Draft

This summarizes the IACC Draft Strategic Plan 2026–2028, a working draft. The public review and discussion date has been postponed; a new date is to be announced, expected September 2026. The plan is not final and not federal policy.

IACC Draft Strategic Plan 2026–2028

A New Federal Framework for Autism

The 2026 to 2028 IACC Draft Strategic Plan reflects a remarkable shift toward many of the medical and scientific questions explored in A Blind Spot on Autism.

This working draft represents a major shift in how autism may be studied, understood, and addressed.

Document Draft Strategic Plan
Status Working draft
Public review & discussion Postponed — date TBA, expected September 2026

The Interagency Autism Coordinating Committee (IACC) has released a working draft of its Strategic Plan for 2026 to 2028. For families who have spent years being told that medical symptoms were simply “part of autism,” the draft reads differently than what has come before.

Below is AIDA's summary of what the draft plan says and why it matters.

One

Autism is more than a behavioral diagnosis

The new federal draft treats autism as a lifelong condition involving multiple biological systems. It prioritizes research and clinical care involving:

Immune and inflammatory biology
Gastrointestinal disease
Mitochondrial and metabolic function
Dysautonomia
Sleep disorders
Epilepsy
Motor planning and apraxia
Mental health and functional decline

The focus is expanding from managing behaviors to understanding health, function, and biology.

Two

There is not just one autism

The plan makes heterogeneity its organizing principle. It says autism may involve different combinations of:

Genetic susceptibility
Immune activation
Environmental exposures
Maternal and prenatal biology
Metabolic function
Microbial ecology
Neurological pathways
Developmental timing
No longer simply What causes autism?
The federal question is Which mechanisms matter in which individuals?

The draft describes autism as arising through multiple interacting pathways, rather than one universal cause.

Three

Regression is now a national priority

The draft estimates that neurodevelopmental regression occurs in 30 to 40% of autistic children.

Loss of language, motor skills, adaptive function, sleep stability, or engagement should not automatically be dismissed as part of autism.

The plan calls for:

  • A standardized definition of regression
  • Rapid medical evaluation
  • Prospective research cohorts
  • Serial biospecimens
  • Biomarker development
  • Subgroup-specific treatment trials
A proposed initiative

It proposes a National Neurodevelopmental Regression Initiative to build the infrastructure needed to detect, understand, and treat regression in autism.

Four

Sudden deterioration requires medical investigation

The plan warns against diagnostic overshadowing. Abrupt regression, OCD symptoms, restrictive eating, aggression, self-injury, sleep collapse, movement changes, seizures, or personality change may have:

Neurological contributors
Environmental contributors
Gastrointestinal contributors
Infectious contributors
Metabolic contributors
Inflammatory contributors
Medication-related contributors
Autoimmune or neuroimmune contributors
The recommendation is not to
  • Presume that every change is caused by autism.
  • Presume that every change is immune-mediated.
It is to

Investigate.

Appropriate clinical history, presentation, laboratory testing, and examination is needed to uncover treatable causes of sudden deterioration.

Five

Maternal health is part of the investigation

The strategic plan identifies research priorities that include maternal health and early developmental exposures.

Research priorities include:

  • Maternal immune activation
  • Placental biology
  • Infection during pregnancy
  • Medications
  • Diet and nutritional status
  • Developmental timing and exposures

Research into maternal health, placental biology, developmental timing, and fetal susceptibility may influence later outcomes.

Six

Federal research is shifting beyond genetics

The draft plan moves federal autism research away from a primarily genetic focus and toward immune, metabolic, microbial, and environmental mechanisms — investigated alongside genetics rather than after it.

The starting point: FY 2025 NIH autism causation funding

$119 million Exclusively genetic research
vs.
$21 million Exclusively non-genetic research
Nearly $6 to genetics for every $1 to non-genetic research

Where the new plan invests: a more balanced portfolio, expanding investigation into:

Immune & inflammatory biology
Metabolic & mitochondrial function
Microbial factors
Gastrointestinal biology
Environmental exposures
Developmental timing
Autonomic dysfunction
Regression & trajectory
Seven

Turning discovery into real-world impact

The proposed National Autism Precision Therapeutics Initiative (NAPTI) creates a clear path from research to patient benefit.

1

Discovery

Identify biological mechanisms and candidate targets.

2

Validation

Harmonize assays and confirm biomarkers.

3

Subgroup definition

Define biologically distinct subgroups of patients.

4

Precision trials

Conduct adaptive, multicenter trials by subgroup.

5

Implementation & outcomes

Move validated findings into care and measure real-world impact.

The goal

The right treatment for the right patient at the right time. Biology-driven research. Subgroup-specific care. Better outcomes across the lifespan.

Eight

Coordinated federal action is essential

The plan calls for federal agencies to work together to move research into clinical care.

NIH
FDA

NIH + FDA

Lead biomarker research, patient subgrouping, and precision trials.

CDC
HRSA

CDC + HRSA

Identify patterns, strengthen surveillance, and educate clinicians.

CMS
AHRQ

CMS + AHRQ

Improve access, diagnostic pathways, and standards of care.

DoD

DoD + federal partners

Expand research, resources, and support across the lifespan.

One shared goal

Better research. Better care. Better outcomes.

This page summarizes AIDA's review of the IACC Draft Strategic Plan for 2026–2028, a working draft. The public review and discussion date has been postponed and a new date is to be announced, expected September 2026. Descriptions on this page characterize the contents of that draft and are not federal policy. The full review is available as a PDF. Further reading is collected in the AIDA Research Library.