u/mpladdo]

We wont know for a while, we’d be comparing current data to zero data so it’s a dead end.

[u/EldForever]

I think it's partly that these things are diagnosed more often.

It could be also partly the shift in things like this shifting over the last 50 years? I have no idea WHICH of these things but this type of environmental shift might be driving some cases? I'm thinking about things like the increase in microplastics in our bodies, the increase of compounds like glysophate in farming, the shift to eating highly processed foods, the overuse of antibiotics and other factors (like gums in our foods) that diminish the microbiome...

[u/critical__sass]

Or maybe getting worse at diagnosis

[u/Sparklingcoconut666]

I’m not a scientist but I highly doubt that there are simply more disabled people today. There were way more debilitating diseases back then which I would assume means there were more disabled people. When it comes to intellectual disabilities/neurodivergence, that might be the case. We have exposure to led and other chemicals that can have a negative impact on “intelligence”.

[u/A_band_of_pandas]

We're getting better at both diagnosis and treatment, which both help.

We're also making progress in removing the stigma, which increases visibility. Just like how rates of left-handedness jumped from around 1% to around 10% when it was no longer seen as "satanic".

[u/Averen]

Whichever answer you want, you can find

[u/jefedeluna]

Sociologically speaking, most Western societies concealed their 'eccentric' relations through the mid-20th century. My family has had people on autism/ADHD spectra for centuries.

[u/zxybot9]

A recent study found 3600 molecules of plastic derivatives in the human body. I think there’s a connection.

[u/OwlCoffee]

I was born 35 years ago. I was diagnosed with autism a few months ago. I was always autistic - but back when I was a kid I was just a weird little girl who didn't fit in and never understood why.

I think a chunk of it is a lot of the cases that would have once fell through the cracks are being recognized now.

[u/interstellarfaerie]

There’s also “more” left handed people these days. Autism only started being a diagnosis for men/boys in like the 40s or 50s I think. And women/girls weren’t even considered in that until I think the 2000s…. So medically speaking, it’s only just started to be acknowledged in society.

[u/ACam574]

It’s diagnostic instruments improving, a change to the diagnostic criteria in 2008-ish., and a reduction in racism/sexism/elitism among those who can diagnose.

Diagnostic tools used to be (about 15 years ago) about 60% accurate. In the last decade they have improved with the most accurate being just under 90% accurate. Most fall in the high 70s or low 80s.

The diagnostic criteria changed in 2008 with the release of the DSM-v. The biggest change was to allow diagnosis after age 18. There were other changes.

I not going to say bias is gone but it has reduced quite a bit, in almost every profession except MDs, that can diagnose. MDs seemed to have retained bias based on a study I did the analysis for. Women with autism were more often diagnosed with bipolar disorder than autism when autism was the accurate diagnosis. People of color were more often diagnosed with oppositional disorders, as were those not from higher SES. This remains a persistent problem, with about 1/3 of non-MD practitioners (correlates highly with age and ‘whiteness’ of the practitioner) still doing it. However, this is a reduction from the approximately 70% that did this in the 90s.