10/10/2026
Are we really seeing an epidemic of ADHD and autism diagnoses or are we finally recognising generations of people who were overlooked?
Following the publication of the government-commissioned review into ADHD and autism assessments, we're once again seeing headlines about rising diagnoses, misdiagnosis and concerns that neurodivergence is being over-medicalised and whilst accurate, thorough assessments are absolutely essential, I think we're missing a rather enormous part of this conversation.
For decades, we have been failing to recognise neurodivergence, particularly in women and girls
Let's look at some statistics.
In England:
• In June 2026, there were 294,792 open referrals for suspected autism, with almost 87% having been open for at least 13 weeks.
• In December 2025, NHS figures identified up to 735,157 open referrals potentially relating to ADHD assessments.
• In December 2024, at least 129,179 children aged 0–17 had an open autism referral. Even this was an underestimate because not all children's assessment services were included.
These aren't simply numbers on a spreadsheet. These are children struggling to access education. Families fighting for reasonable adjustments. Adults trying to understand why they've spent their entire lives feeling different and people being told to wait, sometimes for years, before they can access the understanding and support they deserve.
Historically, much of our understanding of autism and ADHD has been shaped by how these neurotypes present in boys and the consequences of that are enormous.
A UK population study found that the average age of autism diagnosis was 12.3 years for males and 14.9 years for females. That's a difference of approximately two and a half years.
A more recent Scottish study found a five-year difference in median diagnosis age across the neurodevelopmental conditions it examined. That’s five years of potentially unmet needs years, of being misunderstood, of being labelled anxious, difficult, dramatic, overly sensitive or simply not trying hard enough and for some women, those five years become twenty, thirty or forty.
And so many woman were diagnosed with other psychiatric conditions before neurodivergence was even thought about so how many women spent years being treated for anxiety, depression, bipolar disorder or borderline personality disorder before anyone considered autism or ADHD?
We know from research that statistically autistic women are more likely than autistic men to have certain psychiatric diagnoses recorded before their autism is identified. We know ADHD in women can be overlooked when difficulties are internalised rather than outwardly disruptive. We know that masking, people-pleasing, perfectionism and years of adapting to expectations can make neurodivergence harder to recognise and and we know that neurodivergent people can experience genuine mental health difficulties alongside their neurodivergence.
This isn't about suggesting that every mental health diagnosis is incorrect.
A 2025 Swedish study of 72,331 autistic people found:
Autistic females 54.2% had a psychiatric diagnosis before their autism diagnosis
Autistic males 40.9% had a psychiatric diagnosis before their autism diagnosis
Among autistic females in the study, before autism was identified:
Previous diagnosis
Percentage
Anxiety disorder
27.0%
Depression
21.4%
Bipolar disorder
2.2%
Borderline personality disorder
1.7%
Two or more psychiatric diagnoses
28.3%
These figures don't mean every earlier diagnosis was incorrect. But they demonstrate how often autistic women had already encountered psychiatric services before autism was recognised It's about asking how many women have been treated for the consequences of unsupported neurodivergence without anyone recognising the underlying neurodevelopmental differences.
So why are diagnoses increasing? It’s because our understanding has changed! Because diagnostic criteria have evolved. Because we now recognise that autism and ADHD can coexist. Because we have a better understanding of less stereotypical presentations, including those seen in girls and women. Because adults who were missed during childhood are finally seeking answers and because communities are sharing information that previous generations simply didn't have access to and we now have confirmed research that it’s genetic. As soon as a parent is seeing signs in their child, they’re recognising them in themselves. An increase in identified neurodivergent people does not automatically mean an increase in the number of neurodivergent people who exist and we cannot assume that every additional diagnosis represents a newly emerging condition. Research suggests a substantial population of autistic adults in England remains undiagnosed and that should be part of the conversation too.
And yes of course diagnosic accuracy matters. Nobody benefits from an incorrect diagnosis, whether that's autism, ADHD, bipolar disorder, anxiety or anything else but concerns about misdiagnosis must not become an excuse to dismiss people seeking assessments or to make already overwhelmed services harder to access. We need properly funded services, appropriately trained professionals, comprehensive assessments and support based on individual needs and another generation of children being told they're simply naughty, not another generation of girls being told they're just anxious, and not another generation of women reaching adulthood believing they have somehow failed at being human.
Perhaps the question shouldn't just be why so many people are being diagnosed now, perhaps we should also be asking why so many people weren't recognised before because neurodivergent people haven't suddenly appeared.
One of the biggest concerns I have about conversations surrounding misdiagnosis is that they focus so heavily on people being incorrectly identified as neurodivergent, whilst overlooking the very real possibility of neurodivergent children being incorrectly assessed as not neurodivergent and masking plays an enormous part in this.
The DSM-5, one of the diagnostic frameworks used to identify autism and ADHD, considers how neurodevelopmental differences present across different contexts. To receive an ADHD diagnosis, adhd signs need to be seen across 3 settings but what happens when a child has spent years learning to suppress those differences in order to survive their school day, what happens when a child makes eye contact because they've learned they're expected to, when they sit perfectly still despite feeling desperate to move?
When they copy their peers, rehearse conversations, suppress their stimming, force themselves to socialise and spend six hours desperately trying to meet expectations that don't come naturally to them but then happens when the very thing that helps a neurodivergent child navigate school is the thing that prevents professionals from recognising their neurodivergence?
Because masking can contribute to a false-negative assessment. A child may appear to cope beautifully in the classroom, only to come home completely dysregulated, exhausted, overwhelmed or unable to manage another demand, And yet, how often do families hear: "They're absolutely fine at school, they have friends, they academically able, as though any of those things automatically exclude autism or ADHD.
They don't. In fact, the DSM-5 explicitly recognises that autistic characteristics may be masked by learned strategies and NICE guidance in England specifically warns professionals that autism may be under-recognised in girls and that coping mechanisms can conceal autistic characteristics. It also advises that autism should not be ruled out simply because a child makes eye contact, smiles, shows affection or has reached typical language milestones. So why are we still treating a child who appears to cope in school as evidence that their parents must be mistaken? Why are we placing so much weight on what adults can observe, rather than what the child is actually experiencing and why are we still confusing compliance with wellbeing?
A child who is masking is not necessarily a child who is coping. They may simply be a child who has learned that expressing their needs is less acceptable than suppressing them. Of course, not every child who masks is autistic or has ADHD, and not every child who struggles at home is neurodivergent but masking should be explored during an assessment, not used as evidence against a diagnosis.
If we're going to have a national conversation about diagnostic accuracy, we need to acknowledge both sides of the equation, The people incorrectly diagnosed with a condition they don't have and the people incorrectly told they don't have a condition they do. The children who don't fit outdated stereotypes. The girls who quietly struggle. The academically successful children whose distress goes unnoticed. The adults who have spent decades compensating for difficulties nobody recognised.
Misdiagnosis doesn't just mean giving somebody the wrong label. Sometimes it means denying them the right one and those consequences can last a lifetime.
If you want to learn more I have included additional research
NHS England — Autism waiting times, June 2026
NHS England — ADHD referral statistics
2025 research — Later diagnosis of neurodivergent girls and women
2025 research — Psychiatric diagnoses preceding autism
NHS ADHD Taskforce — Underdiagnosis and increased demand
Experts say England's ADHD and autism system is under growing strain, with hundreds of thousands waiting for assessments 🧠⏳
