Policy Responses to Rising Autism Diagnoses in Childhood

1. Key findings

Autism diagnoses have increased significantly

It is very challenging to establish accurate estimates of the prevalence of ASD, and to compare trends, however measured, across countries and over time.

Nonetheless, the number of children diagnosed with ASD has been rising across all countries for which relevant data could be identified. Figure 1.1 attempts to provide information on trends in autism in children during the past decade. Different data reporting can be expected to be sensitive to a change in observed rates; for example, patient data is likely influenced by service capacity in the health system, while survey or administrative data could reasonably be expected to be more complete but may vary depending on the measurement instruments used. Nonetheless, the overall pattern of change shows striking similarities between countries, notably a fast growth in ASD diagnoses in children in recent years.

Figure 1.1, Panel A shows that ASD diagnoses amongst children have increased significantly everywhere, with average annual rates of growth typically around 6‑10% during the past decade. Such high annual growth corresponds to between a 2.5‑fold increase over a 15‑year period (with a 6% annual increase) and a 4‑fold increase over the same period (with a 10% annual increase). The exceptionally high annual growth in Israel corresponds to an almost 10‑fold increase in 15 years.

Figure 1.1, Panel B, which excludes countries using information from patient records or health system contacts, shows that the slope of the trend curve is also surprisingly similar across countries. The data also does not seem to provide any indication yet of a halt or slowdown in the growth of autism diagnoses, as the growth has not even levelled off. Data should not be interpreted as suggesting that underlying rates of prevalence of ASD in some countries are higher than in others, but rather that all four countries are seeing similar increases in the number of children with an ASD diagnosis registered in administrative systems and/or whose carer indicates they have ASD when asked as part of a survey. Finally, the data also suggest that countries in which increases in autism diagnoses started later, such as Israel, seem to be catching up fast and might expect continued increases of considerable magnitude.

Figure 1.1. Autism diagnoses in children are increasing fast everywhere

Average annual growth in children diagnosed with ASD and rate of ASD diagnoses per 100 000 children in selected OECD countries for available age ranges

ASD: autism spectrum disorder.

Note: The differences in the nature of the data make comparisons between countries challenging and the figure should be interpreted with caution. Data refers to available years and the most relevant available source and indicator (survey data for Australia and Canada, administrative data for Israel and the United States, and patient records for the other countries). Data refers to children, ages 5‑14 for Australia, ages 1‑17 for Canada, ages 0‑17 for Denmark, ages 0‑14 for Estonia, ages 0‑19 for Germany, ages 0‑18 for Israel, ages 4‑19 for the Netherlands, ages 0‑19 for Sweden and children aged 8 for the United States. Panel B excludes data based on patient registers.

Source: Australian Bureau of Statistics (2024[1]), Autism in Australia, https://www.abs.gov.au/articles/autism-australia-2022#data-downloads; Statistics Canada (2025[2]), Health indicator statistics for children and youth aged 1 to 17 years, parent reported, https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310094701; Social- og Boligstyrelsen (2024[3]), Demografi – børn og unge [Demographics – Children and young people], https://www.social.dk/data/databank/data-om-borgere/demografi-boern-og-unge; Tervise Arengu Instituut (2024[4]), PKH1: New and prevalent outpatient case consultations by psychiatrist by diagnosis, sex and age group, https://statistika.tai.ee/pxweb/en/Andmebaas/Andmebaas__02Haigestumus__05Psyyhikahaired/PKH1.px/;, Statistisches Bundesamt (Destatis) (2025[5]), Diagnoses of hospital inpatients, https://www-genesis.destatis.de/datenbank/online; Socialstyrelsen (2025[6]), Statistikdatabas för diagnoser, https://sdb.socialstyrelsen.se/if_par/resultat.aspx; CDC (2025[7]), Autism Data Visualization Tool, https://www.cdc.gov/autism/data-research/autism-data-visualization-tool.html. Data for Israel was provided by national authorities.

