Two-fold increase in the prevalence of autism in Israel between 2017 and 2021

The prevalence of autism spectrum disorder (ASD) has increased steadily in most high-income countries over the last decade. Estimates of ASD prevalence among 8-year-old children in the U.S. have increased from 1.47% in 2010 to 2.3% in 2018, and up to 3.5% among 3-17-year-old children in 2020. In Israel, estimates have been lower, with the prevalence of ASD in 8-year-old children increasing from 0.3% in 2009 to 0.64% in 2018. Here, we examined data from the entire population of Israel (∼3 million 1-17-year-old children) and quantified changes in their ASD prevalence between 2017 and 2021. We analyzed consecutive annual reports acquired from the Israeli National Insurance Institute (NII), which monitors all children with ASD in Israel who receive welfare services, and Clalit Health Services (CHS), the largest Health Maintenance Organization (HMO) in Israel that services ∼50% of the population. Both data sources revealed a nearly twofold increase in the ASD prevalence of 1–17-year-old children during this five-year period. Rates differed across age groups with 2-3-year-old (day-care) children exhibiting a ∼4.4-fold increase in prevalence from 0.27% to 1.19% and 4-6-year-old (pre-school) children exhibiting a ∼2.3-fold increase from 0.80% to 1.83%. These results demonstrate that ASD prevalence in Israel is increasing at unprecedented rates and shifting towards diagnosis at earlier ages. These findings highlight the challenge facing health and education service providers in meeting the needs of a rapidly growing ASD population that is being diagnosed at earlier ages. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee/IRB of Ben-Gurion University gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript