The data’s uncomfortable. Ignoring it would be worse.

It’s easy to dismiss stories suggesting NDIS incentives may be inflating autism diagnoses. They feel like attacks: on children, on families, and on neurodiversity itself. Sometimes, however, the evidence makes you uncomfortable for a reason.

Professor Robert Breunig is no partisan warrior. He’s an economist, the director of the Tax and Transfer Policy Institute at ANU, and someone who follows data wherever it leads. What he and Sir Roland Wilson Scholar Maathu Ranjan found earlier this year was simple, precise, and difficult.

Using linked national datasets and exploiting the staggered rollout of the NDIS, the researchers compared autism diagnosis rates across otherwise similar areas. The result: “The NDIS has accounted for nearly half of new autism diagnoses in Australia since 2013,” Breunig writes.

This isn’t about blame, it’s about system design.

Breunig notes that diagnosis patterns changed as the NDIS expanded. Paediatricians and psychiatrists now do fewer assessments. Instead, in some cases service providers both diagnose and deliver supports, creating a system where “those who benefit from providing a service also decide whether the service is necessary.”

That’s not a slur: Breunig says it’s a structural flaw. But, as Health Minister Mark Butler says, “Even at a growth rate of 8 per cent, the NDIS would still be unsustainable.”

So how do we protect children, support families, and save the scheme?

Read the full story online for what’s really driving the surge in diagnoses and why Breunig says the government’s ‘Thriving Kids’ approach is a better way forward.

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How Incentives Shape Diagnosis, and What Comes Next

Breunig’s research dismantles two common myths.

First, no, the growth in autism diagnoses isn’t mainly due to kids being assessed younger. And second, no, there’s no strong link between household income and diagnosis. Autism supports are being accessed broadly, not just by the wealthy or “NDIS savvy.”

But one factor does stand out: incentives.

A Level 2 autism diagnosis opens the door to tens of thousands of dollars in annual support. A Level 1 diagnosis offers no NDIS access at all. That’s a huge difference. And as Breunig notes, it puts real pressure on professionals: “to diagnose in the immediate best interests of patients without considering their long-term needs or the long-term financial implications on the sustainability of the NDIS.”

In that context, the government’s move to shift children off the NDIS and into the new ‘Thriving Kids’ scheme is no surprise. The current model—the medicalised, diagnosis-first approach—was never built for volume. It can’t deliver scalable, community-based early intervention at a national scale.

Instead, Breunig argues, Australia must:

This is no small shift, nevertheless he says it’s necessary. Not just for the budget, but for the children themselves. “Individualised funding is too expensive a model for the whole population with disability,” Breunig writes. Letting it continue unchecked risks collapse.

The good news? There’s a path forward. But it means replacing lifetime entitlement with timely intervention and trusting that we can design a system that works better for everyone, not just those who get through the right diagnostic gate.