Aucademy Aucademy Responding to news and research, Uncategorized

No, the review did not say ADHD and autism are overdiagnosed

A national review was meant to settle the “overdiagnosis” question. It did. The headlines just reported the opposite. Here is what it actually found, where I think it gets things right and wrong, and what we are doing about it in Kent and Medway.

By Dr Chloe Farahar, Director, Aucademy CIC

Read as:

Every section has a Clear Read box (the full version) and an Easy Read box (short sentences and pictures). Read whichever suits you, or both.

What the headlines said

Clear Read

On 9 October 2026 the Department of Health and Social Care published the final report of the Independent Review into Mental Health Conditions, ADHD and Autism, chaired by Professor Peter Fonagy. Within hours, the word leading the coverage was “overdiagnosis”. The BBC’s headline read: “ADHD and autism at risk of over-diagnosis, says government review”. Its first sentence told readers that “there is a risk of people being over-diagnosed with ADHD and autism, an official review in England has found”.

To be fair to the BBC, the article does say the review could not “conclude over-diagnosis was currently occurring at scale”. But that line sits near the bottom, long after most readers have scrolled on. A warning about a possible future risk was presented as the finding. And the story was illustrated with a stock photo of a child holding a colourful puzzle. I will let that speak for itself.

Why does this matter? Because most people will never read a 599-page report. They will read a headline, maybe on their phone, maybe while sitting on a waiting list that has already lasted years. For many Autistic people and people with ADHD (which some of us prefer to call Polyennic, a term coined by Raven Cochrane), the message they received was, quite simply, “you are probably not who you think you are, and you are part of the problem”.

That message is not what the review says. And it causes harm.

Easy Read
  • A big report came out in October 2026.
  • Some news said too many people are told they are Autistic or have ADHD.
  • The BBC news said there is a risk of this.
  • This news upset a lot of people.

What the review actually found

Clear Read

I have read the report so you do not have to. Here are its own words.

The headline impressionWhat the review says
Too many people are being diagnosed“On the basis of evidence available to us we cannot conclude that overdiagnosis is occurring at scale.”
People’s struggles are being exaggerated“None of this should be taken to suggest that people’s distress or difficulties are not real.” Those now presenting “are no less affected than those identified before.”
There are suddenly more Autistic peopleUnderlying prevalence shows “little evidence of a substantial change”. What has risen is recognition, and demand for help.
It is too easy to get a diagnosisMore than 254,000 people had an open autism referral by December 2025, with over 90% waiting longer than 13 weeks. The review’s own Lived Experience Partners described their “anger and upset” at debates that “minimise, trivialise or deny lived distress”.

The review’s central line is one I wish had been the headline: “People are seeking answers and support for very real problems, and they are not the problem.” The problem, it says, is a system that “leans too heavily on diagnosis as the route to help and cannot keep pace”.

It does warn that the risk of misdiagnosis is growing, especially where assessments are rushed, done remotely, or carried out by poorly regulated providers. That is a call for better assessment, not fewer diagnoses.

Easy Read
  • The report found people’s needs are real.
  • It did not find that too many people are being told they are Autistic or have ADHD.
  • Many people wait a very long time for help.
  • People asking for help are not the problem.

What the review gets right

Clear Read

I argue the most important thing in this report is not a number. It is a door. The review says support has been “locked behind” a diagnosis, and that this is wrong. It proposes a move from a “diagnosis-dependent” system to a “needs-led plus diagnosis” system. Help should come before, during and after assessment, and diagnosis should stay available to those who need it.

  • Mental health care should not wait. For Autistic people with anxiety, depression, eating distress, self-harm or trauma, care “should not be withheld while diagnostic clarification is pending”.
  • Adapted care works better. Autistic adults are less likely to benefit from standard NHS Talking Therapies, and more likely to deteriorate. Adapted therapies do better.
  • Environments matter. “The difference lies as much in the environment as in the individual.” This is close to what Autistic scholars have argued for years, through ideas like the double empathy problem.
  • Hospital is not automatically safe. “Admission is not, in itself, safety.” Autistic people and people with a learning disability are over-represented in inpatient care, and the review wants that to change.
  • Nobody should be dropped. The BBC reported that some people “could be removed” from waiting lists and offered other support. What the review actually says is: “No one should be taken off a waiting list without being connected to appropriate help, and alternative support should be actively arranged with the person, not simply signposted.”
“I don’t think you are fragile. I think you are outnumbered.”Professor Peter Fonagy, in a letter to young people written as chair of the review
Easy Read
  • You should get help for what you need.
  • You should not have to wait for a diagnosis to get help.
  • Help should be close to home.
  • Places should change to suit Autistic people.

