Policy Responses to Rising Autism Diagnoses in Childhood

3. Financial benefits for children with autism spectrum disorder

Abstract

This chapter provides a comparative overview of the allowances available to children with ASD and their families across 11 OECD countries. It begins by outlining the range of government supports – carer allowances, disabled child allowances, and additional cost allowances – and explains how these types of benefits differ in purpose. The chapter then examines how countries assess eligibility, highlighting the central role of support needs assessments, the varying weight given to medical diagnoses, and the diversity of administrative practices across systems. Special attention is given to Israel’s diagnosis‑based model, which uniquely links benefit levels to medical conditions, in contrast to the needs‑based approaches prevalent elsewhere. The chapter also reviews the substantial cross‑country variation in benefit generosity, the use of means‑testing, and the ways in which allowances interact with caregivers’ employment decisions. Finally, it discusses provisions that apply specifically to children with ASD, including Ontario’s Autism Program and certain features of Australia’s NDIS.

In Brief

Financial support for families of children with autism

Governments across OECD countries provide a mix of allowances and benefits to respond to the financial challenges families raising a child with autism are facing. Available benefits can include carer allowances to compensate for lost earnings, child disability allowances to ensure an adequate standard of living, and additional cost allowances to cover disability-related expenses such as therapies or home adaptations. While all countries reviewed offer some form of financial assistance, or even combine some of these payments, approaches differ markedly in design, generosity, and eligibility criteria.

Most countries base eligibility on an assessment of the child’s support needs rather than on diagnosis alone. Israel and Australia are the notable exceptions: a formal autism diagnosis automatically entitles a child to a 100% rate of Israel’s Disabled Child Allowance, with possibly higher rates for severe cases, and the Carer Allowance in Australia. Elsewhere, a diagnosis may be required but a diagnosis alone does not guarantee access to benefits. This reflects a broader trend towards support-needs-based systems, where support is linked to the child’s daily living needs rather than medical labels.

Benefit levels vary widely. Denmark’s Compensation for Lost Earnings stands out for its generosity, covering a large share of income lost when parents reduce working hours to provide care. By contrast, in countries such as Germany or Estonia, allowances are modest and leave families with substantial income gaps. Means-testing adds another layer of variation: while benefits in countries like France and Sweden are universal, others, including Canada, Australia, and California (United States), reduce or eliminate payments for higher-income households.

Additional cost allowances can play an important role in funding therapies and services, often through individualised budgets. Australia’s National Disability Insurance Scheme and the Ontario Autism Program exemplify this proactive approach, giving families flexibility to purchase supports. Some other countries rely on flat-rate payments or reimbursements for documented expenses.

Financial support systems reflect different policy priorities: some systems aim to compensate for lost earnings, others to promote inclusion and autonomy through flexible funding. Yet challenges remain. Benefit generosity does not always align with the intensity of care and support needs, and access to support can be uneven across income groups. Especially for parents who are compelled to reduce their working hours to care for a child with disability, state‑provided income support can be crucial.

Countries offer a range of financial benefits for children with ASD

Government support for children with ASD and their families is provided through a range of financial benefits, including direct cash transfers and tax benefits. In all 11 countries covered by this comparative study (Australia, Canada (Ontario), Denmark, Estonia, France, Germany, Israel, the Netherlands, Sweden, the United Kingdom, the United States (California)1), some form of cash benefit is available. Except at provincial level in Canada, for instance in Ontario and British Columbia, none of the countries offer a national-level benefit that is specific to ASD; rather, children with ASD are included in the broader framework for children with disability or special needs. In each country reviewed, except Israel and to some extent Australia, children with ASD must undergo the same assessments and satisfy the same eligibility criteria as those with other disabilities. Although a formal ASD diagnosis may be required in some cases, it does not automatically confer eligibility for state financial support.

Allowances for children with disability can be classified into three categories

These three categories are, not necessarily mutually exclusive:

1. Carer allowances

2. Disabled child allowances

3. Additional cost allowances

The carer allowance is a financial benefit designed to support individuals – typically parents or other family members – who dedicate a significant amount of their time to caring for a person in need of support. These allowances serve multiple purposes: they help to offset lost income resulting from reduced working hours or complete withdrawal from the labour market (Jenson and Jacobzone, 2000[1]; Van Houtven et al., 2019[2]), formally acknowledge the contributions of carers, and promote the provision of care within the home setting (Anttonen and Karsio, 2016[3]). The latter aligns with the principle set out in the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), which advocates for de‑institutionalisation across all aspects of life of persons with disability (United Nations, 2006[4]).

The disabled child allowance is a direct cash benefit provided to children with disability and their families, aimed at alleviating financial strain, supporting home‑based care, and fostering the child’s inclusion in society. Unlike the carer allowance, which centres on the caregiver and care needs, this allowance is more child-focussed, considering the specific needs of the child to help ensure financial security and an adequate standard of living. By offering additional financial resources, the allowance enables families to better support the child’s development and participation in society.

Lastly, the additional cost allowance is a financial benefit aimed at covering specific disability-related expenses, such as specialised therapies, assistive equipment, or home adaptations. In contrast to the disabled child allowance, which offers general financial support based on disability status, this allowance is tied to the actual additional costs incurred by the family of the child. Eligibility is typically determined through a detailed assessment of the additional expenses directly attributable to the child’s disability.

Classifying financial benefits according to their purpose facilitates a cross-country comparison of the support provided to children with ASD. That said, in practice, some allowances may not fit neatly into a single category, as they incorporate elements of more than one type of allowance. In these cases, the financial benefit can be assigned to the category that best reflects its primary function.

Israel’s Disabled Child Allowance has a unique approach to determining eligibility

Unlike most other countries covered in this report, Israel provides only one type of financial benefit for children with disability – the Disabled Child Allowance. This monthly allowance is divided into five levels (50%, 100%, 112%, 188%, and 235%), ranging from NIS 1880 (USD PPP 522) to NIS 8 828 (USD PPP 2 453). A formal medical diagnosis is required and plays a central role in determining the allowance level, as Israel prescribes predefined benefit levels for most conditions. For example, a child with an ASD diagnosis automatically qualifies for the 100% rate, while a child diagnosed with mild intellectual developmental disability receives 50%. Children undergo a care needs assessment only to determine whether their parents’ care provision warrants a higher rate than the standard for their condition. For instance, a child with Down Syndrome who requires intensive care may receive 188% rather than the standard 50‑100%.

Israel’s diagnosis-based approach, where benefit levels are tied to medical conditions and a care needs assessment is conducted only to determine whether a higher allowance level should be granted, poses challenges, especially for conditions such as ASD that span a broad spectrum of severity. As will be detailed in the following sections, this reliance on diagnoses is unique among the countries studied.

Carer allowances are commonly available in the countries reviewed

Except for Israel, Canada, and the Netherlands, every country under review offers at least one carer allowance that caregivers of children with ASD may qualify for (see Table 3.1). In countries where multiple carer allowances are available, these benefits are typically differentiated according to the level to which caregivers are limited in their capacity to work. This approach is intended to better support parents and other informal caregivers who must substantially reduce their working hours or exit the labour market entirely due to the significant care needs of the child.

Support needs and the hours of care required are determining factors for eligibility

In the eight countries providing a carer allowance, an assessment of the child’s care requirements and support needs in daily life is a fundamental component of determining eligibility. These evaluations typically examine aspects of the child’s life such as mobility, cognitive and communicative abilities, social participation, and self-care. Most assessments rely on documentary evidence, such as medical certificates and school reports, and may utilise standardised tools, including questionnaires. In instances where uncertainty remains, in-person evaluations are conducted on a case‑by-case basis; in some countries however, notably Germany, in-person visits are the norm. Frequently, eligibility depends on the hours of care required, with some systems stipulating a minimum number of care hours per week as a condition for eligibility (Sweden’s Assistance Allowance (Assistansersättning) and the United Kingdom’s Carer’s Allowance). Consequently, parents are commonly required to supply evidence demonstrating both the care provided and its impact on their capacity to engage in paid employment, particularly when the child’s disability necessitates continuous care, potentially resulting in one parent having to leave their job.

It is important to note that across all countries covered in this report, these carer allowances are not limited to specific types of medical impairments or disability. In most cases, a formal diagnosis of ASD – or any medical impairment – is not a prerequisite for qualifying for an allowance. For example, in the United Kingdom, Carer’s Allowance eligibility is determined solely by assessing the child’s support needs in daily life and need for care, rather than by confirming a medical diagnosis of a condition. While some countries and regions, such as Australia and California (United States) explicitly require a formal diagnosis – of ASD or any other medical impairment – others, including Denmark, the United Kingdom, and Estonia (Caregiver’s Allowance for Parents), do not. Nonetheless, most assessments incorporate some form of medical documentation describing the child’s condition. However, in none of the eight countries offering a carer allowance does a formal ASD diagnosis automatically entitle an individual to an allowance – Australia’s Carer Allowance is the only exception.

While assessments of a child’s support needs play a crucial role in determining eligibility for a carer allowance, the regularity of reassessments varies greatly. In some countries, only a significant change in the child’s condition triggers an ad hoc reassessment. In contrast, in France, reassessments are typically conducted every two to five years, and in Germany, for children, usually every two years. Age limits also vary among the countries considered: for example, while the German Care Allowance (Pflegegeld) applies to both adults and children, France and Australia have a specific carer allowance for children, imposing an age limit of 20 and 16 years, respectively.

Another important point of comparison is the administrative level at which these allowances are managed. Generally, carer allowances are administered at the federal or state level. In Estonia and Denmark, local authorities, such as municipalities, oversee the allowances. This decentralised approach partly explains why benefits in these countries, particularly in Denmark, tend to be individualised compared to the more standardised systems observed elsewhere.

Individual allowance amounts vary significantly between and within countries

There is also considerable variation in the generosity of benefits across countries. For example, Estonia’s Caregiver’s Allowance for Parents (hooldajatoetus) is on average EUR 90 (USD PPP 154) a month, while Denmark’s Compensation for Lost Earnings (Tabt arbejdsfortjeneste) can reach up to DKK 36 622 (USD PPP 5 878) per month. Variation exists not only between but also within countries, as different levels of financial support are often allocated according to the severity of the child’s disability and its impact on the caregiver’s capacity to work. In France, the Education Allowance for Disabled Children (Allocation d’éducation de l’enfant handicapé, AEEH) comprises a basic monthly allowance of EUR 151.80 (USD PPP 218) plus a complementary amount based on the caregiver’s ability to work, which can raise the total monthly benefit to EUR 1 415.87 (USD PPP 2 037). Similarly, Germany’s Care Allowance (Pflegegeld) is structured into five levels of care need corresponding to the child’s degree of care dependency, with a child classified at the highest level (level 5) qualifying for EUR 990 (USD PPP 1 388) per month.

There is no uniform approach to whether a carer allowance is means-tested. In English-speaking countries such as Australia, the United Kingdom, and California (United States), the caregiver’s income and assets are considered to determine both eligibility and the benefit amount. For example, Australia’s Carer Payment is income‐tested and gradually reduced once the adjusted family net income exceeds a specified threshold, potentially declining to AUD 0. In the United Kingdom, working carers earning more than GBP 196 (USD PPP 289) per week after deductions are ineligible for the Carer’s Allowance. Denmark employs an individualised approach: its Compensation for Lost Earnings (Tabt arbejdsfortjeneste) is income‑based, providing parents with a percentage of their lost income calculated on the basis of their previous gross earnings, up to a maximum of DKK 36 622 (USD PPP 5 878) per month.

The carer allowances in Denmark and the United Kingdom stand out. Denmark’s highly individualised approach features assessment procedures that vary by municipality and determine benefit amounts on a case‑by-case basis, considering factors such as the child’s support needs, the number of care hours required, and the caregiver’s previous income. Although the United Kingdom does not adopt such an individualised method, its eligibility requirements are notably progressive, relying entirely on an assessment of the child’s support needs and limitations in daily life without necessitating a formal medical diagnosis. This approach aligns more closely with the principles of the United Nations Convention on the Rights of Persons with Disabilities and the social model of disability.

