Why is there never any nuance in these discussions? We can both believe that under-diagnosis occurs, and that over-diagnosis occurs. 20% of all pupils in the UK are now classified as so disabled that they require specialised assistance. “SEND” assistance for this can range from free taxi services to and from school (which recently reached £1.2 billion), to support payments, to special assistants in school. The number of ECHP students (those with the highest needs) increasing by 71%, from 253,679 in 2018 to 434,354 in 2024. SEND spending is out of control.

So what happened, exactly? The average child disability rate in Europe is 4.6%. How did the UK end up with 20%? Did the UK suffer a catastrophic nuclear event? A war? Famine? None of the above. It is clear that categorisation has become EXTREMELY loose over time on average. This does not mean that there are not children who are struggling to get diagnosed with ADHD. However ADHD and autism are a spectrum disorder. It is not binary. The UK has drawn the line far closer to the normal side of the spectrum than any other nation on Earth. If costs continue to rise at this rate, it risks destabilising the entire health system. Public sentiment will shift, and we risk undermining children getting any diagnosis at all.

IMHO, this requires at least two tactics at the same time. 1) Invest sufficiently into diagnosis resources. Stringing parents and children along for years while they wait in the system can make the issue much worse than it needs to be. 2) Draw the diagnostic line closer to where the rest of Europe does it. This will mean far fewer children are diagnosed with disabilities, but those who genuinely have a disability are treated much faster and actually receive the resources they need.