Where I would push back

Clear Read

Welcoming a report does not mean agreeing with all of it. A few things concern me.

  • “Needs-led” must not become “diagnosis-denied”. In a stretched system, there is a real risk that “you do not need a diagnosis to get support” quietly becomes “you will not get a diagnosis”. Diagnosis is, for many of us, about identity, community and self-understanding, not only access to services. The review says diagnosis “matters”; we need to hold commissioners to that. Although, I have written on the hope and need that as a society, we should move from diagnosis to recognition, affording more holistic and kinder ways of working out your identity and needs, while still demanding protections as people disabled by current systems.
  • Self-identification is treated with suspicion. The report raises concerns about “neurodiversity assessments” and the “blurring” of the social and the medical. Yet neurodiversity is a social and political idea that emerged from Autistic communities themselves. Community self-identification is often where people first find safety and belonging, and belonging is protective.
  • The language is still largely deficit-based. “Disorder”, “traits”, “impairment”. The review does say “neurodevelopmental difference is not a problem to be eliminated”, which I welcome. I would like the rest of the language to catch up.
  • AI is not a substitute for being understood. The proposed “digitally and AI-enabled” needs assessment framework could help with triage. It could also risk becoming a cheaper replacement for skilled, in-person, adapted assessment. The review says in-person care should be preserved. That needs to be a hard line.
  • Lived experience must mean power, not presence. The review calls for “meaningful partnership with people with lived experience”. Meaningful means paid, and it means a share in decisions, not a place on a consultation list.
Easy Read
  • I like a lot of the report. But I worry about some things.
  • People should still be able to get a diagnosis if they want one.
  • Real people should help with assessments, not just computers.
  • Autistic people who help make decisions should be paid.

What we are doing in Kent and Medway

Clear Read

I am not writing this from the sidelines. Alongside Aucademy, I am Programme Project Manager for the Learning Disability and Autism (LD&A) Programme at Kent and Medway Mental Health NHS Trust. Much of what the review asks for is work we have already started, led by and developed with Autistic people and people with a learning disability as paid partners and decision-makers.

  • Support based on need. The CHECK reasonable adjustments project, a Communication Needs Tool, and the Neurodivergent Profile Guidebook help people say what they need, with or without a diagnosis.
  • Records that remember. Our digital flagging work makes sure people’s needs and adjustments are visible in their records, so they do not have to explain themselves again and again.
  • Skilled staff everywhere. The Oliver McGowan Mandatory Training, simulation-based training, Autistic healthcare webinars, learning disability webinars, and a university course in development with Canterbury Christ Church University.
  • Better diagnosis. A lived expert-led Autism Diagnostic Training and Evaluation Project, so assessment is done well.
  • Fewer people in hospital. Work on resettlement and repatriation for Autistic people, and a review of how inpatient care is designed.
  • Belonging as prevention. The Kent and Medway Learning Disability and Autism Community of Practice, and our lived expert group, which shapes the programme. Autistic community and safe spaces are protective against crisis; the review’s own focus on “belonging, purpose, routine” points the same way.

Simply put: the review has described where we are trying to go. The challenge now is funding it, and keeping Autistic people and people with a learning disability at the centre while we do.

Easy Read
  • We write your needs in your health records. This is called a flag.
  • We train NHS staff about autism and learning disability.
  • We want fewer people to stay in hospital.
  • Autistic people and people with a learning disability help lead this work. They are paid.

If the headlines hurt

Clear Read

If you are Autistic, or Polyennic, or waiting to find out, and the coverage left you doubting yourself: the evidence is on your side. The review’s own lived experience partners were angry about exactly the framing that followed it.

