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The proportion of intellectual disability in autism spectrum disorder over two decades

Salkić, Alen ; Tideman, Magnus ; Martini, Miriam I. ; Larsson, Henrik ; Lichtenstein, Paul ; Chang, Zheng ; D'Onofrio, Brian ; Brikell, Isabell ; Kuja-Halkola, Ralf and Knez, Rajna , et al. (2026) In Psychiatry Research 363.
Abstract

Background: The registered prevalence of autism has increased substantially over the past two decades, potentially impacting the co-occurrence of diagnosed intellectual disability (ID) in autism. Thus, the aim of this study was to investigate the proportion of ID in individuals with autism over two decades (2001–2020). Methods: Data for this study was retrieved for individuals born between 1988–2016 from Swedish population based national registers. A total of 3,045,819 individuals were eligible for inclusion in the current study, out of whom 81,286 had autism assigned 2001–2020. The annual proportion of ID in autism was calculated across year of autism diagnosis and the Cochrane Armitage trend tests were conducted. Results: From... (More)

Background: The registered prevalence of autism has increased substantially over the past two decades, potentially impacting the co-occurrence of diagnosed intellectual disability (ID) in autism. Thus, the aim of this study was to investigate the proportion of ID in individuals with autism over two decades (2001–2020). Methods: Data for this study was retrieved for individuals born between 1988–2016 from Swedish population based national registers. A total of 3,045,819 individuals were eligible for inclusion in the current study, out of whom 81,286 had autism assigned 2001–2020. The annual proportion of ID in autism was calculated across year of autism diagnosis and the Cochrane Armitage trend tests were conducted. Results: From 2001–2020 the prevalence of autism increased by 800%. Among those with autism, 13,403 also had an ID diagnosis, resulting in an overall proportion of ID in autism of 16.5%. The proportion of ID in autism decreased from 55.8% in 2001 to 6.7% in 2020, with a comparable decrease in females and males. A similar trend was discerned when limiting the sample to those diagnosed with autism before age 13 and 7 years. Discussion: The results of this study indicate less congruity between the autism phenotype observed today and earlier conceptualizations of autism, which often included intellectual disability (ID). The findings suggest that changes in diagnostic criteria during this period contributed to a broadening of the ways in which individuals could meet criteria for autism, encompassing a wider range of cognitive abilities.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Autism, Coexistence, Intellectual disability, Proportion
in
Psychiatry Research
volume
363
article number
117246
publisher
Elsevier
external identifiers
  • scopus:105041223828
  • pmid:42214315
ISSN
0165-1781
DOI
10.1016/j.psychres.2026.117246
language
English
LU publication?
yes
id
98e0f5c1-38f4-455d-bef9-60a48a0b1df7
date added to LUP
2026-08-24 08:28:40
date last changed
2026-08-24 08:29:27
@article{98e0f5c1-38f4-455d-bef9-60a48a0b1df7,
  abstract     = {{<p>Background: The registered prevalence of autism has increased substantially over the past two decades, potentially impacting the co-occurrence of diagnosed intellectual disability (ID) in autism. Thus, the aim of this study was to investigate the proportion of ID in individuals with autism over two decades (2001–2020). Methods: Data for this study was retrieved for individuals born between 1988–2016 from Swedish population based national registers. A total of 3,045,819 individuals were eligible for inclusion in the current study, out of whom 81,286 had autism assigned 2001–2020. The annual proportion of ID in autism was calculated across year of autism diagnosis and the Cochrane Armitage trend tests were conducted. Results: From 2001–2020 the prevalence of autism increased by 800%. Among those with autism, 13,403 also had an ID diagnosis, resulting in an overall proportion of ID in autism of 16.5%. The proportion of ID in autism decreased from 55.8% in 2001 to 6.7% in 2020, with a comparable decrease in females and males. A similar trend was discerned when limiting the sample to those diagnosed with autism before age 13 and 7 years. Discussion: The results of this study indicate less congruity between the autism phenotype observed today and earlier conceptualizations of autism, which often included intellectual disability (ID). The findings suggest that changes in diagnostic criteria during this period contributed to a broadening of the ways in which individuals could meet criteria for autism, encompassing a wider range of cognitive abilities.</p>}},
  author       = {{Salkić, Alen and Tideman, Magnus and Martini, Miriam I. and Larsson, Henrik and Lichtenstein, Paul and Chang, Zheng and D'Onofrio, Brian and Brikell, Isabell and Kuja-Halkola, Ralf and Knez, Rajna and Gillberg, Christopher and Taylor, Mark J. and Lundström, Sebastian}},
  issn         = {{0165-1781}},
  keywords     = {{Autism; Coexistence; Intellectual disability; Proportion}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Psychiatry Research}},
  title        = {{The proportion of intellectual disability in autism spectrum disorder over two decades}},
  url          = {{http://dx.doi.org/10.1016/j.psychres.2026.117246}},
  doi          = {{10.1016/j.psychres.2026.117246}},
  volume       = {{363}},
  year         = {{2026}},
}