Some children show a mixture of features, with some early delays and some later losses; and there is evidence of a continuous spectrum of behaviors, rather than, or in addition to, a black-and-white distinction, between autism with and without regression. There are several intermediate types of development, which do not neatly fit into either the traditional early onset or the regressive categories, including mixtures of early deficits, failures to progress, subtle diminishment, and obvious losses. Regression may occur in a variety of domains, including communication, social, cognitive, and self-help skills; however, the most common regression is loss of language. Some children lose social development instead of language; some lose both. Skill loss may be quite rapid, or may be slow and preceded by a lengthy period of no skill progression; the loss may be accompanied by reduced social play or increased irritability. The temporarily acquired skills typically amount to a few words of spoken language, and may include some rudimentary social perception.The prevalence of regression varies depending on the definition used. If regression is defined strictly to require loss of language, it is less common; if defined more broadly, to include cases where language is preserved but social interaction is diminished, it is more common. Though regressive autism is often thought to be a less common (compared with gradual course of autism onset described above), this is an area of ongoing debate; some evidence suggests that a pattern of regressive autism may be more common than previously thought.
A Canadian meta-analysis from 2019 confirmed these effects as the profiles of people diagnosed with autism became less and less different from the profiles of the general population. In the US, the rates for diagnosed ASD have been steadily increasing since 2000 when records began being kept. While it remains unclear whether this trend represents a true rise in incidence, it likely reflects changes in ASD diagnostic criteria, improved detection, and increased public awareness of autism. In 2012, the NHS estimated that the overall prevalence of autism among adults aged 18 years and over in the UK was 1.1%.A 2016 survey in the United States reported a rate of 25 per 1,000 children for ASD. It is important to note that rates of autism are poorly understood in many low- and middle-income countries, which affects the accuracy of global ASD prevalence estimates, but it is thought that most autistic individuals live in low- and middle-income countries.In the UK, from 1998 to 2018, the autism diagnoses increased by 787%. This increase is largely attributable to changes in diagnostic practices, referral patterns, availability of services, age at diagnosis, and public awareness (particularly among women), though unidentified environmental risk factors cannot be ruled out. The available evidence does not rule out the possibility that autisms true prevalence has increased; a real increase would suggest directing more attention and funding toward psychosocial factors and changing environmental factors instead of continuing to focus on genetics.