Easy Read
  • Your feelings and needs are real.
  • You can ask for changes that help you. These are called reasonable adjustments.
  • Spending time with other Autistic people can help.
The views in this blog are my own, written as Director of Aucademy CIC. They are not the views of Kent and Medway Mental Health NHS Trust. Descriptions of Trust work reflect what the Trust has shared publicly or internally with staff.

Sources

  1. Department of Health and Social Care. (2026, 9 October). Independent review into mental health conditions, ADHD and autism: final report, executive summary, and Easy Read version (Looking into mental health conditions, ADHD and autism). GOV.UK. gov.uk
  2. ITV News. (2026, 8 October). ADHD and autism could be at risk of overdiagnosis: so what needs to change?
  3. Triggle, N. (2026, 9 October). ADHD and autism at risk of over-diagnosis, says government review. BBC News.
  4. Milton, D. E. M. (2012). On the ontological status of autism: The “double empathy problem”. Disability & Society, 27(6), 883–887.
  5. Botha, M., & Frost, D. M. (2020). Extending the minority stress model to understand mental health problems experienced by the autistic population. Society and Mental Health, 10(1), 20–34.
autisticltd Book Reviews

Autistic identity, culture, community, and space for well-being

Review by Katie Munday (they / them)

Dr. Chloe Farahar explores the creation and importance of Autistic identity, culture, community, and space for well-being in their chapter of the same name in The Routledge International Handbook of Critical Autism Studies. Chloe has a PhD in social psychology specifically attempting to improve the dominant discourse surrounding “mental illnesses” (neurodivergences). They are currently engaged in post-doctoral research on the Oxford-led ATTUNE project, exploring young neurodivergent people’s experience of mental health and adverse childhood experiences, through participatory arts-based research.

Autistic identity, culture, community, and space for well-being explores the importance of self and community identification, belonging and connectedness. Chloe posits that many Autistic people distance ourselves from the pathology of ‘autism’ therefore distancing ourselves from the protective factors of community. This leaves many Autistic people in limbo – many of us feel that we do not fit into the neuro-normative world or the Autistic community, which can lead to isolation and poor self-esteem.

Chloe appreciates that ‘the culture of autism’ creates internalised stigma, shame and ableism. The ideas which have formed the foundation of knowledge on “autism” are based in deficit, negativity and hopelessness – no wonder so many of us want to distance ourselves from such an awful fate.

Through Autistic identity, culture, community, and space for well-being Chloe suggests that in the creation of safe spaces – such as their own ‘So You’re Autistic’ community group – Autistic people can find ourselves. In these spaces we can create meaningful connections with others and understand our Autistic embodiment in neutral terms: being Autistic is neither good nor bad, it simply is.

Autistic spaces and communities can be places of growth and healing. They can allow us to combat discrimination together, improving collective and individual self-esteem. These spaces could also work as a way for Autistic people to realise our neurodivergence without needing a diagnosis based in deficit and disorder.

Autistic identity, culture, community, and space for well-being is a great exploration of Autistic culture and a summary of the ongoing move from the pathology paradigm to the neurodiversity paradigm. Adding to work from Botha 2020, Kapp, 2019, Chapman 2020, Dekker 1999, Walker 2020, and many others. This is a must-read.

This chapter can be read for free here.

autisticltd Book Reviews

Jacki Edry – Moving forward: Reflections on autism, neurodiversity, brain surgery and faith

book review by Katie Munday (they/ them)

Book cover: a large rainbow coloured water paint design at the centre of a white background. Over the design in black text: Moving Forward. Below in black text: Relections on autism, neeurodiversity, brain surgery and faith. Artwork by Liat Perry.

Written by Jacki Edry, Moving Forward looks to enlighten parents, professionals, and family members with personal insights on neurodivergence.

Jacki Edry is a graduate of Hampshire College and has been exploring the world of neurodiversity for over thirty-five years.  She is a survivor of complex brain surgery and a parent of neurodivergent children. She has spent many years advocating for inclusion programs in the educational system within Israel, as well as providing support for Disabled children and their families.