Statlink

This paper sets out some of the contextual information around changing understanding and diagnostic criteria for ASD. Rather than examining the drivers of rising ASD prevalence, or rising ASD diagnoses, it focusses on how countries support children with ASD and their families, and on whether policies and support systems have adapted in response to increasing diagnosis rates. In this context, it is important to recognise at least three factors which influence understanding of ASD:

• First, understanding of autism has changed significantly ever since it was first recognised as a disorder in 1943. Crucially, this has meant that many different forms and types of related conditions included in earlier versions of diagnostic manuals (DSM‑5, ICD‑11) are now subsumed under ASD and seen as different versions of the same condition or on the same spectrum.

• Second, ASD is now detected much earlier in the life course; it is now increasingly common, and considered appropriate, to diagnose children at the age of two. The focus on the benefits of early intervention – as discussed later in this paper – can be seen as an additional incentive for diagnosis in very young children. At the same time, adult autism diagnosis is now also far more common.

• Finally, one of the biggest changes over time is an increased awareness of ASD, and falling stigma around a diagnosis of ASD, which may have led to greater diagnosis-seeking or help-seeking by persons who may be displaying signs of autism (or their carers). This shifting awareness includes understanding by the medical establishment and the general population that people with ASD can have very high cognitive abilities, and relatively less apparent functional difficulties, but still meet the criteria for a diagnosis of autism under the current DSM‑5 and ICD‑11 definitions.

Diagnostic practices have also changed over time, have become highly standardised across countries, and are often undertaken using standardised tools, in most cases implemented by a multi-disciplinary team. The large increase in the number of people seeking an ASD diagnosis also raises issues around the capacity of the system to provide the necessary diagnosis in a timely manner. Public systems in several countries, including Australia, Israel, France and the United Kingdom, are faced with waiting times and capacity constraints, which has led to an increase in the number of diagnoses made by private assessors who are generally paid by the person seeking a diagnosis. In turn, this has raised issues about the validity of and the equality in access to an ASD diagnosis, at least in Israel.

There is significant heterogeneity in both the level of benefits and criteria to assess entitlement to benefits and services available for children with ASD

OECD countries provide a range of support for children with ASD and their families and carers. This support includes access to financial benefits and to services for children with ASD. The level of benefit entitlement varies across countries, as do the criteria used to assess entitlement (for example, support needs of the child or employment limitations of the parent(s), or carers). In most countries, children with ASD are included under the broader policy framework for children with disability and must therefore undergo the same assessments and satisfy the same eligibility criteria as children with other disabilities. Although a formal ASD diagnosis may be required in some cases, the diagnosis alone does not automatically create benefit eligibility. The only exceptions here are Israel, where an ASD diagnosis alone entitles children to a Child Disability Allowance, and Australia’s Carer Allowance.

When giving financial support for ASD some countries look only at the child’s needs, while others also account for the employment impact of caring responsibilities

Financial benefits for families with children with disability, including children with ASD, can be classified into one (or sometimes several) of three categories.

• A carer allowance is a financial benefit designed to support parents or other family members who are caring for a person in need of support. Such allowances help to offset lost income from reduced working hours or withdrawal from the labour market, acknowledge the contribution of carers, and promote the provision of care within the home setting. Eight of the 11 countries covered in this report offer such a payment for children with disability (all but Canada,1 Israel and the Netherlands).

• A disabled child allowance is a direct cash benefit provided to children with disability and their families, aimed at alleviating financial strain and fostering the child’s participation and inclusion in society. Such allowances are child-focussed, considering the specific needs of the child to help ensure financial security and an adequate standard of living. Seven of the 11 countries provide some form of such an allowance (all but Australia, Denmark, Germany and Sweden).

• An additional cost allowance is a financial benefit aimed at covering specific disability-related expenses, such as specialised therapies, assistive equipment, or home adaptations. Typically, such allowances are tied to the actual additional costs incurred by the family of the child. Additional cost allowances are available in eight countries (all but Estonia, Israel, and the United States) and are often administered at the local level, by municipalities or other local authorities.

Generally, countries provide either a carer allowance or a disabled child allowance, but some – Estonia, France, the United Kingdom and California (United States) – offer both. Additional cost allowances are always offered in addition to one of the other two payments. Sweden stands out as an example of a country offering all three types of payments – its Assistance Allowance has elements of both a carer allowance and disabled child allowance – and the United Kingdom stands out as an example of a country offering two different disabled child allowances, one of them means-tested.

Entitlements vary hugely across countries but generally increase, often sharply, with the level of support the child needs. In most countries, with the notable exception of Israel, families with a child with mild support needs are not entitled to any payment, while payments for families with a child with severe support needs can reach several thousand USD (PPP) per month. Some payments are means-tested, thus, targeted to low-income families; others are paid at a fixed rate irrespective of family income, thus, providing the same payment for every child with the same level of needs; and others are paid as a fraction of the parents’ earnings, thus, following an insurance principle. In some countries, therefore, lower-income families will be more likely to prefer caregiving over employment, as the benefit they are entitled to provides a financial incentive to stop working, while in countries with insufficient carer allowances, families are more likely to prefer staying employed and hiring a caregiver, where possible.

Data in Table 1.1 attempt to measure and compare the level of financial support (excluding in-kind benefits) available for a two‑parent household with a 12‑year‑old child formally diagnosed with ASD and each parent employed and earning the national average monthly wage. Calculations refer to three levels of support needs, assumed to imply a necessary corresponding reduction in working hours of one parent to care for the child. The estimates exclude additional costs allowances and, therefore, underestimate the financial package in countries which offer such payments.

Table 1.1. Financial benefit entitlements vary hugely by country and levels of support needs

Monthly payment in USD (PPP) for three levels of support needs and corresponding reduction in working hours

	Mild support needs (no working hours reduction of either parent required)	Moderate support needs (50% working hours reduction of one parent required)	Severe support needs (100% working hours reduction of one parent required)
Australia	896	1 452	2 577
Canada (Ontario)	554	1 516	3 259
Denmark	0	3 240	5 719
Estonia	0	229	417
France	0	806	1 393
Germany	0	473	1 091
Israel	1 004	1 004	1 888
Netherlands	0	1 623	3 622
Sweden	0	695	7 258
United Kingdom	0	166	892
United States (California)	0	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 wage. Average full-time wages of 2023. Includes only carer allowances and disabled child allowances (except for Canada and Australia). For detailed country-specific information and assumptions, see Table 3.4.

Source: OECD (2025[8]), Annual Purchasing Power Parities and exchange rates (dataset), https://data-explorer.oecd.org/s/3sp. OECD (2025[9]), Average annual wages (dataset), https://data-explorer.oecd.org/s/3sq. Compilation of OECD material.

Statlink

ASD support for children is provided through the education, health and disability-service systems, each with different entitlement approaches

Financial benefits alone provide only a partial picture of the support that families can receive. As children with ASD can benefit from a wide array of paramedical therapies such as speech therapy, occupational therapy and psychotherapy, as well as special support for education, the way in which these supports are organised and funded plays a key role in the overall support package for families. By and large, countries provide services for children with ASD through three main pathways.

• Education system: most countries provide significant tailored education supports and therapies integrated into school services, sometimes without needing a formal medical diagnosis.

• Health system: most countries provide therapies through the public health system, often uncapped; the use of such services usually requires a medical referral.

• Disability-specific programmes: some countries, especially Australia and Canada (Ontario), also provide tailored services through disability schemes, based on a disability assessment.

Even more than for financial benefits, the provision of services is generally linked with an assessment of individual needs. Standardisation and regulation of these needs assessments vary. France uses a structured guide and multi-disciplinary teams for in-depth evaluations; Denmark, Germany and Sweden equally emphasise in-person evaluations. Canada (Ontario), Israel and the United States (California) rely on formal diagnoses as gatekeeping mechanisms, even if services are tailored to individual needs.

In many countries, medical diagnoses are not required to access special educational services, though they may be necessary for placement in an ASD-specific setting. ASD-specific schools exist in a few countries, e.g. in Australia, but they are rare and often private. Generally, countries vary in the extent to which they emphasise special schools, special classes within mainstream schools, or full inclusion in mainstream classrooms for children with ASD. These differences largely reflect each country’s overall approach to educating children with disabilities and special educational needs. Parents in most countries have a considerable say in the choice of school setting and may prefer special settings for children with severe support needs because these environments often offer more intensive individual support and a higher concentration of specialist expertise among teaching staff.

Most countries tailor therapy hours to the child’s individual needs, with no formal upper limit (other than the constraints of the capacity of the healthcare system). Ontario (Canada) and Australia differ from this insofar as they allocate budgets based on assessed needs, thereby indirectly influencing therapy hours. Israel again is a unique case as it standardises therapy hours based on diagnosis. Recognising the importance of very early support, many countries also offer early childhood intervention, such as California’s Early Start Programme and Ontario’s Preschool Speech and Language Program, and similar programmes in European countries. Israel also has a dedicated Early Childhood Program offering (up to) 14 hours of therapy per week for each child with ASD aged 0‑6, again based on diagnosis alone (see Chapter 7 for details).

Social services also play a key role in the lives of children with autism and their families, amongst others, by supporting children’s well-being and autonomy and by alleviating the care responsibilities of parents. Some of the social services offered by the countries reviewed include free transportation to and from school or therapy, family counselling, specialised after-school activities, and respite care.

Significant variability in design of and entitlement to ASD services and support makes cross-country comparison challenging

Estimating and comparing across countries the financial value of the overall service package or, for that matter, the total support package including benefits and services, is impossible, unfortunately, for several reasons. First, in most OECD countries what a family can get will depend entirely on the child’s needs. Paramedical therapies which are in most countries offered and paid by the healthcare system are generally uncapped – children can receive as much as they need, only limited by therapy capacity, waiting times and parents’ availability to arrange sessions – and any estimate of the total cost would simply reflect the assumptions made. Second, where families access general disability support or even mainstream services, the number of families with a child with ASD supported through these services is often unknown. This is, naturally, especially the case in countries and for services that do not require an ASD diagnosis. Third, with a few exceptions, countries simply do not collect information at a level of detail that would allow preparing meaningful estimates.

Accordingly, any assessment of the value of the countries’ total support package can only be qualitative. A key finding is that in most countries the total cost of services for children with ASD and mild support needs will be limited. These children will often be integrated in mainstream classes and receive services mostly through the health system, if any therapies are needed, with limited need for extra services by the education system. On the contrary, children with high support needs could potentially receive multiple services from both the health and the education system, often without an upper limit. This general assessment in particular holds for the European countries covered in this report in which a diagnosis itself has no impact on the services a child and its family can receive. This is slightly different in Israel, Australia, and Canada (Ontario), where systems either set formal upper limits on services or allocate children a defined budget for support. However, also in these countries, children with medium-to-high support needs and an ASD diagnosis and/or a disability status will receive rather generous support.

Israel, again, is a notable exception among the countries covered in this report. In Israel, children with ASD are entitled to a fixed number of therapies per week (e.g. three hours in special education settings for ages 7‑18) on account of their ASD diagnosis and irrespective of their actual assessed support needs. This renders a situation likely in which children with mild support needs might receive more services than systems in other countries would assess as being necessary, while children with severe support needs may be under-served. This adds to a benefit system which also pays a Child Disability Allowance to children based on an ASD diagnosis alone, making a strong case for a shift in attention from children with mild support needs to those with severe support needs.

Conclusions

• The number of children with ASD diagnosis has increased in all countries where data is available. Despite important differences in the types of data that can be used to measure and compare trends in autism diagnoses between countries, overall growth and speed of change over time are very similar across countries.

• Growing ASD awareness and better identification opens the possibility to offer services to more people needing support. The increasingly younger age at identification allows countries to offer early childhood support which has the potential to improve abilities and functioning sustainably.