Table 3.1. Carer allowances

Country	Benefit	Amount & levels	(ASD) diagnosis	Means-testing
Australia	Carer Allowance	Fortnightly payment of AUD 159.30. A child with an ASD diagnosis is automatically entitled to the benefit.	Required	Income‑tested
	Carer Payment	Fortnightly payment with maximum at: AUD 1 149 for a single carer; AUD 1 732.2 for a couple if both care full-time	Required	Income‐ and asset-tested
Denmark	Compensation for Lost Earnings (Tabt arbejdsfortjeneste)	Benefit is a percentage of parents’ lost income, however, at a maximum of DKK 36 622 per month.	Not strictly required	Income‑tested
	Care Leave Scheme (Pasning af nærtstående)	During the leave, the carer is employed by the municipality and receives a salary of DKK 27 033 per month. However, this amount cannot be greater than the salary they would receive from their employer.	Not strictly required	Income‑tested
Estonia	Caregiver’s Allowance for Parents (hooldajatoetus)	Municipalities determine the exact amount on a case‐by‐case basis; on average EUR 90 per month.	Not strictly required	Usually not means-tested
	Care Allowance for Temporary Incapacity for Work (hooldushüvitis)	80% of caregiver’s previous labour income.	Required	Income‑tested
France	Education Allowance for Disabled Children (Allocation d’éducation de l’enfant handicap, AEEH)	Monthly basic allocation plus a complementary amount that varies depending on parents’ capacity to engage in work: 2) EUR 460.14 – 3) EUR 588.22 – 4) EUR 828.11 – 5) EUR 1 016.15 – 6) EUR 1 439.94	Required	Not means-tested
	Leave Allowance (Allocation Journalière de Présence Parentale, AJPP)	Full day: EUR 65.80 – Half day: EUR 32.90 Plus possible monthly supplement: EUR 126.20	Not strictly required	Daily allowance not means-tested Monthly supplement means-tested
Germany	Care Allowance (Pflegegeld)	Monthly: 5 levels depending on the child’s care needs: 1) not eligible – 2) EUR 347 – 3) EUR 599 – 4.) EUR 800 – 5) EUR 990	Not strictly required	Not means-tested
Sweden	Care Allowance (Omvårdnadsbidrag)	Monthly: 4 levels depending on the child’s care needs: 1) SEK 3 063 – 2) SEK 6 125 – 3) SEK 9 188 – 4) SEK 12 250	Not strictly required	Not means-tested
	Assistance Allowance (Assistansersättning)	Benefit is calculated based on approved number of assistance hours multiplied by a standard hourly rate which is approximately SEK 343/hour.	Not strictly required	Not means-tested
United Kingdom	Carer’s Allowance	GBP 81.90 per week	Not strictly required	Income‑tested
	Universal Credit – Carer’s Element	GBP 198.31 per month	Not strictly required	Means-tested
United States (California)	In-Home Supportive Services (IHSS)	Based on authorised service hours multiplied by the applicable hourly wage, which varies by county.	Required	Means-tested

Note: A detailed comparison of carer allowances can be found in Table A C.1.

Source: Information collected by the Secretariat and verified in discussions with national autism organisations and ministries.

Disabled child allowances also offer meaningful financial support

Countries typically provide either a carer allowance or a disabled child allowance, with only a few – namely Estonia, France, the United Kingdom, and California (United States) – offering both types of support. Most countries included in this comparison, except for Australia, Denmark, Germany, and Sweden,2 provide some form of disabled child allowance. The United Kingdom stands out for offering two such allowances: one means-tested as part of the Universal Credit system (the Disabled Child Element), and the other – Disability Living Allowance – which is not subject to means testing (see Table 3.2).

An ASD diagnosis does not automatically entitle to a disabled child allowance

In most countries, an assessment of the child’s support needs forms a central part of the eligibility determination for a disabled child allowance. Israel, however, is a notable exception. There, a formal assessment of needs and functioning is conducted only to evaluate whether a child with ASD may qualify for a rate higher than the standard 100% level automatically granted to children with an ASD diagnosis. In all other countries examined, a formal medical ASD diagnosis alone does not guarantee eligibility for a disabled child allowance. While the extent, depth, and alignment with the social model of disability of support needs assessments vary by country, some form of evaluation is always present.

Israel represents the most medically oriented approach among the countries studied. A formal ASD diagnosis is not only required but also entitles the child to receive a 100% benefit automatically. By contrast, to qualify for Canada’s Child Disability Benefit (CBD), a child does not need to provide a formal medical diagnosis but must have one or more severe and prolonged impairments in mental or physical functions. However, such an assessment of the child’s functioning is not conducted through a separate process; rather, the assessment is integrated into the medical certificate, in which a health professional evaluates the child’s limitations in daily life. The Canadian allowance is income‑tested and can be gradually reduced to CAD 0. Its maximum monthly amount is considerably lower than Israel’s, at CAD 276.83 (USD PPP 244) (June 2025).

Overall, the support needs assessments used to determine eligibility for disabled child allowances across countries are typically identical to those used for carer allowances. These assessments focus on the child’s support needs in key areas of daily life, such as self-care, communication, and social interaction. While the assessments rely heavily on documentary evidence (e.g. medical reports, educational evaluations), in-person evaluations may also be conducted. In France, for example, a multi-disciplinary team from the Department for the Disabled (Maison départementale des personnes handicapées, MDPH) responsible for determining eligibility for the Allocation d’éducation de l’enfant handicapé (AEEH) conducts in-person evaluations. Notably, decisions and processing times may vary significantly between different French departments, risking marked socio-territorial inequalities. The GEVA guide (Guide d’évaluation des besoins de compensation des personnes handicapées) is, however, commonly used in support needs assessments in France. In Germany, assessments for the Care Allowance (Pflegegeld) are carried out by a medical service from the long-term care insurance. In the Netherlands, the Centre for Indications for Care (Centrum Indicatiestelling Zorg, CIZ) evaluates whether a child qualifies for long-term care, based on a comprehensive assessment of medical, functional, and social factors.

As previously noted, the United Kingdom’s Disability Living Allowance (DLA) stands out for relying entirely on a functional assessment of the child, with no requirement for a formal medical diagnosis. Given that many other British disability-related benefits are contingent on receipt of DLA, the United Kingdom’s disability benefit system is function-based rather than diagnosis-based. The child’s assessed actual needs and limitations in daily life determine not only eligibility for the allowance but also the level or amount of support granted.

Allowance levels commonly vary in line with the child’s degree of functional impairment

In Estonia, for example, there are three benefit levels ranging from EUR 138 to EUR 242 (USD PPP 237 to USD PPP 415) per month, depending on the assessed degree of disability. In the United Kingdom, the DLA comprises two components – care and mobility. The care component is divided into three levels of severity, while the mobility component has two levels, reflecting the varying support needs levels of children with disability.

However, variations in the amount of disabled child allowance across countries are not always driven by the severity of the child’s disability. In some cases, they result from income‑testing. For instance, in California (United States) and Canada, where the allowance amount is adjusted to parents’ income, exceeding a specified income threshold renders families ineligible for the financial benefit. In the Netherlands, the amount is not determined by either income or disability severity, but rather by the age of the child. The Dutch disabled child allowance, known as the Double Child Benefit (Dubbele Kinderbijslag), is essentially twice the standard child benefit which is age dependent.

In France, the AEEH consists of a basic allowance that falls under the category of a disabled child allowance. However, additional top-ups to the AEEH are granted based on the number of care hours required and the resulting reduction in working hours of parents or the incurrence of disability-related expenses. As such, these supplementary amounts align more closely with the purposes of carer allowances and additional cost allowances, respectively.

Given that the primary objective of disabled child allowances is to support financial stability and ensure an adequate standard of living for children with disability and their families – rather than to compensate for lost parental income or parents’ complete withdrawal from the labour market – these allowances are typically set at lower levels than carer allowances.

Table 3.2. Disabled child allowances

Country	Benefit	Amount & levels	(ASD) diagnosis	Means-testing
Canada	Child Disability Benefit (CDB)	Up to CAD 3 322 per year (or about CAD 276.83 per month) for each child who qualifies for the Disability Tax Credit (DTC) (June 2025).	Not strictly required	Income‑tested
Estonia	Disabled Child Allowance (Puudega lapse toetus)	Monthly: 3 levels depending on severity: 1) moderate disability: EUR 138 – 2) severe disability: EUR 161 – 3) profound disability: EUR 242	Not strictly required	Not means-tested
France	Education Allowance for Disabled Children (Allocation d’éducation de l’enfant handicap, AEEH)	Monthly basic rate of EUR 151.80. Top-ups (six levels) are determined by assessing additional expenses related to the disability and whether the child’s care needs force parents to reduce or stop working.	Required	Not means-tested
Israel	Disabled Child Allowance (קצבת ילד נכה)	Monthly: 5 levels: 1) 50%: NIS 1 880 – 2) 100%: NIS 3 694 – 3) 112%: NIS 4 352 – 4) 188%: NIS 6 947 – 5) 235%: NIS 8 828 Child with an ASD diagnosis automatically entitled to 100% but can receive higher rate (up to 235%) if has co-morbidities and/or high dependency on others.	Required	Not means-tested
Netherlands	Double Child Benefit (Dubbele Kinderbijslag)	Quarterly: 3 levels according to child’s age: 1) 0‑5 years: EUR 583 – 2) 6‑11 years: EUR 708 – 3) 12‑17 years: EUR 833 EUR 2 702 annual extra payment if parents receive Double Child Benefit for a full year.	Required	Not means-tested
United Kingdom	Disability Living Allowance (DLA)	Weekly: two components based on the child’s support needs. Care component: Lowest GBP 28.70 – Middle GBP 72.65 – Highest GBP 108.55 Mobility component: Lower GBP 28.70 – Higher GBP 75.75	Not strictly required	Not means-tested
	Universal Credit (UC) – Disabled Child Element	Two levels: Lower Rate Addition: GBP 156.11 per month – Higher Rate Addition: GBP 487.58 per month	Not strictly required	Means-tested
United States (California)	Federal Supplemental Security Income (SSI) & California State Supplementary Payment (SSP)	Up to USD 747.20 per month (SSI + California SSP).	Required	Income‑tested

Note: A detailed comparison of disabled child allowances can be found in Table A C.2.

Source: Information collected by the Secretariat and verified in discussions with national autism organisations and ministries.

Additional costs allowances cover disability-related expenses

Additional cost allowances are financial benefits aimed at covering specific disability-related expenses, such as specialised therapies or assistive equipment. Among the countries reviewed, Australia, Canada (Ontario), Denmark, France, Germany, the Netherlands, Sweden and the United Kingdom offer such an allowance, which is notably often administered at the local level – by municipalities or other local authorities – as is the case in the United Kingdom, the Netherlands, Germany, and Denmark (see Table 3.3).

Eligibility is typically determined by support needs and an additional costs assessment

Eligibility for an additional cost allowance requires a direct link between the child’s disability and the extra expenses incurred. Accordingly, the evaluation process typically comprises two components. First, the child’s disability must be determined – a process that usually involves reviewing medical documentation (without necessarily requiring a formal medical diagnosis) combined with an assessment of the child’s support needs. Second, an evaluation of the additional costs takes place to ascertain whether these expenses are necessary because of the disability and if they exceed those normally incurred by a child without a disability. Such additional expenses may include therapies (for instance, occupational or music therapy), modifications to the home or vehicle, and assistive technologies.

Within this second assessment component, a further distinction can be made between reactive and proactive allowances. Reactive allowances provide flat-rate payments or reimbursements for expenses that have already been incurred, without a prior agreement on what will be covered. In contrast, proactive allowances allocate a defined budget to be used for approved services or supports. Additional cost allowances, such as Germany’s Integration Assistance (Eingliederungshilfe), Canada’s Ontario Autism Program (OAP), Australia’s National Disability Insurance Scheme (NDIS), the Netherlands’ Personal Budget (Persoonsgebonden Budget, PGB), and the United Kingdom’s Direct Payments fall into this proactive category. These schemes provide children with disability and their parents with a pre‑approved budget, often guided by a detailed plan outlining which services the funds can be used for. For instance, instead of simply assessing extra expenses already incurred, Australia’s NDIS provides individualised funding packages that enable participants to purchase supports and services – such as therapies, assistive equipment, personal care, and training – in accordance with their approved funding plan.

Some of the allowances even incorporate in-kind benefit characteristics, for example Germany’s Integration Assistance or Canada’s OAP which offers certain services, such as parent training programmes, directly and free of charge. In addition, OAP provides children with an annual budget for Core Clinical Services, according to predefined annual levels varying by the child’s age and intensity of support needs. Parents use this budget to purchase services privately and are reimbursed for approved expenditures. Similar to the OAP, Germany’s Integration Assistance allows children to access certain services directly, such as integration aides in school or autism-specific therapy. Alternatively, children and their parents may choose to receive the Integration Assistance in the form of a personal budget, enabling them to purchase these services privately. This flexible structure of Germany’s Integration Assistance aims to empower individuals with disability by offering greater autonomy and choice over both the providers and the manner in which their support is delivered.

Certain countries set a minimum threshold of additional expenses to qualify for an allowance. For example, Denmark requires an annual minimum threshold of DKK 5 718 (USD PPP 918), after which the specific allowance is calculated based on the documented additional costs – consistent with Denmark’s highly individualised, case‑by-case approach. Like Ontario in Canada (OAP and Assistance for Children with Severe Disabilities, ACSD), France offers two additional cost allowances – the Disability Compensation Benefit (Prestation de compensation du handicap, PCH) which is income‑based, and the AEEH expenses top-up. The latter acts as a top-up to the basic AEEH and consists of four pre‑defined levels, each with its own monthly expense threshold (for instance, to qualify for the top-up Level 1 of EUR 113.85 (USD PPP 164), monthly extra expenses must exceed EUR 265.65 (USD PPP 382)). Sweden’s model is quite similar to France’s, with its Merkostnadsersättning structured into five tiers, each corresponding to a specific monthly expense threshold. In contrast, the United Kingdom adopts a fully individualised approach, determining allowance amounts on a case‑by-case basis without resorting to predefined benefit levels – an approach also pursued by Australia, Ontario in Canada (for its ACSD), Denmark, Germany and the Netherlands.

Distinct provisions for children with ASD compared to children with other disabilities exist

A formal, medical ASD diagnosis alone does not automatically entitle a child to an additional cost allowance, a condition that holds true for both carer allowances and disabled child allowances in all reviewed countries – except Israel’s Disabled Child Allowance and Australia’s Carer Allowance. In every other country, eligibility for any of these benefits is contingent upon a functioning or support needs assessment of the child. However, these assessments may still vary considerably in their depth and alignment with the social model of disability vis-à-vis the medical model. Notably, within each country, disability assessments tend to be largely consistent across the three allowance categories.

Even Canada’s provincial OAP, which is the only ASD-specific allowance among the countries reviewed, requires a support needs assessment to determine the annual budget a child may receive to purchase therapy hours and other clinical services. It is relatively common that provinces in Canada provide allowances targeted to specific types of disability or levels of need – for example, OAP or Alberta’s Assured Income for the Severely Handicapped (AISH), which provides financial support for adults with severe permanent disability – since Canada’s federal financial supports, such as the Child Disability Benefit, and services offer for people with disability are comparatively modest. In that sense, Ontario’s Autism Program fills a gap in Canada’s social protection system – at least for children with ASD. In Ontario (Canada), children with disabilities other than autism may benefit from the Assistance for Children with Severe Disabilities (ACSD) which is open to children with severe disability and offers individualised payments to cover incurred extra expenses. Unlike the OAP, however, the ACSD is means-tested.

Among the allowances reviewed in this section, Australia’s NDIS – open to all children with disability, i.e. not ASD-specific like Canada’s provincial OAP – probably comes closest to the characteristics of Israel’s Disabled Child Allowance. While NDIS eligibility ultimately depends on whether a child’s ASD results in a substantial reduction in functional capacity, children diagnosed with ASD Level 2 or Level 3 used to access the scheme more easily, as ASD Level 2 and Level 3 are included in the NDIA “List A: Conditions that are likely to meet the disability requirements”. However, the NDIA is currently transitioning to greater reliance on functioning and support needs instead of diagnostic labels to determine eligibility.

Table 3.3. Additional cost allowances

Country	Benefit	Amount & levels	(ASD) diagnosis	Means-testing
Australia	National Disability Insurance Scheme (NDIS)	No standardised levels; amount varies depending on individual support needs. In 2025, an average annual NDIS budget of AUD 24 000 for a child with ASD.	Not strictly required	Not means-tested
Canada (Ontario)	Ontario Autism Program (OAP)	OAP’s funding for Core Clinical Services and Supports is divided in four age groups (0‑3 years; 4‑9 years; 10‑14 years; 15‑17 years) and three levels of support needs ranging from limited, to moderate, to extensive. Children aged 15‑17 with limited support needs receive the smallest annual budget (CAD 6 600), while children aged 3‑9 with extensive support needs receive the biggest annual budget (CAD 65 000).	Required	Not means-tested
	Ontario’s Assistance for Children with Severe Disabilities (ACSD)	Monthly benefit ranges from CAD 25 to CAD 646, based on: a) Household income (max. CAD 76 200/year); b) Family size; c) Severity of the child’s disability; d) Extraordinary disability-related costs	Required	Means-tested
Denmark	Additional Expenses Allowance (Merudgiftsydelse)	Allowance covers necessary additional costs directly attributable to the child’s disability. The specific amount is determined based on documented additional expenses and must exceed the annual minimum threshold of DKK 5 718 to qualify for support.	Not strictly required	Not means-tested
France	Education Allowance for Disabled Children (Allocation d’éducation de l’enfant handicap, AEEH)	Monthly basic allocation plus a complementary amount that varies depending on additional expenses caused by the disability: 1) EUR 265.65 – 2) EUR 460.14 – 3) EUR 588.22 – 4) EUR 828.11	Required	Not means-tested
	Disability Compensation Benefit (Prestation de compensation du handicap, PCH)	100% of extra expenses linked to the disability are reimbursed if the household’s annual income is EUR 30 398.54 or below. If annual household income is above, 80% of expenses are reimbursed.	Required	Income‑tested
Germany	Integration Assistance (Eingliederungshilfe)	No predefined levels; funding is individually tailored based on assessed support needs. Options: either in-kind services or a Personal Budget (Persönliches Budget) which is a full-choice, self-managed monthly cash allowance.	Required	Partially means-tested
Netherlands	Personal Budget (Persoonsgebonden Budget, PGB)	Budget depends on assessed support needs and individual municipality rates.	Not strictly required	Not means-tested
Sweden	Additional Cost Allowance (Merkostnadsersättning)	Five levels – amount depends on actually incurred additional costs: 1. Costs are at least SEK 14 700 per year: receive SEK 1 470 per month. 2. Costs are at least SEK 20 580 per year: receive SEK 1 960 per month. 3. Costs are at least SEK 26 460 per year: receive SEK 2 450 per month. 4. Costs are at least SEK 32 340 per year: receive SEK 2 940 per month. 5. Costs are at least SEK 38 220 per year: receive a maximum amount of SEK 3 430 per month.	Not strictly required	Not means-tested
United Kingdom	Direct Payments	No standardised amount; based on individual care needs and costs of services required.	Not strictly required	Means-tested

Note: A detailed comparison of additional cost allowances can be found in Table A C.3.

Source: Information collected by the Secretariat and verified in discussions with national autism organisations and ministries.

Benefit entitlements differ markedly across countries and family situations

While different countries provide different types and combinations of benefits to support families with children with ASD, this section investigates the overall financial support package available to selected model families, to illustrate some typical real-life situations. Most countries consider the intensity of a child’s support needs and often also the extent to which these needs affect parental capacity to engage in paid employment when allocating financial assistance, particularly carer allowances. The two following tables display the total monthly support a family can expect to receive in each country, based on the child’s level of support needs and under two distinct scenarios. All model family types are assumed to be two‑parent households with a 12‑year‑old child formally diagnosed with ASD and with each parent earning the national average monthly salary. In some countries, results would look very different for low earners. Additional cost allowances are excluded, as including them would necessitate excessive assumptions regarding monthly expenses and distort the findings insofar as they would essentially reflect these assumptions.

• Scenario 1 (Table 3.4) assumes that one parent reduces working hours to be able to personally care for their child. For children with mild support needs (fewer than ten hours of care per week), both parents are assumed to maintain full-time employment. For moderate support needs (10‑30 hours/week), one parent is assumed to reduce working hours by 50%, thus earning half the average salary. In cases of severe support needs (more than 30 hours/week), one parent is assumed to stop working entirely to provide full-time care.

• Scenario 2 (Table 3.5) outlines a situation in which parents remain fully employed and instead hire a caregiver to provide the necessary care. For a child with moderate support needs, a caregiver is assumed to be hired for 20 hours per week; and for a child with severe support needs, for 40 hours per week. To allow for cross-country comparisons, including countries such as Estonia, where direct service provision is more common than offering a cash allowance for parents to hire a caregiver, these services have been monetised using the national average hourly wage for a caregiver, multiplied by the required care hours (20 or 40 hours per week).

It is important to note that while some countries officially offer services or financial support to enable parents to hire full-time caregivers, this may be uncommon in practice. For instance, in Australia, in practice, the NDIS may fund a support worker for a child with ASD for a few hours per week, but it is uncommon for the scheme to cover the costs of a full-time caregiver. Similarly, in Estonia, families may be provided with a caregiver to support their child and enable parental employment; however, decisions on the provision of such services are made on a case‑by-case basis at the municipal level.

