The DOI matches its Crossref record; 114 of the 120 references it cites were found in a registry or an index; none of the 122 sources its claims cite is checked for support yet.
Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation
Open accessAbstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted interests and repetitive behaviors. There have been recent concerns about increased prevalence, and this article seeks to elaborate on factors that may influence prevalence rates, including recent changes to the diagnostic criteria. The authors review evidence that ASD is a neurobiological disorder influenced by both genetic and environmental factors affecting the developing brain, and enumerate factors that correlate with ASD risk. Finally, the article describes how clinical evaluation begins with developmental screening, followed by referral for a definitive diagnosis, and provides guidance on screening for comorbid conditions.
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TL;DR
ASD is a neurodevelopmental disorder defined by social communication deficits and restricted/repetitive behaviors, with DSM-5 criteria shifting to a dyad and likely affecting prevalence estimates. The review summarizes epidemiology, genetic/environmental risk correlates, and clinical evaluation, concluding no single causal pathway or biomarker exists.
Key findings
- DSM-5 combined DSM-IV pervasive developmental disorder diagnoses into one ASD spectrum, moved from a triad to a dyad, added sensory symptoms and severity descriptors; a systematic review suggests only 50%–75% of individuals maintain diagnoses, though one study found 91% identified by parental report, and most studies suggest increased specificity with decreased sensitivity.
- WHO estimates global ASD prevalence at 0.76%, but this accounts for only ~16% of the global child population; CDC estimates 1.68% of US 8-year-olds (1 in 59), US parent-reported diagnoses averaged 2.5% in 2016, and US prevalence more than doubled between 2000–2002 and 2010–2012 before appearing to stabilize from 2014 to 2016 with no statistically significant increase.
- Male-to-female ratio is closer to 3:1 than 4:1 in a recent meta-analysis not using DSM-5 criteria; co-occurring conditions are common, including 83% with an additional developmental diagnosis, 10% at least one psychiatric diagnosis, 16% at least one neurologic diagnosis, intellectual disability at 31.0% (26.7%–39.4%), epilepsy ~20%, GI disorders 10–12%, sleep problems 50%–73%, overweight/obesity ~33%/18%, ADHD 25%–81%, and pooled adult anxiety/depression at 42%/37%.
- ASD is neurobiological with genetic and environmental influences, but no single unifying cause has been elucidated; over 700 genes have been implicated, and there is no evidence that vaccines, thimerosal, or mercury is associated with ASD, with the largest Danish cohort finding no increased MMR risk. Prenatal valproic acid and thalidomide increase risk, folic acid may reduce risk in antiepileptic-exposed pregnancies, and advanced parental age and prematurity are risk factors.
Methods
- Narrative review of ASD definition, epidemiology, causes, and clinical evaluation; no primary data collection or systematic search strategy is described.
- Synthesizes published literature, meta-analyses, surveillance data, and professional guidelines (e.g., AAP, ACMGG) rather than conducting new analyses.
- Main analysis is narrative synthesis of cited evidence; no formal meta-analysis or primary statistical modeling performed by the authors is reported.
Limitations
- Stated: no single unifying cause or causal determinations; meta-analysis of pre/peri/postnatal risk factors showed significant heterogeneity preventing true determination; no clear ASD biomarkers or diagnostic measures exist.
- Stated: WHO prevalence estimate covers only ~16% of the global child population; changing diagnostic criteria may impact prevalence and the full DSM-5 impact remains unknown.
- Evident: as a narrative review without described systematic search or quality appraisal, conclusions depend on selected cited studies; some cited estimates predate DSM-5 or use non-DSM-5 criteria, and co-occurring condition rates vary by definition or measurement tool.
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Claims the paper makes
68 Not checked yet · 9 Own interpretation
None of the sources cited for this claim have been checked yet.
