children playing with toys
By School of Behavioral Health - July 2, 2025

Introduction

Autism affects approximately 1 in 31 children in the U.S. each year,1 making it one of the most common neurodevelopmental disabilities.2 It can significantly impact a child's communication, behavior, and learning.3 Although early diagnosis and intervention are critical for improving developmental outcomes, many families still face long delays in accessing care.4,5

Policy Issue

Delays in autism evaluations,5 especially in underserved communities, result in missed critical developmental windows.4,6 However, streamlined diagnostics, culturally responsive care, and care coordination can reduce these disparities.4

Policy Stance

To improve outcomes for children and families, national policies should aim to:

  • Streamline autism diagnostic services.
  • Expand access to early intervention (EI).
  • Promote equity though funding, training, and coordinated care.

Why it Matters

Timely diagnosis and care lead to better developmental outcomes, lower long-term costs, and enhanced health equity. Addressing delays ensures that all families, regardless of background, can access services.

Problem Statement

The average wait time for evaluations exceeds six months; in rural areas, it can be over a year.7

  • While 12% of children under age three experience delays, 90% are not identified early.8
  • Families often feel frustrated and isolated when trying to navigate the system. One parent shared, "The process took almost a year... if you do the process soon, you can get more therapy and more help for my kid, right? But this doesn't happen."9
  • Contributing factors include provider shortages in rural areas, inconsistent use of screening tools, and systemic bias in evaluation practices.10,11

1 in 31 children are diagnosed with ASD in the US.1

Social Justice Lens & Historical Context

  • Disparities: BIPOC families, immigrants, and low-income communities face systemic barriers such as provider shortages, language barriers, and implicit bias.8
  • Context: Historical underfunding of Medicaid and rural health infrastructure has further limited access to timely care. Applying a social justice lens ensures that solutions are equitable, inclusive and responsive to those most affected.10,11

Policy Solution

  1. Fast-track Evaluations: Prioritize high-risk children by using validated, developmentally appropriate screening tools such as the ASQ-3, SWYC, and MCHAT-R/F.
  2. Care Coordination: Implement Autism Family Navigators (AFNs) to support families through screening, diagnosis, and service enrollment, reducing delays and stress.
  3. Advance Equity in Care: Ensure all services are culturally and linguistically appropriate, especially in underserved areas. For example, California's Regional Centers improved rates among Hispanic and low-income families through targeted community partnerships.12

"Autism doesn't come with an instruction guide. It comes with a family who will never give up."
—Kerry Magro, award-winning national speaker who is on the autism spectrum15

Implementation

  • Workforce: Allocate funding and establish loan repayment programs to attract providers to high-need areas.
  • Costs: Upfront investments in AFNs and training can be offset by long-term savings—EI can save up to $250 per child.13

What Does the Research Say?

  • States with expanded EI funding report better outcomes and reduced education costs.10
  • Pilot programs using care coordinators saw reduced delays and family stress by up to 50%.13 

Key Facts

  • AFNs conduct screenings, refer complex cases, and provide wraparound support. 
  • Access to EI promotes developmental gains, especially when using validated, equitable screening tools. 
  • Immediate access to EI ensures developmental gains during critical early years. 

Equity and Inclusion

This policy prioritizes historically marginalized groups—including rural, Black, Hispanic, and non-English speaking families—ensuring access to timely, culturally competent care. 

Conclusion & Call to Action 

Streamlining autism diagnostic services and EI access will reduce disparities and promote equity. Policymakers, social workers, healthcare leaders, advocacy groups, and families must champion these changes.

Written by alumna Saira Din, DSW, JD, MSW, LCSW.

References

1Shaw K. A. (2025). Prevalence and Early Identification of autism spectrum disorder among children aged 4 and 8 Years — Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022. MMWR. Surveillance Summaries, 74. http://dx.doi.org/10.15585/mmwr.ss7402a1

2Brinster, M. I., Brukilacchio, B. H., Fikki-Urbanovsky, A., Shahudullah, H, D., & Ravenscroft, S. (2023). Improving efficiency and equity in early autism evaluations: The (S)TAAR Model. Journal of Autism and Developmental Disorders, 53, 275–284. https://doi.org/10.1007/s10803-022-05425-1

3Centers for Disease Control and Prevention. (2022). About autism spectrum disorder. https://www.cdc.gov/autism/about/index.html

4Sapiets, S. J., Totsika, V., & Hastings, R. P. (2021). Factors influencing access to early intervention for families of children with developmental disabilities: A narrative review, Journal of Applied Research in Intellectual Disabilities, 34(1), 695-711. https://doi.org/10.1111/jar.12852

5Williams, M. E., Harley, E. K., Quebles, I., & Poulsen, M. K. (2021). Policy and practice barriers to early identification of autism spectrum disorder in the California early intervention system, Journal of Autism and Developmental Disorders, 51, 3423–3431. https://doi.org/10.1007/s10803-020-04807-7

6Traube, D. E. & Mamey, M. R. (2022). Relationship between state-level developmental screening and IDEA Part C early intervention rates, Journal of Early Intervention, 44(3) 299-310. https://doi.org/10.1177/10538151211028232

7Williams, M. E., Harley, E. K., Quebles, I., & Poulsen, M. K. (2021). Policy and practice barriers to early identification of autism spectrum disorder in the California early intervention system, Journal of Autism and Developmental Disorders, 51, 3423–3431. https://doi.org/10.1007/s10803-020-04807-7

8Scherr, C. L., Getachew-Smith, H. J., Sudec, L., Brooks, J. J., & Roberts, M. (2020). Exploring parents’ sensemaking processes in the identification of developmental delays and engagement with early intervention services, Social Science and Medicine, 255:112941. https://doi:10.1016/j.socscimed.2020.112941

9Lappé, M., Lau, L., Dudovitz, R. N., Nelson, B. B., Karp, E. A., & Kuo, A. A. (2018). The diagnostic odyssey of autism spectrum disorder. Pediatrics141, S4, S272–S279. https://doi.org/10.1542/peds.2016-4300C

10Barnard-Brak, L., Morales- Alemán, M. M., Tomeny, K., & McWilliam, R. A. (2021). Rural and racial/ethnic differences in children receiving early intervention services. Family & Community Health, 44(1), 52-58. https://doi.org10.1097/FCH.0000000000000285

11Zuckerman, K. E., Chavez, A. E., Wilson, L., Unger, K., Reuland, C., Ramsey, K., King, M., Scholz, J., & Fombonne, E. (2021). Improving autism and developmental screening and referral in US primary care practices serving Latinos. Autism, 25(1), 288-299. https://doi.org/10.1177/1362361320957461

12Disability Rights California. (2023). From Navigation to Transformation: Addressing Inequities in California’s Regional Center System Through Community Led Solutions. https://www.disabilityrightsca.org/latest-news/from-navigation-to-transformation-addressing-inequities-in-californias-regional-center

13Jacobson, J. W., Mulick, J A., & Green, G. (1998). Cost–benefit estimates for early intensive behavioral intervention for young children with autism—general model and single state case. Behavioral Interventions: Theory & Practice in Residential & Community‐Based Clinical Programs13(4), 201-226.  https://doi.org/10.1002/(SICI)1099078X(199811)13:4<201::AID-BIN17>3.0.CO:2-R

14American Academy of Pediatrics. (2024). Screen Tool Finder. https://www.aap.org/en/patient-care/screening-technical-assistance-and-resource-center/screening-tool-finder/

15Autism Society. (2024). Our Team. https://autismsociety.org/team/kerrymagro/#:~:text=Dr.%20Kerry%20Magro%20Ed.,to%20the%20HBO%20series%20