Rush to diagnose ADHD and autism can damage children: As rates soar up to 40-fold, a major review warns of the toll on those wrongly given a label

[Rubydobydo]

Britain risks harming a generation of children by over-diagnosing ADHD and autism, a major review warns today.
Parents are incentivised to have their children diagnosed by misguided schools and welfare systems that reward such 'labels', the report found.
Youngsters have also been influenced by social media posts that wrongly present common traits as evidence of the conditions.
https://www.dailymail.com/health/article-16194777/Rush-diagnose-ADHD-autism-damage-children.html

Discuss?

You can pay several thousand pounds for a diagnostic assessment, yes. Many people are forced to do so because despite a huge amount of tax being taken from us supposedly to fund a healthcare system, it may as well not exist for all the use it is. In fact, NHS paediatricians often ADVISE parents of children referred to them for autism diagnosis to get a private diagnosis if possible because if they wait for the NHS to do it their children will be leaving secondary school before the NHS actually bothers to carry out the diagnostic process.

It’s expensive because it’s done by highly experienced consultant neurologists and paediatricians and SALTs and OTs etc working in a multidisciplinary team. It involves numerous assessments and input from the various specialists. That does not mean that a diagnosis will be given, obviously. Unless you’re suggesting that all of these unrelated specialists who often don’t know each other at all are somehow colluding and putting their careers and professional qualifications at risk to lie and provide fake diagnoses. To what end? Why would they take such a risk? It’s not remotely plausible I’m afraid. They get paid either way and would face being struck off if diagnosing people without sufficient evidence. Why would they?

Delusional.

I agree that many neurodivergent children are being badly let down by the education system, but I don't think the research you've linked quite supports all your conclusions.

The 2023 study is interesting, but it relied on a self-selected sample of parents, so the finding that around 85% of children experiencing school distress were autistic can't be applied to all children struggling with school nationally. It also can't establish that schools are the cause of those difficulties.

I also don't think the government review is saying that diagnosis causes poor mental health or that children shouldn't be diagnosed. It actually acknowledges the benefits of diagnosis and the importance of meeting children's needs.

There's certainly room to criticise the review, but peer-reviewed research isn't automatically more credible than a broad evidence review. And it's worth applying the same standards to both, particularly when it comes to distinguishing correlation from causation.

Yes and this can go on to 24.

It’s not a question of “if” LAs and schools are behaving unlawfully.

It is an evidenced fact that they systemically and deliberately deny the provision required for as long as they can in order to save money, because every week the provision that a child requires and the LA is legally required to provide is not in place saves them money, and when they are found to have broken the law there are no consequences whatsoever. They’re just ordered to do what they should have done in the first place, 12-18 months earlier (it takes that long now to get a tribunal hearing because of the backlog of cases because they are doing this systemically).

Across the entire country, for 5+ years, LAs have consistently lost 98%-99% of SEND tribunal cases. That’s not a difference of opinion or a mistake, that is deliberate, systemic law breaking.

In any other sector (medicine, finance, law) this would result in huge fines, removing the financial incentive for the illegal behaviour. Staff involved would be struck off/ sacked, and in cases of repeated/ deliberate breaches, prison sentences imposed, entirely correctly. And in those other professions we are mostly not talking about staff with a duty of care to vulnerable minors. Education is like the wild west because the regulator does nothing about this and it’s left to individual parents to enforce the law, with each case treated as a separate issue rather than any recognition that the law is being broken deliberately as a matter of unwritten policy, on purpose. Teachers and LA staff should hang their heads in shame, and the Government for turning a blind eye to this, actively incentivising LAs to break the law, and then publishing these appalling policy documents recently suggesting that the problem is the parents and the way to fix the issue is to remove parents’ rights to appeal the 99% of decisions which LAs make which are illegal, as if that will make the problem go away.

You’re absolutely right that something should be done about it: a proper regulator needs to be put in place which takes robust enforcement action itself when legal breaches are reported comes down like a ton of bricks on all schools which don’t comply with EHCPs and all LAs which refuse to follow the SEND Regulations, with personal and organisational sanctions for those involved. This is the norm of how law and regulations are enforced in every other sector.

Instead, we have a Government trying to pretend the problem is “overdiagnosis” or “sharp elbowed parents” (disgraceful!!!), and doubling down on the failed system. They are pretending that the laws introduced in 2013/2014 are the problem when in fact the law has never been implemented, and LAs spend millions of pounds fighting legal battles they know they will lose while destroying children’s educations and their families, on purpose, rather than spending this money on what they are legally required to be doing. It’s not the law that needs changing, it’s that the law needs to be enforced with extremely harsh penalties on those who continue to break it, and break our children.

