“The Autism Act 2009 was a milestone, but it has not led to the kind of meaningful, lived change that autistic adults need. The challenges we face are structural, systemic, and worsening in the face of benefit reform and austerity.”

(House of Lords Select Committee on the Autism Act 2009, 2025: pp 37)

The quote above comes from the new “Time to deliver: The Autism Act 2009 and the new autism strategy” put together by the House of Lords Select Committee on the Autism Act 2009. Unlike the painfully short Autism Act of 2009 this is a 252 page long document detailing the successes and the failures of the Autism Act and the following Autism Strategy Documents. I have gone through all 252 pages so you don’t have to.

So first off a debt of thanks to those who pushed for the consultation to be more accessible to the more marginalised members of the community. Because of the drive to hear a wide range of voices the work contains a broader understanding of Autism and current issues facing Autistic people. A core take home message of the report is the need for Autistic-led knowledge production and practice guidelines - the Autistic voice must not just be heard but must be leading at every stage and every level.  

The report, from a deficit and medical model standpoint, is a huge leap forward in parliamentary terms from the previous reviews and strategies coming from the Autism Act. It is worth noting when I read the “National strategy for Autistic children, young people and adults: 2021 to 2026”, I nearly threw my laptop across the room in disgust. Whilst there is still discussion of the medical model, this newer work strives to have a Neurodivergent Paradigm and Social Model of Disability focus. From a cultural point of view it is an important shift. This work is in many respects as scathing as you can get of the current situation whilst working within the confines of parliamentary niceties. 

So to get to the contents of the report. 

From an NHS and diagnostic point of view, there has been notable and quantifiable change since 2009. The Autism Act 2009 and the following strategies have led to structural shifts in services offered to support adult diagnosis. We now see adult pathways with people leading on ensuring these services are available and up to date. Which is better than nothing, but the report states repeatedly that there are extreme delays in the diagnosis process and accessing services. The feedback regarding the assessment pathway in the report states clearly it is not fit for purpose. Disparities in diagnosis can also be seen across genders and ethnic backgrounds - we are still recovering from “extreme male brain” discourse.    

Where healthcare in general is concerned good practice does exist, but it is patchy and few and far between. Under the current system support only becomes available at crisis points and, in the rare cases support has been available earlier, budget cuts threaten to remove it.  Both mental and physical health of Autistic people is often misinterpreted, overlooked or downplayed. For some, particularly members of our community with a Learning Disability, our pain is viewed as a behavioural issue with chemical and physical restraint used rather than further investigations. We know the healthcare system is stretched to its limit and people fall through the cracks. Better training is needed, less siloing of Autism into its own little box and more holistic care and increased funding. 

On the topic of funding, money is another big issue in the report - from the direct impact of decades of austerity and welfare cuts on Autistic people’s lives, to the constant bickering over whose budget support should come from. Too often support comes down to little spinning pound signs; it is great that it is discussed in detail but this will not change until the government, regardless of which tie colour they have, puts concerted effort into funding support across departments (Autism in an NHS silo anyone?). 

Little surprise to anyone who is Autistic but spikey profiles mean that many environments are sensory hell. Moreover many places do not consider Autism or Neurodivergent people in their set up (the report mentions the “Design for the Mind. Neurodiversity & the Built Environment - PAS 6463” so I know I didn’t dream it). This is compounded by some other people’s reactions and prejudices - though not everyone’s and good communication can go a long way to supporting people. 

This leads me nicely on to the fact that awareness does not equal guaranteed acceptance. Now my own personal issues with the concept of acceptance aside, there is some good stuff here. The issues surrounding “Superpowers” discourse and the disconnect between the general population’s understanding of being Autistic and the lived experience of Autism is important to raise. Once again we see the stereotypes of the white, cis male genius looming over the societal understanding of Autism. If you don’t fit this box, good luck with mainstream acceptance is the take home from a wide range of organisations and marginalised voices. While we are talking about stereotypes and stigma, the discourse around Autism for political clout is causing real and serious risk to the Autistic community.    

Next up, education and transition to adulthood. We are seeing children struggling and autistic traits being punished through Neuronormative codes of conduct rules. Children are segregated and secluded from mainstream schools. Again Autistic people, remember we are talking about literal children, are pushed to crisis and punished for it. Where support is sought, reasonable adjustments are misunderstood, withheld and gatekept. When it comes to going to university the removal of EHC (Education, Health and Care) plans at the point of entry into higher education is mentioned as a barrier and point where meaningful support collapses (thank you Children and Families Act 2014 for putting this stigmatising wall up). It is the same story we have seen across the report - support is patchy, good practice is a luxury not a matter of course. Autistic children become pawns in the education system and for those who make it to further and higher education the barriers get larger and the support dwindles. 

Onward to employment, and whilst there are the odd pockets of good practice, I cannot say I had high hopes for their findings. Yep there it is at the start of the section - 3 in 10 Autistic people are employed. Now do I believe everyone can undertake paid work in the system we are currently in - no. Do I think that people have value beyond human capital - very much so. We do however need to talk about the barriers stopping Autistic people who can and do want to work from entering and staying in paid work. It is worth looking at the stats that say 12% of all Autistic university graduates are unemployed compared to 5% of graduates with no known disability or Neurodivergence. Anecdotally a family member is about to submit her 1000th job application, for many of us these are not just fun little statistics. 

So what is the barrier?

 Employers’ stigma, concern of the cost of Neurodivergent employees, a work culture that would not work with an Autistic member of staff. Whilst it will be of no surprise to some of you that the job centre is inaccessible and fraught with problems this further compounds the aforementioned issues. Access to Work gets a mention, I will say that the contents of that mention is that it is not fit for purpose and functionally useless, but a mention is a mention.   

For those of you who still want to apply for something, psychometric tests disadvantage Autistic people (I won’t name and shame the organisation that ripped their questions from the Autism Quotient). AI systems don’t favour Neurodivergent candidates, and if you do get to interview Neuronornative social demands are likely to take you out of the running. It is all a bit bleak isn’t it, and if by some miracle you overcome those hurdles staying in work becomes a minefield.     

The report moves to the criminal justice system. Now by now you’ll have probably noticed my sarcasm surrounding the lack of support, you will not see it here; the criminal justice system is failing Autistic and other Neurodivergent people with life changing consequences. Autistic people are more likely to be victims of crime and statistics into Autistic perpetrators of crime is inconsistent. Whilst there are moves within prisons to support Autistic prisoners there is a long road before prison that is fraught with misunderstanding and risk. 

The report does attempt to shine a light on good practice. It is not that good practice doesn’t exist but it is lost in unjoined up, disparate and often luck of the draw services. Time and time again where things are going well and supporting the Autistic community it is through determined actions of individuals working in a failing system. Good practice becomes a battle against reforms and austerity measures rather than a necessity for the Autistic community.          

The Time to Deliver report is important, if only to state clearly, and as concisely as 252 pages can be, what many of us already know. The system is not working for Autistic people. Whilst there are positive recommendations and a welcome shift to a difference rather than deficit model, much of what is said is not new. As the quote at the beginning states the Autism Act 2009 was a milestone but without direct legally binding action we risk just continuing the status quo. With a new strategy due in 2026, the Autistic community will have to wait until next year to find out if it really is Time to Deliver.