The Real Autism Epidemic: Narratives that Enable Systemic Inaction
In short: Greater inclusion and acceptance around autism are not the reason services are stretched thin. Longstanding underfunding and poorly designed systems are. Treating inclusion as a strain on resources shifts blame away from the changes that are actually needed.
When Silence Causes Harm
Autism is having a moment in the national discourse right now, particularly in conversations about policy, public health, and the way we speak about disability. Much of that discussion has left me feeling uneasy and increasingly frustrated. After listening to a recent New York Times podcast episode of The Daily called “The Autism Diagnosis Problem,” I felt compelled to respond. Silence now feels irresponsible.
A Faulty Narrative About Autism and Scarcity
The episode identifies the increase in autism diagnoses as the result of a more inclusive definition of autism, incorporating those formerly diagnosed with Asperger’s Syndrome into the broader autism spectrum. It examines the impact that expanded diagnostic criteria and cultural destigmatization have had on the availability of resources for the autistic community, arguing these developments have led to scarcity that harms those with the highest support needs by stretching already limited resources.
It also introduces concerns about representation. Alongside the claim that expanding diagnostic criteria strain a finite system is a deeper anxiety about who speaks for autistic people as a whole. It suggests that autistic people with lower support needs, who are more likely to have consistent access to speech and public platforms, are increasingly centered in these conversations, while those with the highest support needs are largely absent from public discourse.
Taken together, this framing shifts the focus from structural limitations toward autistic people themselves:
“What is striking me here is that years of work went into destigmatizing autism, and the end result of that is that you have people increasingly being included in different aspects of society, included in schools, included in classes, being prouder to talk openly about their condition. However, that has also meant more people competing for a finite number of resources. And the irony of this is that the net effect seems to be that the students with the most severe needs are being excluded from places like the classroom, as you mentioned, because they are being told we simply do not have the resources to support you in this environment, and you’re going to need to go elsewhere.”
Misidentifying the Problem
This reasoning reflects a fundamental misunderstanding of what drives resource scarcity in disability services. It both oversimplifies and inverts the situation by treating autistic people as the cause of shortages they must navigate, while ignoring the systems that have long failed to meet the needs of disabled communities.
It also reinforces an unnecessary and harmful divide within the autistic community: that autistic people with lower support needs not only draw resources away from those with higher support needs, but also speak over them in advocacy spaces—a claim that fails to acknowledge systemic barriers to consistent communication access and participation.
Reframing the Narrative Around Scarcity
Resource shortages in disability services are real, but their roots have little to do with who carries an autism diagnosis and far more to do with longstanding structural conditions:
chronic underfunding
long waitlists for access to care
workforce shortages and high turnover
bureaucratic barriers
systems designed around crisis management rather than care that supports autonomy and participation
These conditions are embedded in infrastructures that were not designed with disabled communities in mind.
What Reframing Looks Like in Practice
In a previous role as a school-based speech-language pathologist supporting autistic students with high support needs, the pressures we faced were not due to how many autistic people were seeking services, nor to competition between students with differing support needs. The school served only students requiring significant supports, and the services needed in that setting differed from those typically accessed by autistic students with lower support needs in broader school environments.
The challenges we encountered stemmed from limitations within the system itself: chronic understaffing, unfilled positions, inconsistent training, and the absence of adequate crisis support infrastructure. These issues reflected conditions of the setting, not diagnostic patterns or competition between autistic people.
My experience reflects one setting, and I do not claim that every school or program faces the same constraints. The patterns I observed, however, are consistent with widely documented national trends: high needs, low staffing, limited crisis supports, and systems stretched beyond capacity.
How We Understand Disability Matters
Much of this misunderstanding comes from viewing disability through the medical model—the idea that disability is an individual problem rooted in personal deficits. This framework places the onus on disabled people to adapt, even when the barriers they face are created by their surrounding environment.
However, disability scholars and advocates have long offered a different framework: the social model of disability, which recognizes that many of the challenges disabled people face arise not from their bodies or minds, but from environments, systems, and expectations that fail to accommodate human variation.
This reframes the question from “How do we change the person?” to “How do we remove the barriers that prevent disabled people from participating fully in their communities?”
The Neurodiversity Movement
The neurodiversity movement is grounded in this social-model understanding of disability. It argues that neurological differences like autism are part of natural human variation, and that many of the barriers autistic people face arise from environments and systems not designed to accommodate them.
At its core, this movement argues for building systems capable of meeting the needs of a diverse population, including those who require intensive, lifelong support. It calls for changing the conditions that exclude people by improving environments and supports—not by gatekeeping who receives them.
While visibility and acceptance may increase awareness, they do not create scarcity. Underinvestment does.
Redividing the Autism Spectrum
The episode goes further by suggesting that autistic people with lower support needs are improperly included within existing systems and gestures toward a separate diagnostic category for those with the highest needs, effectively pathologizing both.
This reinforces the same misconception running throughout the episode: that autistic people themselves are the source of scarcity, rather than the inadequacy of the systems meant to support them.
Which Voices Are Heard
This framing also obscures why many autistic people with the highest support needs are underrepresented in advocacy conversations—not because others speak over them, but because participation itself has been made inaccessible through the lack of reliable communication supports and inclusive infrastructure.
I am not autistic, and I don’t claim to speak for autistic people. My perspective comes from working alongside autistic individuals whose communication, autonomy, and access are shaped by systems around them that limit their ability to participate on their own terms. Those experiences make the consequences of these public narratives impossible to ignore, particularly when they reinforce the barriers that prevent autistic people with the highest support needs from being heard.
Where, then, do we go from here? Who speaks for autistic people with the highest support needs? If we invested in the conditions that make participation possible—reliable communication access, inclusive community environments, and a fully funded free and appropriate public education—they could take part in these conversations themselves.