In the paper
“studies estimating the potential impact of moving from the DSM-IV to the DSM-5 have predicted a decrease in ASD prevalence (4,5)”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Definition
What the sources say
- Not checked yetcites [4] Maenner MJ Rice CE Arneson CL Potential impact of DSM-5 criteria on autism spectrum disorder prevalence estimates. JAMA Psychiatry 2014; 71: 292- 300. 10.1001/jamapsychiatry.2013.3893 24452504 PMC4041577
- Not checked yetcites [5] Kulage KM Smaldone AM Cohn EG. How will DSM-5 affect autism diagnosis? A systematic literature review and meta-analysis. J Autism Dev Disord 2014; 44: 1918- 32. 10.1007/s10803-014-2065-2 24531932
hedgedconditional- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“children who previously met criteria for PDD-NOS under the DSM-IV might now be diagnosed with SPCD.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Definition
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“a systematic review suggests only 50% to 75% of individuals maintain diagnoses (9)”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Definition
What the sources say
- Not checked yetcites [9] Sturmey P Dalfern S. The effects of DSM5 autism diagnostic criteria on number of individuals diagnosed with autism spectrum disorders: a systematic review. Rev J Autism Dev Disord 2014; 1: 249- 52. 10.1007/s40489-014-0016-7
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“Often those who did not meet the requirements were previously classified as high functioning Asperger’s syndrome and PDD-NOS (11,12).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Definition
What the sources say
- Not checked yetcites [11] de Giambattista C Ventura P Trerotoli P Subtyping the autism spectrum disorder: comparison of children with high functioning autism and asperger syndrome. J Autism Dev Disord 2019; 49: 138- 50. 10.1007/s10803-018-3689-4 30043350 PMC6331497
- Not checked yetcites [12] Mazurek MO Lu F Symecko H A prospective study of the concordance of DSM-IV and DSM-5 diagnostic criteria for autism spectrum disorder. J Autism Dev Disord 2017; 47: 2783- 94. 10.1007/s10803-017-3200-7 28620892
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Caucasian children are consistently identified with ASD more often than black or Hispanic children (6).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [6] Baio J Wiggins L Christensen DL Prevalence of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveill Summ 2018; 67: 1- 23. 10.15585/mmwr.ss6706a1 29701730 PMC5919599
plaincorrelational- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“these known genetic disorders account for a very small amount of overall ASD cases (27-30).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [27] Sztainberg Y Zoghbi HY. Lessons learned from studying syndromic autism spectrum disorders. Nat Neurosci 2016; 19: 1408- 17. 10.1038/nn.4420 27786181
- Not checked yetcites [28] Johnson CP Myers SM. Identification and evaluation of children with autism spectrum disorders. Pediatrics 2007; 120: 1183- 215. 10.1542/peds.2007-2361 17967920
- Not checked yetcites [29] Reddy KS. Cytogenetic abnormalities and fragile-X syndrome in autism spectrum disorder. BMC Med Genet 2005; 6: 3. 10.1186/1471-2350-6-3 15655077 PMC548305
- Not checked yetcites [30] Yoo H. Genetics of autism spectrum disorder: current status and possible clinical applications. Exp Neurobiol 2015; 24: 257. 10.5607/en.2015.24.4.257 26713075 PMC4688327
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The prevalence of ASD in the US more than doubled between 2000–2002 and 2010–2012 according to Autism and Developmental Disabilities Monitoring Network (ADDM) estimates (6).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [6] Baio J Wiggins L Christensen DL Prevalence of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveill Summ 2018; 67: 1- 23. 10.15585/mmwr.ss6706a1 29701730 PMC5919599
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“With the increased use of chromosomal microarray, several sites (chromosome X, 2, 3, 7, 15, 16, 17, and 22 in particular) have proven to be associated with increased ASD risk (28).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [28] Johnson CP Myers SM. Identification and evaluation of children with autism spectrum disorders. Pediatrics 2007; 120: 1183- 215. 10.1542/peds.2007-2361 17967920
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“ASD is more common in males (22,23)”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [22] Demily C Poisson A Peyroux E Autism spectrum disorder associated with 49,XYYYY: case report and review of the literature. BMC Med Genet 2017; 18: 9. 10.1186/s12881-017-0371-1 28137251 PMC5282903
- Not checked yetcites [23] Tartaglia NR Wilson R Miller JS Autism spectrum disorder in males with sex chromosome aneuploidy: XXY/klinefelter syndrome, XYY, and XXYY. J Dev Behav Pediatr 2017; 38: 197- 207. 10.1097/DBP.0000000000000429 28333849 PMC5423728
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“Studies of children with sex chromosome aneuploidy describe a specific social functioning profile in males that suggests more vulnerability to autism (22,23,31,32).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [22] Demily C Poisson A Peyroux E Autism spectrum disorder associated with 49,XYYYY: case report and review of the literature. BMC Med Genet 2017; 18: 9. 10.1186/s12881-017-0371-1 28137251 PMC5282903
- Not checked yetcites [23] Tartaglia NR Wilson R Miller JS Autism spectrum disorder in males with sex chromosome aneuploidy: XXY/klinefelter syndrome, XYY, and XXYY. J Dev Behav Pediatr 2017; 38: 197- 207. 10.1097/DBP.0000000000000429 28333849 PMC5423728
- Not checked yetcites [31] Ross JL Roeltgen DP Kushner H Behavioral and social phenotypes in boys with 47,XYY syndrome or 47,XXY klinefelter syndrome. Pediatrics 2012; 129: 769- 78. 10.1542/peds.2011-0719 22412026 PMC3356148
- Not checked yetcites [32] Bardsley MZ Kowal K Levy C 47,XYY syndrome: clinical phenotype and timing of ascertainment. J Pediatr 2013; 163: 1085- 94. 10.1016/j.jpeds.2013.05.037 23810129 PMC4097881
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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- Probably not a substantial claim. 17
- It may state two separate claims as one. 34
None of the sources cited for this claim have been checked yet.
In the paper
“In 2013, the Diagnostic and Statistical Manual of Mental Disorders—5th edition (DSM-5) was published, updating the diagnostic criteria for ASD from the previous 4th edition (DSM-IV) (Table 1) (1,2).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Definition
What the sources say
- Not checked yetcites [1] American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing, 2013.
