Preface 3

Foreword 5

Acknowledgements 6

Note on language 12

Abbreviations and acronyms 13

Executive summary 18

Part I Cross-country comparison 21

1 Key findings 22

Autism diagnoses have increased significantly 22

There is significant heterogeneity in both the level of benefits and criteria to assess entitlement

to benefits and services available for children with ASD 24

Conclusions 27

References 28

Note 29

2 Diagnosing autism in children and adolescents 30

In Brief 31

The evolution of autism diagnosis: From schizophrenia to autism spectrum disorder 31

Evolving diagnostic practices for ASD have contributed to growing rates 34

Trends in autism diagnosis and prevalence are showing an upward trend 38

Diagnosis rates vary across different population groups 46

Diagnostic guidelines and regulations are key for accurate autism assessments 50

References 53

3 Financial benefits for children with autism spectrum disorder 61

In Brief 62

Countries offer a range of financial benefits for children with ASD 62

Benefit entitlements differ markedly across countries and family situations 73

References 78

Notes 79

4 Services for children with autism spectrum disorder 80

In Brief 81

Eligibility for services for children with ASD is primarily based on needs 81

Variations in the inclusiveness of national education systems persist 82

Paramedical therapies for children with ASD are extensive across most countries, especially at

a young age 90

OECD countries also provide a broad range of social services 93

References 95

Notes 98

Part II Country case studies 99

5 Autism policies in Australia 100

In Brief 101

Introduction 101

Autism-related disability policies have a long history in Australia 102

The proportion of children with autism in Australia is high, at around 4.3% among 5-14 year-olds103

Diagnosis of autism in Australia follows rigorous guidelines 105

Australia offers multiple allowances to parents of children with disability 108

Rising ASD diagnosis rates are not fully matched by growth in allowance uptake 109

Income support is available for parents of children with disability and intensive care needs 112

Australia’s National Disability Insurance Scheme is a key pillar of support 113

Majority of Australia’s social and paramedical services are covered by the NDIS 119

An individualised approach to schooling for children with SEN in Australia 121

Spending on SEN supports, allowances, and NDIS for children with ASD 124

Conclusion 125

References 126

Notes 129

6 Autism policies in Germany 130

In Brief 131

Introduction 132

Initially Germany was slow to recognise the needs of people with autism 132

Germany’s data on autism is limited to documented diagnoses in routine care 133

Germany has detailed guidelines for both the diagnosis and treatment of ASD 133

Germany offers a carer allowance and an additional cost allowance 135

Therapy costs are usually covered by statutory health insurance 141

Special education schools still play a prominent role in Germany 142

Conclusion 144

References 144

7 Autism policies in Israel 147

In Brief 148

Introduction 149

Autism has been a recognised disability in Israel since the late 1990s 149

The number of children diagnosed with autism has been growing exponentially 150

Diagnosis of ASD follows strict legal guidance in Israel 152

Israel offers one allowance for children with disability 153

The largest share of Disabled Child Allowance recipients are children with autism 156

Weekly hours of therapeutic services for children with ASD are strictly defined 159

Children with ASD have access to comprehensive educational support 160

Children with ASD frequently attend special education schools and classes 163

Israel provides a broad range of social services to children with ASD 166

Spending on SEN supports, allowances, and therapy for children with ASD 166

Conclusion 168

References 169

Notes 171

8 Autism policies in the Netherlands 172

In Brief 173

Introduction 173

The Netherlands has a strong legal framework for disability protection, including autism 174

Recent data from the Netherlands shows an upward trend in self-reported ASD 175

The Netherlands has extensive guidelines for the diagnosis and treatment of ASD 176

The Netherlands offers two allowances relevant for children with ASD 178

Therapies are typically covered by statutory health insurance but may be capped 181

The regional level plays a central role in the organisation of SEN provisions 182

Conclusion 185

References 186

9 Autism policies in Sweden 189

In Brief 190

Introduction 191

For long referred to as “child psychosis”, autism awareness started increasing in Sweden from

the late 1970s onwards 191

The UNCRPD paved the way for more inclusive disability policies in Sweden 192

Autism diagnosis rates among children seem to be growing in Sweden 192

Autism assessment guideline in Sweden recommends a holistic approach 194

Allowances in Sweden serve distinct purposes 195

Different trends in benefit recipients and expenditure across allowances 198

Educational support for children with ASD is comprehensive 204

Sweden offers generous social and therapeutic services 208

Conclusion 209

References 210

Notes 212

Annex A. Evolution of autism diagnosis criteria in DSM and ICD (1952-2022) 213

Annex B. Detailed autism assessment guidelines 215

Annex C. Detailed financial benefits and services tables 225