Autism spectrum disorder today: critical reflections on hyperdiagnosis

This study discusses the hyperdiagnosis of autism spectrum disorder (ASD), which occurs when the identification of this disorder exceeds actual clinical relevance, including cases without significant functional impacts. Although the greater recognition of the disorder has included and supported many people, the accelerated increase in diagnoses raises questions about technical criteria, the possible use of diagnoses to obtain benefits, and the influence of social and institutional factors. Recent epidemiological studies have indicated a gradual increase in the global prevalence of ASD. Brazilian data show that about 1.2% of its population has received such a diagnosis, which evinces greater recognition and access to diagnosis. The evolution of the concept of this disorder has broadened diagnostic criteria, including milder and more heterogeneous manifestations of the condition, which has contributed to the significant increase in diagnosis rates worldwide. Factors such as greater social awareness, search for school reports, and institutional pressure for behavioral adequacy also influence increases in diagnosis. Hyperdiagnosis has negative consequences, such as early stigmatization, inadequate treatments, emotional impact on families, and distortion of epidemiological data, harming public policies. The difference between early, desirable, and judicious diagnoses and hasty ones (based on superficial evaluations) is highlighted. To promote more responsible diagnoses, this study proposes the continuous training of professionals, interdisciplinary assessments, longitudinal follow-up, and the appreciation of singularities. It also defends the expansion of public policies with no exclusive dependence on medical reports to guarantee support, prioritizing individuals’ real needs.

Keywords:
Autism Spectrum Disorder; Diagnosis; Overdiagnosis