- Not checked yetcites [2] American Psychiatric Association. Diagnostic and statistcal manual of mental disorders. 4th ed. Washington: American Psychiatric Publishing, 1994.
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“while those diagnosed with ASD are more likely to have the condition, there is a higher number of children whose ASD diagnosis is missed, particularly older children, adolescents, adults, or those with a former diagnosis of Asperger’s disorder or PDD-NOS (14).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Definition
What the sources say
- Not checked yetcites [14] Lai MC Lombardo MV Chakrabarti B Subgrouping the autism "spectrum": reflections on DSM-5. PLoS Biol 2013; 11: e1001544. 10.1371/journal.pbio.1001544 23630456 PMC3635864
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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In the paper
“The Centers for Disease Control and Prevention (CDC) estimates about 1.68% of United States (US) children aged 8 years (or 1 in 59 children) are diagnosed with ASD (6,17).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [6] Baio J Wiggins L Christensen DL Prevalence of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveill Summ 2018; 67: 1- 23. 10.15585/mmwr.ss6706a1 29701730 PMC5919599
- Not checked yetcites [17] Palinkas LA Mendon SJ Hamilton AB. Annual review of public health innovations in mixed methods evaluations. Annu Rev Public Heal 2019; 40: 423- 42. 10.1146/annurev-publhealth-040218-044215 PMC6501787 30633710
hedged- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In the US, parent-reported ASD diagnoses in 2016 averaged slightly higher at 2.5% (18).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [18] Kogan MD Vladutiu CJ Schieve LA The prevalence of parent-reported autism spectrum disorder among US children. Pediatrics 2018; 142: e20174161. 10.1542/peds.2017-4161 30478241 PMC6317762
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“in the US, the prevalence of ASD has appeared to stabilize with no statistically significant increase from 2014 to 2016 (19).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [19] Xu G Strathearn L Liu B Prevalence of autism spectrum disorder among US children and adolescents, 2014-2016. JAMA 2018; 319: 81. 10.1001/jama.2017.17812 29297068 PMC5833544
hedged- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Insurance mandates requiring commercial plans to cover services for ASD along with improved awareness have likely contributed to the increase in ASD prevalence estimates as well as the increased diagnosis of milder cases of ASD in the US (6,20,21).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [6] Baio J Wiggins L Christensen DL Prevalence of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveill Summ 2018; 67: 1- 23. 10.15585/mmwr.ss6706a1 29701730 PMC5919599
- Not checked yetcites [20] Mandell DS Barry CL Marcus SC Effects of autism spectrum disorder insurance mandates on the treated prevalence of autism spectrum disorder. JAMA Pediatr 2016; 170: 887- 93. 10.1001/jamapediatrics.2016.1049 27399053
- Not checked yetcites [21] Hansen SN Schendel DE Parner ET. Explaining the increase in the prevalence of autism spectrum disorders: the proportion attributable to changes in reporting practices. JAMA Pediatr 2015; 169: 56- 62. 10.1001/jamapediatrics.2014.1893 25365033
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“the number of people who would be diagnosed under the DSM-IV, but not under the new DSM-5 appears to be declining over time, likely due to increased awareness and better documentation of behaviors (4).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Definition
What the sources say
- Not checked yetcites [4] Maenner MJ Rice CE Arneson CL Potential impact of DSM-5 criteria on autism spectrum disorder prevalence estimates. JAMA Psychiatry 2014; 71: 292- 300. 10.1001/jamapsychiatry.2013.3893 24452504 PMC4041577
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Not only are females less likely to present with overt symptoms, they are more likely to mask their social deficits through a process called “camouflaging”, further hindering a timely diagnosis (25).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [25] Volkmar F Siegel M Woodbury-Smith M Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry 2014; 53: 237- 57. 10.1016/j.jaac.2013.10.013 24472258
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The World Health Organization (WHO) estimates the international prevalence of ASD at 0.76%; however, this only accounts for approximately 16% of the global child population (16).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [16] Baxter AJ Brugha TS Erskine HE The epidemiology and global burden of autism spectrum disorders. Psychol Med 2015; 45: 601- 13. 10.1017/S003329171400172X 25108395
hedged- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Overall, most studies suggest that the DSM-5 provides increased specificity and decreased sensitivity compared to the DSM-IV (5,13)”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Definition
What the sources say
- Not checked yetcites [5] Kulage KM Smaldone AM Cohn EG. How will DSM-5 affect autism diagnosis? A systematic literature review and meta-analysis. J Autism Dev Disord 2014; 44: 1918- 32. 10.1007/s10803-014-2065-2 24531932
- Not checked yetcites [13] Gibbs V Aldridge F Chandler F Brief report: an exploratory study comparing diagnostic outcomes for autism spectrum disorders under DSM-IV-TR with the proposed DSM-5 revision. J Autism Dev Disord 2012; 42: 1750- 6. 10.1007/s10803-012-1560-6 22677932
hedgeddirect- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“in a recent meta-analysis (24), true male-to-female ratio is closer to 3:1 than the previously reported 4:1, though this study was not done using the DSM-5 criteria.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [24] Loomes R Hull L Mandy WPL. What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry 2017; 56: 466- 74. 10.1016/j.jaac.2017.03.013 28545751
