The United States is the country with one of the highest reported rates of Autism Spectrum Disorder (ASD) in the world. Estimates from a 2023 study from the Centers for Disease Control (CDC) suggest 1 in 36 children are autistic. But this doesn’t necessarily mean that autism is more prevalent here than in other countries. In this article, we’ll compare autism rates by country, explore why ours is seemingly among the highest, unpack some of the cultural stigma around ASD, and touch on how autism is diagnosed and treated around the world.

Autism Rates By Country

Autism rates vary significantly globally. Here are some key countries with notable autism rates in children, as well as the diagnostic prevalence in boys versus girls. 

* Data unavailable but autism is noted as significantly more prevalent in boys than in girls. Globally, the ratio of boys to girls diagnosed with ASD is generally estimated to be about 4:1.

Looking at this data, an obvious question is: Why is autism so high in the USA? Well, a high rate of autism doesn’t necessarily mean that it’s more prevalent here or in the other countries noted – or that lower rates out of the Middle East and Southeast Asia (and the fact that there are no rates out of Sub-Saharan Africa) indicate that it is less prevalent in those regions. These numbers do not suggest who is at high risk for autism.

Reasons for ASD Diagnostic Variance

Instead, higher rates often reflect better diagnostic practices, societal acceptance, and healthcare infrastructure. Increased global awareness and equitable access to diagnostic tools may narrow the apparent differences over time. Let’s dig a little deeper into the reasons behind these variances:

• Improved Diagnosis & Awareness
  

  High-income countries often have better access to diagnostic tools, training for healthcare providers, and public awareness campaigns.
  

• Cultural & Societal Factors
  

  In some countries, stigma around autism leads to underdiagnosis or misclassification of symptoms (more on this later). In others, cultural norms emphasize inclusion and lead to greater identification of children on the spectrum.
  

• Healthcare & Reporting Systems
  

  Countries with robust healthcare systems tend to report higher rates because more children are screened and diagnosed.

• Research & Funding
  

  Wealthier nations invest more in autism research, contributing to higher diagnosis rates and better understanding.

• Population-Based Studies
  

  Studies in certain countries (like South Korea) reveal higher rates because of targeted efforts to identify undiagnosed individuals.

Cultural Stigma & Autism

Cultural stigma surrounding autism in some countries stems from deeply rooted societal, religious, and historical beliefs. These stigmas often lead to misunderstandings, misdiagnosis, or avoidance of seeking help for individuals with autism. 

• Lack of Awareness & Education
  

  In some cultures, autism is misunderstood or seen as a form of “mental illness,” resulting in fear or discrimination. Limited access to accurate information perpetuates myths, such as blaming parents for poor parenting. Without widespread education on neurodiversity, families may struggle to understand autism as a neurological condition, leading to judgment or shame.

• Social Expectations & Norms
  

  Many societies value social conformity and place a high emphasis on behaving “normally.” Autistic learners who may exhibit “unique” behaviors are sometimes seen as not meeting societal standards, leading to isolation. In cultures where family reputation is highly valued, a child with autism may be perceived as a failure or source of embarrassment.

• Superstitions & Spiritual Beliefs
  

  In some parts of the world, autism is mistakenly linked to curses, evil spirits, or divine punishment. Families may seek help from spiritual healers or religious leaders rather than medical professionals. Some believe that having a child with autism is a test of faith, leading to feelings of guilt or secrecy.

• Limited Medical & Diagnostic Understanding
  

  Autism is often undiagnosed or mistaken for other conditions in places with less advanced healthcare systems. Parents (often mothers) are blamed for their child’s autism, with accusations of poor parenting, emotional neglect, or improper diet during pregnancy.

• Discrimination & Marginalization
  

  Families may hide a diagnosis to avoid social exclusion or discrimination in schools, workplaces, and communities. Accessing education or employment can be difficult due to rigid systems that do not accommodate neurodiversity.

• Gender Roles & Expectations
  

  In some cultures, particularly patriarchal ones, boys are expected to carry on the family legacy – a developmental disability in a male child may be stigmatized more heavily. Girls with autism may be overlooked or misdiagnosed because their symptoms often present differently and are less disruptive in traditional settings.