• Financial benefits vary greatly across countries even for children with similar support needs. In most countries, children with mild support needs will rarely receive any benefits, and entitlements generally increase sharply with the level of needs. In some countries, families can receive several thousands of USD per month, to compensate reduced working and increased caring time.

• Countries differ in the type of payments they offer, which can be focussed on the child, on the carer or on the extra costs that occur, or a combination of all or some of these parameters, and in the degree to which these benefits are targeted through fixed-rate or means-tested payments.

• Services and therapies for children with ASD are offered through three channels predominantly, the education system, the health system, and specific disability programmes. In nearly all countries, access is determined through a needs-based assessment, ensuring support can be tailored flexibly to each child. Diagnosis plays a role in services offered by the health system but no or only a limited role for education supports.

• Therapies provided by health systems are generally uncapped but capacity constraints and waiting times are frequent in healthcare systems of all countries. Capacity constraints also arise for the provision of an ASD diagnosis, in turn implying a growing role for the private market and, thus, a growing need for guidance, supervision and public control.

• Overall, ASD tools and policies across OECD countries demonstrate a big shift away from a purely medical approach, except in Israel, and a strong focus on children’s actual needs and functioning. Disability assessment across OECD countries could learn from this shift.

• While the number of young people with an ASD diagnosis has increased fast, much of this increase seems to be on the mild-support-needs side of the spectrum. It is, therefore, unlikely that the increase in disability benefit claims of young people observed in many OECD countries is driven by increases in ASD diagnoses, except for Israel, where disability payments for children with ASD are not contingent upon a support needs assessment.

• In view of the ongoing shift in all OECD countries towards ASD diagnoses and provision of ASD services very early in life, it is surprising how little is known about the impact of early supports on social and economic outcomes later in life. Countries could make efforts to evaluate functioning, skills, and well-being of children diagnosed with ASD over their lifetime, from diagnosis to early adulthood. This could be done by following a representative population cohort over time, with due consideration to ethical and privacy concerns for the people involved.

• More generally, too little is known about what type and combination of services and supports make the biggest difference for children diagnosed with ASD. In times of growing demand for services, and tight healthcare budgets, more rigorous evaluations are needed to ensure children can access the most effective and cost-effective service package with the best therapeutic outcomes.

References

[1] Australian Bureau of Statistics (2024), Autism in Australia, 2022, https://www.abs.gov.au/articles/autism-australia-2022#data-downloads (accessed on 20 May 2025).

[7] CDC (2025), Autism Data Visualization Tool, https://www.cdc.gov/autism/data-research/autism-data-visualization-tool.html (accessed on 20 May 2025).

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

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

[3] Social- og Boligstyrelsen (2024), Demografi - børn og unge [Demographics - children and young people], https://www.social.dk/data/databank/data-om-borgere/demografi-boern-og-unge (accessed on 13 February 2026).

[6] Socialstyrelsen (2025), Statistikdatabas för diagnoser [Statistical database for diagnoses], https://sdb.socialstyrelsen.se/if_par/resultat.aspx (accessed on 10 December 2025).

[2] Statistics Canada (2025), Health indicator statistics for children and youth aged 1 to 17 years, parent reported, https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310094701 (accessed on 10 February 2026).

[5] Statistisches Bundesamt (Destatis) (2025), Diagnoses of hospital inpatients, https://www-genesis.destatis.de/datenbank/online (accessed on 20 May 2025).

[4] Tervise Arengu Instituut (2024), PKH1: New and prevalent outpatient case consultations by psychiatrist by diagnosis, sex and age group, https://statistika.tai.ee/pxweb/en/Andmebaas/Andmebaas__02Haigestumus__05Psyyhikahaired/PKH1.px/ (accessed on 20 May 2025).

Note

← 1.  Canada’s Employment Insurance Caregiver Benefit is designed to provide temporary income replacement to individuals who must take time off work to care for a critically ill or injured family member, including a child, adult, or person requiring end-of-life care – e.g. a maximum of 35 weeks for children. It does not cover disability as such or ongoing caregiving needs related to stable, chronic conditions.