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“ASD occurs in all racial, ethnic, and socioeconomic groups, but its diagnosis is far from uniform across these groups.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [6] Baio J Wiggins L Christensen DL Prevalence of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveill Summ 2018; 67: 1- 23. 10.15585/mmwr.ss6706a1 29701730 PMC5919599
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“While genetics clearly play a role in ASD’s etiology, phenotypic expression of genetic susceptibility remains extremely variable within ASD (54).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [54] Veenstra-Vanderweele J Christian SL Cook EH Jr. Autism as a paradigmatic complex genetic disorder. Annu Rev Genomics Hum Genet 2004; 5: 379- 405. 10.1146/annurev.genom.5.061903.180050 15485354
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Advanced maternal and paternal age have both been shown to have an increased risk of having a child with ASD (59).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [59] Croen LA Najjar DV Fireman B Maternal and paternal age and risk of autism spectrum disorders. Arch Pediatr Adolesc Med 2007; 161: 334- 40. 10.1001/archpedi.161.4.334 17404129
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Neuropathologic studies are limited, but have revealed differences in cerebellar architecture and connectivity, limbic system abnormalities, and frontal and temporal lobe cortical alterations, along with other subtle malformations (28,37,38).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [28] Johnson CP Myers SM. Identification and evaluation of children with autism spectrum disorders. Pediatrics 2007; 120: 1183- 215. 10.1542/peds.2007-2361 17967920
- Not checked yetcites [37] Skefos J Cummings C Enzer K Regional alterations in Purkinje cell density in patients with autism. PLoS One 2014; 9: e81255. 10.1371/journal.pone.0081255 24586223 PMC3933333
- Not checked yetcites [38] Stoodley CJ D’Mello AM Ellegood J Altered cerebellar connectivity in autism and cerebellar-mediated rescue of autism-related behaviors in mice. Nat Neurosci 2017; 20: 1744- 51. 10.1038/s41593-017-0004-1 29184200 PMC5867894
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“candidate genes in ASD include those that play a role in brain development or neurotransmitter function, or genes that affect neuronal excitability (46,47).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [46] Rubenstein JL Merzenich MM. Model of autism: increased ratio of excitation/inhibition in key neural systems. Genes Brain Behav 2003; 2: 255- 67. 10.1034/j.1601-183X.2003.00037.x 14606691 PMC6748642
- Not checked yetcites [47] McDougle CJ Erickson CA Stigler KA Neurochemistry in the pathophysiology of autism. J Clin Psychiatry 2005; 66 Suppl 10: 9- 18. 16401145
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Prenatal exposure to thalidomide and valproic acid have been reported to increase risk, while studies suggest that prenatal supplements of folic acid in patients exposed to antiepileptic drugs may reduce risk (55-57).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [55] Surén P Roth C Bresnahan M Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children. JAMA 2013; 309: 570- 7. 10.1001/jama.2012.155925 23403681 PMC3908544
- Not checked yetcites [56] Bjørk M Riedel B Spigset O Association of folic acid supplementation during pregnancy with the risk of autistic traits in children exposed to antiepileptic drugs in utero. JAMA Neurol 2018; 75: 160. 10.1001/jamaneurol.2017.3897 29279889 PMC5838632
- Not checked yetcites [57] Rasalam AD Hailey H Williams JHG Characteristics of fetal anticonvulsant syndrome associated autistic disorder. Dev Med Child Neurol 2005; 47: 551- 5. 10.1017/S0012162205001076 16108456
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Genetic factors play a role in ASD susceptibility, with siblings of patients with ASD carrying an increased risk of diagnosis when compared to population norms, and a much higher, although not absolute, concordance of autism diagnosis in monozygotic twins (42-44).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [42] Kim H Keifer C Rodriguez-Seijas C Quantifying the optimal structure of the autism phenotype: a comprehensive comparison of dimensional, categorical, and hybrid models. J Am Acad Child Adolesc Psychiatry 2019; 58: 876- 86.e2. 10.1016/j.jaac.2018.09.431 30768420 PMC6488452
- Not checked yetcites [43] Sandin S Lichtenstein P Kuja-Halkola R The familial risk of autism. JAMA 2014; 311: 1770- 7. 10.1001/jama.2014.4144 24794370 PMC4381277
- Not checked yetcites [44] Risch N Hoffmann TJ Anderson M Familial recurrence of autism spectrum disorder: Evaluating genetic and environmental contributions. Am J Psychiatry 2014; 171: 1206- 13. 10.1176/appi.ajp.2014.13101359 24969362
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A small explorative study of neocortical architecture from young children revealed focal disruption of cortical laminar architecture in the majority of subjects, suggesting problems with cortical layer formation and neuronal differentiation (39).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [39] De Rubeis S He X Goldberg AP Synaptic, transcriptional and chromatin genes disrupted in autism. Nature 2014; 515: 209- 15. 10.1038/nature13772 25363760 PMC4402723
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Other risk factors for ASD include increased parental age and prematurity (33-35).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [33] Durkin MS Maenner MJ Newschaffer CJ Advanced parental age and the risk of autism spectrum disorder. Am J Epidemiol 2008; 168: 1268- 76. 10.1093/aje/kwn250 18945690 PMC2638544
- Not checked yetcites [34] Agrawal S Rao SC Bulsara MK Prevalence of autism spectrum disorder in preterm infants: a meta-analysis. Pediatrics 2018; 142: e20180134. 10.1542/peds.2018-0134 30076190
- Not checked yetcites [35] Wang C Geng H Liu W Prenatal, perinatal, and postnatal factors associated with autism: a meta-analysis. Medicine (Baltimore) 2017; 96: e6696. 10.1097/MD.0000000000006696 28471964 PMC5419910
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“ASD is a neurobiological disorder influenced by both genetic and environmental factors affecting the developing brain.”
