C4C publishes national report on autism service provision in Italy, Germany and Greece

Our project consortium has published National Perspectives on Service Provision for Autism, a report examining how autism-related care and family support are organised in three partner countries: Italy, Germany, and Greece. The report complements our scoping review by grounding its evidence in the everyday realities of national health, education, and welfare systems.

Italy

Italy's approach is built around the National Health Service, specialised child neuropsychiatry services, and inclusive mainstream schooling supported by trained teachers. National guidelines promote individualised, multidisciplinary intervention plans focused on communication tools such as PECS, structured routines, and sensory-adapted environments. 

Despite this defined framework, implementation varies significantly by region due to uneven resources. Research shows Italian parents of autistic children experience high stress and psychological burden, shaped by symptom severity, limited social support, and service navigation difficulties. 

Some regions, including Emilia-Romagna, have introduced formal caregiver recognition, counselling, respite care, and peer-support groups — but access remains inconsistent nationwide.

Germany

Germany offers a dense network of therapeutic and educational supports, anchored by the autismus Deutschland e. V. association and its roughly 60 autism therapy centres. 

Diagnosis, however, is a major bottleneck: only specially qualified professionals can diagnose autism, waiting lists are frequently closed, and adults can wait over two years for assessment. A nationwide 2024–2025 survey of 660 caregivers found striking burden levels: 

• 93.8% reported time-related strain, 
• 87.4% developmental strain, and 
• 82.1% emotional strain above threshold, with 64.3% of comments attributing this to systemic deficits (bureaucracy, lack of recognition, financial fears) rather than caregiving itself. 

This is the first study of its kind in Germany and points to an urgent need for systemic reform alongside continued expansion of therapy and vocational training programmes.

Greece

Greece combines public health, education, and welfare mechanisms with an active network of family organisations. A nationwide study found autism prevalence of a little more than 1 percent among 10-11-year-olds, but with wide regional variation and delayed diagnosis — the average age at diagnosis is just over six years, with less than 4 percent diagnosed before age four. 

Reimbursement for special therapies through EOPYY, educational assessment centres, and disability certification via KEPA all provide meaningful support, but families still face upfront costs, waiting lists, and complex administrative procedures, especially outside major cities.

A shared pattern across countries

Across all three countries, the report finds that parents and caregivers act not just as recipients of support but as coordinators and advocates navigating fragmented systems. Regional inequality, delayed access, and administrative burden emerged as recurring challenges. 

These findings will directly inform C4C's training programme, ensuring it is adaptable across different national systems while addressing both practical caregiving skills and the wellbeing of carers themselves.