Moving Forward is an auto-biographical account of raising Neurodivergent children and surviving complex brain surgery all the while becoming closer with God and her Jewish faith. The book is split into five parts; Autism and neurodiversity; Sensory perception and processing; Brain surgery, faith and healing; Regeneration and recovery; and Navigating new pathways.

The first two parts are a reflection on Jacki’s Neurodivergent children, their journey to diagnosis and support within school. Of particular interest was her children being misdiagnosed with ADHD. After many years of research and advocacy, both children were re-diagnosed with Irlen Syndrome, a visual processing difference in which the eyesight is considered typical but the processing of visual stimulus is not. This story acts an example of how the first (and easiest?) answers and diagnosis, are not always accurate. Jacki herself was then diagnosed with Irlen Syndrome and the children were diagnosed as Autistic.

Jacki gives some good advice for families of people who are newly diagnosed, my favourite of which “one of the most important things you will need to do after receiving a diagnosis is to take a deep breath. Take some time to digest the news. […] I suggest you leave the ‘why’ behind and focus on doing your best to support each other and to investigate your next steps together.” (page. 24). Jacki appreciates that there can be some extreme feelings after confirmation of neurological differences and that the first move is to let it sink in.

The second half of Moving Forward reflects on Jacki’s experience of surviving complex brain surgery. She shares excerpts from her personal diary, where she reflects on how her sensorial changes have given her more insight in to her children’s sensory processing differences. Jacki also explores how she solidified her Jewish faith whilst in recovery. I feel dispersing the diary entries throughout the stories of her children’s burgeoning Neurodivergence would have made Jacki’s reflections stronger still.

Moving Forward is an intimate account of one women’s experience of brain surgery, parenting neurodivergent children, and living in God’s light. Jacki shares her intersecting experience of disability and neurodivergence, parenthood and healing, and those who read it are all the better for it.

[Person first and identity first language are used throughout this book, as are words such as ‘impairment’ and ‘problems’. These may be a translation issue as they do not fit with the overall feel of the book.]

autisticltd Guest Autistic blog posts

De-centering the ‘male’ Autistic experience

By Katie Munday (they / them)

Historically, being Autistic was considered a male childhood experience, with boys more readily diagnosed than girls. This trend is still prevalent in many areas of autism research but thankfully the gap between male and female diagnosis and realisation is slowly closing. As is the access to diagnosis and realisation for transgender, non-binary and gender divergent individuals.

There have been many reasons why many girls and women have been overlooked for diagnosis including (but not limited to); systemic misogyny and transphobia, autism research which favours ‘male’ traits and cultural gender stereotypes.

Systemic misogyny and transphobia

Misogyny across medical systems, which upholds ideas of female ‘hysteria’ and over-emotionality, means women are more likely to be disbelieved or wrongly diagnosed with personality differences and mental health issues. These diagnosis can then cause access issues to Autistic identification.

Professionals are not seeing the very real connection between what would be considered ‘disorders’ (what I prefer to call embodied self-preservation) and Autistic experience, which often includes consistent trauma. So, even when females are diagnosed with personality differences they are often overlooked for also being Autistic.

Access to diagnosis is also difficult for transgender and gender divergent individuals who wish to transition medically. Often these people are left to choose between being supported with their Autistic diagnosis or gender affirmation, but very rarely are they given the opportunity for help with both. Unfortunately, Autistic people are still seen as children who do not understand gender and therefore are not ‘really’ transgender. This infantilsation denies Autistic people gender affirming healthcare and many forgo an autism diagnosis so they can get help with the more immediate need of living their authentic gender.

Many people turn up to gender identity health clinics because they are confused by their gender and need help untangling it all, some of us live in gender flux and fluidity and this confusion should never mean punishment. All gender experiences are relevant, and all people should have access to gender affirming and diagnostic healthcare, this means creating more support for people of colour, queer people, physically Disabled people and all other marginalised groups.

Autism research which favours ‘male’ traits

Across 70 years of autism research the most researched group of people have been young white males. This means that all criteria for diagnosis, and the supposed ‘support’ which comes with it, is based on ‘male’ behaviours. Anyone who does not present these traits are not considered Autistic and may be misdiagnosed with another form of neurological difference.