- Also stated in: § Summary · plain
“ASD is a neurobiological disorder influenced by both genetic and environmental factors affecting the developing brain.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Summary · plain
None of the sources cited for this claim have been checked yet.
In the paper
“Transcriptional and splicing dysregulation or alterations in epigenetic mechanisms such as DNA methylation or histone acetylation and modification may play a role (42,49-51).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [42] Kim H Keifer C Rodriguez-Seijas C Quantifying the optimal structure of the autism phenotype: a comprehensive comparison of dimensional, categorical, and hybrid models. J Am Acad Child Adolesc Psychiatry 2019; 58: 876- 86.e2. 10.1016/j.jaac.2018.09.431 30768420 PMC6488452
- Not checked yetcites [49] Voineagu I Wang X Johnston P Transcriptomic analysis of autistic brain reveals convergent molecular pathology. Nature 2011; 474: 380- 4. 10.1038/nature10110 21614001 PMC3607626
- Not checked yetcites [50] Ladd-Acosta C Hansen KD Briem E Common DNA methylation alterations in multiple brain regions in autism. Mol Psychiatry 2014; 19: 862- 71. 10.1038/mp.2013.114 23999529 PMC4184909
- Not checked yetcites [51] Sun W Poschmann J Cruz-Herrera Del Rosario R Histone acetylome-wide association study of autism spectrum disorder. Cell 2016; 167: 1385- 97.e11. 10.1016/j.cell.2016.10.031 27863250
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Maternal history of autoimmune disease, such as diabetes, thyroid disease, or psoriasis has been postulated, but study results remain mixed (60,61).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [60] Xiang AH Wang X Martinez MP Maternal type 1 diabetes and risk of autism in offspring. JAMA 2018; 320: 89- 91. 10.1001/jama.2018.7614 29936530 PMC6134431
- Not checked yetcites [61] Croen LA Grether JK Yoshida CK Maternal autoimmune diseases, asthma and allergies, and childhood autism spectrum disorders: a case-control study. Arch Pediatr Adolesc Med 2005; 159: 151- 7. 10.1001/archpedi.159.2.151 15699309
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Genome wide association studies and whole exome sequencing methods have broadened our understanding of ASD susceptibility genes, and learning more regarding the function of these genes can shed light on potential biologic mechanisms (45).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [45] Walsh CA Morrow EM Rubenstein JLR. Autism and brain development. Cell 2008; 135: 396- 400. 10.1016/j.cell.2008.10.015 18984148 PMC2701104
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A recent meta-analysis reported several pre, peri and postnatal risk factors that resulted in an elevated relative risk of ASD in offspring (35), but also revealed significant heterogeneity, resulting in an inability to make true determination regarding the importance of these factors.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [35] Wang C Geng H Liu W Prenatal, perinatal, and postnatal factors associated with autism: a meta-analysis. Medicine (Baltimore) 2017; 96: e6696. 10.1097/MD.0000000000006696 28471964 PMC5419910
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This could be due to the theory that older gametes have a higher probability of carrying mutations which could result in additional obstetrical complications, including prematurity (36).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Epidemiology
What the sources say
- Not checked yetcites [36] Parner ET Baron-Cohen S Lauritsen MB Parental age and autism spectrum disorders. Ann Epidemiol 2012; 22: 143- 50. 10.1016/j.annepidem.2011.12.006 22277122 PMC4562461
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Brain overgrowth both in terms of cortical size and additionally in terms of increased extra-axial fluid have been described in children with ASD and are areas of ongoing study both in terms of furthering our understanding of its etiology, but also as a potential biomarker (40,41).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [40] Shen MD Kim SH McKinstry RC Increased extra-axial cerebrospinal fluid in high-risk infants who later develop autism. Biol Psychiatry 2017; 82: 186- 93. 10.1016/j.biopsych.2017.02.1095 28392081 PMC5531051
- Not checked yetcites [41] Hazlett HC Gu H Munsell BC Early brain development in infants at high risk for autism spectrum disorder. Nature 2017; 542: 348- 51. 10.1038/nature21369 28202961 PMC5336143
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While no clear biomarkers or diagnostic measures exist, clinical genetic testing is recommended as part of the initial medical evaluation.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Summary
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Sleep problems have been reported to occur in anywhere from 50% to 73% of patients with ASD with variation in prevalence dependent on the definition of sleep symptoms or the measurement tool used (90-92).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [90] Reynolds AM Soke GN Sabourin KR Sleep problems in 2- to 5-year-olds with autism spectrum disorder and other developmental delays. Pediatrics 2019; 143: e20180492. 10.1542/peds.2018-0492 30745433 PMC6398427
- Not checked yetcites [91] Krakowiak P Goodlin-Jones B Hertz-Picciotto I Sleep problems in children with autism spectrum disorders, developmental delays, and typical development: a population-based study. J Sleep Res 2008; 17: 197- 206. 10.1111/j.1365-2869.2008.00650.x 18482108 PMC4041696
