Around the World: Autism in the United States

1 in 31: The Number the Rest of the World Cites

Nearly every year, the CDC (Centers for Disease Control and Prevention) publishes, through its ADDM surveillance network (Autism and Developmental Disabilities Monitoring Network), the most widely cited prevalence estimate in the world. The latest, released in April 2025 using 2022 data: 1 in 31 eight-year-olds in the US is identified with autism spectrum disorder — up from 1 in 36 just two years earlier.

This network has existed since 2000 (Children's Health Act) and monitors 16 sites across 14 states and Puerto Rico. For direct comparison, France recorded, that same year, 1 in 106 at the exact same age — a gap that most likely reflects different screening methods rather than a genuine difference in how common autism actually is between the two countries (see the comparison section below).

Source: CDC, ADDM Network, MMWR Surveillance Summaries, April 2025.

Childhood: Diagnosis, Early Intervention, and School

The American Academy of Pediatrics recommends routine autism screening at 18 and 24 months, during standard pediatric checkups. Once a disorder is suspected, children under 3 can access Early Intervention (Part C of the IDEA law) — publicly funded therapy services that begin without waiting for a definitive diagnosis, a principle fairly close to France's early intervention package.

On the education side, the key federal law is IDEA (Individuals with Disabilities Education Act). It guarantees every child with a disability a "Free Appropriate Public Education" (FAPE) and requires an IEP (Individualized Education Program) to be built with the parents — the functional equivalent of France's Projet Personnalisé de Scolarisation. The principle of the "Least Restrictive Environment" echoes, almost word for word, the French idea of "mainstream inclusion."

But while schooling follows a single federal rule, medical care (ABA therapy in particular) depends on a patchwork of 50 different state laws — with age caps and session limits that vary widely, and a federal exemption (ERISA) that lets large companies who self-insure their employees escape these state mandates entirely.

Adolescence: Preparing for a Cliff No One Names in Advance

IDEA requires, starting at age 16 (sometimes earlier depending on the state), that transition services be written into the IEP — goals around employment, further education, or independent living after high school. On paper, that's structured foresight. In practice, IDEA coverage itself ends at high school graduation, at the latest by age 21 depending on the state (sometimes 18).

It's this exact deadline that quietly sets up what American literature has come to call the "services cliff." A term you'll find both in an official report to Congress and in everyday language among affected families.

Adulthood: The Cliff, Then What Tries to Fill It

Every year, roughly 50,000 autistic young people leave the US school system — and with them, most of the services mandated by law. (Report to Congress, IACC/HHS, 2022) More than 66% of autistic young adults have neither a job nor further education within two years of leaving high school — a figure that remains high even four years later, according to the National Autism Indicators Report from the Drexel Autism Institute (2015) — still the most widely cited study on this topic, despite its age, for lack of an equivalent update since.

On top of this drop in services come a set of unforgiving administrative deadlines: Medicaid eligibility gets re-evaluated at 18, coverage under a parent's health insurance can end at 26, and legal adulthood at 18 transfers every decision to the individual at once, unless a specific guardianship process is in place.

Faced with this gap, a handful of large companies have built their own responses. SAP launched its "Autism at Work" program in 2013 — today more than 150 autistic employees across a dozen countries, with a retention rate above 90%. JPMorgan Chase, running a similar program since 2015, reports autistic teams working up to 48% faster on certain tasks. Microsoft, for its part, entirely redesigned its hiring process — several days of skills-based assessment rather than a traditional interview, which often disadvantages autistic candidates.

Real initiatives, but ones that remain limited to a few dozen companies — far from a systemic answer to the sector's most striking figure: the underemployment rate for autistic adults is estimated, according to some sources, at close to 85%, despite average or above-average intelligence in a large share of them.

What Really Sets the US Apart From France

The clearest divergence isn't school — the two countries have fairly similar frameworks, IEP and PPS. It's the nature of the break at adulthood. In France, medico-social support (IME, MAS, ESAT) doesn't stop abruptly at one fixed age in the same way: it transforms, with its own delays and waiting lists, but without this same brutally dated legal "cliff."

In the US, by contrast, access to care depends as much on postcode (which state) as on a parent's employment status (what kind of insurance plan) — a double variable with no real equivalent in the French system, where health coverage remains universal regardless of employer.

Frequently Asked Questions

Sources: CDC, ADDM Network (April 2025); Individuals with Disabilities Education Act (IDEA); Report to Congress, IACC/HHS (2022); Scientific American (February 2025); National Autism Indicators Report, Drexel Autism Institute (2015); SAP, Microsoft, JPMorgan Chase — Autism at Work / Neurodiversity Hiring programs.