Health authorities say the pause is temporary, a response to overwhelming demand. But for families already navigating long waits for diagnosis, the halt raises deeper questions about what happens when public systems reach their limits.

Advocates and researchers warn the consequences are not abstract. Evidence increasingly links delayed diagnosis and inadequate support to severe mental-health outcomes, including suicide risk among autistic people.

The pause in autism and ADHD referrals, reported by the BBC as demand surges beyond service capacity, illustrates a broader systemic strain across health and education sectors in the UK. When those systems falter, the burden often falls hardest on vulnerable populations. For autistic children, delayed diagnosis can mean lost access to school supports, prolonged mental-health struggles and, according to emerging research, increased risk of suicide.

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Pausing autism and ADHD referrals

Local services in parts of the UK have begun pausing new referrals for autism and ADHD assessments, citing unprecedented demand and backlogs.

Providers say waiting lists have grown so large that accepting additional referrals risks overwhelming already stretched clinical teams. Some areas have warned families they may need to seek alternative pathways while the backlog is addressed.

The backlog reflects a dramatic rise in demand for neurodevelopmental assessments across Britain, a trend that accelerated during the pandemic and continues today.

Families often wait years for an assessment, which acts as the gatekeeper to educational accommodations, therapy services and specialized supports.

When referrals pause entirely, families are left in limbo.

Without diagnosis, children frequently struggle to access formal support in schools or health services. In some cases, they disappear from the system altogether.

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Autism diagnosis and suicide risk

Delays in diagnosis may carry serious mental-health consequences.

Recent research highlighted the importance of faster autism diagnosis and tailored care as part of suicide prevention strategies.

The research emphasizes that autistic individuals often face unique stressors, including social exclusion, bullying, and barriers to mental-health services, that can compound over time.

A UK-focused study on suicide prevention among autistic people found that suicide is a leading cause of death for this population, yet research rarely asks autistic people what they need to stay safe.

In Community Priorities for Preventing Suicide in Autistic People: An Approach to Guide Policy and Practice, nearly 4,000 autistic participants emphasized the importance of faster, autism-specific diagnosis, better post-diagnostic care, and healthcare services trained to support autistic patients.

Beyond clinical care, participants prioritized reducing stigma and building social supports across education, employment, and community systems.

The findings suggest suicide prevention must move beyond crisis interventions and address broader social and systemic pressures affecting autistic people in the UK.

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An education system under pressure

The pressure extends beyond health services into the education system.

Special-needs schools across Britain report a “massive need” for placements, as more families seek specialized environments for autistic students who struggle in mainstream classrooms.

At the same time, some autistic children are dropping out of school entirely.

A growing number of families report that their children are unable to attend due to anxiety, lack of accommodations, or exclusionary discipline practices.

Advocates argue that when support systems break down, children are effectively pushed out of classrooms. In extreme cases, autistic people may also be held in institutional settings due to a lack of appropriate support, a practice autism advocates in Wales are calling on governments to end.

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A system at the breaking point

The crisis seen in the UK reflects a broader global pattern of health and education systems struggling to support autistic people. Across countries, diagnosis delays, fragmented services, and inadequate mental-health care are common.

Taken together, these findings suggest that the pressures visible in the UK are also demonstrated around the globe. Overstretched services, long waiting lists, and rising school exclusion, are not isolated failures but part of a global structural problem in which systems have not adapted quickly enough to rising neurodivergent identification and support needs.

The overlapping crises, including paused referrals, mental-health risk and educational exclusion, is what some advocates describe as a perfect storm.

Each problem reinforces the other. Without diagnosis, children struggle to access school support. Without school support, mental-health problems escalate. Without specialized care, families are left navigating the system alone. The result is a widening gap between demand and the systems designed to deliver them. For many families, the never-ending wait for help has become the defining reality.

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From the death of neurodivergent children in Hamilton and the UK, to collapsing urban mental-health systems, to international warnings from experts, January’s reporting traces a single throughline: institutions built without autistic people in mind eventually become dangerous to them.

What follows is a summary of recent media coverage and the broader research that explains why these outcomes were not only predictable, but structurally produced.

Systemic failure is not an anomaly. It’s a predictable outcome.

This post uses media coverage from last month and the broader research that explains why these outcomes keep repeating, across jurisdictions and political systems.

Urban mental health system collapse

CTV reports on a new “report card” showing sharp deterioration in Toronto’s mental-health infrastructure, including service shortages, emergency backlogs, and increasing crisis acuity. Mental health systems designed for short-term crisis intervention fail people who require lifelong, non-linear support. While the reporting is broad, the implications for neurodivergent people are severe.

Neurodivergent adults are consistently overrepresented in emergency mental-health settings due to lack of community-based services. System collapse does not create vulnerability, it exposes it. Neurodivergent patients have been using the emergency services for years due to system gaps.

Research consistently shows that when community-based supports erode, neurodivergent people are pushed into crisis-driven systems that are ill-equipped to support them. Emergency rooms are not substitutes for continuity of care, but they become default entry points when prevention fails.

Read more:

Mental health in decline: Toronto’s first report card on mental wellness in the city Not everyone is equally affected and concerning patterns are emerging.

Addressing Stigma-Related Health Disparities for Autistic Individuals Disproportionate stigma across the life course in interpersonal, healthcare, and educational contexts.

Hamilton bus crash: disability, exclusion, and preventable death

The death of an autistic boy in a school-related bus incident in Hamilton was not framed by family advocates as a tragic fluke, but as the result of missing, inadequate, or ignored school supports. Transportation planning, supervision, individualized safety protocols: all were named as gaps.

This story echoes well-established research finding autistic children face higher injury and fatality risk when systems rely on standardized procedures rather than individualized accommodations. When safety is treated as optional, or contingent on staffing levels, disabled children absorb the risk. Family advocates are calling for urgent reform after this tragic school bus incident. The reporting focuses not only on the tragedy itself, but on the absence of appropriate school supports: transportation planning, supervision, and individualized accommodations.

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World Health Organization (WHO) — World Report on Disability Documents elevated injury and mortality risks for disabled children in poorly adapted systems.

UN Committee on the Rights of Persons with Disabilities (CRPD) — Canada reviews Repeatedly flags systemic safety failures where accommodations are treated as discretionary.

Canadian Human Rights Commission — Disability discrimination in education Documents systemic discrimination against students with disabilities.

More UK reporting on disability system breakdown

A coroner raised concerns after another child’s death. They concluded that critical opportunities for appropriate care were missed, noting that the child had not been assessed by dietitians knowledgeable about autism and had never received a formal autism diagnosis prior to his death.

This case is not an isolated failure but a reflection of deeper structural pressures within public health and disability support systems in the UK and beyond.

The BBC article is another example systemic strain within the UK’s disability or mental-health support systems, highlighting delayed services, unmet needs, and policy gaps that leave disabled people without adequate care. Even in countries with universal healthcare, bureaucratic fragmentation and austerity measures disproportionately harm disabled and neurodivergent populations.

Comparative policy research shows that autism outcomes correlate less with national wealth and more with service coordination and rights-based frameworks. Even within universal systems, autistic people are disproportionately affected when coordination breaks down. Universal coverage does not guarantee universal access.

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Learning from deaths: Children with a learning disability and autistic children aged 4 – 17 years Draws on data from the National Child Mortality Database (NCMD).

Care Quality Commission (UK) — Autism & learning disability reviews Repeatedly documents systemic neglect tied to coordination failures.

Global Autism Convention: adults left behind

Autistic adults are expected to age out of support without aging into rights.

This article reports on experts at a global autism convention calling attention to a familiar gap: supports drop off sharply in adulthood. The focus shifts from awareness to employment, housing, autonomy, and dignity, underscoring how people and systems worldwide still frame autism as a childhood issue.

Research across regions shows adult outcomes are driven not by autistic traits, but by policy neglect, a failure to plan beyond childhood and schooling.

Global studies consistently show that adult outcomes for autistic people are driven by policy neglect rather than individual capacity. At a global autism convention in Bengaluru, experts issued a familiar warning: supports still disappear in adulthood. Employment, housing, autonomy, and dignity remain underdeveloped policy areas worldwide, despite growing awareness of autism.

Read more:

UN Special Rapporteur on the Rights of Persons with Disabilities Identifies service fragmentation as a major rights violation.

Autism-Europe’s analysis of EU’s implementation of the UNCRPD Examines CRBD recommendations , specifically those relevant for autistic people.