The costs wouldn’t be astronomical if the Government provided a range of different schools appropriate to different children’s needs. Then there would be appropriate provision within a reasonable local area and the need for extremely expensive bespoke packages would be far, far lower. And children would be in an appropriate environment from near the start of education rather than having to wait years either out of school entirely/ attending an inappropriate school causing them severe mental health damage and failure to teach them properly, meaning the level of required support to thrive would be far lower because the school system would not cause immense damage to them while the LA obstruct them being moved to appropriate provision, often for many years.

Very few of the above posts help towards any understanding of WHY so many suffer so badly. And that affects the whole family, that’s clear to see.
Is it prematurity?
Is it forever chemicals polluting parents?
Is it, in milder forms, a lack of consistent parenting?
We’ve no idea really, albeit I hope someone is working on the problem somewhere. Presently we trying to stem the flood with a t towel. It can’t go on escalating for all our sakes, whichever way you look at it.

It’s parenting and attachment gone wrong often starting in utero. If a mother is highly stressed in pregnancy this does affect how that baby is essentially wired up. Coupled with babies and toddlers who spend far, far too long in childcare which doesn’t foster security. Coupled with permissive parenting and a diagnostic culture where nothing and I mean nothing is the parents doing - then this was and is inevitable.

But they’re all just essentially boxes. It all comes down to the quantitative data. How high or low you score on scales, and other questions etc. The fact you think it’s hard to get? You should be the embarassed one.

Even I would know all the correct things to say and do, and tick if I wanted a private diagnosis. I’m sorry you’re so naive.

Except that autism is a neurodevelopmental condition, so you’re entirely wrong. Firstly, there is undeniable scientific evidence that it is genetic. Secondly, part of the diagnostic criteria is that it must be evidenced that the condition has been present throughout the child’s life. Therefore, by definition anything that was caused by childhood experiences is not autism because it doesn’t meet the diagnostic criteria, e.g. environmental factors after a child is born such as “spending far too long in childcare” (if one was to have any scientific evidence for this negatively impacting children in a statistically significant manner, which there is not) or “permissive parenting” (!?).

Sorry, you have a problem with quantitative data being used as evidence?

Not that an autism diagnosis is based on this alone, quite obviously, and if you knew anything about the diagnostic process you would know this.

It’s just a very interesting viewpoint. Presumably, on this basis, you disregard the entirety of science? I wonder how you think the device you’re posting from was created.

EHCPs can continue to 25, or 26 in some cases, if necessary rather than to 24. If posters are going to post judging others, they should at least get the correct information.

ADHD and ASD both have huge genetic risks factors.

There's some suggestion that ND or people with traits are finding each other more in modern world and getting together through neiche interests or work - there are clusters round engineering sites round the world apparently.

Older fathers - Children of older fathers have statistically higher, though still overall rare, risks of developing autism spectrum disorder, schizophrenia, bipolar disorder, and ADHD. We have more older fathers and have for a while and once the gentic mis-tranlations happen they can like all genetcis be passed down.

Early life and prenatal risks - research continues to explore contributing biological influences—such as preterm birth and prenatal environmental exposures.

That is if there is an actual increase in numbers which is unclear.

It could be we have widened diagnostic criteria and removed stigma and are finding more cases that were always there.

It's also possible school and wider enviroment has changed hugely and that making more who used to cope not.

There is lots of research being done in many areas - but I do not think anyone really knows what is going on yet.

I think you should hear some of the labels that those of us who spent years with undiagnosed neurodivergence were forced to live with.

As I said, that was one example of research. The medical journals contain hundreds more if you’d like to take a look. There’s an absolutely enormous body of research on this matter. Why do you think pretty much all credible neurodevelopmental paediatricians, SALTs, educational psychologists, autism specialists and charities, etc disagree with the Government’s proposed policies to make the educational system even worse and have pointed out how catastrophic the effects of what they have proposed would be if their ludicrous policies were ever implemented? Why do you think all credible peer reviewed academic and medical research disagrees with the unevidenced conclusions of the report published today which was commissioned by said politicians?

It’s hard to know what’s going to happen with all this. Labour have a review but have kicked it into the long grass to post budget. They seem to be priming the electorate for changes but we’ll see.

Indeed, they’re certainly ramping up the prejudice and stigma, just like the disgraceful Badenoch and Farage.

Who knew that politicians’ ineptitude to manage the economy appropriately was the fault of children with disabilities? If only we’d all realised earlier that autistic children are the source of the UK’s problems.

It’s so ludicrous as well as abhorrent to try to use disabled children - our most vulnerable citizens of all - as a political football to score points and to attempt to create a distraction from politicians’ incompetence. It’s quite astonishing really that they have the audacity to make such statements in public and keep a straight face. But I suppose, who better to scapegoat? These vulnerable minors can’t vote. Perfect!

