Last Fri­day, the UK gov­ern­ment pub­lished an “In­de­pen­dent re­view in­to men­tal health con­di­tions, At­ten­tion Deficit Hy­per­ac­tive Dis­or­der (AD­HD) and Autism Spec­trum Dis­or­der” (ASD).

The re­view is in­ter­est­ing. Our sit­u­a­tion is some­what sim­i­lar.

The re­port refers to the star­tling in­crease in the di­ag­noses of AD­HD and ASD in the UK, brought to light by the num­ber of young peo­ple claim­ing un­em­ploy­ment ben­e­fits who say they are un­able to hold a job be­cause of these ail­ments. Chil­dren di­ag­nosed with AD­HD, for ex­am­ple, are four times more like­ly to end up as NEETS, “Not in Ed­u­ca­tion, Em­ploy­ment or Train­ing.”

Both of these con­di­tions, AD­HD and ASD, have his­tor­i­cal­ly been un­der­diag­nosed. I first heard of them whilst train­ing in the 1970s, and in­deed at that time, they were rarely di­ag­nosed. The very first child I saw with ASD came in­to the Pae­di­atric Emer­gency Room at 2 o’clock in the morn­ing be­cause his moth­er was ashamed of bring­ing him out of the house. We were see­ing a bit more AD­HD, but it was still rare. We thought we were see­ing more of it be­cause we had a pae­di­atric con­sul­tant in­ter­est­ed in the dis­or­der and who had es­tab­lished one of the first clin­ics for AD­HD in Bal­ti­more.

That sit­u­a­tion has changed dras­ti­cal­ly. In the US of the 1970s, ASD was di­ag­nosed once in every 4 to 5000 chil­dren. Now it’s one in every 31 chil­dren. Some­thing is wrong. Some­thing is ei­ther dam­ag­ing the brains of chil­dren, or the di­ag­no­sis was be­ing missed (prob­a­bly true) or is now be­ing wrong­ly made (al­so prob­a­bly true).

AD­HD has gone from one in 17 chil­dren in the 1990s, main­ly seen in boys ex­hibit­ing hy­per­ac­tive, dis­rup­tive be­hav­iour in class­rooms, to one in ten in 2025. Boys are still twice as like­ly to be di­ag­nosed with AD­HD.

In the UK, the pro­por­tion of young peo­ple with an autism di­ag­no­sis has in­creased 40-fold since 2000, while AD­HD di­ag­noses have risen 15-fold over the same time pe­ri­od.

As far as I am aware, there are no lo­cal fig­ures for ei­ther dis­or­der, but I clear­ly re­mem­ber when the di­ag­no­sis of ASD be­came “pop­u­lar” in the ‘90s, when chil­dren I was see­ing for se­vere­ly de­layed men­tal de­vel­op­ment (what we used to call men­tal re­tar­da­tion) be­gan ap­pear­ing in my clin­ic at the Er­ic Williams Med­ical Sci­ences Com­plex with par­ents, de­light­ed with a new di­ag­no­sis of “autism,” or as they proud­ly re­ferred to it “, on the spec­trum.” The chil­dren were be­ing di­ag­nosed by peo­ple I had nev­er heard of and who re­fused to an­swer my ques­tions when I called them to in­quire about their ex­pe­ri­ence, train­ing and de­grees.

Prac­ti­cal ob­ser­va­tion and these new fig­ures sug­gest over­diag­no­sis.

As one com­men­ta­tor says, “I was very shy when young. No­body con­sid­ered that to be a men­tal con­di­tion or ab­nor­mal. I grew out if it. My friend has a ten-year-old son, al­so very shy with strangers. In­tel­li­gent. But of­fi­cial­ly autis­tic. Yet has plen­ty of friends in school. Now la­belled for life as ‘not nor­mal’. And that be­comes his iden­ti­ty. Doc­tors used to hand out an­tibi­ot­ic pre­scrip­tions for mi­nor ill­ness. Now they hand out a la­bel. It is not good.”

Apart from the fun­da­men­tal prob­lem of over­diag­no­sis, the COVID ex­pe­ri­ence be­tween 2020 and 2023 played a role in stim­u­lat­ing in­hibito­ry so­cial be­hav­iour or frus­trat­ing chil­dren by lock­ing them down, “ex­clud­ing them,” as the re­port says, “from their nor­mal so­cial struc­tures, ed­u­ca­tion­al rou­tines and ac­cess to open space”. Lo­cal of­fi­cials who were re­spon­si­ble for that and who rec­om­mend­ed or were giv­en na­tion­al awards for these de­ci­sions that harmed chil­dren, should pon­der on their lega­cy, which will be ful­ly as­sessed in times to come.

So­cial me­dia and smart­phones al­so con­tribute to the in­crease in di­ag­noses, with many chil­dren self-di­ag­nos­ing based on mis­lead­ing ad­vice from so­cial me­dia plat­forms such as In­sta­gram or Tik­Tok. This is apart from the time teenagers spend on­line, “doom­scrolling for hours,” ex­pe­ri­enc­ing poor sleep, which dam­ages their at­ten­tion span and con­tributes to men­tal con­fu­sion and dis­tress. Get the child out­doors and off the smart­phone should be the mantra.

The re­port con­cludes that po­ten­tial harms of over­diag­no­sis in­clude the di­ag­no­sis “be­com­ing part of the child’s iden­ti­ty” and defin­ing them “by their dif­fi­cul­ties, not strengths, po­ten­tial and cir­cum­stances.”

Apart from this, the prob­lem now is two-fold. One, the cor­rect di­ag­no­sis must be made by prop­er­ly trained pro­fes­sion­als. Two, there is the pos­si­bil­i­ty of neg­a­tive feed­back and a re­turn to the days of scep­ti­cism that there re­al­ly are such di­ag­noses as ASD and AD­HD.