• Lack of Role Models or Representation
  

  Limited or negative portrayals of autism in media perpetuate stereotypes, reinforcing stigma. Having prominent advocates or organizations to normalize autism and reduce stigma.

Reducing the stigma around autism requires a multifaceted approach. Education and awareness campaigns can demystify ASD, promoting understanding and encouraging early diagnosis and intervention. Community-based programs that involve religious and community leaders can address stigma in culturally sensitive ways, fostering acceptance at the local level. Global advocacy from international organizations promoting neurodiversity can go a long way to reducing stigma worldwide. Inclusive school and workplace environments normalize interactions with individuals on the spectrum, breaking down stereotypes and building acceptance.

Autism Diagnosis Worldwide

Autism is diagnosed and treated differently around the world. In the US, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) serves as the primary diagnostic tool, offering detailed behavioral criteria and supporting early screenings as part of routine pediatric care. 

Globally, the ICD-11 (International Classification of Diseases), maintained by the World Health Organization, is widely used and offers broader diagnostic criteria. Some countries, such as China, also use adaptations like the CCMD (Chinese Classification of Mental Disorders). In the UK, both the ICD-11 and DSM-5 are used alongside National Health Service (NHS) guidelines for comprehensive assessments. 

Autism Treatment & Services Worldwide

Treatment approaches also vary significantly. In the US, Applied Behavior Analysis (ABA) is the most prevalent therapy, often supported by insurance and advocacy, and is frequently combined with speech and occupational therapy. 

In Canada and Australia, ABA is widely used but is often supplemented with developmental methods like the Early Start Denver Model (ESDM) and Floortime. In Europe, there is a stronger emphasis on inclusion and developmental approaches. The UK favors methods like TEACCH and Social Stories, while France is shifting from psychoanalysis to evidence-based therapies like ABA.

• Early Start Denver Model

  ESDM is a play-based, early-intervention approach that focuses on building communication, social, and cognitive skills through natural interactions.

• Floortime

  A relationship-based therapy, Floortime encourages emotional and social development by engaging children at their developmental level through play and interactive activities.

• TEACCH

  TEACCH (Treatment and Education of Autistic and Related Communication Handicapped Children) is a structured teaching method that uses visual aids and organizational strategies to promote learning and independence in individuals with autism.

• Social Stories

  Social Stories uses short, personalized stories designed to teach children with autism specific social skills and behaviors by describing situations in a clear, step-by-step manner.

In Asia, access to ABA is growing but remains limited. Japan emphasizes group-based interventions for social integration, and urban centers in China are seeing an increase in ABA availability. In the Middle East and Sub-Saharan Africa, therapy access is sparse, and informal or community-based support is more common. 

Thankfully, across all regions, there is a growing global trend toward promoting neurodiversity, inclusion, and culturally sensitive therapeutic approaches.

ABA Therapy at ABtA

At A Bridge to Achievement (ABtA), we are exclusively dedicated to the autism community. We conduct autism assessments and offer a variety of ABA therapy programs:

• Building Bridges is for young learners preparing for Kindergarten. 
• BRIDGES (Building Relationships, Independence, Determination, Group & Essential Skills) is an Activities for Daily Living program for preteens, teenagers, and young adults. 
• Social Skills Groups are for learners interested in enhancing their communication and social competencies.  
• The Vocational Skills program is for teens and young adults who are keen to pursue job opportunities. 
• Balance is a telehealth program for caregivers seeking to build a stronger relationship with their child and a more balanced home environment.  

How can the ABtA family help yours? Contact us with questions or go ahead and request services. Support starts here.

Parents and caregivers often experience a range of emotions when seeking an autism assessment for their learner. 

Many feel nervous or anxious beforehand, worrying about what the assessment might reveal and what it could mean for their learner’s future. Some feel overwhelmed by researching which practice should do the assessment and the logistical demands of the process, such as gathering documentation or understanding the steps involved. Others feel hopeful, viewing the assessment as an opportunity to gain clarity and better support their learner. Uncertainty or defensiveness can also arise, particularly if they are unsure about whether the assessment is necessary or fear the potential stigma associated with a diagnosis.