National Autism Indicators Report: The Intersection of Autism, Health, Poverty and Racial Inequity Adult outcomes correlate more with support access rather than individual traits.

January reporting points to a pattern that is by now unmistakable. Institutions respond after harm occurs rather than anticipating it. Supports are offered conditionally, dependent on funding cycles, staffing levels, or crisis thresholds, rather than guaranteed as a matter of rights. Neurodivergence, meanwhile, continues to be treated as a disruption to systems designed for a narrow norm, not as a core design consideration. What January’s coverage exposes is not a lack of evidence or understanding, but a persistent failure to act on what is already known.

The evidence base is remarkably consistent. Inclusion is less costly than exclusion when measured over a full lifespan. Early and sustained supports reduce later crises across education, health, and justice systems. Outcomes improve when disabled and autistic people are involved in designing the policies and services meant to support them. Yet these findings rarely translate into durable implementation. As a result, governments and institutions revisit the same tragedies, commissions, and reviews, often framing them as unprecedented despite their familiarity.

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Amrutha Rao’s autism was hidden behind the “gifted” label for most of her life.

In 2019, she immigrated to Canada and became a citizen. What shifted during the move was her relationship to masking her autism. Rao noticed while there were many ways she was treated differently when moving to Canada, many of the patterns remained the same.

“Different cultures, same shape,” says Rao.

“Neurodivergent people are celebrated for output and insight, if those gifts arrive neatly packaged. Difference is welcome until it requires the system to stretch. Then it becomes a fit issue, a tone issue, or a leadership concern.”

Despite strong qualifications and unique talents, many neurodivergent people are either unemployed or underemployed due to systemic barriers deigned for neurotypical norms. Traditional hiring practices such as ambiguous job postings and unstructured interviews often disadvantage neurodivergent candidates even when they possess the required skills and credentials. These outcomes are linked to environments which reward conformity to neurotypical communication and social expectations, limiting opportunities for capable individuals whose cognitive styles differ from traditional norms. This is one reason why Rao created the Strategic NeuroInclusivity Framework (SNF) for Canadian employers.

The framework is designed to embed inclusion operationally, structurally, and culturally. It provides practical ways to bring clarity, consistency, and support for diverse cognitive strengths into everyday workflows. The pilot, starting in February, already involves over 40 managers and their teams. The participants will have the opportunity to explore practical tools such as structured agendas, communication standards, onboarding templates, observation methods, and see how these initiatives integrate naturally into the work.

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What is an SNF Imagineer?

SNF Imagineers help engineer the future state of inclusion by building, testing, and refining inclusive organizational systems in real work environments.

Neurodivergent employees are twice as likely to experience workplace stress and three times more likely to leave their jobs prematurely without proper supports.

This absence of support limits daily performance and career growth and contributes to a higher turnover rate. The costs of this are significant, with a lack of neuroinclusivity potentially costing millions in lost productivity annually.

Embedding inclusion into leadership practice and organizational systems anticipates barriers before they appear. This approach moves beyond episodic adjustments or case-by-case accommodations, making inclusion a consistent, measurable component of operational excellence.

The bulk of Rao’s academic training is in testing hypotheses by building and observing real world engineering systems. She applied the same approach used in cancer research to the design of inclusive organizational systems through SNF. The goal is to test inclusion as infrastructure by engineering and evaluating organizational systems in practice.

In structured and predictable settings, Rao generally did well. When expectations were sudden or unstructured, however, her capacity could drop quickly.

“I experienced periods of being unable to speak,” she says, “cognitive shutdown under stress, and sensory overload, especially in response to repetitive sounds.”

Despite this, she maintained very high grades in demanding academic environments.

Rao built a strong academic foundation across technology, marketing, and business management. She earned a Master of Technology in Industrial Biotechnology from the Shanmugha Arts, Science, Technology and Research Academy (SASTRA), followed by a Post Graduate Diploma in Management – Communications (PGDM-C) with a focus on Strategic Marketing and Communication from MICA, The School of Ideas. In 2021, she completed a Master of Business Administration at the University of Toronto’s Rotman School of Management, which equipped her with a global perspective and leadership skills in business strategy.

Her high performance made it easy for systems to assume she was fine.

It wasn’t until her third master’s degree, after receiving simple accommodations, when she realized how different her experience could be with minimal support. That moment led her to pay thousands of dollars for an adult autism assessment.

Educational and diagnostic frameworks often miss autistic people who compensate effectively, especially when giftedness is involved. The results helped her see how many of the challenges she had managed quietly were not personal failings, but predictable outcomes of systems built around narrow assumptions about how competence appears in systems deigned for others.

Understanding this made it clear that her experience reflected a broader systemic pattern rather than an individual anomaly. It turns out, when you perform well enough, she says, the system assumes you aren’t playing the game on “Hard Mode.”

Hiring practices and workplace cultures create barriers by rewarding the visible, fast, and easily legible while overlooking deep, high-resolution thinking. In recruitment, structured assessments and panel interviews are merit-based on paper, but they favor candidates who can present answers in the “expected” way, quickly and concisely.

“True inclusion is when people can show up as they are and have their contributions shape the work. It is a culture and a set of practices that anticipate difference rather than reacting to it as an anomaly. We need to stop asking neurodivergent people to fit into neurotypical shapes and start asking why those shapes were so small to begin with.”

Neurodivergent strengths are central to this. People who notice hidden patterns, approach challenges from new angles, or see connections others miss, are often not given room to act on those insights. An inclusive approach looks like a culture where the person who identifies a hidden flaw in a plan is thanked instead of being labeled “difficult” or ostracized for bringing it to light. It is a space in which the need for coherence is seen as a commitment to logic, and precision is seen as an asset.

The SNF replaces ambiguity with predictable processes and clear structures, allowing people to contribute their best work without the exhaustion of navigating hidden social norms. From Rao’s perspective, creating structurally inclusive environments where all minds thrive, is the real work of leadership, not just delivering on outcomes.

Growing up gifted and autistic, Rao learned early how workplaces often reward speed and visibility while overlooking depth. She can notice patterns, anticipate challenges, and approach problems differently than many of her colleagues, but those abilities are only valuable if the system is wired to receive them. The SNF provides this interface. It allows the organization to leverage high-resolution thinking for collective impact and demonstrates how processes can be built for cognitive diversity.

“The SNF is my response to the inefficiency of office vibes,” says Rao, or in essence, creating a system which rewards capability over conformity to arbitrary social norms.

“My lived experience has shown me that ambiguity is the greatest enemy of equity,” she says. “When expectations are vague, the person who thinks differently is the first to be penalized for their personality rather than their results.”

The sun chews at his fur. White, meant for ice and glare, turns into a curse against the blistering desert sand. He lumbers forward… Paws sink in dunes that shift like the broken promises he’s come to expect. Each step is a negotiation within this alien landscape.

No ice to brace against, no cold to numb the skin, no silence or the calm of snow. Instead, heat shimmers on the horizon like a cruel mirage while voices of unseen insects buzz in his ears. A constant, needling hum. He stops, nose raised. This air offers nothing he understands.

No seal, no salt, no memory of frozen sea. Only grit fills his lungs, scouring from the inside, his instincts written for another time and place. In the frozen north he is apex, a ruler carved from ice and hunger, but here in the desert every step writes his defeat, a slow death delivered by a land that will not recognize his worth.

Autistic clinician and author Daniel Wendler presents the metaphor of the polar bear in his public speaking engagements. He calls this the Polar Bear Predicament.

In the Arctic, the polar bear stands at the very peak of the food chain. Encountering one on its own ground leaves little chance of escape. Yet place this same creature in a desert, far from ice and sea, and its strength counts for little. It will falter, unable to survive without assistance. When working with people who are like polar bears, powerful in the right setting but misplaced in another, we need to ask: what supports will help them flourish when the world around them does not fit?

Neurodivergent individuals aren’t looking for sympathy or lowered expectations. They’re looking for opportunities to demonstrate what they can do. When workplaces are designed to be inclusive, people with diverse ways of thinking and being are able to flourish. By recognizing and leveraging their unique abilities, teams gain an edge: stronger performance, greater creativity, and a healthier workplace culture.

It’s been well established that cognitively diverse teams solve problems faster than non-diverse ones. The key is creating a psychologically safe environment in which team members feel comfortable expressing different ideas and modes of thinking.

