Diagnoses of autism spectrum disorders in Germany: Time trends in administrative prevalence and diagnostic stability.
German insurance data show more autism labels but most disappear in five years, so double-check every file.
01Research in Context
What this study did
The team looked at every German insurance record for people .
They counted how many had an autism code in 2006 and again in 2012.
Then they checked which kids still carried the same code five years later.
What they found
Autism diagnoses rose from 1 in 450 to 1 in 260.
Only one-third of the classic autism codes stayed the same.
Two-thirds of the mild or rare codes were later dropped.
How this fits with other research
Lovell et al. (2016) saw the opposite.
In a U.S. clinic, 9 out of the kids kept the diagnosis from age 3 to age 9.
The gap is about method: clinic experts vs. insurance clerks.
Scattoni et al. (2023) found a similar rise in Italy, so more diagnoses are real, not just German paperwork.
Why it matters
When you read an intake file that says "ASD," ask how the label was given.
If it came from a quick doctor visit, plan a full ADOS or ADI-R before you write goals.
Re-testing shields kids from wrong services and saves hours of off-target therapy.
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02At a glance
03Original abstract
For Germany, no data on trends in autism spectrum disorder diagnoses are available. The primary aim of this study was to establish the time trends in the administrative prevalence of autism spectrum disorder diagnoses. The second aim was to assess the stability of autism spectrum disorder diagnoses over time. We analysed administrative outpatient data (2006-2012) from a nationwide health insurance fund and calculated the prevalence of autism spectrum disorder diagnoses for each year, stratified by age and sex. Additionally, we studied a cohort with a first-time diagnosis of autism spectrum disorder in 2007 through 2012, investigating the percentage of retained autism spectrum disorder diagnoses. From 2006 to 2012, the prevalence of autism spectrum disorder diagnoses in 0- to 24-year-olds increased from 0.22% to 0.38%. In insurees with a first-time autism spectrum disorder diagnosis in 2007, this diagnosis was carried on in all years through 2012 in 33.0% (The International Classification of Diseases, Tenth Revision diagnoses: F84.0/F84.1/F84.5) and 11.2% (F84.8/F84.9), respectively. In Germany, like in other countries, there has been an increase in the administrative prevalence of autism spectrum disorder diagnoses. Yet, prevalences are still lower than in some other Western countries. The marked percentage of autism spectrum disorder diagnoses which were not retained could indicate a significant portion of autism spectrum disorder misdiagnoses, which might contribute to rising autism spectrum disorder prevalences.
Autism : the international journal of research and practice, 2018 · doi:10.1177/1362361316673977