If you're autistic, once you hit 18 you are tossed out with the trash

Obviously bad physical health can frustrate and depress, but it only changes reality, and does not directly change our perception of it.

Or worse yet, go undetected.

I was out of college before I realized I had been pushing upstream for my entire school career. My partner had gotten identified and gotten help, it wasn't easy but much easier.

I had always tested very highly on standardized tests but was a horrible student. My mom would tie me to chairs, my teachers would verbally abuse me, all of it. Not to mention the social issues I had.

It's a relief to know now, but it leaves me wondering how differently my life would've turned out had someone thought to test and accommodate. Even now I am just kind of not really sure what to do with the knowledge, beyond not guilt-tripping myself for being more "normal".

Other forms of preparation for life: social skills; financial skills; political engagement; health, are rarely prioritised.

Giving autistic children help with academic learning and disruptive behaviour is conventional, as it is for all students (albeit with special measures and allowances made). Other life skills are neglected, as they are for all students.

What is today's social contract?

I really have no idea.

There are always gaps in the system. No matter what your issue, and no matter what the system.

That being said, once you're identified and diagnosed in the US, insurance is required to cover behavior analysis services until later than 18. But I'm not aware of any systemic services once you're in your late 20's, unless you're on the severe end of the spectrum.

The goal of those services isn't to "fix" or "cure" anything, as there's not a known fix or cure. Their goal is to help you with your goals. Often these include social interactions with peers to try to help you lead a life integrated with the rest of society. Sometimes it's academic (the goal is usually to have the students included in a general-education class).

But the real issue is the lack of available care. It's generally a very difficult field to work in, and there aren't enough providers by a long shot. The fact that insurance covers treatment helps, but it also creates a ton of demand. Clients who are younger than school-age can generally find services quickly and easily. But clients that attend school can see waiting lists for over a year in major metropolitan areas.

And it's difficult to attract people to the field. This is where insurance is a double-edged sword. By accepting insurance you have a large number of potential clients, but the rates that insurance pays are so low that it's difficult to attract quality staff. Think on the order of $15 / hr for the primary employees that the client will interact with. And it's not an easy job. My spouse ended up with major surgery that was likely the result of a client who grabbed my spouse by the hair and threw my spouse to the ground. It's hard to attract quality staff who will take that kind of risk for that kind of pay.

My spouse routinely hires high-school graduates and pays for training in the field, because it's the only way to fill those roles. Only to see the staff member leave after 3 months for another agency where they can get $2/hr more because they're already "experienced".