There’s a lot to process ahead of the assessment, and even more to consider with a positive diagnostic result. Many caregivers don’t know how to feel after an autism diagnosis. So, what is the next step after being diagnosed with autism? Our advice is to ask questions. The answers you’ll glean will help better understand your learner’s needs, strengths, and the support they’ll require – as well as foster collaboration, set the stage for effective intervention, and ensure compassionate support.

In this article, we’ll give you some categories to think about and some specific questions that may be relevant to your learner and situation. The first two sections – Understanding the Diagnosis and Intervention & Therapy – are higher level, and the ones that follow are more specific to the services we provide A Bridge to Achievement.

Understanding the Diagnosis

The first thing to do after an autism diagnosis is to understand how your learner’s autism manifests and the type of support they will need. Every autistic learner is unique; an autism diagnosis is not a one-size-fits-all label. By asking the diagnostic professional these questions, you will gain knowledge that sets the foundation for making informed decisions about therapy, interventions, and support systems.

• What does this diagnosis mean for my learner’s daily life and development?
• How does my learner’s profile compare to others on the autism spectrum?  
• What are my learner’s strengths, and how can we build on them?  
• What specific challenges or behaviors should we prioritize for support?  
• How might this diagnosis evolve as my learner grows?  

Intervention & Therapy  

Therapeutic intervention can significantly impact a learner’s development and long-term outcomes. ABA therapy, speech therapy, and occupational therapy address specific challenges while building critical life skills. 

• What types of therapies or interventions would you recommend for my learner?   
• How can Applied Behavior Analysis (ABA) therapy help address my learner’s unique needs?  
• How do you set goals for ABA therapy, and how will we measure progress?  
• What role will I play in therapy, and how can I support my learner at home?  
• What other therapies might we need to consider in addition to ABA?  

Behavioral Strategies  

Asking these questions allows you to understand the “why” behind behaviors and find compassionate, effective ways to respond. 

• How will you address challenging behaviors in a way that aligns with my family’s values?  
• How do you teach skills that promote independence, such as communication, self-care, or social skills?  
• What strategies do you use to handle sensory sensitivities or meltdowns?  

Family Involvement & Collaboration  

Therapy isn’t just about the professional sessions – it’s a partnership. As a caregiver, you play a vital role in helping your learner succeed.

• How can we ensure consistency between therapy and home routines?  
• What kind of training or resources do you offer to help caregivers or siblings understand and support my learner?  
• How will you involve me in creating or revising my learner’s therapeutic plan?  

Educational Support  

Whether it’s creating an Individualized Education Plan (IEP), ensuring teachers understand your child’s learning style, or exploring alternative educational environments, education is one of the most important arenas where support must be tailored to a child’s needs.

• How can we collaborate with my learner’s school to ensure effective accommodations?  
• What should I look for in an IEP to align it with ABA goals?  
• How can we advocate for my learner’s needs in educational settings? 
• Do we need to consider homeschool or other learning alternatives for my learner? 

Social & Emotional Development  

Social and emotional development is often an area of difficulty for learners with autism, and it’s also one of the most rewarding to nurture. Building social skills and emotional regulation not only helps learners navigate relationships but also improves their overall well-being. Therapy can provide structured ways to teach these skills, and as a caregiver, you can reinforce them in daily interactions can provide structured ways to teach these skills, and as a caregiver, you can reinforce them in daily interactions.

• How will therapy address social skills, such as making friends or understanding social cues?  
• How do you help learners regulate emotions and build resilience?  
• Are there strategies for helping my learner communicate frustrations or needs without challenging behaviors?  

Progress & Expectations  

Measuring progress is a critical part of any therapeutic plan. Regular check-ins with therapists ensure that goals remain relevant and achievable. Progress may vary, and that’s okay – it’s important to set realistic expectations and remain flexible when adjustments are needed.

• How will you track my learner’s progress, and how often will we review it?  
• What realistic outcomes can we expect over the next six months or year?
• How do you handle situations where progress slows or goals need adjustment?  

Professional Credentials & Approach  

Asking these questions of a practice and your assigned Board Certified Behavior Analyst (BCBA) can help you determine if their approach aligns with your values, ensures personalized care, and fosters a strong therapeutic relationship. They also signal that you are invested in a collaborative, thoughtful approach to your learner’s development.