Decades of research show how neurodivergent people bring exceptional value to workplaces. In The Inclusivity and Inclusion Revolution, Deloitte research shows how diversity without inclusion is simply not enough.

Diversity, while valuable on its own, only truly yields better business outcomes when paired with a strong culture of inclusion. Deloitte’s research highlights a foundational formula—diversity plus inclusion leads to superior results. Put simply, the full benefits of a diverse workforce are diminished without an inclusive environment in which all people feel they belong and can contribute. Creating a truly diverse workplace requires ensuring a level playing field for all talent, and many organizations still need to work toward this goal.

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The United Nations estimates better autism inclusion could add billions in productivity gains across economies. This was reiterated by the London School of Economics in 2014, which argued that doubling the employment rate for autistic adults could generate potential societal savings of $900 million to $1.5 billion annually in the UK alone. These projections, however, remain largely ignored.

Despite our proven strengths, autistic people remain one of the most underemployed groups worldwide. In Canada, only 33 percent of autistic adults are employed, compared to nearly 80 percent of non-disabled adults. In the U.S., the CDC reports the employment rate for autistic adults at around 29 percent, making autism the lowest employment rate among all disability categories. These statistics have generally stayed the same as the years progress. The gap between potential and opportunity underscores a massive economic and social loss.

For those who are employed, new research from Understood states 50 percent of neurodiverse employees won’t talk about their neurodivergence for fear of being stigmatized or mistreated in the workplace. This due to a number of factors, many of which can be rooted in unconscious biases.

Six Ways to Support the Polar Bears in Your Workplace

1. Examine your assumptions

Neurodiversity isn’t a single story. While autism is often the most recognized, it also includes ADHD, dyslexia, dyspraxia, Tourette’s, brain injuries, and sometimes mental health conditions. Recognizing the full spectrum helps avoid stereotypes.

Try Harvard’s Project Implicit Bias Tests to uncover hidden assumptions.

2. Offer flexibility

Not every polar bear works the same way. Some thrive with structure, others with freedom. Flexibility in scheduling, communication styles, or task organization can open space for better performance.

Explore the Job Accommodation Network (JAN) for ideas on accommodations.

3. Communicate with clarity

Unclear directions can create anxiety. Think of clarity as kindness — people do better when expectations, timelines, and goals are spelled out.

Practice with a Plain Language Checklist to make your communication sharper.

4. Rethink your workspace design

Open offices aren’t always inclusive. Bright lights, constant chatter, or background noise can overwhelm the senses. A small change like noise-reducing headphones or softer lighting can make a big difference.

Try using the an Accommodations Checklist for autistic employees.

5. Define what success looks like

Don’t just assign a task. Describe what the finished product should look like. Giving context helps employees see how their contribution fits into the larger picture.

Use the SMART Goals Framework to set clear, shared outcomes.

6. Remember — no two polar bears are alike

Knowing one neurodivergent colleague doesn’t mean you know them all. There’s as much variation among neurodivergent people as there is among anyone else. Stay curious, keep listening, and avoid assumptions.

The Neurodiversity Hub has useful resources for employers.

Employers have the opportunity to participate in this community of practice and gain access to a set of resources designed to support them in their journey toward greater awareness and understanding . Through active engagement, they can build the knowledge and capacity needed to create more accommodating work environments and foster a truly inclusive workforce which can maximize growth and potential.

This article was adapted from a neurodivergent advocacy and employee network in the Ontario Public Service which hosted a webinar led by autistic clinician Daniel Wendler.

Since the United Nations General Assembly designated April 2 as World Autism Awareness Day (WAAD) in 2007, global perspectives on autism have significantly expanded. The UN continues to advocate for the full realization of human rights and equal societal participation for autistic people. Over time, the movement has evolved from awareness to acceptance and action, with many countries now recognizing April as Autism Acceptance Month.

The UN 2025 WAAD event, "Advancing Neurodiversity and the UN Sustainable Development Goals (SDGs)," highlights how inclusive policies can drive meaningful change for autistic people while contributing to broader global sustainability efforts.

Bringing together global experts, policymakers, and autistic voices, the event will focus on inclusive healthcare, quality education, workplace accessibility, reducing inequalities, and designing autism-friendly communities. Organized by the Institute of Neurodiversity (ION) with support from the United Nations Department of Global Communications, discussions will emphasize accessibility, equality, and innovation across multiple sectors. As the largest neurodiversity initiative worldwide, ION advocates for equal opportunities, and promotes autism education and acceptance.

A Shifting Perspective on Autism: From History to the Present

The modern understanding of autism has evolved through shifting perspectives in medicine, psychiatry, psychology, genetics, and education.

In Autism: A Social and Medical History, Mitzi Waltz explores how scientific evidence and cultural beliefs have shaped the treatment and societal perception of autistic people. Autism’s historical narrative has frequently been dictated by external voices, often excluding autistic perspectives from discussions about their own experiences.

In recent years, autistic voices have gained prominence through self-advocacy and collective action. However, despite this progress, institutions and organizations have been slow to integrate their insights, leading to ongoing struggles for recognition and inclusion. This lack of integration has been especially harmful to a generation of autistic adults who grew up without proper diagnosis, support, or understanding—often referred to as the "lost generation."

The Lost Generation of Autistic Adults

Many adults remain undiagnosed due to historical misconceptions and shifting diagnostic criteria. The concept of a “lost generation” of autistic adults has emerged as researchers and clinicians uncover cases of individuals who, due to outdated understandings, were overlooked or misdiagnosed with other conditions.

Autism spectrum conditions were historically diagnosed in childhood. However, recent studies highlight the challenges adults face in obtaining a diagnosis due to the lack of developmental history, the effects of learned masking behaviors, and the high prevalence of co-occurring conditions (Lai & Baron-Cohen, 2015; Fusar-Poli et al., 2022). Women, in particular, have been disproportionately underdiagnosed due to gendered biases in diagnostic criteria, among other reasons.

A 2022 study found that adults diagnosed with autism later in life often spent over a decade navigating misdiagnoses before receiving an accurate assessment (Fusar-Poli et al., 2022), emphasizing the need for a more nuanced diagnostic approach.

On a global scale, autism ranks among the top contributors to non-fatal health burden for people under the age of 20, according to groundbreaking findings from the Global Burden of Diseases, Injuries, and Risk Factors, published in December. This research shows how 61.8 million people worldwide—or about one in every 127—are autistic.

As understanding evolves, personalized and precision-based medical approaches are emerging, integrating biological, behavioral, and therapeutic interventions. Creating autism-friendly environments, expanding diagnostic access, and incorporating neurodivergent perspectives into policy are crucial steps toward addressing the needs of autistic adults and ensuring equitable support across lifespans.

Advances in Autism Research and Looking to the Future

In recent years, autism research has made significant strides in both diagnosis and treatment, driven by advancements in genetics, neuroscience, and emerging technologies. The increasing recognition of autism as a spectrum with highly individualized presentations has paved the way for more precise and tailored diagnostics to emerge.

However, despite these advancements, challenges remain in fully understanding the complexities of the spectrum and ensuring equitable access to effective treatments and support systems. Looking to the future, researchers and policymakers are focusing on precision medicine, technology-driven therapies, and the role of social policy in improving outcomes for people on the spectrum (Qin et al., 2024).

Scientific progress alone is not enough. Social policy plays a critical role in translating research findings into meaningful improvements in the lives of autistic people and their families. Governments and advocacy organizations are recognizing the need for policies that support the expansion of the autism research focus, along with inclusive education and employment initiatives. Policies promoting interdisciplinary collaboration and global research partnerships can accelerate breakthroughs in understanding autism’s complex causes, treatments, and inclusive designs.

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A Future Focused on Inclusion and Empowerment

The future of autism research is not just about advancing medical and technological interventions. It’s also about fostering an inclusive society where autistic people can be positioned to thrive. As awareness of neurodiversity grows, workplaces, schools, and communities must continue to evolve and embrace an assets-based perspective to recognize both our strengths and challenges.

Many researchers are starting to believe, with a growing body of research and advocacy, the future of autism care and inclusion is poised to be more personalized, effective, and empowering than ever before. The path forward requires a commitment to interdisciplinary collaboration, technological innovation, and policy reform, all guided by the principle that autistic people deserve respect, understanding, and opportunities to reach their full potential.

As we mark World Autism Awareness Day, it's crucial to acknowledge the significant strides being made on a global scale. The UN, through its various agencies and initiatives, is championing neurodiversity more every year. This is evident in the growing emphasis on inclusive education and employment practices, the promotion of accessible technologies, and the fostering of respectful dialogue.

