The number of Israeli children eligible for disability benefits tied to autism diagnoses has jumped fivefold over the past decade, from 10,000 to more than 60,000, and Israel's health, finance, and welfare ministries are now weighing a fundamental change to how those diagnoses translate into government support, according to a report by Ynet.
The controversy burst into public view after Tzvika Cohen, acting director-general of Israel's National Insurance Institute, made remarks at a professional conference held by the Brookdale Institute roughly two weeks ago. Cohen described people writing online that they had achieved an "exit" or had "scammed" the National Insurance Institute after their child was recognized with autism, comments that were later published on the website Shavim and by Ynet and sparked significant backlash. The National Insurance Institute said in response that Cohen's remarks were taken out of context, and that his actual point was about the broader rise in benefit payments as an integral part of the growing need among children and their families for support.
Behind Cohen's comment lies a much larger structural story. The number of children diagnosed on the autism spectrum in Israel has been climbing rapidly, far outpacing population growth. In recent years the number of diagnosed children rose more than 30 percent, from 50,000 in 2021 to 68,000 in 2023, the most recent year for which full data has been published. As a share of the population, that means the diagnosed rate rose from 0.5 percent of all Israelis to 0.7 percent. Since most of those diagnosed are children, the rate is far higher among younger age groups, with 2 percent of all Israeli children now diagnosed on the spectrum, and the rate approaching 3 percent among the youngest children.
That numerical growth has translated into an enormous expansion in the support systems required to serve them. An autism diagnosis in Israel entitles a family to a disabled child benefit at the full 100 percent rate, currently 3,820 shekels per month. National Insurance Institute data shows the number of children receiving that benefit due to an autism diagnosis grew fivefold over a decade, from 10,000 to 50,000, and a report published this year by the OECD indicates that growth has continued since, with the number of children eligible for the benefit having since crossed 60,000.
The strain isn't limited to benefit payments. Children diagnosed on the spectrum are entitled to three paramedical treatments through Israel's health maintenance organizations, though parents often struggle to actually access them given a severe shortage of therapists in the public system. In the education system, a diagnosis opens the door to special education frameworks and in-school treatment, and the number of special education students has jumped by tens of percentage points in recent years, driving a matching need for more teachers, preschool teachers, and therapists that the system has likewise struggled to meet. In both cases, the entitlement often remains only a recommendation on paper due to staffing shortages.
Israel is not alone in seeing this surge. The OECD report examined the trend across multiple countries and found that while Israel's recent growth rate is unusual, diagnosis rates are climbing quickly worldwide, and Israel's overall share of diagnosed children, 1.8 percent, is not high relative to other countries.
The report points to several possible explanations for the broader rise: greater awareness leading previously undiagnosed populations, including women and girls, to seek evaluation; reduced stigma; and diagnosis at younger ages than in the past. Professionals in the field point to 2013 as a turning point, when the American Psychiatric Association's DSM diagnostic manual broadened the criteria defining an autism spectrum diagnosis, bringing higher-functioning individuals who previously would not have qualified under the definition.
Israeli officials are now asking whether that expansion can be partially rolled back. Israel, along with Australia, is unusual in offering its citizens, children in particular, the same basket of supports regardless of functional level once a diagnosis is made. In most countries, the scope and type of support is instead determined by functional level. A committee has been working within the Ministry of Health over the past year examining exactly this question, and a draft report is expected to be published for public comment in the coming months. Conversations with professionals invited into the committee's discussions suggest its direction: replacing the current binary, uniform diagnosis, on the spectrum or not, with a graduated scale based on a child's functional level. The tool would first be implemented within the health system, but could eventually affect education and the National Insurance Institute as well.
Parents and advocacy organizations are watching the committee's work with concern. Attorney Rotem Eisik, who heads the rights promotion and government relations division at Alut, Israel's national autism society, argues that before any conversation about benefits, the health and education systems need to expand their workforce so every diagnosed child can actually receive the treatments they're entitled to. Many families, she said, are currently forced to pay for these services out of pocket, using the National Insurance benefit to help cover the cost.
"First the public system needs to be rehabilitated, and only then can we perhaps begin examining what to do regarding the benefits," Eisik said. Alut is also concerned about a scenario in which, following the committee's conclusions, a mechanism emerges recommending reduced support for higher-functioning children. "The fact that a child is verbal, or that his difficulties are less visible, doesn't mean he doesn't have complex needs in other areas," Eisik added.
She said she hopes any changes result in lower-functioning children receiving a broader basket of support rather than the reverse. "I understand the direction that says there are more diagnosed children, the budget is rising, and there needs to be an understanding of how to become more efficient," she said. "The real efficiency is knowing how to provide support at younger ages, so children can integrate into society in the future."
