Illinois has become the first state in the nation to let trained speech-language pathologists diagnose autism spectrum disorder in toddlers, a change lawmakers say could shrink evaluation waits that currently stretch as long as two years down to roughly one month. Gov. JB Pritzker signed House Bill 5225, now Public Act 104-0561, in early July, opening a new diagnostic path for children under age three enrolled in Illinois Early Intervention. The law grew directly out of a Northwestern University study that tracked hundreds of toddlers across the state.
As WBEZ Chicago reports, Illinois has long relied on just two categories of experts to diagnose autism — psychologists and developmental physicians — and openings with both have been scarce. According to reporting from Evanston Wire, the state had only 23 developmental behavioral pediatricians as of 2025 to handle specialized evaluations, compared with more than 4,000 speech-language pathologists already working inside the state's Early Intervention system. That imbalance has been the central bottleneck driving multi-year waitlists for families statewide.
The Northwestern Study Behind the Law
The legislation traces back to Northwestern's “Reduce the Wait” study, which enrolled and evaluated 639 toddlers between the ages of 16 and 36 months across Illinois from November 2022 through February 2025, with boys making up 70% of participants. The four-year effort was led by Megan Roberts, a professor in Northwestern's Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, per the same account. Roberts and her research team set out to test whether early intervention clinicians could diagnose autism as reliably as specialized medical teams working in community settings.
The results were striking enough to move legislators. Trained speech-language pathologists in the study agreed with expert multidisciplinary diagnostic teams 93% of the time, a rate the article notes compares favorably to a separate study in which general pediatricians matched expert diagnoses in just 82% of cases. Families who went through trained early intervention providers waited an average of one month for an evaluation, versus roughly 15 months through traditional diagnostic channels — a gap the research ties to Illinois's severe shortage of specialists able to conduct the evaluations.
What the New Law Actually Allows
Public Act 104-0561 permits speech-language pathologists trained in autism diagnosis to evaluate children under three who are already enrolled in Illinois Early Intervention, according to the Illinois Speech-Language Pathology and Audiology Practice Act's updated provisions. That authority is deliberately narrow: children with co-occurring medical conditions such as seizures, gastrointestinal problems, or sleep disorders must still be referred to physicians or clinical psychologists, per the Illinois House Democratic Caucus. To perform these evaluations, speech-language pathologists must complete specialized training in age-appropriate diagnostic methods and certify at least 5 hours of continuing education in autism evaluation methods with every license renewal, according to the Illinois Speech-Language-Hearing Association.
The law also tackles the cost side of the equation. Provisions in the act require both private health insurance plans and Illinois Medicaid to cover autism evaluations performed by qualified speech-language pathologists, as well as any Applied Behavior Analysis treatment those clinicians subsequently order, according to the Illinois Senate Democratic Caucus. Lawmakers have framed that insurance mandate as essential to preventing socioeconomic disparities in access to early therapy once the diagnostic pathway opens up.
Families Still Waiting on Full Implementation
The law will not take effect immediately. Public Act 104-0561 carries an official implementation date of January 1, 2028, giving state agencies up to 18 months to write administrative rules and build out training programs, according to Coral Care. That transition window is meant to let the Illinois Department of Financial and Professional Regulation and early intervention administrative bodies establish the credentialing frameworks the law requires before families can actually access SLP diagnoses.
WBEZ's coverage highlighted families for whom the stakes of these waitlists are personal. The station's report featured lead researcher Megan Roberts alongside mothers Kiana Spears, whose child was diagnosed as part of the Reduce the Wait study, and Debra Vines, CEO and founder of The Answer Inc. WBEZ also described how long waitlists for autism diagnosis can cause young children to miss a critical window for early intervention services — the underlying urgency that drove the legislation in the first place.
A National Backdrop of Rising Demand
Illinois's move comes against a backdrop of surging autism prevalence nationwide. Centers for Disease Control and Prevention data published in 2025 found that 1 in 31 children, or 3.2%, in the United States are identified on the autism spectrum, up from 1 in 36 in earlier monitoring reports. That national trend has overwhelmed specialized diagnostic centers and lengthened waitlists across the country, adding pressure on states to find new ways to expand who can perform evaluations.
Whether other states follow Illinois's example remains an open question. For now, Illinois families with toddlers in Early Intervention will have to wait for the state's rulemaking process to run its course before the promise of a one-month diagnosis, instead of a two-year wait, becomes a reality.