The very few Autistic people who fit the stereotype of Rain Main and Sheldon Cooper have the privilege of far fewer barriers to diagnosis. However, girls and women, transgender and non-binary folk and males who do not show these traits are often overlooked as we do not live up to the standard of male stereotyped Autistic traits.

This is further complicated for those of us who are people of colour, physically Disabled, Queer and trans because our social ‘difficulties’ are often understood as a common ‘impairment’ of our other marginalised identities. This is a glowing indictment of the racism, ableism and queerphobia within medical systems but also within places of education, work and anywhere else we are seen as being ‘problematic’ or ‘too much.’

These male stereotypes are based around white western ideals of behaviours; giving eye contact, staying still, keeping quiet, but ideas of ‘appropriate’ behaviour vary across different cultures. There are many indigenous cultures, for example, which deem eye contact as incredibly rude, but this is not accounted for in white western medicine.

Autism research has focused on male stereotypes for so long that the idea of a ‘female autism phenotype’ has arisen. Not only does this create even more barriers for those of us outside the binary but it also continues to other female Autists, favouring males as the ‘real’ Autistics. (I could, and probably will, write a piece on the ‘female phenotype’ but I lack the spoons to write about that particularly misogynistic, racist and transphobic idea at the moment).

Cultural gender stereotypes

Criteria for diagnosis, which favours males and is steeped in misogyny, are based on the undeniable inequality that all of us who aren’t cisgender male face.

Girls and women are often overlooked as Autistic as they often (strangely!) fit western female stereotypes. Many of them are either quiet: “she’s so shy!” or very talkative: “they’re quite the chatter box!” These vast differences in communication, confidence and the need to talk are both seen as inherently female: potential non-speaking or hyper-verbal traits are often considered as just a ‘girl thing’ and therefore often overlooked.

In many Western cultures, girls are kept young, virtuous and innocent for as long as possible. This can run parallel with the interests of Autistic people who often stay loyal to their hobbies for longer than their neurotypical peers. This is often misunderstood and pathologised as developmental regression but it is just the lack of fear we have about enjoying what we enjoy loudly and proudly!

Heteronormativity also plays a big part in gender stereotypes; girls are to grow into women who have children with a man and keep the household. Girls are explicitly and implicitly told that they are to grow up to be the main caregiver of children, do all the housework and most times squeeze in a full or part time job. Due to this many women are exhausted beyond measure; this is considered a cultural norm and does not consider neurological differences.

As we know, burnout between neurotypical people and Autistic people are vastly different, add in the overwhelming responsibilities placed upon women and we are sure to suffer poor mental health. Unfortunately, these cultural norms feed into misogynistic medical systems, which suggest that mums simply need to ‘rest more’ or pop a few Xanax and carry on exactly as they are. There never seems to be any understanding that this burnout is due to being Autistic, as well as living in a garbage heteronormative world. Less still can it be seen for what it often is: an Autistic person raising other Autistic young people in a world that is simply not made to support or enrich us at all.

So how can we de-centre the ‘male’ Autistic experience?

Firstly, challenging oppression benefits us all and this is in no way a fight against men and boys who also deserve diagnosis, support and acceptance. I want to create a world in which we can all reach understanding and support earlier in our lives.

Unfortunately, systemic misogyny and transphobia, focusing on ‘male’ traits and cultural gender stereotypes are all reciprocally determinant, they reinforce each other and are a difficult cycle to break.

Difficult, but not impossible.

Change won’t come overnight. It comes from the writings of brilliant Autistic academics and those of us who continue to put pressure on politicians and policy makers, the advocates and activists who show up every damn day to fight our oppression.

No contributions from any of us who stand up to oppression is small – we are all part of a bigger movement to change systemic ableism, racism, transphobia and bigotry. We can change things through our anger, through our writing, for showing up for one another, through social media, protests, pride events, Autistic run conferences, supporting Autistic artists, activists and writers.

These acts can and will invoke change so that the Autistic kids of tomorrow have more of a chance at Autistic joy, pride and acceptance.