In the past decade, OECD countries have seen a sharp almost exponential increase in the number of children diagnosed with autism spectrum disorder (ASD). The speed of change and an associated increase in many countries in public spending for various treatments, services and supports for children with ASD, has raised concerns on the most effective and adequate policy response. These concerns are particularly strong in Israel where the increase in ASD diagnoses started a bit later but was even faster. The Ministry of Finance of Israel, therefore, turned to the OECD Secretariat, commissioning a comparative study on recent developments, services and policies in different OECD countries, and recent policy responses.
The first part of the report provides a comparison of policy approaches across 11 diverse OECD countries, including smaller and larger countries, European and non-European countries, and countries with distinct health and social protection systems. The covered countries include Australia, Canada, Denmark, Estonia, France, Germany, Israel, the Netherlands, Sweden, the United Kingdom, and the United States. As policies in Canada and the United States vary strongly by province/state, much of the information in this report refers to the province of Ontario (Canada) and the state of California (United States) – two regions with very developed programmes for children with autism.
The second part of the report zooms into five countries, Australia, Germany, Israel, the Netherlands and Sweden, digging deeper in all directions of policy and practice – data collection, diagnosing practices, policy responses, service availability and policy design – and building in-depth case studies to strengthen and deepen mutual learning. The second phase included discussions with a range of stakeholders from the five countries to get a better understanding of both regulations and policy implementation.
The purpose of this report is to provide a comparative picture across a selection of OECD countries on trends in diagnosing practices and the number of children diagnosed with ASD and on financial benefits and relevant services (education, health and social services) that are available to them. The comparison pays particular attention to differences, both within systems and across countries, between children with different levels of support needs (mild, moderate, severe), as the population diagnosed with ASD is characterised by huge unevenness – which in many ways is the general characteristic of a “spectrum”.
The report finds that the population of children diagnosed with ASD is growing in all countries, with some variation in the timing and speed of change, suggesting significant potential for mutual learning from policies and practices in other countries. It also finds that the approach of Israel is unique in many ways. In almost all countries studied, at least some assessment of needs is required for a child with ASD to be able to access financial benefits and services. Only for Israel’s Disabled Child Allowance, a diagnosis of ASD alone is sufficient for benefit access, with repercussions on many different aspects of policy.