On Monday, September 22, 2025, the U.S. Department of Health and Human Services issued a press release announcing “bold new actions to confront the nation’s autism spectrum disorder (ASD) epidemic”. The release, along with the attached fact sheet, reported that ASD rates have surged 400% since 2000, with 1 in 31 American children now affected. It also highlighted several possible contributing factors, including cerebral folate deficiency, and announced a new $50 million funding initiative to support autism research.

In Australia, the most recent government report on autism was published in 2022. Findings showed a 41.8% increase between 2018 and 2022, with roughly 1 in 33 Australians under the age of 25 living with ASD (1.1% for all ages). This is a substantial increase from the prevalence of Autism in children aged 0–15 in the late 90s of 0.489%. This figure is even higher for children, as 4.3% of 5–14-year-olds have been diagnosed with autism. Strikingly, almost three quarters of those with ASD (73%) had a “profound or severe disability”.

Given these trends, it is encouraging to see increased U.S. investment in understanding autism, its contributing factors, and underlying causes. Hopefully, this U.S. investment in research will inspire the Australian government to devote more resources toward the understanding and prevention of autism, in order to minimize societal and economic impact.

Toby Rogers, PhD at the September 9th Permanent Subcommittee on Investigations Hearing

Autism spectrum disorder (ASD) has been the subject of extensive research, particularly as prevalence rates continue to rise. Just this month, Economist Toby Rogers PhD submitted a written statement to, and spoke before, the Permanent Subcommittee on Investigations (U.S), detailing his findings from this paper. Rogers first delved into the subject while completing his PhD thesis at The University of Sydney with the title “The Political Economy of Autism”.

His testimony highlighted several alarming facts including that the prevalence of autism has risen from 1 in 10,000 from the 1970s to 1 in 31 today—a 32,158% increase in the last 52 years. Rogers also noted that the search for “the gene for autism” has consumed over $2.3 billion, yet results have been limited. He explained that “[c]laims that autism is genetic don’t make sense because autism prevalence was rising too fast — there’s no such thing as a genetic epidemic.”

In his statement, Rogers cited a key study by Ozonoff et al. (2018) showing that up to 88% of autism cases involve autistic regression—where a child loses previously acquired skills—suggesting an acute environmental trigger. He emphasized the need for vaccinated versus unvaccinated studies, referencing research indicating higher autism risk associated with early vaccination. Drawing on his review of over 1,000 studies, Rogers concluded that toxic exposures are major contributors to rising autism and chronic disease rates, urging immediate action to reduce these hazards.

Autism Tsunami: The Impact of Rising Prevalence on the Societal Cost of Autism in the United States

The paper, on which much of his testimony was based—Autism Tsunami: The Impact of Rising Prevalence on the Societal Cost of Autism in the United States—co-authored by Rogers, Mark Blaxhill and Cynthia Nevison, highlights the alarming and unprecedented levels of ASD in the U.S. and, using modeling tools, forecasts the societal costs this wave of chronic illness is likely to pose.

It projects a significant increase in both the prevalence of autism and the associated societal costs, with far-reaching implications for individuals, families, and governments. The paper provides a stark analysis of the future financial burden autism is expected to impose on the United States.

One of the key implications of this research is the projected shift in financial responsibility. The costs associated with caring for an individual with autism throughout their entire life is roughly $7.2 million per individual—an amount currently shouldered primarily by families but expected, as aging parents pass on, to shift largely to the government. Hundreds of billions of dollars currently paid by parents for costs associated with caring for an individual with autism will soon shift from the household to the government, a cost that is projected to be greatly higher considering the growing number of people with autism. We will soon be facing, as Rogers puts it, a “fiscal cliff”.