• What is your experience working with learners like mine?  
• How do you ensure therapy is individualized to meet my learner’s specific needs?  
• What is your approach to incorporating the learner’s preferences and interests into therapy?  

Empowerment & Advocacy  

Advocacy is one of the most powerful tools a caregiver can have. Over time, fostering self-advocacy equips your learner to speak up for themselves. 

• How can I best advocate for my learner in different settings, like school or community activities?  
• What resources, books, or tools would you recommend to help us better understand autism?  
• How do you help foster self-advocacy and confidence as my learner grows?  

Long-Term Planning  

While it’s essential to focus on next steps, planning for the future is equally important. Skills learned today – like communication, self-care, and problem-solving – lay the foundation for greater independence as your learner grows. 

• What skills should we focus on now to prepare my learner’s for the future?  
• Can ABA therapy help my learner transition to school, work, or independent living as they grow?  
• Are there local or community resources we should explore for additional support?  

If you’re ready to schedule an autism assessment at A Bridge to Achievement or have questions for our team – get in touch! Support starts here.

If you’re noticing possible challenges with your child’s or teenager’s social or emotional development, you may be wondering if an autism evaluation is needed. When possible, early detection for a child with autism is ideal to ensure they and you have the right support in the years to come. However, testing can be initiated at any age. An autism evaluation is a pivotal step toward effective intervention for your learner, including Applied Behavior Analysis (ABA) therapy.

A professional may use a number of assessment tools to diagnose autism, all of which are designed to help parents and families obtain an accurate understanding of their learner’s developmental profile. 

If you’ve been referred by your child’s educator, doctor, or psychologist for Autism Spectrum Disorder testing, you may have many questions about what to expect. In this article, we’ll answer key questions like:

• What is done during an autism evaluation?
• How long is an autism evaluation?
• How can I prepare my child?
• What happens after an autism diagnosis?

As you navigate this process with your learner, knowing in advance what to expect and where to find answers to your questions can reduce some of the natural stress you may be feeling.

What Is Done During an Autism Evaluation?

A comprehensive autism assessment is usually conducted by a psychologist or medical doctor; a pediatrician in the case of children. These professionals use a variety of assessment tools and methods, including observations, interviews, standardized tests, and questionnaires. This holistic approach ensures a thorough understanding of the learner’s developmental profile, strengths, and challenges.

Most commonly, autism evaluations will utilize one or more of the following:

• Autism Diagnostic Observation Schedule – Second Edition (ADOS-2)
• Autism Diagnosis Interview – Revised (ADI-R)
• Childhood Autism Rating Scale (CARS)
• Gilliam Autism Rating Scale – Second Edition (GARS-2)

In each instance, autism evaluation tools help your clinical team assess your child’s skills in key domains such as communication, daily life activities, social/peer interactions, and more.

How Long Does an Autism Evaluation Take?

To complete the necessary diagnostic steps, you may need to schedule more than one assessment appointment. Generally, each visit lasts two to three hours. 

An autism evaluation will consist of an interview and observation at an interactive appointment designed to help with making a diagnosis. The process is backed by research, with the goal of producing an accurate profile of your learner.

While some evaluations may be completed in a single day, others require multiple visits over a period of several weeks to capture a comprehensive picture of your learner’s abilities and needs. Many factors – chiefly the assessment tools deployed – affect the amount of time it takes to complete an autism evaluation. Here are some examples of how unique factors influence the duration of testing and diagnosis:

• Age: A younger child may need more time to engage with your clinical team and give responses.

• Environments: It’s helpful for experts to observe and interact with your child in a number of settings, such as school, home, or a clinical space.

• Collaboration: Engaging multiple specialists from different fields can take time to schedule but offer important insights for your learner’s journey.

Overall, families and caregivers typically should be prepared that autism evaluations are complex and simply take time to be completed for a thorough diagnosis. There are a few ways you can contribute to moving the process along efficiently and aiding the work of your clinical team:

1. Don’t delay
   Young children starting at around 12 to 18 months may show signs of neurodiversity. Seeking an assessment at the youngest age possible positions your learner for the best support during the critical brain development period.
2. Take notes
   Sharing with the evaluation team your family’s observations (in detail) about milestones and other behavior-related history can help strengthen the diagnostic process. 
3. Involve your child
   Talk with your learner about upcoming evaluation appointments to help them feel prepared for their experience. This can sometimes help your child lean into the process, giving evaluators more access for diagnostic purposes.

