Who Owns Autism? Economics, Fetishism, and Stakeholders

Abstract

This chapter outlines the growth of the value of the autism diagnosis in the U.S. from an economic and comparative perspective. The existing international literature on the economics of autism almost exclusively concerns medical and therapeutic costs, estimates of loss of productivity of caregivers, supported employment, and residential care, rather than the dynamic construction of value. In contrast, this chapter focuses on how the economics of autism are linked to the changing concept of autism. The chapter illustrates how the economics of autism goes beyond dollars and their flows to the analysis of how financial interests help constitute not just costs but forms of knowledge. Topics covered include: the rise of therapeutic specializations, the survival of which requires a steady stream of new autism diagnoses; special education litigation, which disproportionately involves cases of autism; and the role of family wealth in diagnosis. These topics help to demonstrate that the concept of autism, as way of organizing a wide-ranging spectrum of individual skills and challenges, has taken on an unanticipated and often masked economic power. The final section of the chapter theorizes autism as a new sacred object, fetishized in the interests of an emerging “autism industrial complex.”