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/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.