One out of every 44 children in the United States has been diagnosed with autism or autism spectrum disorder (ASD), and its prevalence has been rising sharply over the past decade. Autism is about four times more common in boys than girls. Most children aren't diagnosed until age 5 or later.
There is no cure for autism, but early diagnosis and treatment can vastly improve the lives of those with autism. Children with autism need intensive therapy and special educational services. Adults with autism face an additional set of challenges. The law protects people with autism at all ages.
What Is Autism?
Autism is a neurodevelopmental disorder that is thought to be present from birth. It is characterized by impaired social development, poor communication skills, and repetitive or restrictive behaviors.
The autism spectrum includes autism, Asperger’s syndrome, and pervasive development disorder (PDD or PDD-NOS). People with autism can have high, normal, or low intelligence. About a quarter of children with autism may be nonverbal (they don't speak or they speak very little). Both genetic and environmental factors contribute to the development of autism.
Does Health Insurance Cover Autism?
Most of the legislation to provide insurance coverage for the diagnosis, testing, and treatment of autism has been enacted in the last decade. Currently, 46 states and the District of Columbia require insurance coverage for services for autism spectrum disorders for children. In some states, mandatory coverage is limited to certain age groups, such as children up to age fifteen, while other states require insurance to cover services for young adults as well. Denial of coverage can be appealed in these states. Notably, Idaho, North Dakota, Tennessee, and Wyoming don't require insurance coverage for autism services for any age group.
Children and adults with autism who have limited means can qualify for Medicaid in many states. Some states make Medicaid services available through Home and Community Based Waivers or other Medicaid waivers.
Does My Child Qualify for Special Ed?
The Individuals with Disabilities Education Act (IDEA), a federal law ensuring services to children with disabilities, does include autism in its list of disabilities that benefit from the protections of the IDEA law. But just having a diagnosis of autism is not enough to qualify for special education services or an "individualized education program" (IEP). You must have evidence that your child’s autism or ASD negatively affects their educational performance.
IDEA provides that children with disabilities that affect their education are entitled to a free appropriate public education (FAPE) and an IEP to help them meet individualized goals and get related services. A school district that isn't able to offer the appropriate services can pay to enroll a child with disabilities in a private school or a school for children with disabilities that better meets the child’s needs. If your child's autism is having an impact on their education, ask your school district for an evaluation.
State Laws on Restraints and Seclusion in Schools
Historically some schools have used restraints and seclusion to limit the movement of children with challenging behaviors. About half of the states have laws that limit the use of restraints (that limit movement with straps or belts) and seclusion (locking in a room or enclosure). A federal bill called Keeping All Students Safe Act is currently being considered in Congress would prohibit the use of seclusion and limit the use of restraints in all public schools. It would also require that parents be informed when their children are restrained.
Financial Help for Children With Autism
Children with autism that severely limits their functioning can qualify for Supplemental Security Income (SSI), if their household income is very low. After age 18, they may qualify for Social Security Disability Insurance or disabled adult child benefits through Social Security (more on this below).
Parents and others can put money into an ABLE savings account for a child with autism without jeopardizing their eligibility for SSI or Medicaid. A supplemental needs trust or special needs trust can also hold assets to help pay for a disabled person’s care and expenses without disqualifying them from government benefits.
Working as an Adult With Autism
Many adults with autism or ASD can work regular jobs and support themselves. Those in the mainstream workplace can rely on the Americans with Disabilities Act (ADA) in order to receive accommodations that allow them to succeed at their jobs. Reasonable accommodations for autism might include time off work for medical appointments, scheduling changes, or changes to the job to limit contact with the public.
Adults with severe autism who can't work may be able to receive Social Security disability benefits. Social Security may grant benefits to people who have severe difficulty with social interactions and communication. People with autism who need guardians to manage their financial and personal affairs can be assigned representative payees to receive their government benefits. For more information, read our article on getting disability benefits for autism.
Adults with very low income and resources can receive cash benefits through SSI, which comes with medical benefits through Medicaid. Vocational and adult services programs are also available.
Where to Get Help for Autism-Rights Issues
Each state has a protection and advocacy agency that addresses disability-related issues. Visit the National Disability Rights Network for a list of protection and advocacy agencies in your state.
Updated December 16, 2022