Published in the July 2026 issue of the ISHA Voice
By Megan Roberts
What is wrong with the current system? Today, an autism diagnosis within Early Intervention (EI) requires a physician — typically a Developmental Behavioral Pediatrician (DBP). In practice, diagnostic teams already include DTs, OTs, SLPs, and sometimes PTs, because we know that multidisciplinary evaluations best serve children and families. However, under current private insurance and Medicaid law, only a physician or clinical psychologist (in the EI context, a DBP) can diagnose autism. The problem: there are only 23 DBPs in the entire state, 19 of whom are in Cook County — creating significant waitlists across Illinois.
What does this new law do? This law allows a trained SLP to serve as the diagnosing clinician on the team for a subset of children — specifically those without co-occurring medical conditions. This does not change the team-based approach. It simply means that EI teams could provide an autism diagnosis without a DBP for some children, and that Medicaid and private insurance would recognize that diagnosis. In order to do this, three changes needed to occur:
- The SLP Practice Act — to specify the conditions under which SLPs may diagnose autism (within the EI system only, for children without co-occurring medical conditions, and only with proper training) - this matches what the study found.
- Medicaid law — to ensure the autism diagnosis by an SLP is recognized by Medicaid.
- Private health insurance law — to ensure the autism diagnosis by an SLP is recognized by private insurers.
Why did we focus on SLPs? We focused on SLPs for three reasons: (a) Autism diagnosis is already within the national scope of practice for SLPs, (b) SLPs already diagnose other neurodevelopmental disorders listed in the DSM-5 (e.g., language disorders) and (c) SLPs are licensed clinicians.
How do you know EI teams without a pediatrician will be accurate? This proposal is grounded in the RTW study, in which EI teams diagnosed 639 children with 93% accuracy. We are confident that EI teams — with appropriate training — are skilled enough to diagnose autism in certain circumstances, with the SLP serving as the diagnosing clinician.
What are the next steps? This law does not take effect until January 1, 2028, giving us ample time to work collaboratively with EI administrators, EI providers, DBPs and other EI advocates to get the implementation right. We are committed to ensuring families receive high-quality, team-based evaluations.
What kind of training will be needed? We still need to work through many of the details within the EI system, but the training created as part of the research study will be free and available to anyone interested.
How do I get updates on this process? We will post updates on our progress on our IG and Facebook pages (ei.northwestern) but you can always email me (megan.y.roberts@northwestern.edu.)