In addition, prepare – ahead of your first appointment – all relevant medical records that could help your evaluation team identify your child’s individual skills or needs.

When you schedule an autism evaluation with A Bridge to Achievement (ABtA), we’ll give you more personalized information about how long each appointment will last and what to bring with you.

What Happens After an Autism Evaluation?

Keep in mind not every learner who is evaluated for autism will be diagnosed with autism. In all cases, you’ll receive a detailed report showing what kind of information was collected during the assessment process and what it means, including recommendations for an alternative diagnosis if needed. 

At A Bridge to Achievement, we’ll meet with you (or discuss over the phone if you live a great distance away) to go over your child’s evaluation results and answer questions, when requested. You’ll receive detailed information about recommended therapies and treatment options – all formed with the specific goals and needs of your learner top of mind.

Often, ABA therapy is part of an individualized treatment plan. Once autism evaluation diagnostic steps are complete, you can begin discussions with your clinical team about the next steps. ABA is designed to foster your child’s development and is often one of many therapeutic options.

The Importance of an Autism Evaluation

A thorough autism evaluation is crucial in understanding a learner’s unique strengths and challenges. This understanding paves the way for targeted interventions that can significantly enhance the child’s development and quality of life. When parents view the evaluation as a positive step, this helps build the necessary support and resources for their child.

In some cases, families are discouraged by either the duration of autism testing or the long waits sometimes encountered to receive assessment appointments. At A Bridge to Achievement, we understand how important the timeline is for connecting your child with support services. 

Between our dedication to serving only the autism community and our three North Carolina locations, we often see shorter wait times than those found at other clinics or centers. That said, we are at the mercy of insurance provider timelines. Typically, it takes five to six weeks between assessment to starting services, if applicable. Our intake team will inform you if this timeline changes.

Your learner’s well-being is our priority, and we are here to help you every step of the way. Call or email us with questions – we can help you navigate the testing process. Support starts here! 

The word “spectrum” in Autism Spectrum Disorder (ASD) is key. Each learner’s experience with autism is unique, leading to a diverse spectrum of abilities and needs. Someone with autism may exhibit differences with social interaction, communication, and repetitive behaviors, and may display a wide variety of strengths and differences in sensory processing.

Once you are aware of how neurodiversity can show up for people, you may find yourself asking “odd” questions that didn’t occur to you before – case in point: Why does my kid hum when they eat? In this article, we’ll look at the process of diagnosing autism, consider an array of symptoms and behaviors associated with ASD, pose some frequently asked questions that may surprise you, and get into the underlying clues potentially embedded in their answers. 

Diagnosing Autism

Let’s start with the question that brought us here: Is humming while eating a sign of autism? The short answer is: maybe.  

Humming while eating could possibly be a sign of autism, but it’s not likely autism if this is the only observable concern. An autism diagnosis requires several symptoms to be present before a diagnosis can be given. And these symptoms must also be apparent in social and communication skills and present as restrictive and repetitive behaviors, or RRBs (more on RRBs later). 

As is well documented, early diagnosis and intervention is tremendously beneficial for learners with autism. Not so well documented, though, is that beginning the diagnostic process is easy. You can request services from a practice you identify through research, or you can ask your doctor for suggestions – most assessments do not require a referral. 

The diagnostic process involves a series of prescribed assessments performed by a psychologist or developmental pediatrician. An autism diagnosis requires interviews, surveys, and deliberate observation – there’s nothing invasive, painful, or difficult about it. The hardest part is waiting for the appointment.

Between deciding to request an assessment and waiting for it, keep a journal of your own observations of yourself or your loved one – taking note of those “odd” questions that come to mind. 

Understanding Autism Signs & Behaviors

It’s important to keep in mind that there are multiple symptoms and behaviors that may be associated with ASD that can also be present in individuals who are not autistic. Humming while eating could simply be enjoyable by someone. This behavior is referred to as sensory stimulation, stereotypy, or “stimming” – a repetitive event that activates the senses and makes us feel better. Stimming is a behavior almost everyone engages in, including people with autism.  

