Beyond Awareness: The Autism Opportunity Gap and the Role of Social Class in Shaping Inclusion in Bangladesh

Autism has become increasingly visible within Bangladesh’s health, education and disability-policy landscape, yet visibility does not necessarily translate into equitable participation. Existing discussions frequently emphasise awareness, stigma and early identification, while giving less attention to the unequal social resources that determine whether recognition can be converted into diagnosis, intervention, education, social participation and lifelong opportunity. This critical narrative review examines autism-related inequality in Bangladesh through the combined lenses of the social model of disability, stigma theory, the social determinants of health, Bourdieu’s theory of capital and intersectionality. It argues that social class should be conceptualised as a multidimensional social position rather than income alone, encompassing economic, cultural and social capital as well as geography and institutional access. The review develops an Autism Opportunity Gap (AOG) Framework that traces a cumulative pathway from social position to resource access, opportunity pathways and life outcomes. The framework distinguishes between awareness and opportunity and proposes that autism policy should be evaluated by asking not only whether autism is recognised, but who can obtain appropriate support, participate in education and community life, transition to adulthood and exercise citizenship and rights. Evidence from Bangladesh indicates persistent gaps in diagnostic capacity, geographic distribution of services, caregiver support and inclusive education, while recent Bangladeshi research also demonstrates socioeconomic differences in autism-related pathways. The article concludes that reducing the AOG requires decentralised and affordable services, inclusive education, family support, lifelong employment and participation strategies, and meaningful involvement of autistic people in research and policy. The framework is presented as a testable conceptual model rather than an established causal theory; empirical studies are required to validate its constructs and pathways. Medicine Today 2026, Vol.38 (2): 311-318