Children with mild support needs would typically not receive an allowance

For children with ASD and mild support needs, most countries would not provide any financial benefit, except for Australia, Canada and Israel. In Israel, children diagnosed with ASD, even if they have only mild support needs, are automatically entitled to 100% of the Disabled Child Allowance, amounting to USD PPP 1 004 (NIS 3 694) per month, based on their medical diagnosis. Notably, less than 10% of children with ASD receiving Israel’s Disabled Child Allowance are eligible for a higher amount because of significant dependency on others (i.e. an allowance level higher than 100%). While Australia and Ontario (Canada) would also offer financial support for children with mild support needs, their funding explicitly serves to enable parents to purchase therapies and related services, such as occupational therapy, that are otherwise not, or not sufficiently, available free of charge through the public system. In contrast, most other countries – including Israel – provide these services directly through public systems, whether via the health system, the education system, or other policy channels. As Ontario (Canada) and Australia operate schemes that allocate funds directly to families to buy services themselves, they offer some financial support even for children with mild support needs – approximately USD PPP 554 (CAD 633) and USD PPP 896 (AUD 1 228), respectively. In Israel, like in most other countries, parents are not expected to arrange or finance (most) therapeutic services privately. Instead, services such as speech therapy are provided publicly and may even be integrated into the child’s school day, for example within communication classes for children with ASD. As a result, Israel’s Disabled Child Allowance stands out as comparatively generous for children with ASD who have only mild support needs.

Benefit generosity varies significantly across countries

Families in California (United States) with both parents earning an average wage are not eligible for any disability-related allowance, regardless of the intensity of the child’s support needs, as California’s benefits for families with a child with disability (ASD or otherwise) are means-tested. At a gross monthly income of approximately USD 4 841 (or about 75% of one average wage), a two‑parent household with one child (diagnosed with ASD) exceeds the income threshold for Supplemental Security Income (SSI) and State Supplementary Payment (SSP) benefits. Families with earnings below this threshold may qualify for a maximum benefit of USD 747.2 per month. Even one employed parent earning the United States’ national average salary of approximately USD 6 676.25 would already render the family ineligible for SSI, which is primarily intended for very low-income households.

At the other end of the generosity spectrum are Sweden and Denmark. Denmark’s financial support – the Compensation for Lost Earnings – is incomparably generous, on average amounting to USD PPP 3 240 (DKK 20 750) for moderate support needs and USD PPP 5 719 (DKK 36 622) for severe support needs (Table 3.4). Nevertheless, a parent who reduces working hours or exits the workforce entirely to care for their child would still face some income loss. For example, a parent previously earning Denmark’s national average monthly salary of USD PPP 6 480 (DKK 41 500) would lose around 12% of income in the severe‑case scenario, despite the generous compensation.

The gap between lost earnings and the allowance received is significantly wider in some other countries. In Germany, where the average monthly salary is roughly USD PPP 5 491 (EUR 4 025), assuming a child’s moderate support needs require a parent to reduce working hours by 50% would imply that the parent would lose approximately USD PPP 2 746 (EUR 2 013) per month. Yet, the parent would receive only USD PPP 473 (EUR 347) as monthly allowance. In Israel, the average monthly full-time wage is USD PPP 4 475 (NIS 16 463), hence a parent reducing working hours by 50% would lose USD PPP 2 238 (NIS 8 232) and receive USD PPP 1 004 (NIS 3 694) in monthly Disabled Child Allowance. Sweden’s Care Allowance does not suffice either to compensate for the lost earnings a parent would encounter if they had to reduce their working hours by 50% to care for their child with ASD.

In the Netherlands, there is no dedicated carer allowance. Instead, families may access a Personal Budget (PGB) to purchase disability-related supports and care, including informal care provided by relatives or friends. Parents who reduce their working hours to care for their child may therefore receive compensation for the care they provide through the PGB. The Dutch benefits reflected in Table 3.4 consist of the Double Child Benefit – a fixed, age‑dependent payment that does not vary with the intensity of the child’s support needs or the parent’s income loss – and the PGB. Even with these financial supports, a parent of a child with moderate support needs could face a reduced monthly income of USD PPP 4 752 (EUR 3 514), compared with the average monthly wage of USD PPP 6 259 (EUR 4 628.50) previously earned.

While some countries may appear less generous in terms of direct allowances for parents of children with significant care needs, they may offer alternative forms of mainstream income support that help offset lost earnings. Calculations in Table 3.4 do not capture the full scope of financial supports available to families with a child with disability but considers exclusively those payments that are directly linked to the child’s disability. This could explain the large differences observed between countries like Denmark and Sweden for a child with moderate support needs.

Table 3.4. Monthly financial benefit across three levels of support needs – parental care

Scenario 1: One parent reduces working hours in line with care needs of the child (0%, 50% and 100%)

	Mild support needs (0% working hours reduction)			Moderate support needs (50% working hours reduction)			Severe support needs (100% working hours reduction)
	National currency	Percentage of average wage	USD (PPP)	National currency	Percentage of average wage	USD (PPP)	National currency	Percentage of average wage	USD (PPP)
Australia	AUD 1 228	15%	896	AUD 2 004	25%	1 452	AUD 3 556	44%	2 577
Canada (Ontario)	CAD 633	9%	554	CAD 1 731	26%	1 516	CAD 3 722	55%	3 259
Denmark	DKK 0	-	-	DKK 20 750	50%	3 240	DKK 36 622	88%	5 719
Estonia	EUR 0	-	-	EUR 138	7%	229	EUR 251	12%	417
France	EUR 0	-	-	EUR 578	16%	806	EUR 999	28%	1 393
Germany	EUR 0	-	-	EUR 347	9%	473	EUR 800	20%	1 091
Israel	NIS 3 694	22%	1 004	NIS 3 694	22%	1 004	NIS 6 947	42%	1 888
Netherlands	EUR 0	-	-	EUR 1 200	26%	1 623	EUR 2 678	58%	3 622
Sweden	SEK 0	-	-	SEK 6 125	14%	695	SEK 64 004	151%	7 258
United Kingdom	GBP 0	-	-	GBP 115	3%	166	GBP 619	17%	892
United  States (California)	USD 0	-	-	USD 0	-	-	USD 0	-	-

PPP: purchasing power parities.

Note: The assumed reference family is a two‑parent household with a 12‑year‑old child formally diagnosed with ASD, in which both parents earn the national average monthly salary. Average wages of 2023.

Country-specific information and assumptions:

Australia: includes Carer Allowance, Carer Payment, Child Disability Assistance, Carer Supplement, and National Disability Insurance Scheme. The average annual NDIS budget of a child with ASD in the age range 9‑14 in 2025 is roughly AUD 18 622. A child with moderate support needs likely receives this average, while a child with mild support needs was assumed to receive half the average, and a child with severe support needs double the average.

