Autism Diagnosis Is Expanding — At a Cost
Autism may be overdiagnosed — and, Liao and Fombonne argue, that children with the greatest needs may be paying the price.
By
Kerri Miller
April 23, 2026
Clinical Scorecard: Autism Diagnosis Is Expanding — At a Cost
At a Glance
Category Detail
Condition Autism Spectrum Disorder (ASD) Key Mechanisms Overdiagnosis due to diagnostic substitution, clinician boundary stretching, and changes in diagnostic criteria. Target Population Children receiving autism diagnoses in community settings. Care Setting Clinical and community settings.
Key Highlights
Nearly 50% of children diagnosed with autism did not meet criteria upon reevaluation. Concurrent intellectual disability in autism has decreased from 70% to 30% over four decades. Resource allocation is a central concern, potentially disadvantaging children with significant challenges. Guideline-Based Recommendations
Diagnosis
Improve differentiation between autism and co-occurring psychiatric conditions. Avoid mechanical use of standardized tools without considering confounders. Management
Ensure equitable access to evaluation and treatment resources. Monitoring & Follow-up
Regularly reassess diagnostic criteria and thresholds to reflect current understanding. Risks
Overdiagnosis may divert resources from children with the most significant challenges. Patient & Prescribing Data
Children diagnosed with autism, particularly those with milder or ambiguous presentations.
Better-resourced families may secure diagnoses and services more easily, amplifying disparities.
Clinical Best Practices
Clinicians should be cautious in applying autism diagnoses, considering the full clinical picture. Diagnostic processes should prioritize accurate identification of autism to optimize resource allocation. Related Resources & Content
