Over the past 50 years, autism laws and policies have supported the needs and rights of individuals living with autism spectrum disorder. They have protected access to healthcare, education, employment, housing, and community integration. The lives of people with autism have been improved; their families and communities strengthened by this far-reaching framework of federal and state law, case law, and policy. Autism laws and policies reduce stigma and foster inclusiveness, promote education and awareness, and provide a foundation for continued advocacy efforts.
Federal Autism Legislation
The first federal law to prohibit discrimination against individuals with disabilities was the Rehabilitation Act of 1973, which promoted independent living, vocational rehabilitation, and supported employment for people with disabilities (Pub. L. 93–112, 87 Stat. 355). Two years later, Protection and Advocacy (P&A) systems were created in response to Geraldo Rivera’s exposé of the horrific conditions at the Willowbrook State School, an institution for children with disabilities. As a result, each state developed its own system of disability advocacy, and there was a shift to deinstitutionalization and community integration. In 1975, the Individuals with Disabilities Education Act (IDEA) was enacted, guaranteeing a free, appropriate public education for all children with disabilities in the least restrictive environment (U.S. Department of Education, 2004). In 1977, demonstrations in San Francisco led Congress to pass Section 504 of the Rehabilitation Act of 1973, which prohibits discrimination based on disability in programs and activities that receive federal financial assistance. It ensures that individuals with disabilities have the same opportunities and access to benefits and services and requires schools to provide accommodations and modifications to students with disabilities (29 U.S.C. § 794 of the Rehabilitation Act of 1973). The Fair Housing Act was amended in 1988 to protect individuals with autism from housing discrimination and requires reasonable accommodations and modifications to ensure equal access (Fair Housing Amendments Act, 1988).
In 1990, the Americans with Disabilities Act (ADA) was passed, which protects the rights of individuals with disabilities, including those with autism. It prohibits discrimination against people with disabilities in various aspects of life, including employment, public entities at the local and state level (schools, government offices, etc.), public accommodations (restaurants, hospitals, retail stores, etc.), and telecommunications (Americans with Disabilities Act, 1990). One of the most critical pieces of legislation is the 2024 reauthorization of the Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act, which expands previous iterations of legislation and funding dating back 20 years. The Autism CARES Act is the primary source of federal funding for autism research, services, training, and monitoring. It aims to advance support for individuals with autism throughout their lives, including the aged and those with communication challenges. The Act ensures continued funding for programs like the Developmental Disabilities Surveillance and Research Program and the Interagency Autism Coordinating Committee. (Autism CARES Act, 2024).
The Stephen Beck, Jr. Achieving a Better Life Experience (ABLE) Act was passed in 2014, which allows people with disabilities to save money in a tax-advantaged account, called an ABLE account, without jeopardizing their eligibility for public benefits like SSI and Medicaid. Currently, to be eligible for an ABLE account, a person’s disability must have begun before the age of 26. On January 1, 2026, the ABLE Age Adjustment Act will expand eligibility to people who have a disability that began before age 46. This will allow another 6 million people to be eligible for an ABLE account (Social Security Administration).
The Workforce Innovation and Opportunity Act (WIOA) is a federal law that provides funding for workforce development programs, including job search, education, and training services, designed to help individuals access employment and meet the needs of employers (WIOA, 2014). It requires states to allocate 15% of their vocational rehabilitation budget to pre-employment transition services, which can include services for youth with autism who may need employment assistance.
State Law and Policy
Each state has its own laws and policies related to autism insurance, eligibility for educational services, employment protections, and housing assistance. Although all states have mandates dictating insurance coverage of autism-related services such as ABA, they vary in terms of coverage limits and requirements. Information on state-specific insurance coverage can be found on the American Speech-Language-Hearing Association website. States also differ in the procedures and criteria used to identify autism spectrum disorder, which can lead to variations in reported prevalence rates between states. Relatedly, there are wide differences in state eligibility requirements for special education services based on degree of disability, age, and whether a medical vs. school assessment (or both) are necessary to qualify for support (Barton, 2016). Likewise, policies regarding adult transition vary widely from state to state, largely dependent on available support and resources (Interagency Autism Coordinating Committee).