This is all interesting. Thank you.
I’m interested in you mentioning changed environments. We often see neurodiverse children who clearly have neurodiverse parents and even grandparents. But the older generations, although may have struggled with some things, have largely coped well and lived full lives. But their children have significant difficulties from an early age which really affects their ability to participate in “normal“ life

Again, look at how school has changed.

We have to wait 15 moths for the diagnosis. Would not class this as a "rush".

In the meantime, gets next to zero support at school, daily struggles, frustrations and physical health issues brought on by stress.

I totally agree with pp’s saying that we just know more now, so more people are being diagnosed because parents etc recognise a potential issue or need (are there really more stars now or just better telescopes?!)

the other side of things though is that school funding has been pared right back so there are fewer TA’s in classes to give extra support, everything is more stretched so less support can be given as usual arrangements without an EHCP.

I just want ds to be able to support himself as an adult and have a good & happy life. It’s so frustrating when so much time and energy has to be spent on dealing with a really unreasonable school placing silly demands on him, whilst telling me (Attendance Officer) that I need to try harder to get him back to school but they make no effort at all to remove the barriers which sometimes prevent him from going (not the responsibility of the Attendance Manager)

if school removed those barriers for him, the whole class would benefit too

Yes. It’s shocking that this man hasn’t been struck off or even put in prison for the malpractice and significant harms and even deaths that he has caused. Utterly disgraceful that the Government is associating itself with him - it shows a lot about their morality and integrity, i.e. non-existent!

I'm not disputing that there's a substantial body of research showing the difficulties neurodivergent children face, or that many professionals have serious concerns about government policy. I share concerns about children not getting the support they need.

But saying that all credible research disagrees with the review, or that pretty much all credible professionals oppose it, is a very sweeping claim that would itself need evidence. The study you linked is a good example of why methodology matters. Its findings are interesting, but they don't establish national prevalence or prove causation.

It's also important to distinguish between disagreeing with the government's proposed policies and demonstrating that the evidence review itself is scientifically flawed. Those aren't necessarily the same thing.

I'm happy to consider specific research that contradicts the review's findings, but simply saying there are hundreds of studies doesn't tell us which conclusions are wrong or why.

Like I said, the medical journals contain hundreds of statistically validated studies that have been peer reviewed and published covering everything from why ND children cannot function in the current state school system; to the damage to mental health that forcing them into an inappropriate environment causes; to the mental health damage caused by being in an environment that’s overwhelming in which they are forced to mask for most of their waking hours; to the fact that their risks of self-harm, suicide, rape and sexual abuse, addiction etc are all elevated 10-20 times higher than in the general population as a result of being placed in such environments. There are genetic studies showing the magnifying glass effect I mentioned i.e. the effects of both positive and negative environments are magnified for these children, evidencing the “dandelions/ orchids” distinction with autistic genetics being effectively a highly leveraged evolutionary bet. These genes have spread across the population and not died out despite the immense suffering of individuals who carried them being misunderstood and mistreated despite their outsized contribution to human society, because they these genes are good for human society; there’s a reason why a vastly disproportionate number of our entrepreneurs, mathematicians, engineers, scientists, composers, artists, authors, inventors, etc are autistic. If given the right environment these children flourish, to everyone’s benefit. You’d probably have nothing like the creature comforts you enjoy without autistic people. But if forced into a hostile and unsuitable environment, the children carrying these genes are vastly more likely to crash and burn, than an NT child subjected to the same level of hostility. The data on this is indisputable.

Anybody pretending “we don’t know why this is happening” is either ignorant, or lying. Far more research of course needs doing, but it’s already very clear and indisputable what needs to be done to improve things, yet we have politicians suggesting the opposite. Then they’ll blame these children for the fact that their own policies, which ignored all of the existing evidence, trashed these children’s lives, and pretend it’s their fault. It’s not. It’s the fault of all of the ignorant people who can’t be bothered to read the medical research, or refrain from making children with disabilities a scapegoat and political issue when frankly, it’s an absolute joke that this is anybody’s focus when you look at the laughable mismanagement of every single aspect of UK administration from the economy to trade policy to tax policy to public service management and design.

Disabled children are yet another victim of this incompetence - extremely vulnerable ones who, very conveniently, are in no position to fight back or vote against this. They are quite clearly not the cause of the UK’s problems, so perhaps the Government should focus on implementing some policies that improve the economy rather than trash it further, for a change. Then, perhaps, they might be able to fund functional health and education services rather than blaming the citizens who need to use these services for their own failings.

I do not agree with the conclusions based on my own lived experience of young people I know. I have seen none be harmed by being dx and many harmed by not being dx