Research is continually expanding our understanding of autism, challenging outdated assumptions and paving the way for more effective interventions and supports. Simultaneously, the lived experience of autistic people and their families is informing policy, shaping services, and driving a deeper understanding of the unique strengths and perspectives found in the autistic community. This World Autism Awareness Day, we recognize these advancements and reaffirm our commitment to a future where neurodiversity is embraced as an essential part of a functional society.

References

Fusar-Poli, L., Brondino, N., Politi, P. et al. (2022). Missed diagnoses and misdiagnoses of adults with autism spectrum disorder. Eur Arch Psychiatry Clin Neurosci .272, 187–198.

Howlin, Patricia. (2021). Adults with autism: Changes in understanding since DSM-III. Journal of Autism and Developmental Disorders, 51. 4291–4308.

Lai MC, Baron-Cohen S. Identifying the lost generation of adults with autism spectrum conditions. Lancet Psychiatry. 2015 Nov;2(11):1013-27.

Mintz, M. (2017). Evolution in the Understanding of Autism Spectrum Disorder: Historical Perspective. Indian J Pediatr. 84, 44–52.

Qin, L., Wang, H., Ning, W., Cui, M., & Wang, Q. (2024). New advances in the diagnosis and treatment of autism spectrum disorders. European Journal of Medical Research, 29, Article 322.

Santomauro, Damian F et al. (2025). The global epidemiology and health burden of the autism spectrum: Findings from the Global Burden of Disease Study 2021. The Lancet Psychiatry. 12(2), 111–121.

Waltz, M. (2013). Autism: A Social and Medical History. Palgrave Macmillan.

Rosen, N.E., Lord, C. & Volkmar, F.R. (2021). The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond. Journal of Autism and Developmental Disorders. 51, 4253–4270.

The Government of Canada believes its policies proposed in the Framework for Autism in Canada should lead to autistic people being included, accepted and supported in a way that improves quality of life. Reaching this goal means doing things differently. It requires that stereotypes and old theories are dealt with head-on, such as the idea that social deficits or a lack of empathy define all autistic people, and autistic people alone. This proposal is a recognition of the literature on the Double Empathy Problem and the need to apply the Double Empathy framework to Canada’s Autism Strategy in a key priority area identified in the strategy—economic inclusion.

As the Government of Canada assembles the National Autism Network and the Federal-Provincial-Territorial (FPT) Working Group on Autism, the Double Empathy framework should be used as a guiding principle to ensure better communications so autistic people are listened to and understood better.

Autistic people in Canada face disproportionately high rates of unemployment and underemployment. Traditional employment discourse often relies on deficit-based medical models, which fail to consider the Double Empathy Problem—a framework recognizing how communication barriers between autistic and non-autistic (allistic) people are reciprocal rather than one-sided. By integrating Double Empathy into human resource policies, hiring practices, and workplace accommodations, Canada can significantly improve employment prospects for autistic people. This proposal outlines how Double Empathy-informed employment policies can enhance economic inclusion and create a more neurodiverse-friendly labor market.

The groundwork for communications and understanding between autistic people and allistic needs to be laid at every level of society to ensure the successful implementation of the strategy. Well-meaning people often want to do the right thing; however, a mistake people often make is attempting to be ‘welcoming’ without first doing the work and making the proper perceptual and systemic adjustments.

The act of being welcoming is a surface-level gesture, which often refers to creating a friendly environment. It's about initial impressions and attempting to make people feel comfortable. It can be passive, involving gestures like smiles, greetings, and a general sense of hospitality. However, it doesn't address underlying systemic barriers or ensure equitable participation, which makes these gestures performative in nature.

Inclusion goes beyond surface-level gestures. It's about actively creating an environment where everyone feels valued, respected, and empowered to participate fully. In this case, Inclusion means including autistic ways of learning, communicating, being, and seeing. This is why the Double Empathy framework needs to be applied. This requires the development of a knowledge base that can be shared with all networks, to help all people, both autistic and allistic.

To break from past stigma and stereotypes, we must accept that communication and empathy between autistic and allistic people is a two-way street. For this reason, the Double Empathy framework should be integrated as a guiding principle in Canada’s Autism Strategy, and applied to the National Autism Network and the Federal-Provincial-Territorial (FPT) Working Group on Autism to build on a new foundation of knowledge, participation and equality.

Background

Economic inclusion is a key pillar of Canada’s Autism Strategy, which was tabled in Parliament in September 2024. The strategy aligns with the Federal Framework on Autism Spectrum Disorder Act (Bill S-203) and the Canadian Academy of Health Sciences (CAHS) 2022 report, which identifies economic participation as a critical area for policy intervention. The Government of Canada has committed to improving employment accessibility through the Disability Inclusion Action Plan (DIAP) and the Employment Strategy for Canadians with Disabilities (2024-2040). However, existing policies do not adequately address the role of social perception and communication biases in autistic employment disparities.

The Double Empathy Problem and Employment Outcomes

Research consistently demonstrates how autistic people are often perceived as less competent, likable, or trustworthy by neurotypical peers, which negatively impacts employment opportunities. Introduced by Damian Milton, the Double Empathy Problem challenges the assumption that autistic people alone are responsible for communication challenges. Instead, Double Empathy emphasizes that autistic and allistic people experience misunderstandings due to differing communication styles.

Barriers to Employment for Autistic Canadians

One significant barrier autistic people face in employment is the pervasive emphasis on "culture fit" during hiring and workplace integration. Many organizations prioritize hiring people who seamlessly align with existing workplace norms, values, and social dynamics. However, this concept inherently excludes autistic people, whose behaviors, learning and communication styles may diverge from neurotypical expectations. Instead of fostering diversity and inclusion, the emphasis on "culture fit" reinforces systemic biases, limiting opportunities and exacerbating the employment gap for all neurodivergent people.

Hiring Bias and Interview Disadvantages

Traditional hiring processes prioritize neurotypical communication styles and implicit norms, disadvantaging autistic candidates. Autistic applicants often perform well in work-related tasks but struggle in the dominant forms of social dynamics and unstructured interviews due to indirect questioning styles. Disclosure also remains a significant barrier; autistic people who disclose their diagnosis face stigma and discrimination but those who do not may lack necessary accommodations and continue to mask as a matter of basic survival. Masking is often necessary, but when you have to hide who you are your whole life, the damage can be devastating.

Workplace Miscommunication and Social Exclusion

Workplace employee surveys in public service consistently show that people with disabilities are a group of people who experience some of the lowest sense of belonging in the workplace. Autistic employees frequently experience misinterpretation of their social behavior and communication styles, leading to exclusion from professional networks and social capital. Many employers misinterpret autistic communication styles as a lack of cooperation or teamwork skills, despite evidence proving how autistic people can thrive in collaborative settings when workplaces provide structured support that embraces diverse working approaches.

Lack of Double Empathy-Informed Workplace Communications

Many workplace adjustments focus on sensory needs but neglect social and communication adjustments. Current diversity and inclusion training may not use Double Empathy principles, leaving employers unaware of reciprocal communication differences. This lack of knowledge creates an environment in which autistic people are at a disadvantage and risk being excluded and made pariahs.

The Double Empathy Framework

The Double Empathy Problem proposes that communication breakdowns in mixed-neurotype interactions result from a mutual lack of shared experience rather than autistic-specific deficits. For instance, studies have found that allistic people: 1) struggle to recognize autistic facial expressions (Brewer et al., 2016); 2) overestimate their ability to communicate effectively with autistic people (Heasman & Gillespie, 2019); and 3) report lower levels of rapport in mixed-neurotype interactions (Crompton et al., 2020). There are many more examples.

The Double Empathy Problem challenges traditional deficit-based views of autism and provides a more nuanced understanding of neurodiverse communications. Research indicates that social misunderstandings between autistic and allistic people stem not just from autistic traits but also from a shared difficulty in understanding each other’s perspectives and experiences. Moreover, disadvantages often arise due to the dominant societal norms rather than inherent impairments.

The application of Double Empathy as a framework for a neuroinformed public service offers a transformative approach to economic inclusion for autistic people. By shifting from deficit-based perspectives to reciprocal communication models, Canada is better positioned to reduce employment disparities and create a workforce that values neurodiverse contributions. Integrating Double Empathy into employment policies will create better conditions to ensure that autistic people have equal access to meaningful work opportunities and, more importantly, economic stability.