- Not checked yetcites [92] Polimeni MA Richdale AL Francis AJ. A survey of sleep problems in autism, Asperger's disorder and typically developing children. J Intellect Disabil Res 2005; 49: 260- 8. 10.1111/j.1365-2788.2005.00642.x 15816813
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“research continues to reveal factors that correlate with ASD risk, but no causal determinations have been made.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [52] Ruzzo EK Pérez-Cano L Jung JY Inherited and de novo genetic risk for autism impacts shared networks. Cell 2019; 178: 850- 66.e26. 10.1016/j.cell.2019.07.015 31398340 PMC7102900
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Research continues to reveal factors that correlate with ASD risk and these findings may guide further etiologic investigation, but no final causal pathway has been elucidated.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Summary
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Other behavioral or psychiatric co-occurring conditions in ASD include anxiety, attention deficit/hyperactivity disorder (ADHD), obsessive compulsive disorder, and mood disorders or other disruptive behavior disorders (81).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [81] Soke GN Maenner MJ Christensen D Prevalence of co-occurring medical and behavioral conditions/symptoms among 4- and 8-year-old children with autism spectrum disorder in selected areas of the United States in 2010. J Autism Dev Disord 2018; 48: 2663- 76. 10.1007/s10803-018-3521-1 29524016 PMC6041136
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“there is no evidence that vaccines, thimerosal, or mercury is associated with ASD (68-70).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Causes
What the sources say
- Not checked yetcites [68] Taylor LE Swerdfeger AL Eslick GD. Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies. Vaccine 2014; 32: 3623- 9. 10.1016/j.vaccine.2014.04.085 24814559
- Not checked yetcites [69] Uno Y Uchiyama T Kurosawa M Early exposure to the combined measles-mumps-rubella vaccine and thimerosal-containing vaccines and risk of autism spectrum disorder. Vaccine 2015; 33: 2511- 6. 10.1016/j.vaccine.2014.12.036 25562790
- Not checked yetcites [70] Hviid A Hansen JV Frisch M Measles, mumps, rubella vaccination and autism a nationwide cohort study. Ann Intern Med 2019; 170: 513- 20. 10.7326/M18-2101 30831578
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Studies using electronic health record (EHR) analysis revealed prevalence of epilepsy ~20% and GI disorders [without inflammatory bowel disease (IBD)] at 10–12% (82).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [82] Kohane IS McMurry A Weber G The co-morbidity burden of children and young adults with autism spectrum disorders. PLoS One 2012; 7: e33224. 10.1371/journal.pone.0033224 22511918 PMC3325235
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Research continues to reveal factors that correlate with ASD risk and these findings may guide further etiologic investigation, but no final causal pathway has been elucidated.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Summary
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At this time there is inadequate evidence to recommend routine testing for celiac disease, immunologic or neurochemical markers, mitochondrial disorders, allergy testing, hair analysis, intestinal permeability studies, erythrocyte glutathione peroxidase studies, stool analysis, urinary peptides or vitamin and mineral deficiencies without a history of severe food selectivity.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Other common co-occurring medical conditions include gastrointestinal (GI) disorders, including dietary restrictions and food selectivity, sleep disorders, obesity, and seizures (81-84).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [81] Soke GN Maenner MJ Christensen D Prevalence of co-occurring medical and behavioral conditions/symptoms among 4- and 8-year-old children with autism spectrum disorder in selected areas of the United States in 2010. J Autism Dev Disord 2018; 48: 2663- 76. 10.1007/s10803-018-3521-1 29524016 PMC6041136
- Not checked yetcites [82] Kohane IS McMurry A Weber G The co-morbidity burden of children and young adults with autism spectrum disorders. PLoS One 2012; 7: e33224. 10.1371/journal.pone.0033224 22511918 PMC3325235
- Not checked yetcites [83] Kielinen M Rantala H Timonen E Associated medical disorders and disabilities in children with autistic disorder: A population-based study. Autism 2004; 8: 49- 60. 10.1177/1362361304040638 15070547
- Not checked yetcites [84] Curtin C Anderson SE Must A The prevalence of obesity in children with autism: a secondary data analysis using nationally representative data from the National Survey of Children’s Health. BMC Pediatr 2010; 10: 11. 10.1186/1471-2431-10-11 20178579 PMC2843677
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“According to a surveillance study of over 2,000 children with ASD, 83% had an additional developmental diagnosis, 10% had at least one psychiatric diagnosis, and 16% at least one neurologic diagnosis (79).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [79] Levy SE Giarelli E Lee LC Autism spectrum disorder and co-occurring developmental, psychiatric, and medical conditions among children in multiple populations of the United States. J Dev Behav Pediatr 2010; 31: 267- 75. 10.1097/DBP.0b013e3181d5d03b 20431403