Projecting the Costs of Autism Through 2060

The study begins by examining historical data on autism prevalence and using it to forecast future trends. The authors estimate that the prevalence of ASD will continue to rise sharply, potentially exceeding 7% in children by 2032. This is a dramatic increase from current levels, which are already considered high. The study uses a comprehensive model that factors in historical trends, costs per individual across multiple age groups, and inflation projections to estimate the total annual cost of autism in the U.S. up to 2060.

According to the study’s projections, the annual costs associated with autism in the U.S. will escalate from the current $238 billion to $589 billion by 2030, $1.36 trillion by 2040, and an astonishing $5.54 trillion by 2060. These figures represent a “tsunami” of expenses that will impact all levels of society.

Noteworthy Findings and Implications

One of the study’s key contributions is its dynamic model, which contrasts with previous static models that assumed linear increases in autism prevalence and costs. The fluid nature of the model allows for a more realistic projection of how rising autism rates will continue to drive up costs over time. This approach underscores the urgency of addressing the autism epidemic, not only from a health perspective but also from an economic one.

Another significant finding is the projected shift in financial responsibility. Currently, much of the cost associated with caring for individuals with autism falls on parents and local school systems. However, as the study points out, by around 2040, these costs will increasingly be borne by federal and state governments (especially housing costs which are among the highest) as the first generation of the autism epidemic ages and their parents pass away.

This shift poses a major challenge for public policy and fiscal planning, as governments will need to find new sources of revenue to cover these escalating costs.

The study also highlights the importance of prevention as a cost-saving measure. Given the projected financial burden, the authors argue that more attention should be paid to identifying and mitigating the environmental factors that contribute to the rising prevalence of autism. This could potentially slow or reverse the trend, thereby reducing the long-term economic impact.

Mitigating Environmental Factors

However, as the authors discuss in the paper, the effects of this crisis can be tempered “via identifying and better regulating environmental factors that increase autism risk.”

Although autism is popularly understood to be largely genetic, evidence suggests otherwise. Genetic mutations account for less than 1% of all children with autism. Research indicates that while over 1,000 genes have been reported in association with ASD, many of these links remain unconfirmed. Most common gene variations only slightly affect risk, and not all individuals with these variations develop ASD.

By contrast, environmental factors have been shown to play a significant role. Maternal chemical and drug intolerances have been identified as potential risk factors for both autism and ADHD. More recently, a 2024 study suggested that exposures to toxicants such as heavy metals, organophosphate pesticides, and tobacco smoke may stimulate epigenetic changes in gene expression.

These findings highlight that autism is not an inevitable genetic outcome but one that can be influenced by environmental conditions. This creates a critical opportunity: by addressing modifiable environmental risk factors, we not only improve public health but also reduce the projected long-term societal and financial burdens outlined in the
Autism Tsunami paper.

A Call to Action

The findings of this study are a wake-up call for policymakers, healthcare providers, and society at large. The authors stress the need for governments to start planning now for the impending financial crisis that will result from the continued rise in autism prevalence. This includes not only securing the necessary funding but also implementing strategies to prevent new cases of autism and better support those who are already affected.

Overall, the study provides a sobering look at the future of autism in the U.S. The projected increase in both prevalence and costs demands immediate attention and action from all levels of society.

Hopefully the Australian Government will follow suit and invest in understanding the causes and solutions to the surge in Autism. Without proactive measures, the financial burden of autism could become unsustainable, leading to severe economic and social consequences.

Functional Practitioners Address Environmental Causes

A well-trained functional medicine practitioner will take a comprehensive history to identify potential environmental factors (toxins, infections, nutritional deficiencies, stress) and follow with lab testing to determine and address root causes. This personalised and precise approach to healthcare offers much hope for effective treatment and prevention of environmentally-driven health conditions such as autism.

*Background and Controversy

The paper was first published in July of 2021 in the Journal of Autism and Developmental Disorders and was among the top 1% of most downloaded articles on the site and top 10 most downloaded papers in history for the University of Sydney. In June of 2023, it was retracted and later republished in Science, Public Health Policy and The Law.