Ryan noticed that his son Atlas was missing developmental milestones when he was between 12 and 18 months old. It took three years for Atlas to receive an autism assessment. He was diagnosed only months before starting school, when he was nearly seven, non-verbal, still wearing nappies and reliant on others for every part of daily care.
His experience sits within an assessment system that an independent review says is under severe pressure. Published in England on 9 October 2026, the review found a growing risk that people are being over-diagnosed or misdiagnosed with ADHD and autism.
The authors stopped short of finding overdiagnosis at scale. They said, however, that diagnoses have increased over the past 25 years and now appear to exceed the expected number of cases in the population in some younger age groups. Referrals and diagnoses have risen sharply while population-level prevalence appears broadly stable.
For patients, the concern is practical. An inaccurate diagnosis can send someone towards the wrong treatment, the authors said, while overdiagnosis can lead to medical treatment when other forms of support would be more appropriate.
The review also warned that diagnoses of mental health problems, ADHD and autism too often become labels which define people through their difficulties rather than their strengths and potential. The authors said this could damage prospects at school, at work and in relationships.
Children diagnosed with autism or ADHD before 17 are around four times more likely to be not in education, employment or training between 16 and 24. The review said diagnoses were functioning as lifelong labels for some people.
The pressure on families has been building since 2014, when changes required parents to secure an autism or ADHD diagnosis before their children could qualify for extra help in school.
Awareness of the conditions increased over the following decade, bringing hundreds of thousands of people into the assessment system. Waiting lists for ADHD assessments reached 560,000 in December 2025, more than 17 times the number recorded in 2019. More than 254,000 people had an open autism referral in December last year.
Long waits are themselves causing harm to people seeking diagnoses for mental health conditions, ADHD and autism, the review found.
To meet demand, the NHS has increasingly turned to private providers. They now carry out more than half of NHS-funded ADHD assessments and a third of autism assessments, while the cost of private ADHD diagnosis has risen by 252 per cent in three years.
The review found no consistent oversight, transparency or quality assurance across the private sector. It called for tougher regulation of firms conducting NHS assessments, citing concerns about quality and consistency, and proposed a ban on advertising.
Professor Peter Fonagy, who chaired the review, said: “It was clear the system was under immense strain and it was time to get away from diagnosis being a very narrow pathway to finding support.”
Wes Streeting ordered the 10-month review after saying in an interview that young people were being over-diagnosed and written off.
The Government has set out a move towards earlier, needs-led support for children, young people and adults, without requiring them to wait for a clinical diagnosis before getting help.
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