Ontario (Canada): includes Child Disability Benefit (federal) and Ontario Autism Program (provincial). Ontario Autism Program’s annual (core clinical services) budgets of a child with ASD vary by age and intensity of support needs. At age 10‑14, intensity of support needs ranges from limited to moderate to extensive, thus assumed to mirror the three levels of support need in the above table.

Denmark: includes Compensation for Lost Earnings and Care Leave Scheme. Compensation for Lost Earnings is capped at DKK 36 622 per month.

Estonia: includes Caregiver’s Allowance for Parents, Care Allowance for Temporary Incapacity for Work, and Disabled Child Allowance. The Disabled Child Allowance is divided in three levels (moderate, severe, profound). A child with mild support needs most likely does not fall into any of these categories, while a child with moderate needs would most likely be eligible for Level 1 of the allowance, and a child with severe needs for Level 2.

France: includes Education Allowance for Disabled Children (AEEH) and Leave Allowance. To be eligible for AEEH, the child must have a disability rating of ≥ 80% or a rating of 50‑79% with “adapted schooling”. The rates are the following: mild = 1‑15%; moderate = 20‑45%; significant = 50‑75%; severe = 80‑95%. Consequently, a child with mild support needs is assumed to be ineligible for AEEH. A child with moderate support needs might receive Level 3 AEEH, a child with severe support needs Level 5 AEEH.

Germany: includes Care Allowance. The Care Allowance is divided in five levels – a child with mild support needs is assumed to receive Level 1 (= EUR 0), a child with moderate support needs Level 2, a child with severe needs Level 4.

Israel: includes only Disabled Child Allowance. A child with serve support needs is most likely entitled to a higher than standard rate because of their dependency on others, estimated at a level of 188%.

Netherlands: includes Personal Budget (PGB) and Double Child Benefit. Does not include the annual Extra Child Benefit Payment because one parent is assumed to become the child’s paid informal carer and thus exceeds the income threshold. The above amount shows the total Double Child Benefit, which includes the regular Child Benefit all parents receive. We assume that a child with “moderate support needs” does not fulfil the requirement of “intensive care needs” for entitlement to the Double Child Benefit. We assume that a parent that reduced working hours to care for their child receives the PGB as an informal carer with an hourly wage of EUR 15 which is slightly above the minimum wage.

Sweden: includes Care Allowance and Assistance Allowance. The Care Allowance is divided in four levels depending on the child’s care needs – a child with mild support needs is assumed ineligible, a child with moderate support needs could receive Level 2, and a child with severe needs would most likely receive Level 3. The standard hourly rate for the Assistance Allowance is SEK 342.6. A child with mild or moderate support needs would not meet the severity threshold of very extensive care needs. A child with severe support needs is considered to meet the threshold. In this case, one parent can be hired as the official carer for their child – here 40 hours/week.

United Kingdom: includes Carer’s Allowance, Universal Credit Carer’s Element, Disability Living Allowance (DLA), and Universal Credit Disabled Child Element. A child with mild support needs is deemed ineligible for DLA, a child with moderate support needs might receive the lowest Care Component of DLA, and a child with severe support needs the middle Care Component of DLA.

California (United States): includes In-Home Supportive Services (IHSS) Program, Federal Supplemental Security Income (SSI), and California State Supplementary Payment (SSP).

Source: OECD (2025[5]), Annual Purchasing Power Parities and exchange rates (dataset), https://data-explorer.oecd.org/s/3sp. OECD (2025[6]), Average annual wages (dataset), https://data-explorer.oecd.org/s/3sq. Compilation of OECD material.

Statlink

In Sweden, the Assistance Allowance is reserved for children with very extensive care needs and is therefore generally not available to children with ASD who have moderate support needs. In such cases, the Care Allowance would replace only about 29% of lost income due to working hours reduction. By contrast, for children with severe support needs who qualify for the Assistance Allowance, parents may choose to either hire a caregiver or to serve as their child’s formal caregiver themselves. In such cases, the total monthly benefit even exceeds the average monthly wage in Sweden.

Allowances may create different incentives across income levels

While Table 3.4 and Table 3.5 both assume parental wages at the country’s national full-time average, families with below-average earnings may find disability-related financial supports considerably more generous, particularly in countries where these allowances are determined not by parental income but solely by the child’s support needs. For instance, in Sweden, a parent earning the average or below average monthly wage may find it more attractive to leave their employment and become their child’s official caregiver. In Australia and Ontario (Canada), despite most allowances being means-tested, total benefit amounts would differ only marginally between families with average and below-average incomes. In the Netherlands and Germany, allowance rates are fixed and not means-tested (except for the Dutch Extra Child Benefit Payment), thus remaining stable regardless of household income. In contrast, in Denmark and California (United States), household income significantly affects the level of financial support: in Denmark, Compensation for Lost Earnings is calculated based on previous earnings, while in California (United States), current income (via a means-test) determines both eligibility and the amount.

For lower-income families receiving non-means-tested but fixed-rate disability benefits, the relative loss of income from reducing working hours to care for a child is (much) smaller than for average‑earning families. This may create a stronger incentive to reduce employment and rely on allowances, especially in systems where costs of third-party care must be borne privately. Conversely, in countries where carer allowances do not sufficiently compensate for lost income, leaving families with significantly reduced financial resources, there may be a greater motivation to remain in the workforce and instead hire an external caregiver. However, this option assumes sufficient availability of care staff, which may be unrealistic given the shortages of qualified personnel in many OECD countries (OECD, 2023[7]).

Hiring a caregiver is more beneficial in some countries than reducing employment

Table 3.5 outlines the total monthly benefits under Scenario 2, in which both parents maintain full-time employment and hire a third-party caregiver to provide the necessary care for their child with disability. As previously noted, caregiving services are monetised by multiplying the estimated national average hourly wage of a caregiver by the required number of care hours (20 and 40 hours, respectively).

Table 3.5. Monthly financial benefit across three levels of support needs – formal care

Scenario 2: Parents hire a third-party caregiver instead of reducing their own working hours

	Moderate support needs (20 care hours/week)		Severe support needs (40 care hours/week)
	National currency	USD (PPP)	National currency	USD (PPP)
Australia	AUD 5 204	3 799	AUD 9 956	7 267
Canada (Ontario)	CAD 3 223	2 822	CAD 6 706	5 872
Denmark	DKK 12 000	1 874	DKK 24 000	3 748
Estonia	EUR 858	1 425	EUR 1 601	2 659
France	EUR 1 666	2 324	EUR 1 742	2 430
Germany	EUR 796	1 086	EUR 1 859	2 536
Israel	NIS 3 694	1 004	NIS 6 947	1 888
Netherlands	EUR 1 440	1 947	EUR 3 158	4 271
Sweden	SEK 6 125	695	SEK 64 004	7 258
United Kingdom	GBP 1 395	2 010	GBP 2 851	4 108
United States (California)	USD 0	0	USD 0	0

PPP = purchasing power parities.