Overcoming Stereotypes and Stigma

Autism is a spectrum, and we are not all the same. However, stereotypes about autism stem from deficit-based models and mass media representations, which frame autism in ways that are not representative of the spectrum. This contributes to "othering," stigma, and discrimination, reinforcing societal barriers that limit opportunities for autistic people (Goffman, 1990; Cage et al., 2018; Pearson & Rose, 2021).

Double Empathy-Informed Research and Methodologies

Research and communications that applies the Double Empathy framework will promote evidence-based decision making, and individualized understanding over assumptions and broad stereotypes. Methodologies that encourage multiplicity and neurodiversity highlight the importance of: 1) assessing individual differences to move beyond simplistic group categorizations; 2) avoiding rigid methodologies that reinforce old stereotypes and assumptions; and 3) engaging in immersive shared experiences to foster mutual understanding.

By prioritizing neurodiverse perspectives, the Double Empathy framework provides a pathway toward more effective communications for both autistic and allistic people. This is not meant to dismiss medical models—which overlook Double Empathy—but rather to introduce a more balanced perspective that is currently missing.

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The Case for the Double Empathy Framework

The strengths of neurodiverse people remains largely untapped in Canada. This is due to a number of reasons, many of which can be linked to systemic barriers and stigma based on old theories and poor representations of neurodiverse people in mass media, all of which is due to a lack of education, or more importantly, a lack of incentive to educate oneself about autism and neurodiversity.

Companies embracing neurodiverse hiring programs—such as Microsoft and JPMorgan Chase—are gaining a competitive advantage by leveraging the unique cognitive strengths of autistic employees, including pattern recognition and problem-solving skills. This is an example of how employers can shift away from viewing autism as a workplace challenge and toward recognizing the benefits of neurodivergent thinking. These insights reinforce the need for workplaces to adopt communication strategies and policies that foster mutual understanding, aligning with the core principles of the Double Empathy framework.

In the past ten years there have been important developments in Canada, specifically in the realm of lived experience and self-advocacy. The 2007 Senate report, "Pay Now or Pay Later: Autism Families in Crisis," inspired the Autism Alliance of Canada to initiate a nationwide effort to lobby the Government of Canada to adopt a national autism strategy, a campaign the Alliance has maintained for over 14 years.

Canada enacted the Federal Framework on Autism Spectrum Disorder Act in 2023 with unanimous support from both the Senate and the House of Commons. On September 26 of 2024, the Framework for Autism in Canada and Canada’s Autism Strategy was tabled in Parliament. It is anticipated that a leading organization for the National Autism Network will be announced in the spring of this year. Once established, the Network will unite the expertise and resources of autism organizations and stakeholders, including people with lived experience.

The Government believes that progress can come from these developments but only if they are met with new responses. The proposed Double Empathy framework is a new response to the Canada Autism Strategy. In essence, to argue against the Double Empathy framework is to uphold double standards, stereotypes, and discrimination—the continued isolation and separation of autistic people from society.

Autistic people in Canada continue to face significantly higher rates of unemployment and underemployment compared to both the broader disability community and the general population. This ongoing economic instability has wide-ranging consequences, impacting personal well-being and broader social and economic conditions. Financial hardship among autistic and disabled people was further intensified during the COVID-19 pandemic, as many were excluded from critical financial relief programs. The lack of adequate support systems left many struggling to meet basic needs, which highlights the pressing need for policies that foster economic inclusion and long-term stability.

According to Statistics Canada (2022, 2023), the employment rate for persons aged 16 to 64 with disabilities was 65. percent, significantly lower than the 80.1 percent employment rate for those without disabilities. Additionally, the unemployment rate for persons with disabilities (6.9) was nearly twice as high as for persons without disabilities (3.8). Employment rate for autistic Canadians aged 20 to 64 was 33 percent.

One of the key factors contributing to these employment challenges is the Double Empathy Problem. For instance, a study on Autism and Employment Challenges found that autistic participants were significantly better at accurately interpreting the behavior of other autistic people compared to allistic participants. This reinforces the idea that workplace challenges are not simply deficits within autistic people but rather reflect a misalignment in communication and social expectations between neurodivergent and neurotypical employees.

Another study, published in Autism Research, explored how autistic and allistic people interpret the behaviors of autistic employees in the workplace. Findings demonstrated how autistic participants were more accurate in understanding autistic employees' behaviors, whereas allistic participants struggled with accurate interpretation. These results provide further evidence that employment challenges for autistic people are deeply rooted in systemic barriers and allistic assumptions and misunderstandings rather than intrinsic social impairments.

By addressing Double Empathy in workplace policies and management practices, organizations can create a more inclusive and supportive work environment for all employees. This shift away from a deficit-based model toward a more nuanced framework of mutual understanding is crucial for improving employment outcomes for autistic adults and equal participation in the workforce.

Implementation of the Double Empathy Framework

Over the next five years, the Canada Autism Strategy will be implemented through several governance mechanisms, including the Federal-Provincial-Territorial (FPT) Working Group on Autism, the Interdepartmental Steering Committee on Autism, and a newly established National Autism Network. The Public Health Agency of Canada (PHAC) will also explore Indigenous-led approaches to addressing autism-related priorities within Indigenous communities. This proposal advocates for the use of Double Empathy as a guiding principle for these initiatives.

National Autism Strategy Secretariat

The PHAC’s National Autism Strategy Secretariat will coordinate the implementation of the Framework for Autism in Canada, aligning its work with the key priority areas. The Secretariat will facilitate collaboration among federal, provincial, and territorial partners through established governance mechanisms and a newly created national network engaging experts and stakeholders. Using Double Empathy as an additional communications framework will help ensure that the diverse perspectives of both autistic and allistic people are recognized and respected, fostering mutual understanding, reducing misunderstandings, and promoting more inclusive, effective collaboration in policy development and implementation.

National Autism Network

The PHAC will provide funding to establish the National Autism Network to support key priority areas. The Network will establish advisory committees composed of Autistic people, advocates, and family members to guide policy and program development. The Network will also develop a national research network to advance interdisciplinary research, and enhance knowledge mobilization. Using Double Empathy as an additional communications framework will help ensure mutual understanding and effective communication between all stakeholders, fostering a more inclusive, productive and collaborative environment.

Federal-Provincial-Territorial (FPT) Working Group on Autism

The FPT Working Group will have an updated mandate with revised Terms of Reference and a workplan to support the autism framework and strategy. The PHAC will facilitate information sharing and best practices across jurisdictions and sectors, with a focus on key priority areas such as economic inclusion. Using Double Empathy as an additional communications framework will help ensure that the perspectives and experiences of autistic people are central to the development of economic inclusion strategies, leading to more effective and sustainable outcomes.

Interdepartmental Steering Committee on Autism

The mandate of the Interdepartmental Steering Committee will be updated to enhance coordination across federal initiatives. For example, the PHAC will ensure that the voices of autistic Canadians are considered in the Disability Inclusion Action Plan, which supports inclusive employment opportunities and workplace accommodations. Using Double Empathy as an additional communications framework will help ensure that the voices of autistic Canadians are not just heard, but truly understood and incorporated into the Disability Inclusion Action Plan, resulting in policies that create real and sustainable change.

Distinctions-Based Approaches to Implementation

The Government of Canada acknowledges the unique experiences of Indigenous communities regarding autism. The PHAC will continue to engage First Nations, Inuit, Métis, and Urban-Indigenous Peoples to develop distinctions-based, Indigenous-led approaches to autism-related priorities. Using Double Empathy as an additional communications framework will help ensure that the development of distinctions-based, Indigenous-led approaches to autism is grounded in genuine understanding and reciprocal communication, rather than assumptions.

Embracing Lived Experiences

The successful implementation of Canada’s Autism Strategy depends on diverse expertise and perspectives. The National Autism Network will play a central role in bringing together autistic people, advocates, family members, caregivers, and experts to provide continuous input on key priority areas. One of the Network’s first tasks will be to establish Advisory Committees to contribute to the Implementation Plan.

These committees will also provide guidance to other governing bodies, such as the FPT Working Group and the Interdepartmental Steering Committee, ensuring a coordinated national approach. By fostering collaboration across governing bodies and prioritizing input from people with lived experience, the Implementation Plan will drive meaningful and sustainable support for autistic people, their advocates, caregivers, and families. Using Double Empathy as an additional communications framework will help ensure that communication within and between Advisory Committees, governing bodies, and people with lived experience is clear, respectful, and productive, minimizing misunderstandings and fostering effective collaboration.

