Autism Diagnoses Spiked After COVID-19, But Probably Not For The Reason You Think

Autism diagnoses rose sharply after the COVID-19 pandemic began, but the pattern may not mean that autism itself suddenly became more common.

The rise was driven overwhelmingly by diagnoses among girls and women, while rates among boys and men remained stable or declined.

So what caused this to happen?

A new study published in JAMA Network Open suggests that many of these girls and women may simply have gone unrecognized in the past.

A team led by researchers at Saint Louis University examined electronic health records from 171,134 people who received care every year between 2016 and 2024 within a large US healthcare system.

Across the entire group, the annual rate of newly recorded autism diagnoses declined until 2020 and then began rising. When the researchers separated the data by sex, however, they uncovered two strikingly different trends.

New diagnoses among males remained stable or declined, while the rate among females increased by an average of 19 percent each year from 2020 to 2024.

The annual number of females receiving a newly recorded diagnosis nearly doubled, rising from 284 in 2016 to 513 in 2024.

The findings suggest that the apparent post-pandemic surge was not a uniform increase across the population. Rather, healthcare providers may be getting better at recognizing autism in people whose traits have historically been overlooked.

"Aggregate growth masked a significant sex disparity," the researchers write.

Autism has long been diagnosed more frequently in boys and men. Many screening tools and conventional descriptions of autism were developed from research predominantly involving males, potentially making other presentations harder to recognize.

A 2026 study published in The BMJ found that girls were diagnosed later than boys, but that the gap in diagnosis rates narrowed considerably by adulthood.

Autistic girls may display greater social motivation or camouflage their difficulties, potentially making them harder to identify using conventional screening tools.

In the study, girls and women were diagnosed with autism about three and a half years later than boys and men. The delay was also seen in children, with girls typically diagnosed about a year and a half later than boys.

The biggest increase was among teenage girls, with new diagnoses rising by about 22 percent each year from 2020 to 2024. Researchers suggest many may have been missed as children and diagnosed only in their teenage years.

The timing does not establish that the pandemic caused either autism or the broader diagnostic trend.

Restrictions during the early months of COVID-19 interrupted routine medical appointments, developmental screening, and in-person schooling. Once services resumed, assessments that had been delayed may have produced a rebound in diagnoses.

Telehealth also became more widely accepted for autism assessments, potentially making evaluations more accessible. Meanwhile, increasing public awareness – including women sharing their experiences online – may have helped some people recognize autistic traits in themselves and seek professional assessment.

Importantly, when the researchers repeated their analysis without the unusual 2020 data, the broader pattern remained: Diagnoses increased among females while remaining stable or declining among males. In that analysis, the turning point for females shifted back to 2018.

That indicates the pandemic disruption alone cannot explain the trend.

The study has significant limitations. It tracked the first autism diagnosis recorded within one healthcare system, which was not necessarily each person's first diagnosis in their lifetime.

Diagnoses were identified through billing codes and were not independently confirmed using standardized assessments or detailed medical-record reviews.

The predominantly White cohort was also limited to people who consistently accessed the same healthcare system, so the findings may not apply to the wider US population.

Related: Scientists Identify 2 Distinct Subtypes of Autism in The Brain

The researchers therefore measured changes in recorded diagnoses among people consistently engaged with healthcare, rather than changes in the underlying biological occurrence of autism.

Even with these caveats, the findings point to a persistent diagnostic gap. Later recognition can delay access to support, educational or workplace accommodations, and a community that helps people understand their experiences.

The study suggests rising autism figures may partly tell a story not of autism suddenly becoming more common, but of healthcare systems finally beginning to see people they had missed.

The study was published in JAMA Network Open.