While the Department of Health says it is "not aware of any evidence of any major shifts in prevalence of autism in Australia" it is now the biggest primary disability in the National Disability Insurance Scheme trial, even though the National Disability Insurance Agency's eligibility criteria for ASD are gobbledygook. Apparently, the NDIA expected much smaller numbers than have been observed, although estimated numbers for the government's previous Helping Children with Autism package had been surprisingly accurate. Relatively little is known about the economic cost of autism in Australia. A report in 2011 estimated conservatively that autism in Australia costs at least $8.1 billion a year. A more recent rough estimate suggests autism costs the Australian budget at least $20 billion a year. Research says a child with ASD means an average $35,000 a year decrease in family income, due to the at-home care such a child will require from family. Policy could also move to workplace inclusion. While a valid ASD diagnosis recognises support needs, the community must also recognise that every person with ASD has valuable (and mostly underused) skills and abilities. With the right support and accommodations, all autistic people can contribute substantial value to their community and to the economy. For example, The Dandelion Project is part of an international effort to create 1 million jobs for people with ASD in the IT sector. As things stand, education, employment and accommodation outcomes for autistic people are abysmal. Australia has shocking poverty of people with disability; with poor education and employment outcomes, it's very likely that autistic people are represented strongly in these statistics. Even with the coming NDIS, limited access to professional behaviour supports for autistic people remains a major service deficit. People cannot access services that do not yet exist.

In the education sector, governments and education administrations expect/require teachers with little or no clinical/professional training in behaviour management to develop and deliver clinical-level behaviour management plans for autistic students who have already progressed to having severe or profound behavioural challenges. Typically, teachers are trained to not access other professional services. Teachers are expected to be self-sufficient and to rule their classroom. Teachers are not advised/taught that trying to deliver clinical (or disability) services that they are untrained in is seriously unprofessional conduct. For example, they are not expected to do surgery or dentistry, so why does their employer expect them to manage clinical-level behavioural issues? Without the necessary behaviour supports, the system often fails autistic people. Bad outcomes are unnecessary and can always be avoided. Australia's Department of Social Services documents that behavioural methods are the only evidence-based early intervention for autism that it rates as "based on established research evidence", but then both DSS and the NDIS mostly fund multi and trans-disciplinary teams that do not even include/involve a behavioural clinician. Few autistic students have professionally supervised behaviour management plans. Service providers in the post-school sector often cannot offer service for many autistic people with severe or profound disability because their service cannot deliver appropriate behaviour management. Mostly, people with ASD don't have professional behaviour support because Australians have little regard for behaviour science. For example, in 2010, the ACT government said "We do not actually use the ABA [applied behaviour analysis] intervention method".

There are risks with any clinical practice. Behaviour science is no exception. People who have experienced or seen poor/bad and/or unethical practices done in the name of behaviour management are right to be wary. Their concerns must be respected. The best protections against wrongdoing are strong regulation, professional training, independent performance monitoring and review, and an active and engaged community of practice. For decades the Australian Psychological Society has failed to recognise and administer behaviour science practice locally. Federal, state and territory governments should, as a priority, adopt and promote registration and training through the international behaviour analyst certification board. Australia has to catch up; it has no universities offering this training while our smaller neighbour, New Zealand, has two. There are thousands of international positions advertised, but none in Australia. Policies, effort and resources are needed to establish and promote the strong sector and community of practice required to address the behavioural needs of autistic Australians and to improve outcomes for autistic people and others who need behavioural supports at a clinical level. Bob Buckley, a father of two including an autistic son, is convener of Autism Aspergers Advocacy Australia (A4) and chairman of Speaking Out for Autism Spectrum Disorder.

This piece was also published by Policy Forum.net, the website of the Asia and the Pacific Policy Society based at ANU Crawford School.