Buescher and colleagues1 have broken new ground in their article “Costs of Autism Spectrum Disorders in the United Kingdom and the United States” by comparing costs for children vs adults, by estimating costs by sector, and by comparing estimates across countries. This accomplishment is especially remarkable given the challenge presented by a profound lack of infrastructure for routinely monitoring costs and outcomes in people with autism spectrum disorders. We wish to reflect further on the conceptual and measurement advances needed to reach a point where we can meaningfully link investments in services to life course outcomes.