CONCLUSION

This proposal advocates for the integration of the Double Empathy framework as a foundational principle within Canada's Autism Strategy. This initiative aims to cultivate a more empathetic and effective communication landscape, specifically bridging the persistent communication gap between autistic and allistic people. By embedding this framework, we seek to move beyond traditional deficit-based models and foster a culture of mutual understanding and respect. The application of Double Empathy will ensure that the strategy's implementation, from policy development to service delivery, is grounded in genuine reciprocal communication.

Furthermore, the intention extends beyond the immediate scope of Canada’s Autism Strategy. We envision the Double Empathy framework permeating broader societal structures, particularly in areas crucial for economic inclusion. Sectors such as human resources, employment services, and workplace accommodations stand to benefit significantly from a communication approach that acknowledges and values neurodiversity. By promoting the Double Empathy framework within these realms, we can create more inclusive and equitable environments, enabling autistic people to fully participate and thrive in the workforce and society at large.

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References

Austin, R. D., & Pisano, G. P. (2017). Neurodiversity as a Competitive Advantage. Harvard Business Review, 95(3), 96-103.

Brewer, R., Biotti, F., Catmur, C., Press, C., Happe, F., Cook, R., & Bird, G. (2016). "Can Neurotypical Individuals Read Autistic Facial Expressions? Atypical Production of Emotional Expressions in Autism Spectrum Disorders." Autism Research, 9(2), 262-271.

Cage, E., Monaco, J., & Newell, V. (2018). Experiences of Autism Acceptance and Mental Health in Autistic Adults. Journal of Autism and Developmental Disorders, 48(2), 473-484.

Chapple, M., Davis, P., Billington, J., Myrick, J. A., Ruddock, C., & Corcoran, R. (2021). Overcoming the double empathy problem within pairs of autistic and non-autistic adults through the contemplation of serious literature. Frontiers in Psychology, 12.

Conroy, Samantha. Vogus, Timothy. (2025, Jan 07). On the folly of rewarding your version of performance: Signaling and the double empathy problem in pay‐for‐performance across neurotypes. Human Resource Management. 1–15. Wiley Periodicals LLC.

Crompton, C. J., Ropar, D., Evans-Williams, C. V., Flynn, E. G., & Fletcher-Watson, S. (2020). Autistic peer-to-peer information transfer is highly effective. Autism, 24(7), 1704–1712.

Flower RL, Dickens LM, Hedley D. Barriers to Employment: Raters' Perceptions of Male Autistic and Non-Autistic Candidates During a Simulated Job Interview and the Impact of Diagnostic Disclosure. Autism Adulthood. 2021 Dec 1;3(4):300-309.

Goffman, E. (1990). Stigma: Notes on the Management of Spoiled Identity. Penguin Books. (Originally published in 1963, reprinted in 1990).

Heasman, B., & Gillespie, A. (2019). Neurodivergent Intersubjectivity: Distinctive Features of How Autistic People Create Shared Understanding. Autism, 23(4), 910–921.

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This month’s roundup includes columns and editorials, scientific research, social policy, business, and technology. From in-depth discussions on neurodivergent identity and workplace inclusion to the latest medical and psychological studies, this issue covers a variety of neurodiversity-related media and research.

Columns and Editorial

• Hire More Neurodivergent Workers (The Globe and Mail) This article argues that hiring neurodivergent workers is a key strategy to addressing Canada’s growing talent shortage.

• “Disrupting Imprints in Autism” (Psychology Today)
  Explores how outdated psychological and societal views on autism continue to shape modern understanding, often to the detriment of autistic people. The piece calls for a shift in perception to move beyond deficit-based models.

• “Autism in Women: An Under-Diagnosed Reality” (Psychology Today)
  Highlights the challenges women face in getting an autism diagnosis due to gender biases in diagnostic criteria and societal expectations.

• “Harvard & Walter Fernald Center: A History of Disability” (Harvard Magazine)
  Investigates the legacy of the Walter E. Fernald State School, a former institution for intellectually disabled individuals, and how its history informs contemporary discussions on disability rights and care.

Health & Medical Research

• “Rising Autism Rates” (ABC News)
  Investigates whether increased autism diagnoses reflect a true rise in cases or improved detection methods.

• “Delayed Autism Diagnoses” (MedicalXpress)
  Explores disparities in the timing of autism diagnoses across different racial and socioeconomic groups.

• “ADHD & Smoking Treatment” (STAT News)
  Investigates whether nicotine and other smoking-related treatments could be used to manage ADHD symptoms, given their impact on dopamine regulation.

• “Non-Pharmacological ADHD Management” (ResearchGate)
  This study reviews alternative treatments for ADHD, including behavioral therapy, diet changes, and mindfulness interventions.

• “Reexamining Reciprocity in Autism” (ResearchGate)
  A systematic review of how autistic people experience and express social reciprocity, challenging the stereotype that autistic people lack social interest.

• “Cerebellar Neuromodulation & Social Cognition in Autism” (ResearchGate)
  This study examines how cerebellar function affects social cognition in autistic people through both human and animal studies.

• A Pilot Randomized Trial of a Brief Mental Health Crisis Prevention Program for Autistic Youth (Journal of Autism and Developmental Disorders, February 2025) This study evaluates the effectiveness of a brief mental health crisis prevention program designed for autistic youth.

• Autism & Multilingualism (Washington Post)
  A new study suggests that multilingual children with autism have enhanced executive function skills compared to their monolingual peers, offering a fresh perspective on language acquisition and neurodiversity.

• Mitochondria and Social Memory (Neuroscience News)
  This study explores how mitochondrial function impacts social memory, providing insight into neurological conditions.

• New Autism-Related Genetic Findings (PubMed)
  A genetic study identifies new autism-linked genes, offering further understanding of how genetic variations influence neurodevelopment.

• Health Outcomes in Neurodivergent Individuals (Molecular Autism)
  A study on health outcomes in neurodivergent populations, focusing on healthcare disparities and potential strategies for improving access and treatment.

• “ADHD in Autistic Adults” (JAMA Network)
  Reports on a study showing that ADHD symptoms persist into adulthood for many autistic people, affecting their mental health and daily functioning.

• Shared Root Cause of Psychiatric Conditions (Cell)
  New research reveals that several conditions, such as autism and schizophrenia, may share common genetic pathways, opening new avenues for treatment.

• Advances in Autism Research (Nature)
  A comprehensive review of recent breakthroughs in autism research, focusing on brain imaging and early intervention strategies.

Education & Accessibility

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• “Neurodivergent Scientists & Disclosure Challenges” (STAT News)
  Discusses the challenges neurodivergent scientists face in professional settings, including disclosure of diagnoses and how masking affects collaboration.

• “Peel District’s Inclusive School Programs” (Peel Schools Media Release)
  Highlights the Peel District School Board’s efforts to create more inclusive educational spaces for neurodiverse students through its Stay & Play initiative.

• “Quebec’s Teacher Evaluation Plan & Special Education” (Canadian Press)
  Examines the push for stricter teacher evaluations and its potential impact on special education students.

• Challenges for Neurodiverse Students (The Conference Board of Canada)
  The article highlights the barriers neurodiverse students face in education, including a lack of tailored support systems and inclusive teaching practices.

• Indigenous Views on Autism (CBC)
  Indigenous families in Saskatchewan share their perspectives on autism, blending traditional cultural views with modern healthcare approaches.

• York Catholic Program and Literacy Gains (Toronto Star)
  A successful literacy program helped struggling students make significant progress, but its discontinuation raises concerns about education policy decisions.

Mental Health and Policy

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• Autistic Leaders in Medicine (Insight Plus)
  A call for greater representation of autistic professionals in medicine, emphasizing the unique skills and perspectives they bring to the field.

• “Cyprus & Disability Rights” (Cyprus Mail)
  Investigates how disabled individuals in Cyprus face social invisibility and lack of access to basic human rights.

• “Autism BC’s Call for Police Reform” (Quesnel Observer)
  Advocates for law enforcement training in handling neurodivergent individuals following the police-involved death of a neurodiverse teenager.

• Impact of COVID-19 on Hospital Admissions (ResearchGate)
  This study examines how COVID-19 affected hospital admissions for children with developmental disabilities, revealing significant health inequities.

