By Shiri Epstein, NoCamels -
A new way of examining the data has found that the number of children diagnosed with Autism Spectrum Disorder (ASD) in Israel increased twofold in the years 2017 to 2021, while cases in toddlers more than quadrupled in the same period.
Autism is a developmental disorder that affects how people interact and communicate, often hindering them in social situations. In many cases, autistic individuals struggle to initiate conversation or respond to others’ initiations and non-verbal cues, maintain eye contact and/or appreciate someone else’s perspective.
The researchers behind the multi-institutional study based their findings on two separate sets of data from the National Insurance Institute, the social security organization used by the entire population, and Clalit, which provides healthcare for around 52 percent of all Israelis.
They determined that the two datasets were especially reliable as Israeli parents of children with ASD will use at least one of the two institutions for services and benefits.
It was vital to cross-reference both datasets to reach an aggregate, however, as the two organizations had slightly varying statistics.
The study was led by Prof. Ilan Dinstein of Ben-Gurion University of the Negev (BGU), alongside Clalit, Israel’s top public healthcare provider; ALUT, the Israeli Society for Autistic Children; and the Ministry of Health.
“ASD prevalence in children 1–17 years old has almost doubled; ASD prevalence in children 2–3 years old has increased by a factor of 4.4,” the researchers said in their findings, which were published at the end of last month in the journal Autism Research.
It is not completely clear why there has been such a significant rise in ASD diagnoses in Israel, Dinstein tells NoCamels, but there are several hypotheses.
“First, awareness has increased and stigma has decreased over the years. Parents, teachers, and clinicians are faster to recognize symptoms and parents are more willing to accept a diagnosis,” he says.
“Moreover, autistic children are eligible for many services and a monthly stipend from the NII so parents are more motivated to seek the diagnosis. In addition, there are several potential autism risk factors that are increasing in the general population, such as older parental age at birth and higher survival rates of premature births.”
Dinstein, who is a faculty member at both the university’s Psychology Department and Cognitive and Brain Sciences Department, as well as deputy director of its Azrieli National Centre for Autism and Neurodevelopment Research, cautions that there may be other, additional factors that we are not as yet aware of.
Among the different age brackets, the proportion of two- and three-year-olds with ASD rose from 0.27 percent to 1.19 percent in that four-year period. In four- to six-year-olds, the proportion rose from 0.8 percent to 1.83 percent, in eight-year-olds it grew from 0.82 percent to 1.56 percent, and in children aged 10 years and over, there was slightly lower growth.
“Our analysis shows that the ASD population is growing rapidly, particularly at young ages, which means that education and healthcare services are confronted with a huge challenge to keep up with providing the necessary services,” said Dinstein.
While both organizations use the same diagnosis tools, the study said, there are potentially multiple explanations for data disparities, including clerical discrepancies; socioeconomic factors (Clalit is generally the preferred healthcare provider for lower-income families); and more families of newly diagnosed children turning first to the NII and only later to their healthcare provider.
The results of the study bring Israel’s ASD rate among children into line with global averages, whereas previously the country had been shown to have a below-average rate of diagnosis.
“The large increase in the prevalence of autism in Israel corresponds with global data in this field,” said Prof. Gal Meiri, Director of the Child and Adolescent Psychiatry Unit at Soroka Medical Center in Be’er Sheva and Medical Director of the Azrieli National Research Centre.
“This increase challenges clinicians and the various systems that provide services to children and people with autism and intrigues researchers in Israel and around the world,” he said.
According to Dinstein, early intervention has “very high impact” on the progress of a child who has been diagnosed with ASD.
“Children who are diagnosed before the age of 2.5 years old and receive intervention are three times more likely to improve in their social abilities than those diagnosed at later ages,” he explains.
“We showed this in a paper published [in 2022] that followed up approximately 200 kids.”
In light of the findings, both Dinstein and Meiri warned that the amount of support available to ASD families must increase in line with the higher levels of diagnosis in children.
Prior research has demonstrated that early diagnosis can lead to improved communication and social skills although it also requires intervention and the availability of support services, even as the children age into maturity.
The study uniquely broke down the data into age groups by educational levels, in order to provide local and national authorities with better information about where resources would be optimally dispersed.
“While it is important that the health system in Israel is diagnosing ASD at very young ages, it is equally important that intervention services be available to those who are diagnosed – with such fast growth, this is clearly a challenge,” said Dinstein.
“Moreover, these children will likely require support at various levels during adulthood as well. This study is, therefore, a wake-up call for the government to start planning ahead,” he said.
“Autism is a disorder that accompanies people with autism and their families throughout their lives,” Meiri explained.
“Early and intensive intervention has been proven to be effective and advances children with autism, and the new data require attention and preparation by policy makers in this area, so that proven interventions can reach every child and every person who needs them.”
“We are eager to ensure that government officials have the data that will help them plan services,” Dinstein tells NoCamels. “To do this properly you really need to know increases per age group.”
