The number of autism cases in the California Developmental Services system has grown nearly 60-fold since the 1980s.
Figure 1: The exponential curve of California Department of Developmental Services autism growth. Data sources: California DDS website at https://www.dds.ca.gov/transparency/facts-stats/, as well as public record requests to California DDS by Autism Society San Francisco Bay Area.
By Jill Escher
California is not only the nation’s most populous state, with 39 million residents, it is also home to the nation’s most robust autism data, thanks to more than four decades of developmental disability case-finding and record-keeping mandated by the state’s unique Lanterman Act. The autism in the state Department of Developmental Services (DDS) largely do not represent the broader spectrum, as eligibility criteria limits entry to cases of significant functional disability. Twenty years of data show that birth-year prevalence of DDS autism is roughly half that seen in the broader-definition CDC ADDM Network studies.
Yesterday DDS quietly posted its autism and related data for 2023, and while the historic event earned no media attention, the numbers should be sending shockwaves across our state and country.
In 2023, the DDS system hit several alarming new milestones:
Even as California’s population shrank in 2023, the DDS autism caseload hit an all-time high of more than 177,400, a staggering increase when you consider that statewide DDS counted only about 3,000 cases in the 1980s. This is a nearly 6,000%, or 60-fold, increase (Figure 1).
In 2023, 17,563 DDS new autism cases were added in 2023, a one-year onboarding about equal the entire DDS autism caseload as it existed in 2001. The 2023 DDS autism caseload increased a whopping 11% over 2022.
The DDS autism caseload nearly doubled over just 7 years. The autism caseload was about 90,000 is 2016.
For the first time ever, autism surpassed 50% of the overall DDS active caseload, eclipsing intellectual disability and other categories.
The "severe behavior" population in DDS is also surging. Over 10 years, the number of cases involving severe behaviors grew 1,116%, even as the overall DDS caseload grew 331% (most severe behavior cases involve autism).
While many people simply presume these skyrocketing rates are simply due to "awareness,” diagnostic expansion or shifts, there is simply no evidence to support these theories. In fact, as discussed above, the DDS system is limited to the more affected portion of the autism population, and the regional centers, under crushing pressure from the mounting autism caseload strive to minimize admissions. The state, alarmed by the inexplicably rising rates of DDS autism, also enacted more stringent entry criteria in 2023—criteria were more liberal before then. Also, diagnostic shift from intellectual disability, for example, has never explained the soaring autism rates (Figure 2).
Most of the individuals represented in these DDS autism numbers suffer significant cognitive and functional disability and will need considerable amounts of lifespan supervision and care. Autism represents our country's most urgent public health emergency, even if the facts of the ongoing increase do not fit the prevailing media or activist narratives, and are thus widely ignored.
For more information about autism’s rising rates, please see our February 15, 2024 NCSA webinar, below, featuring myself (Jill Escher) and Dr. Walter Zahorodny of Rutgers University, and lead investigator for the CDC ADDM New Jersey autism study.
Jill Escher is president of NCSA. She lives in the San Francisco Bay Area.