• Considerations for Online Psychiatric Research (Mount Sinai Research)
  Researchers emphasize the need for ethical guidelines and better data security in online psychiatric research, given its growing popularity.

• Human Rights Complaints Against UNB Law School (CBC)
  Law students at the University of New Brunswick have filed human rights complaints, alleging discrimination against neurodiverse and disabled students.

Business & Consumer Affairs

• Social Security Overpayment (Moneywise)
  This story on an autistic man in Wisconsin sheds light on the challenges many face with social security overpayments and the financial hardship they cause.

• Neurodiversity at Work (Vanderbilt University)
  An event at Vanderbilt University highlights the growing movement for neurodiversity inclusion in the workplace, promoting innovative hiring practices.

• Designing a Neurodiverse City (Bloomberg)
  This article explores urban planning strategies that make cities more accessible and accommodating for neurodivergent people.

• The Business of Employing Neurodiverse Adults (Newstalk Podcast)
  This podcast discusses how businesses can benefit from hiring neurodiverse employees and outlines best practices for creating an inclusive workplace.

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We are building a section for international communities, initiatives and collaborations. Do you have an initiative or network you would like to promote? Email us at info@neuropower.ca

The weight of it all pressed down on Laura Dove like a physical force—the weight of knowing that while Medicaid might offer some support for autistic children, once they become adults, the lifeline essentially disappears, leaving families like hers adrift.

Exhausted, she lay in bed, staring at the ceiling, the fluorescent lights of the hospital room buzzing overhead. Her mind, usually a whirlwind of ideas and connections, felt sluggish, clogged. Words, once her weapon of choice, felt like heavy stones lodged in her throat. She couldn't speak, couldn't think, couldn't even seem to regulate her own breathing. This wasn't just fatigue. It was a deep, soul-crushing exhaustion born from years of battling a system that seemed designed to break her.

“If you have money, there’s support,” says Dove, who’s been using Medicaid and food stamps to survive over the last eight years.

While Medicaid provides some support for autistic children, that safety net vanishes for adults, leaving many without essential care. Misdiagnosed for years, Dove experienced repeated hospitalizations for what was labeled nervous breakdowns—when in reality, she was suffering from autistic burnout.

“There's no treatment for adult autism,” says Dove. “You need another condition.”

Co-occurring medical conditions are well-researched in children with autism spectrum disorder (ASD), while emerging evidence indicates that adults with ASD face higher rates of adverse physical health outcomes.

Adding to this concern, recent studies suggest a reduced life expectancy for adults with ADHD—a diagnosis also shared by both Dove and her son, Elliott.

The pursuit of support for Dove’s undiagnosed autistic son had taken its toll. By her bed, mountains of medical files, a seemingly endless stream of forms for schools and organizations, dead end after dead end. It all culminated in physical collapse.

Dove’s son, like many others, was initially diagnosed with ADHD. She spent years navigating a labyrinth of health and education systems, a journey that had taken a devastating toll on her own health, compounding with chronic illness.

This lack of support for autistic adults, however, is not confined to the United States.

The lack of support and services for autistic adults is a global issue. North of the border, autistic people face similar challenges in accessing services.

Last year, the Autism Alliance of Canada published a report Exploring the Needs of Autistic Adults in Canada. The survey was led by autistics, for autistics.

Autistic adults in Canada face significant challenges across multiple areas of life, with cost of diagnosis being one of the most common barriers to access. Financial vulnerability is also a major concern, as over a third of participants were unemployed at the time of the study. Many others rely on government disability assistance, which reflects broader trends of poverty among those on disability benefits.

Social isolation further compounds these difficulties, with nearly 90 percent of respondents reporting exclusion more than twice the rate seen among Canadians during the pandemic. This sense of disconnection poses serious health risks, including increased susceptibility to conditions such as dementia and heart disease.

The Autism Alliance of Canada’s study is ahead of the curve, as there is little research globally on services for autistic adults, including medical care and service delivery. Advocates are still fighting for international acceptance, rather than general awareness, as national autism strategies emerge to address systemic failures.

A 2022 study on autistic adult services in the European Union, part of the ASDEU project, echoed findings from the Autism Alliance of Canada. It highlighted the diverse needs of autistic adults in areas like housing, employment, education, and social services, with many struggling to access appropriate support. The study also revealed significant gaps in provider knowledge, including a lack of autism training among service staff, unawareness of wait times, and failure to meet established care recommendations. Addressing these gaps is crucial for improving service delivery and ensuring better support for autistic adults. Another 2022 study found that autistic adults experience lower-quality healthcare and poorer overall health outcomes.

The growing prevalence of autism diagnosis among young adults could signify the historical failings of screening and diagnostic criteria. It could also indicate systemic bias, how people mask their symptoms during childhood, throughout their youth, all the while being misdiagnosed and treated for other conditions.

On a global scale, autism ranks among the top contributors to non-fatal health burden for people under the age of 20, according to groundbreaking findings from the Global Burden of Diseases, Injuries, and Risk Factors, published in December. This research shows how 61.8 million people worldwide—or about one in every 127—are autistic.

While Autistic people face a heightened risk of mental health challenges, self-injury, and suicidality, it wasn’t until 2018 that research first examined the treatment and support available to autistic adults for these same issues.

The rising rates of autism diagnoses across the US highlights the need for expanded healthcare services and further research into sociodemographic disparities within this growing population. Between 2011 and 2022, autism diagnoses among women surged by 315 percent, compared to a 215 percent increase among men.

Studies suggest that societal expectations around gender norms may contribute to women masking autistic traits, possibly due to social pressures and stigma. However, as awareness grows, more women and girls may feel empowered to seek a diagnosis. Changes in developmental screening practices, diagnostic criteria, policies, and environmental factors may all play a role in the increasing number of cases.

Falling Through the Cracks: The Maze to an Autism Diagnosis

For many families, the path to an autism diagnosis is not a straight line—it’s a maze full of dead ends, misdirection, and missed opportunities. For one mother, that reality became clear as she looked back on the signs she had overlooked in her own child.

“My child was missed by so many people, including me,” says Dove. “The DSM gives a very narrow description of autism, and if you don’t fit it, you’ll be overlooked.”

The Diagnostic and Statistical Manual of Mental Disorders (DSM) continues to evolve, with updates reflecting growing research and understanding of autism. However, many medical practitioners consider additional factors beyond the DSM, incorporating clinical judgment, patient history, and broader frameworks to better capture the diverse presentations of autism across different age groups and genders.

Even those who do fit the criteria sometimes go unnoticed because many psychologists and doctors still rely on outdated, surface-level assessments. For this reason, Dove’s sister was diagnosed a level three autistic when she was a toddler.

“My sister fits the classic definition of autism,” she says. “The delayed speech, difficulty with back-and-forth conversation, very obvious traits. But for those of us who mask, or also have ADHD, it’s not so clear.”

The challenge is compounded by the way autism has traditionally been studied.

“They’ve been looking at autism from the outside for so long,” she explains. “That’s finally starting to change, but awareness takes time. And the way they frame it—as a deficit—only makes it harder for people who don’t fit the stereotype.”

Lost in the System: The Fight for Autism Support After Diagnosis

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For Dove, the battle for autism support services has been an uphill fight.

“When my diagnosis finally came, I thought things would get easier,” she says. “Instead, no support services were offered. Not for me. Not for my son. Nothing.”

Dove describes navigating a labyrinth of bureaucracy—contacting organizations, filling out extensive paperwork, trying to secure financial assistance.

Dead end, after dead end.

“The waitlists are long. There aren’t enough practitioners who understand autism. Organizations are overwhelmed, underfunded, and unable to keep up with demand.”

In the end, the system leaves autistic families to fend for themselves.

“Finding support takes so much footwork,” says Dove. “Even after all the effort I’ve put in, I still haven’t found anything sustainable. It all comes down to money.”

The Uphill Battle for an Education That Works

Finding the right school for a neurodivergent child can be an exhausting maze of trial, advocacy, and frustration. Dove faced this firsthand when her son Elliott was denied accommodations. She reached out to the school and hoped the administration would recognize the flaw in their approach. Instead, their response was dismissive.

Elliott struggled to keep up with academic expectations as the need for executive functioning increased while he progressed through high school. This led to severe mental health challenges for both mother and son.