State policies regarding autism in the workplace can vary significantly and impact employment rates and outcomes in the autism community. Some states have enacted laws and programs to address workplace challenges faced by autistic individuals, following federal guidance through WIOA (Roux, 2017). Housing options for people with autism vary widely from state to state based on autism housing policies, support services, waiver programs, and funding mechanisms for residential support. Certain states offer programs that provide financial support for in-home care, while other states have mandated that insurance companies provide coverage. Regulations and accessibility standards also vary widely, which can ultimately impact the availability and suitability of housing for people with autism, especially those with cognitive and adaptive impairments. Information and resources are available from the Housing and Services Resource Center on the Interagency Autism Coordinating Committee Website.
Landmark Cases
Several landmark legal cases have shaped the framework of autism and disability rights in the United States. In Board of Education of the Hendrick Hudson Central School District v. Rowley, the Supreme Court defined the requirement for a “free appropriate public education” and helped establish a standard for IEP development (Board of Education v. Rowley, 1982). The court further clarified IEP services in Endrew F. v. Douglas County School District, stating that IEPs must be “reasonably calculated to enable a child to make progress in light of the child’s circumstances” (Endrew F. v. Douglas County School District, 10th Cir. 2018).
One of the most significant cases is the Olmstead Decision of 1999. The Supreme Court ruled in “Olmstead v. L.C.” that unjustified segregation of individuals with disabilities constitutes discrimination in violation of Title II of the Americans with Disabilities Act. This landmark decision required states to provide community-based services rather than institutionalizing individuals with disabilities whenever appropriate. It emphasized the importance of integrating individuals with disabilities into the community and supporting their right to live and participate in society fully (Olmstead v. L.C., 527 U.S. 581 (1999).
Legal Policy and Prevention of Stigmatization
The enactment of these laws and the outcomes of these landmark cases have not only provided tangible benefits in terms of access and rights but have also contributed to an overall reduction in the stigma associated with autism. While efforts to promote inclusiveness and raise awareness have been crucial in fostering a more accepting society, there is still much work to be done. Policies that ensure reasonable accommodations in various aspects of life, from education to employment, have played a significant role in normalizing the presence of individuals with autism in all areas of public life.
Advocacy Resources
For those seeking more information or assistance, numerous advocacy resources are available. Organizations such as the Autism Society of America, Autism Speaks, and local chapters of the ARC provide support, resources, and advocacy efforts to ensure the continued advancement of autism rights and services. These organizations work tirelessly to promote understanding, acceptance, and inclusion of individuals with autism and their families, ensuring that their voices are heard and their rights are protected.
Judith A. Lucas, MD, MJ, is a board-certified developmental-behavioral pediatrician at the Albany Medical Center in Albany, New York. She has a master’s in jurisprudence in Children’s Law and Policy. She provides developmental and behavioral healthcare for children with disabilities from infancy through young adulthood. For more information, email lucasJA@amc.edu.
References
“H.R.7213 – 118th Congress (2023-2024): Autism CARES Act of 2024.” Congress.gov, Library of Congress, 23 December 2024, https://www.congress.gov/bill/118th-congress/house-bill/7213.
29 U.S.C. § 794 of the Rehabilitation Act of 1973
Americans with Disabilities Act of 1990, 42 U.S.C. § 12101 et seq. (1990).
Barton, Erin E et al. “An Analysis of State Autism Educational Assessment Practices and Requirements.” Journal of autism and developmental disorders vol. 46,3 (2016): 737-48. doi:10.1007/s10803-015-2589-0
Board of Education of the Hendrick Hudson Central School District v. Rowley, 458 U.S. 176 (1982)
Endrew F. v. Douglas County School District RE–1, 580 U.S. ___ (2017)
Fair Housing Amendments Act, 42 U.S.C. §§ 3601-3619, 3631
https://iacc.hhs.gov/resources/transition/websites/
Olmstead v. L.C., 527 U.S. 581 (1999)
Pub. L. 93–112, 87 Stat. 355
U.S. Department of Education. (2004) Individuals with disabilities education act. Public Law 108-446. https://www.congress.gov/bill/108th-congress/house-bill/1350/text
Workforce Innovation and Opportunity Act, Pub. L. No. 113-128, 128 Stat. 1425 (2014).
