CRITICAL ANALYSIS OF THE GROWTH OF AUTISM SPECTRUM DISORDER DIAGNOSES IN THE LIGHT OF SCIENTIFIC ADVANCES: PROGRESS IN THE IDENTIFICATION OR INCREASE IN PREVALENCE?

Abstract

Autism Spectrum Disorder (ASD) has stood out in recent decades for a significant growth in the number of diagnoses at a global level. This phenomenon raises questions about whether this increase reflects a real growth in the prevalence of the condition or whether it is mostly related to the evolution of diagnostic criteria and the improvement of clinical identification methods. This study aims to investigate the extent to which scientific, methodological and social advances have influenced the diagnostic rates of ASD, to the detriment of an effective increase in incidence. This is an integrative literature review, with a qualitative approach and exploratory character. Scientific articles, guidelines, and official documents published between 2000 and 2024, available in databases such as PubMed, Scopus, SciELO, Lilacs, and Web of Science, were analyzed. The data were analyzed in the light of the transformations observed in diagnostic manuals, such as the DSM-5, as well as international epidemiological registries, such as those of the Centers for Disease Control and Prevention (CDC). The results indicate that significant changes in the classification criteria, greater training of health professionals, increased access to assessment services, in addition to increased awareness of society and families about the disorder, are determining factors for the increase in the number of diagnoses. In addition, the inclusion of more subtle manifestations of the spectrum is highlighted, such as mild and atypical cases, which previously went unnoticed. Although the role of environmental and epigenetic factors in the increase in prevalence cannot be completely ruled out, the main factor responsible for the increase in ASD diagnoses is related to technical-scientific advances and the greater sensitivity of health systems to the early and accurate identification of the disorder.