Autism and ADHD Assessments Are Changing: What the Latest UK Review Means for Families

Autism and ADHD have been receiving considerable attention in the UK recently.

In October 2026, the government published the findings of a major independent review into mental health, autism and ADHD. The review looked at increasing demand for assessments, long waiting lists, access to support and how diagnostic services should develop in the future.

For families and adults considering an assessment, some of the headlines may understandably have raised questions.

Are more people really autistic or ADHD? Are diagnoses being given too easily?

Will it become harder to access an assessment?

And what should you look for when choosing an assessment provider?

There are a few important points worth understanding.

Demand for autism and ADHD assessment has increased significantly

More children and adults are being referred for autism and ADHD assessment than ever before.

This does not necessarily have one simple explanation.

Greater awareness, improved recognition of less stereotypical presentations, increased understanding of masking, and recognition of autism and ADHD in groups historically overlooked may all contribute to more people seeking assessment.

At the same time, NHS services are experiencing very significant pressure.

Recent NHS services report waits of well over a year for some children and young people, with individual services publishing average waits of 64 weeks for ADHD, 88 weeks for autism and, elsewhere, around 99 weeks to a first appointment. Waiting times vary considerably around the country.

For the person waiting, however, statistics do not tell the whole story.

A child may still need support in school. An adult may still be struggling at work. Families may still be trying to understand why everyday life feels so difficult.

Support should not have to wait for a diagnosis

One of the most positive messages in the government's response is a commitment to developing more needs-led support, rather than making people wait for a formal diagnosis before receiving help.

We strongly welcome that principle.

A child does not suddenly develop sensory needs, communication differences or difficulties with executive functioning on the day they receive a diagnosis.

Likewise, an adult does not need a diagnostic label before their experiences become real.

Schools, workplaces and services can often make helpful adjustments based on an individual's needs while an assessment is still being considered or awaited.

But diagnosis can still matter

Needs-led support and diagnosis are not mutually exclusive.

For many people, a comprehensive assessment can provide something important that generic support alone cannot: an explanation.

Understanding that someone is autistic, has ADHD, or both can help make sense of experiences across childhood, education, relationships, work and everyday life.

For some people, diagnosis brings relief. For others, it provides access to appropriate treatment, accommodations or further specialist care.

Most importantly, assessment should provide a clearer understanding of the individual — not simply a label.

What about concerns about “over-diagnosis”?

The recent review has prompted considerable discussion about whether autism and ADHD may sometimes be over-diagnosed. The review concluded that diagnostic practice and service quality require stronger oversight while also recognising the enormous pressures within existing neurodevelopmental services. This is an area where careful language matters.

Concern about diagnostic quality should not mean questioning the legitimacy of autistic people or people with ADHD.

Nor should it take us back to outdated stereotypes about who “looks autistic” or what someone with ADHD should look like.

Instead, it reinforces something we believe strongly at The Autism Assessment Centre:

assessment needs to be thorough. A diagnostic decision should not be based on one questionnaire, one brief appointment or whether someone appears obviously autistic or ADHD to an observer. It should consider development, lived experience, functioning across settings, alternative explanations, masking and compensatory strategies, and the person's individual strengths and support needs.

Greater regulation of autism and ADHD assessments

One of the most significant proposals following the review is stronger regulation of diagnostic services.

The government has said it intends to work towards making autism and ADHD diagnostic assessment a CQC-regulated activity, covering NHS-funded and privately funded assessments. The aim is to improve confidence that assessments are clinically robust regardless of who provides them.

We welcome greater emphasis on quality and clinical standards.

People seeking an assessment should be able to feel confident that the clinician assessing them has appropriate training and experience and that diagnostic decisions are based on recognised clinical guidance.

What should a good autism or ADHD assessment look like?

There is no single identical pathway for everyone, but a comprehensive assessment should look beyond surface presentation.

It should consider:

• developmental history

• current experiences and support needs

• information from different settings where appropriate

• validated assessment tools used within their proper clinical context

• possible overlapping or alternative explanations

• masking and compensatory strategies

• strengths as well as areas of difficulty

• clinical judgement rather than questionnaire scores alone

  
  

For autism assessment, observational assessment may also form part of the wider clinical picture. At The Autism Assessment Centre, where an ADOS-2 is clinically appropriate, we complete this face-to-face rather than using a remote ADOS-2 as a substitute for an in-person observational assessment.

Autism and ADHD do not always look stereotypical

One of the reasons assessment requires expertise is that neurodivergence can look very different from person to person.

An autistic person may make eye contact, have friendships, enjoy socialising, have a career or be highly empathetic.

Someone with ADHD may be quiet, academically successful or appear extremely organised because they have developed elaborate strategies to compensate.

Some children appear to cope throughout the school day and become overwhelmed once they return home.

Some adults have spent decades learning social rules consciously without recognising that they are masking.

A good assessment needs to be curious about what is happening beneath the surface, not simply what can be observed in one room.

Private assessment should not mean a guaranteed diagnosis

Choosing to pay privately should mean accessing an assessment sooner or choosing a particular clinical service. It should never mean purchasing a particular diagnostic outcome.

We will never promise an autism or ADHD diagnosis before an assessment has taken place.

Sometimes an assessment confirms what a person or family suspected. Sometimes it does not.

Either way, the role of the clinician is to consider the evidence carefully, explain the clinical reasoning clearly and help the person understand what may be contributing to their experiences.

What does this mean if you are considering an assessment now?

You do not need to abandon plans for assessment because of recent headlines.

Equally, you should feel comfortable asking an assessment provider questions about how they work.

You may want to ask:

• Who will complete the assessment?

• What professional qualifications do they hold?

• What information will be gathered?

• How are diagnostic decisions made?

• Is information considered by more than one professional where appropriate?

• How does the service consider masking?

• What happens if the assessment does not result in a diagnosis?

• What support is offered afterwards?

  
  

A reputable service should be comfortable answering these questions.

Our approach

At The Autism Assessment Centre, we believe that diagnostic assessment should be careful, individualised and neuroaffirming.

We do not expect people to fit stereotypes.

We do not diagnose from questionnaires alone.

We consider masking and compensatory strategies.

We take time to understand the whole person.

And we believe that whether or not a diagnosis is ultimately made, an assessment should leave someone with greater understanding rather than simply another label.

Considering an autism or ADHD assessment?

If you are wondering whether autism, ADHD or both may be part of the picture for you or your child, you do not need to have all the answers before contacting us.

We are happy to talk through what you have noticed, explain the different assessment pathways and help you decide what the most appropriate next step may be.

Contact The Autism Assessment Centre to arrange a free initial consultation.