plainn = 2,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A recent meta-analysis of 30 studies measuring rates of anxiety and 29 studies measuring rates of depression reported a high degree of heterogeneity from the current literature, but stated pooled lifetime prevalence for adults with ASD to be 42% for any anxiety disorder and 37% for any depressive disorder, though the use of self-report measures and the presence of ID could influence estimates (95)”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [95] Hollocks MJ Lerh JW Magiati I Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis. Psychol Med 2019; 49: 559- 72. 10.1017/S0033291718002283 30178724
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Rates of overweight and obesity in ASD are reported to be roughly 33% and 18% respectively, higher than rates in typically developing children (81-84,93).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [81] Soke GN Maenner MJ Christensen D Prevalence of co-occurring medical and behavioral conditions/symptoms among 4- and 8-year-old children with autism spectrum disorder in selected areas of the United States in 2010. J Autism Dev Disord 2018; 48: 2663- 76. 10.1007/s10803-018-3521-1 29524016 PMC6041136
- Not checked yetcites [82] Kohane IS McMurry A Weber G The co-morbidity burden of children and young adults with autism spectrum disorders. PLoS One 2012; 7: e33224. 10.1371/journal.pone.0033224 22511918 PMC3325235
- Not checked yetcites [83] Kielinen M Rantala H Timonen E Associated medical disorders and disabilities in children with autistic disorder: A population-based study. Autism 2004; 8: 49- 60. 10.1177/1362361304040638 15070547
- Not checked yetcites [84] Curtin C Anderson SE Must A The prevalence of obesity in children with autism: a secondary data analysis using nationally representative data from the National Survey of Children’s Health. BMC Pediatr 2010; 10: 11. 10.1186/1471-2431-10-11 20178579 PMC2843677
- Not checked yetcites [93] Hill AP Zuckerman KE Fombonne E. Obesity and autism. Pediatrics 2015; 136: 1051- 61. 10.1542/peds.2015-1437 26527551 PMC4657601
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“of genetics continues to advance rapidly, recent publications suggest whole exome sequencing may become the preferred method for clinical genetic testing in individuals with ASD (100,101).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [100] Srivastava S Love-Nichols JA Dies KA Meta-analysis and multidisciplinary consensus statement: exome sequencing is a first-tier clinical diagnostic test for individuals with neurodevelopmental disorders. Genet Med 2019. [Epub ahead of print]. 10.1038/s41436-019-0554-6 31182824 PMC6831729
- Not checked yetcites [101] Feliciano P Zhou X Astrovskaya I Exome sequencing of 457 autism families recruited online provides evidence for autism risk genes. NPJ Genom Med 2019; 4: 19. 10.1038/s41525-019-0093-8 31452935 PMC6707204
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Research continues to reveal factors that correlate with ASD risk and these findings may guide further etiologic investigation, but no final causal pathway has been elucidated.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Summary
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“clinical genetic testing is recommended and can provide information regarding medical interventions or work up that might be necessary and help with family planning (96).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [96] Miller DT. Genetic testing for autism: recent advances and clinical implications. Expert Rev Mol Diagn 2010; 10: 837- 40. 10.1586/erm.10.82 20964600
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In the past, rates of co-morbid intellectual disability (ID) in patients with ASD were reported from 50% to 70%, with the most recent CDC estimate reported at 31.0% (26.7% to 39.4%) with ID defined as intelligence quotient (IQ) ≤70 (6,80).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [6] Baio J Wiggins L Christensen DL Prevalence of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveill Summ 2018; 67: 1- 23. 10.15585/mmwr.ss6706a1 29701730 PMC5919599
- Not checked yetcites [80] Yeargin-Allsopp M Rice C Karapurkar T Prevalence of autism in a US metropolitan area. JAMA 2003; 289: 49- 55. 10.1001/jama.289.1.49 12503976
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“In children with ASD seeking treatment, the rate of any anxiety disorder was found to be similar at 42% and in addition this study reported co-morbid oppositional defiant disorder at a rate of 46% and mood disorders at 8%, with 66% of the sample of over 600 patients having more than one co-occurring condition (94).”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
What the sources say
- Not checked yetcites [94] Lecavalier L McCracken CE Aman MG An exploration of concomitant psychiatric disorders in children with autism spectrum disorder. Compr Psychiatry 2019; 88: 57- 64. 10.1016/j.comppsych.2018.10.012 30504071 PMC6295217
plainn = 600- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Currently no clear ASD biomarkers or diagnostic measures exist, and the diagnosis is made based on fulfillment of descriptive criteria.”
§ Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation > Evaluation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Although it is interesting that, among these common abnormalities in ASD, GIS are closely associated with neurological and behavioral symptoms, in both greater frequency and severity [4].”