Other symptoms associated with autism include:

• Challenges with verbal and nonverbal communication
• Hyperfocus on specific topics or activities
• Difficulty with changes in schedules or environment
• Hyper or hypo sensitivity to sensory stimuli

Many autistic learners have some, but not all of these symptoms, and they may look different between individuals. Just as neurotypical people vary greatly in their personality and behavior, so do autistic people – or any individuals in the neurodiverse community. Autism is far from a “one size fits all” diagnosis.

For example, stimming for one autistic person may include repetitive vocalizations. For another, it may be flapping their hands. While another may occasionally pace or walk in circles when excited. All of these behaviors meet the same need for sensory input, but the intensity of the behavior and the way the behavior presents, may differ greatly across individuals.

These are examples of RRBs – restricted and repetitive behaviors. RRBs encompass a wide range of repetitive actions, interests, and behaviors and can include repetitive movements, insistence on sameness or routines, highly focused interests, and sensory-seeking behaviors. These behaviors are one of the core diagnostic criteria for autism and can vary widely in severity and presentation among individuals.

Enlightening, right? Knowing the signs and symptoms of autism can be enormously beneficial when talking with your doctor or beginning the diagnostic process. Certainly, these signs and behaviors will be observed by a psychologist or developmental pediatrician during the formal assessment, but it’s helpful to have some shared language when entering new territory. 

Behaviors That May Indicate Autism

Let’s dig into some other observations that have the potential to reveal RRBs and other signs of autism. As we’ve mentioned, you can observe indicative behaviors in people who are not autistic – be sure to seek out a professional diagnosis if you think you or your loved one may have autism. 

Is ripping paper a sign of autism? 

Repetitive behaviors can serve as a way to self-regulate or cope with overwhelming sensory input, providing comfort or a sense of control in otherwise unpredictable environments. In this case, the tactile sensation of tearing paper could provide sensory stimulation or feedback that alleviates discomfort or anxiety.

Is mimicking accents a sign of autism? 

Echolalia involves repeating phrases, words, or sounds heard from others – sometimes including mimicking accents or intonations – and it’s a common communication trait in learners with autism. Accent mimicry within echolalia could stem from a combination of sensory processing differences, a need for communication practice, and a desire for social connection, i.e. attempting to fit in or establish rapport with others by adopting speech patterns perceived as socially appropriate or desirable

Is thumb sucking a sign of autism? 

Considered a self-soothing behavior, thumb sucking serves as a way to provide sensory stimulation, regulate sensory input, and assist in coping with sensory overload or anxiety. Of course, not all autistic individuals suck their thumbs, and self-soothing behaviors can vary widely based on unique sensory profiles and coping strategies. What’s more, self-soothing is a coping mechanism we all have; it’s not unique to autism. 

Is fixation a sign of autism? 

Intense interests, or fixations, are common among learners with ASD, often manifesting as an acute focus on specific topics, objects, or activities. They can serve as a source of comfort and stability in a world that can otherwise feel chaotic or overwhelming due to sensory sensitivities and social challenges. Fixations can also provide a sense of purpose, pride, and a means of connecting with those with similar passions.

Is hard blinking a sign of autism? 

Frequent or hard blinking can be a manifestation of sensory input regulation and motor stereotypies, particularly in response to overwhelming visual stimuli. Additionally, hard blinking can serve as a repetitive motor behavior, providing comfort or a means of self-stimulation. Staring, particularly at mirrors or lights, is also a form of visual stimming. 

Is walking backwards a sign of autism? 

Walking backwards can be observed as a motor behavior, potentially serving as a coping mechanism to regulate sensory input or manage anxiety in certain environments. 

Is bedwetting a sign of autism? 

Difficulty recognizing and responding to bodily sensations (sensory processing) as well as challenges in expressing toileting needs (communication), can contribute to bedwetting. Additionally, heightened stress or anxiety commonly experienced by learners with autism can further impact bladder control.

If these questions and answers have led to an “aha” moment, or you’re interested in having your loved one assessed for autism – reach out to our team or go ahead and request services. At A Bridge to Achievement, we conduct private autism assessments and, depending on your proximity to our offices and your insurance coverage, we can typically begin the assessment process within two or three months of your request. We are here to support you.