It's worth noting the UK already commissioned a review that was published this year, that showed ADHD is in fact under-recognised here[0]. I can only assume they're commissioning a new one because that one gave the "wrong" answer.

For a long time ADHD was ignored or dismissed in the UK as an "americanitis", so it's no surprise that there's a backlog of people who weren't diagnosed in childhood.

[0] https://www.england.nhs.uk/long-read/report-of-the-independe...

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captainbland 3 hours ago | parent | next [-]

I think a crucial bit of context is that in the UK, many people who are seeking diagnosis as adults grew up in areas where there were no or very few child psychiatry services in the 80s/90s. In such areas only very profound cases would be referred to out of area services. Most people with neurodevelopment disorders in such areas were diagnosed with SpLDs like dyspraxia or dyslexia which could be diagnosed by community paediatricians, usually with evidence from educational psychologists and occupational therapists.

In fact the pattern is almost the opposite of what you'd see in the US where it would be hard to get diagnosed with a SpLD and e.g. ADHD was more widely recognised. But the rub lies in the fact that ADHD, ASD and many SpLDs have fairly high rates of comorbidities with one another, to the point where if you've got dyspraxia and no other diagnosable comorbidity, you're actually in the minority of people with it.

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alexfoo 3 hours ago | parent | prev [-]

Also the NHS ADHD/ASD services are completely overrun. Waiting lists for children can be more than 5 years long.

In order to cope with this the NHS has spun out much of the ADHD/ASD assessments through the Right To Choose program (well, in England at least, Scotland/Wales/NI are on their own), which means that private companies are being paid by the NHS to make up the shortfall. Ref: https://adhduk.co.uk/right-to-choose/

Some people say some of the private companies are too lenient with their diagnoses. Some people say that the NHS is too strict with their diagnoses. I'm sure the real answer is somewhere in the middle.

As you say, the sharp rise in diagnoses is probably more due to people become more aware, with less stigma attached, and having better access to assessment.

Shit like _Rain Man_ almost 30 years ago or, more recently stuff like _The Good Doctor_ really don't help though, as those just reinforce the negative stereotypes of Autism.

ADHD also has a strong genetic component with heritability around 75% according to various studies. My parents (undiagnosed but one definitely ADD+ASD) have 1/4 children diagnosed (and another 2/4 almost certainly undiagnosed, one neurotypical), and 6/10 grandchildren diagnosed (the other 4 are neurotypical).

Who knows, in 20 years time mainstream schools could have switched from 20% SEND and 80% neurotypical to 80% SEND and 20% neurotypical.

	▲	Mountain_Skies 2 hours ago \| parent [-]
		In my family it's been difficult for some to accept my sister's autism diagnosis because Rain Man is the prototype of autism they have in their heads. Younger family members who have been exposed to classmates who are on the Autism spectrum have been accepting of the diagnosis as their image of autism is very different than the one older family members have. Good thing is despite some not believing in the accuracy of the label, they're still supportive of her.