From Food Selectivity and Its Implications Associated with Gastrointestinal Disorders in Children with Autism Spectrum Disorders (2022) · cites this paper as [4]
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369
Shrestha, S., & Offer, S. M. (2016) · Medical Epigenetics · doi:10.1159/000444713 · Cited by 8,951
Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., Kurzius-Spencer, M., Zahorodny, W., Robinson, C., Rosenberg, et al. (2018) · MMWR. Surveillance Summaries · doi:10.15585/mmwr.ss6706a1 · Cited by 6,078
Maenner, M. J., Shaw, K. A., Baio, J., EdS1, Washington, A., Patrick, M., DiRienzo, M., Christensen, D. L., Wiggins, L. D., Pettygrove, S., et al. (2020) · MMWR. Surveillance Summaries · doi:10.15585/mmwr.ss6904a1 · Cited by 3,780
What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis
Loomes, R., Hull, L., & Mandy, W. P. L. (2017) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2017.03.013 · Cited by 2,804
Model of autism: increased ratio of excitation/inhibition in key neural systems
Rubenstein, J. L. R., & Merzenich, M. M. (2003) · Genes, Brain and Behavior · doi:10.1034/j.1601-183x.2003.00037.x · Cited by 2,768
Synaptic, transcriptional and chromatin genes disrupted in autism
Study, T. D., De Rubeis, S., Autism, H. M. C. F., UK10K Consortium, The Autism Sequencing Consortium, He, X., Goldberg, A. P., Poultney, C. S., Samocha, K., Ercument Cicek, A., et al. (2014) · Nature · doi:10.1038/nature13772 · Cited by 2,746
Identification and Evaluation of Children With Autism Spectrum Disorders
Johnson, C. P., Myers, S. M., & and the Council on Children With Disabilities (2007) · Pediatrics · doi:10.1542/peds.2007-2361 · Cited by 2,011
Transcriptomic Analysis of Autistic Brain Reveals Convergent Molecular Pathology
Voineagu, I., Wang, X., Johnston, P., Lowe, J. K., Tian, Y., Horvath, S., Mill, J., Cantor, R. M., Blencowe, B. J., & Geschwind, D. H. (2011) · Nature · doi:10.1038/nature10110 · Cited by 1,874 · cited 2×
“Potential “networks” of ASD genetic risk convergence include pathways involved in neurotransmission and neuroinflammation (49).”
BackgroundPrevalence of Autism in a US Metropolitan Area
Yeargin-Allsopp, M., Rice, C., Karapurkar, T., Doernberg, N., Boyle, C., & Murphy, C. (2003) · JAMA · doi:10.1001/jama.289.1.49 · Cited by 1,248
Cited by
Sorted by citations
Fecal microbiota transplantation: current challenges and future landscapes
Yadegar, A., Bar‐Yoseph, H., Monaghan, T. M., Pakpour, S., Severino, A., Kuijper, E. J., Smits, W. K., Terveer, E. M., Neupane, S., Nabavi-Rad, A., et al. (2024) · Clinical Microbiology Reviews · doi:10.1128/cmr.00060-22 · Cited by 397
Challenges Surrounding the Diagnosis of Autism in Children
Hus, Y., & Segal, O. (2021) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s282569 · Cited by 225
Mushrooms as future generation healthy foods
Bell, V., Silva, C. R. P. G., Guina, J. A., & Fernandes, T. H. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.1050099 · Cited by 179
Vadapalli, S., Abdelhalim, H., Zeeshan, S., & Ahmed, Z. (2022) · Briefings in Bioinformatics · doi:10.1093/bib/bbac191 · Cited by 168
Sleep Problems in 2- to 5-Year-Olds With Autism Spectrum Disorder and Other Developmental Delays
Reynolds, A., Soke, G. N., Sabourin, K. R., Hepburn, S., Katz, T., Wiggins, L. D., Schieve, L. A., & Levy, S. E. (2019) · PEDIATRICS · doi:10.1542/peds.2018-0492 · Cited by 137
Metadata
- Authors
- Hodges, H., Fealko, C., & Soares, N.
- Affiliations
- Baylor College of Medicine (US)
- Western Michigan University (US)
- Corresponding author
- Soares, Neelkamal
- Venue
- Translational Pediatrics
- Publisher
- AME Publishing Company
- Published
- 2020-02
- Volume
- 9
- Issue
- S1
- Pages
- S55-S65
- ISSN
- 2224-4336 (ISSN-L)
- 2224-4344
- PMC
- PMC7082249
- OpenAlex
- W2981275956
- Cited by
- 1,127
- References
- 120
- Citations by year
- 2026: 223 · 2025: 283 · 2024: 235 · 2023: 201 · 2022: 114 · 2021: 55 · 2020: 14
- FWCI
- 12.80
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Translational Pediatrics (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- autism spectrum disorder, prevalence, diagnostic criteria, genetic factors, environmental risk factors, neurodevelopmental disorders, social communication deficits, restricted and repetitive behaviors, developmental screening, diagnosis, comorbidity screening
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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