Eventually, the school admitted they simply did not have the resources to support her son properly. Faced with a system unwilling to adapt, Dove looked into specialized schools for children with ADHD and autism, schools that prioritized building executive functioning skills. But the cost was staggering—$35,000 a year, on top of the $15,000 they were already paying for Catholic school.

Without financial support from her family, it simply wasn’t an option.

“I wish they had schools like that in the public system,” she says. “But they don’t.”

The challenges didn’t stop there. Her son was disciplined for behaviors tied to his autism—stimming, echolalia, simply existing in a way that didn’t fit the mold. Despite succeeding academically, he was still treated as a pariah. For many neurodivergent students, the biggest barrier to education isn’t their disability—it’s the system itself.

“I've heard this story so many times from other parents—how hard we have to fight to get basic accommodations, to make sure our children are being respected.”

In 2024, after bouncing from school to school, Elliott graduated from high school. He now studies sound engineering at Anne Arundel Community College in Maryland.

Dove remains deeply worried about the future, especially when it comes to healthcare access. Medicaid, which has been a lifeline for many neurodivergent people, faces an uncertain fate under shifting political leadership in the US.

"I'm worried about access to healthcare or any kind of government support," she says.

Yet, despite the fear, she also sees signs of hope. She says the autistic community is growing louder in its advocacy and pushing back against outdated perspectives.

NEW RESEARCH

Life expectancy and years of life lost for adults with diagnosed ADHD in the UK

Investigating deaths of autistic people in health and social care in England and Wales

AI-boosted virtual reality system to help autistic students improve social skills

CAMI systems further understanding of Autism Spectrum Disorders

New human brain atlas charts gene activity and chromosome accessibility

EVENTS & INITIATIVES

Canadian Autism Leadership Summit

Family Justice Council Guidance on Neurodiversity in the UK

Inaugural 2025 Davos Neurodiversity Summit During the World Economic Forum

February 11 Webinar: Early Diagnosis of Autism and Emerging Solutions

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Looking back on 2024, we see a year of both progress and continued challenges. Over the next few months, we’ll be examining research and news items that could be laying the groundwork for future advancements in neurodiversity inclusion and acceptance.

The increase of autism and ADHD diagnosis, particularly in young adults, has shone a light on the evolving diagnostic criteria for neurodivergent conditions, highlighting the historical failings of screening and diagnostics, which has led to a crisis in medical access. Even in countries with the most services and support are not prepared to deal with the backlogs. For instance, the following chart shows the rapidly growing waiting lists for autism and ADHD assessments in England.

In a study from Oct. 2024, autism diagnosis among US children and adults shows an increase of 175 percent over a decade. The sharpest increase in diagnosis was young adults aged 26 to 34, which rose to 450 percent.

The growing prevalence of autism diagnosis among young adults could signify the historical failings of screening and diagnostic criteria. It could also indicate how people mask their symptoms during childhood and throughout their youth, or being misdiagnosed with another condition(s). The waiting lists for autism and ADHD assessments are expected to keep growing around the world. In Wales alone, the number of children waiting for an assessment could triple over the next two years.

On a global scale, autism ranks among the top contributors to non-fatal health burden for people under the age of 20, according to groundbreaking findings from the Global Burden of Diseases, Injuries, and Risk Factors, published in December. This research shows how 61.8 million people worldwide—or about one in every 127—are autistic.

Moving from Surviving to Thriving

Ever since the United Nations designated April 2 as World Autism Awareness Day, the UN has observed the day as a means to affirm and promote the full realization of all human rights and fundamental freedoms for autistic people on an equal basis with others. Progress has been made thanks to the many autistic advocates who have worked tirelessly to bring the lived experience of autistic people to the wider world.

Today, 17 years later, we have moved beyond raising awareness to promoting acceptance and appreciation of autistic people and their contributions to society. In 2024, the central theme was moving from surviving to thriving.

"Acceptance of our autistic and neurodivergence traits and being who we are is what we want,” says Sydney Elaine Butler, Founder of Accessible Creates.

“Awareness is just acknowledging that Autism exists, but acceptance says I see you for all you are and want to do better and help the world be better for you.”

Later in the year, The World Economic Forum reiterated why businesses must take action on disability inclusion by 2025, stating that the chief areas of concern includes how real leadership, data and representation are the trifecta for true disability inclusion—a $18 trillion opportunity businesses can’t afford to miss. In their words, it’s the last call for businesses to lead or lag on disability inclusion.

The World Economic Forum also published briefing papers on neurodiversity, including the role Chief Health Officers (CHO) role in realizing business opportunities and fostering an inclusive work environment.

Implementing a national autism strategy is crucial for countries to address the complex needs of autistic people and their families. This includes focus on employment for autistic adults, recognizing their unique skills and talents.

Building on two decades of progress in autism support and services in the United States, the Autism CARES Act of 2024 was signed into law by President Biden on December 23, 2024. This renewed and expanded legislation aims to provide continued support for autistic people and their families with nearly $2 billion of funding over the next five years to support research and programs.

In Australia, the federal government released their first national autism strategy this year, investing $42 million over a seven-year period to create an inclusive society, in which all autistic people are supported and empowered to thrive.

The United Kingdom was one of the first countries to implement a national autism strategy, starting in 2010. Canada tabled a framework for a national autism strategy in September of 2024. Our homebase is in Toronto—so we are digging into Canada.

UPDATE: Canada’s Autism Strategy

The 2007 Senate report, "Pay Now or Pay Later: Autism Families in Crisis," inspired the Autism Alliance of Canada to initiate a nationwide effort for Canada to adopt a national autism strategy, a campaign the Alliance has maintained for over 14 years.

Canada enacted the Federal Framework on Autism Spectrum Disorder Act (Bill S-203) in 2023 with unanimous support from both the Senate and the House of Commons.

On September 26 of 2024, the Framework for Autism in Canada and Canada’s Autism Strategy was tabled in Parliament. It is anticipated that a leading organization for the National Autism Network will be announced in the spring of this year. Once established, the Network will unite the expertise and resources of autism organizations and stakeholders, including people with lived experience.

Strategic priorities identified include: 1) screening, diagnosis and services; 2) economic inclusion; 3) data collection, public health surveillance, and research; 4) public awareness, understanding and acceptance; and 5) tools and resources.

The National Autism Secretariat is currently focused on forming the National Autism Network, which will provide a forum for ongoing engagement on federal policies and programs. The Network will prioritize the voices of people with lived experience to advance strategic priorities outlined in the national strategy.

The framework includes a 5-year commitment to reporting to Parliament, so you can expect to see a report in 2029 detailing progress made over the first five years.

Concerns over Canada’s Autism Strategy

This CBC article highlights some concerns over Canada's new national autism strategy. While Health Minister Mark Holland called it an "important first step," families of autistic children express disappointment. Their main concern is the lack of concrete plans to address the existing backlog for diagnosis and treatment.

The article delves deeper into the specific concerns of families and more details in the new strategy. You can find more information by following the link provided.

In the province of Ontario, the autism therapy bottleneck continues to worsen as enrolments decline. The waitlist for services is more than 73,000, according to documents obtained by The Canadian Press.

Autism Alliance of Canada Releases Podcast Series

A five-episode podcast series dedicated to examining Canada's autism strategy was released to address some of the concerns and provide more information about the strategy. Through open and insightful conversations with leading experts and members of the autism community, the series explores various aspects of the national strategy, including screening, diagnosis, and efforts to promote public awareness and acceptance. The discussions focus on how the strategy aims to provide support to autistic people, their families, and caregivers nationwide.

New Research from 2024

Autistic traits foster effective curiosity-driven exploration

Game changer: exploring the role of board games in the lives of autistic people

Beyond first impressions: the importance of seeing the whole person

Collaborative autism study spotlights IU Columbus neuroscience research

A qualitative exploration of the experiences of self-diagnosed autistic women and gender-diverse individuals who are not pursuing an autism diagnosis

Scientists uncover previously overlooked strengths of dyslexia and dyscalculia

Academic Journals

Autism

Autism Research

Autism Research and Treatment

Canadian Journal of Autism Equity

Disability& Society

Disability Studies Quarterly

International Journal of Disability, Development and Education

Journal of Autism and Developmental Disorders

Neurodiversity Journal

The International Society for Autism Research (INSAR)

Communities & Collaborations

Global: Neurodiversity Celebration Week

Canada: Autism Data Collaborative (ADC)

We are building a section for international communities, initiatives and collaborations. Do you have an initiative or network you would like to promote? Email us at info@neuropower.ca