Note: The assumed reference family is a two‑parent household with a 12‑year‑old child formally diagnosed with ASD, in which both parents earn the national average monthly salary. Average wages of 2023.

Country-specific information and assumptions:

Australia: includes Carer Allowance, Carer Payment, Child Disability Assistance, Carer Supplement, and NDIS. NDIS funding for support workers falls under “CORE – Assistance with Daily Life”. The national average hourly wage of a caregiver is estimated to be AUD 40.

Ontario (Canada): includes Special Services at Home, Child Disability Benefit (federal), and Ontario Autism Program (provincial). Special Services at Home covers the costs of a special needs worker. The national average hourly wage of a caregiver is estimated to be CAD 20.

Denmark: includes Additional Expenses Allowance. Family can hire a caregiver and have costs covered by Additional Expenses Allowance, but rather uncommon. Some municipalities may provide a caregiver as a direct service – decisions are made on a case‑by-case basis. The national average hourly wage of a caregiver is estimated to be DKK 150.

Estonia: includes Disabled Child Allowance and direct municipal support. Municipalities decide on a case‑by-case basis on the necessity of a caregiver, but rather uncommon. The national average hourly wage of a caregiver is estimated to be EUR  9.

France: includes AEEH and Disability Compensation Benefit (PCH). Parents can hire a caregiver and have costs covered by PCH; however, only possible for a maximum of 3h/day. PCH will reimburse only 80% of caregiver salary due to high family income and at a max. of EUR 18.96 per hour.

Germany: includes Care Allowance as a service. Germany offers care services with a maximum budget per month according to Pflegegrad (level of care needs).

Israel: includes only Disabled Child Allowance. A child with serve support needs is most likely entitled to a higher than standard rate because of their dependency on others, estimated at a level of 188%.

Netherlands: includes Double Child Benefit and Personal Budget. Family can either benefit from a caregiver provided by ZIN (Care in kind) or hire a caregiver with costs covered by their Personal Budget (PGB). The national average hourly wage of a caregiver is estimated to be EUR 18. The above amount includes the total Double Child Benefit, which includes the regular Child Benefit all parents receive.

Sweden: includes Care Allowance and Assistance Allowance. The hourly rate in 2025 is SEK 342.6.

United Kingdom: includes DLA and Direct Payments. Family can hire a caregiver and cover costs with Direct Payments. However, Direct Payments are income‑ and assets-tested: financial benefit begins to be reduced as those increase, but there are no standard thresholds; decisions are made on a case‑by-case basis at municipal level.

California (United States): IHSS would be the relevant benefit but parents’ income is too high to qualify for it.

Source: OECD (2025[5]), Annual Purchasing Power Parities and exchange rates (dataset), https://data-explorer.oecd.org/s/3sp. OECD (2025[6]), Average annual wages (dataset), https://data-explorer.oecd.org/s/3sq. Compilation of OECD material.

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In the Netherlands, where no carer allowance is available, the Personal Budget provides families with funding to purchase, amongst others, care services. This gives parents a strong financial incentive to remain in employment, as parents who previously earned an average monthly wage would still experience an income loss even if they became their child’s official caregiver and received compensation through the PGB (see above). In contrast, in countries such as France and Germany, the available financial support for purchasing care services is most likely insufficient to fully cover the actual costs, potentially limiting the feasibility of this option for many families. Similarly, in Sweden, the Care Allowance is insufficient to cover the cost of a caregiver for a child with moderate support needs who is not eligible for the Assistance Allowance, effectively requiring a parent to provide this care themselves. In Israel, the Disabled Child Allowance can be used to pay for a caregiver and may be sufficient to fully cover the associated costs if parents choose to remain in full-time employment. However, this might be feasible primarily because wages of care personnel in Israel are relatively low compared to the national average salary (approximately ≤ 50% of the average wage). In countries where caregiver wages are higher, aligning more closely with national average earnings, parents may face greater challenges affording a caregiver for their child with the state‑provided allowance.

The total monthly benefit may also be influenced by the number of children with care needs in a family. In most countries, allowances are child-dependent, meaning parents receive a separate allowance for each eligible child; this is the case, for example, in Germany and the Netherlands. Denmark, by contrast, follows a different approach: its Compensation for Lost Earnings is based on the reduction in parental working hours and corresponding income loss, rather than the number of children with disability.

Excluding allowances compensating additional costs from these calculations – except for Australia’s NDIS and Ontario’s Autism Program – may underestimate the actual generosity of some countries’ financial supports for children with disability. This is likely true for Sweden, offering an Additional Cost Allowance in addition to the Care Allowance and the Assistance Allowance. However, estimating additional expenses for children with disability in different country contexts exceeds the scope of these comparative tables. Similarly, the comparisons also exclude tax benefits, such as tax deductions and non-refundable credits (for example Canada’s Caregiver Credit or Disability Tax Credit), since these are generally modest in value compared to other financial benefits.

References

[3] Anttonen, A. and O. Karsio (2016), “Eldercare Service Redesign in Finland: Deinstitutionalization of Long-Term Care”, Journal of Social Service Research, Vol. 42/2, pp. 151-166, https://doi.org/10.1080/01488376.2015.1129017.

[1] Jenson, J. and S. Jacobzone (2000), “Care Allowances for the Frail Elderly and Their Impact on Women Care-Givers”, OECD Labour Market and Social Policy Occasional Papers, No. 41, OECD Publishing, Paris, https://doi.org/10.1787/414673405257.

[5] OECD (2025), Annual Purchasing Power Parities and exchange rates (dataset), https://data-explorer.oecd.org/s/3sp (accessed on 8 September 2025).

[6] OECD (2025), Average annual wages (dataset), https://data-explorer.oecd.org/s/3sq (accessed on 8 September 2025).

[7] OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/7a7afb35-en.

[4] United Nations (2006), Convention on the Rights of Persons with Disabilities and Optional Protocol.

[2] Van Houtven, C. et al. (2019), The Economics of Informal Care, Oxford University Press, https://doi.org/10.1093/acrefore/9780190625979.013.265.

Notes

← 1.  As policies in Canada and the United States vary strongly by province/state, much of the information refers to Ontario (Canada) and California (United States) – the regions with the most developed programmes for children with autism.

← 2.  Sweden’s Assistance Allowance in fact combines elements of a carer allowance with elements of a disabled child allowance: on the one hand, it ensures that children with disability, through individually tailored support provided by an assistant, can live and participate in the society on an equal basis with others; on the other, it reduces some of the supervision and care burden on parents by enabling them to hire an assistant for several hours per week.