(UK) Govt: "Rising rates" of ASD/ADHD doesn't mean more kids have ASD/ADHD: report
- 17 hours ago
- 3 min read
A rise in rates of autism and attention deficit hyperactivity disorder (ADHD) could be caused by "Institutional incentives”, a Government-commissioned review suggests
Experts said diagnosis is “increasingly being used to secure support” and that education systems are “not merely responding to diagnosis, but are also shaping demand for it”.
In December, the Government launched a review into ADHD, autism and mental health services to examine rising demand for services.
Now experts have reported on their initial findings, highlighting how “rising distress” among younger people appears to be one of the factors behind an increase in demand for services.
They also highlighted a “medicalisation of distress” which can lead to a diagnosis being the “main route of support”, even when alternative responses may be more appropriate.
The authors of the review said: “Historical analyses show that behaviours in children once regarded as within the range of normal variation, or even as something to be welcomed in some contexts, are now more often interpreted as requiring intervention or treatment.”
They added that there is a “risk that a wide range of difficulties – particularly those arising from social, educational or environmental pressures – may increasingly be interpreted primarily through a medical lens”.
But they said that rising rates of diagnosis for ADHD and autism “does not necessarily mean rising prevalence” of the conditions.
Instead, the increase in diagnoses could be influenced by “improved recognition, changes in help-seeking behaviour, evolving social patterns, and the possibility that under-recognition may persist in parts of the population”, they said.
But the academics behind the review stressed that “the current position cannot be explained by a single narrative”.
They conclude: “In some areas - particularly among younger people - there is credible evidence of increasing psychological distress.
“In others, notably ADHD and autism, rising diagnoses and referrals appear to exceed changes in underlying epidemiological prevalence and are likely to reflect a combination of improved recognition, changing help-seeking behaviour, institutional incentives and pressures within existing service pathways.
“Across both ADHD and autism, best currently available population-based estimates remain relatively stable, while administrative diagnoses, self-identification and recorded service demand have increased substantially.
“In autism, the evidence also points to particularly rapid growth in identified need within educational systems, including increasing identification among girls and among young people without learning disability.
“These patterns suggest that rising demand is not simply the result of increasing prevalence, but of several processes operating simultaneously: real increases in distress in some groups, improved recognition of previously unmet need, changing expectations about support, and systems that frequently rely on formal diagnosis as the primary route to assistance.”
Writing in The Times, chair of the review Professor Peter Fonagy, a clinical psychologist at University College London, said: “Distress is real. But how we interpret and respond to it is shaped by the systems we have built.
“We need a system that is more proportionate, more responsive and less dependent on diagnosis alone.
“One that can offer support earlier, in a wider range of settings, and in ways that are aligned to need rather than determined by labels. . . .
“We look forward to receiving the final report and its recommendations in due course.”
Commenting, Mel Merritt, interim assistant director of policy, research and strategy at the National Autistic Society, said: “This report makes one thing unmistakably clear: autistic people’s needs are not being met in education, employment or healthcare.
“We have been concerned from the outset that this review could fuel the increasingly polarised debate about autism.
“Unfortunately, we are now seeing exactly that. Too much attention is being placed on questioning people’s motivations for seeking a diagnosis, instead of recognising the very real distress that autistic people and their families experience – distress that is too often overlooked.
“We want to shift the conversation towards solutions that genuinely address unmet needs.”
Alexa Knight, director of policy at the Mental Health Foundation, said: “The rise in psychological distress found by the review represents one of the greatest crises the country faces.
“We welcome that this review has clearly identified that psychological distress and suffering has been on the increase in England, especially among young people.
“This is a vitally important starting point and makes the case for a bold, prevention-first approach that matches the scale of the challenge.”
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