The Influence of Policy on Early Diagnosis and Other Autism Services: a Narrative Review

Little is known about how policy—laws, regulations, procedures, administrative actions, incentives, or voluntary practices of governments or other institutions—shapes access to early autism services including diagnosis before age three. Early diagnosis and treatment are considered critical to improve outcomes. Understanding how policy influences such services could have substantial impact on outcomes for autistic children. We conducted a narrative literature review to determine what is known on how policy impacts early autism diagnosis and treatment. We found 17 articles that describe policy factors promoting early diagnosis and seven articles that identify policy factors affecting variability in autism services. We identified the following themes: (1) state policy factors influence access to diagnosis and other autism services, (2) innovative screening models affect early diagnosis, (3) provider training programs increase autism screening and diagnosis, (4) insurance policy influences autism services variability, and (5) resource availability affects geographic variability in autism services. Although common themes exist, more robust investigation is needed on policy impacting early autism services—beyond insurance and early intervention—and utilizing more rigorous designs.