According to the Centers for Disease Control and Prevention (CDC), about 1 in 68 children were identified as having ASD in 2012 (about 1.5 percent of 8-year-olds). ASD is a complex developmental disorder with characteristics that can range from mild to more pronounced (see fig. 1). Each autism characteristic may vary in type and degree from person to person and can fluctuate over time. The combination of characteristics results in a highly individualized condition, as illustrated in figure 2. To successfully transition into adulthood, youth with ASD need to be able to access services that are individualized, timely, equitable, and community- and evidence-based, among other things, according to a roundtable panel we convened in 2016 to examine the needs of transitioning youth with ASD. The panel also identified 14 key services and supports that may help youth with ASD attain the goals of education, employment, health and safety, independent living, and community integration as they transition to adulthood (see table 1). Recent research analyzing the outcomes of youth with ASD suggests that they encounter obstacles to attaining their goals for adulthood. According to analysis of data from Education’s National Longitudinal Transition Study-2 (NLTS2), in 2009: 36 percent of young adults with ASD had attended some type of postsecondary education institution. Of those youth, 32 percent had attended a 4-year college; 70 percent had attended a 2-year college; and 33 percent had attended a vocational, business, or technical school. 19 percent of autistic adults in their early 20s had lived independently at some point, either with or without supports. Fourteen percent had lived in a supervised setting, such as a group home or medical facility, which may have provided services such as life skills education or vocational supports. The analysis further indicates that young adults with autism are less likely to live independently than youth with other disabilities, including intellectual disabilities and emotional disturbances. About one-third of young adults with autism did not participate in any community activities, and one-quarter had not had any contact with friends for at least a year. In elementary and secondary school, students with disabilities—including students with autism—are entitled to receive special education and related services through the Individuals with Disabilities Education Act (IDEA), which is overseen at the federal level by Education. Part B of IDEA requires states to make a free appropriate public education in the least restrictive environment available to eligible children with disabilities as a condition of grant eligibility. In general, under Part B, Education provides formula grants to assist states and school districts to pay the excess costs of providing special education and related services to eligible students with disabilities, including those with autism, beginning at age 3 and lasting through 21, depending on state law or practice. In general, school districts provide public school students with special education and related services—such as speech therapy, psychological services, and physical therapy—tailored to their needs based on an individualized education program (IEP). An IEP is a written statement developed by a team of school officials, parents, the student if appropriate, and at the discretion of the parent or school, other individuals who have knowledge or special expertise regarding the student. The IEP includes, among other information, a statement of the child’s present levels of academic achievement and functional performance, annual goals and a statement of the special education and related services and supplementary aid and services needed to attain those goals. Beginning no later than the first IEP to be in effect when the student turns age 16, or younger if determined appropriate be the IEP team, a student’s IEP must include postsecondary goals and the transition services needed to assist the student in reaching those goals. To the extent appropriate, and with the consent of the parents or student who has reached the age of majority under state law, schools must invite representatives from state vocational rehabilitation (VR) agencies to IEP team meetings where postsecondary goals and transition services will be discussed. These students remain eligible for transition planning and services, as well as other IDEA services, until they exit high school. Title I of the Rehabilitation Act of 1973 (Rehabilitation Act), as amended, contains new federal requirements in the state VR program, administered by Education, that require state VR agencies to provide pre-employment transition services to students with disabilities who are eligible or potentially eligible for VR services. State agencies may also provide transition services to groups of students and youth with disabilities prior to or after applying for VR services. Finally, VR agencies may provide individualized VR services including individualized transition services, to students and youth with disabilities who have been determined eligible for VR services under an approved individualized plan for employment under the VR program. Students may apply for and be determined eligible for VR services prior to graduating from high school, and youth may apply for and be determined eligible for VR series prior to reaching adulthood. Generally, as they enter adulthood, youth and young adults with ASD may seek to obtain needed services from the state adult service systems, which are funded by multiple federal agencies: HHS’s Centers for Medicare & Medicaid Services (CMS) oversees Medicaid, which can be used to fund long-term and home- and community-based services. These services are generally administered to eligible individuals with ASD through state agencies serving individuals with developmental disabilities or disabilities more broadly. Education’s Rehabilitation Services Administration, within the Office of Special Education and Rehabilitative Services, funds the VR State Grants program to assist individuals with disabilities including transition-age students and youth with ASD in developing the skills to prepare for, secure, retain, advance in, and regain employment. This program is in the form of federal/state matching grants provided to state VR agencies. SSA provides cash benefits to qualifying individuals through the agency’s Supplemental Security Income (SSI) and Disability Insurance (DI) programs. Individuals can apply for benefits through SSA field offices. DOL provides funding for employment and training for a broad array of individuals with barriers to employment, including youth and those with disabilities, often through the One-Stop delivery system. HUD provides funds for rental assistance for low-income individuals with disabilities through various programs, offers online tools to assist with locating housing resources, and funds Housing Counseling Agencies that assist families and individuals seeking affordable housing. The Autism Collaboration, Accountability, Research, Education, and Support Act of 2014 (Autism CARES Act) reauthorized the Interagency Autism Coordinating Committee, which is led by HHS and composed of representatives from multiple HHS subagencies, Education, the Department of Defense (DOD), and the Environmental Protection Agency (EPA), as well as certain non-federal stakeholders. Among other things, the IACC is responsible for developing and annually updating a strategic plan with budgetary recommendations for ASD research. The 2013 strategic plan (the most recent plan), is divided into seven general topic areas that were created to address critical gaps and opportunities. Each general topic area includes specific objectives and a recommended budget for associated research-related activities. The 2014 reauthorization expanded the scope of the strategic plan to include, as practicable, services and supports. The strategic plan is intended to promote public-private coordination and community engagement and to accelerate research and service efforts to improve the health and well- being of individuals with ASD. The IACC is also responsible for monitoring ASD research across federal agencies, and the 2014 reauthorization also expanded this monitoring role to include, as practicable, monitoring of services and support activities. In the past, the IACC has fulfilled the responsibility for monitoring research by tracking and compiling information on ongoing research in the field. The Autism CARES Act led to the creation of the role of the Autism Coordinator within HHS, separately but in coordination with the IACC, to oversee and implement federal ASD activities nationwide, taking into account the strategic plan developed by the IACC, and ensure that federal ASD activities are not unnecessarily duplicative. We have conducted previous work on IACC’s federal autism activities. In 2013 we reported that the IACC’s and federal agencies’ efforts to coordinate and monitor federal autism activities were limited. Specifically, IACC members provided mixed views on the usefulness of the IACC’s meetings, strategic plan, and portfolio analysis in aiding coordination and monitoring activities, and only some agencies regularly used the committee’s strategic plan and research funding analysis. Additionally, we found that shortcomings in the data the IACC used for its research funding analysis limited its ability to coordinate HHS autism activities and monitor federal autism activities. We found that, collectively, these weaknesses limited the IACC’s ability to monitor its progress. For a complete list of our previous work in this area, see the Related GAO Products page at the end of this report. Based on the results of our nationally generalizable school district survey, we estimate that in school year 2015-16 most school districts (about 85 percent) provided transition-age students with ASD instruction on life and social skills, as well as behavioral skills (see fig. 3), services we previously reported such youth may need to support their transition to adulthood. Self-advocacy (87 percent), social (86 percent), and organizational (86 percent) skills were provided by the most districts, according to our survey. Schools may employ different strategies for providing these services based on individual student needs. For instance, officials we interviewed in one district said that for many students with occasional behavior issues, staff teach students how to cope with and have control over their emotions. However, if a student needs intensive behavioral supports, the district may send the student to a nonpublic school that specializes in serving youth with ASD. The officials noted that it is difficult to find teachers who understand how to support students with intense behavior issues. Fewer, though still a majority of, school districts reported providing certain types of services to support the transition to employment, according to our survey. Specifically, while an estimated 85 percent of districts reported providing career counseling, we estimate that 74 percent provided interview skills, 69 percent provided work experiences, and 63 percent provided job coaching.