Over the past decade, the number of people receiving diagnoses of autism and ADHD has increased dramatically. This trend is visible across the UK, particularly in areas where NHS waiting lists are long and private assessment services have multiplied. It is a complex picture, shaped by cultural change, increased awareness, environmental pressures and, increasingly, an unregulated private market.
The rise in diagnosis is not simply a reflection of better recognition. It is also a reflection of how society has changed. As Steve Silberman explores in Neurotribes, our understanding of neurodiversity has broadened. We now recognise a wider range of autistic profiles, including those previously overlooked. This is a positive development. Many people who would once have struggled without explanation now have language, identity and support.
But alongside this progress, there are emerging concerns.
The impact of an unregulated assessment market
The rapid expansion of private neurodevelopmental services has created a landscape that is difficult for families to navigate. Many new clinics present themselves as specialists, offering “gold‑standard” assessments or multidisciplinary teams. Yet, as someone who has worked in neurodevelopmental services for many years, I recognise very few of the names now claiming expertise. Some individuals were not permitted to carry out assessments within NHS teams because they could not demonstrate the necessary skills, even under supervision. Now they are able to set up their own clinics, advertise themselves as experts and diagnose complex developmental conditions.
This unregulated surge is already leading to unnecessary diagnoses. I know people personally who have been diagnosed with autism through Right to Choose pathways delivered by private companies contracted by the NHS. They do not believe they are autistic. Their families do not recognise an autistic profile. Their original referral was simply an exploration of wider developmental questions. Yet they have been given a diagnosis of “mild autism”. This is not because autism is being better recognised — it is because inexperienced clinicians, fragmented assessment models and commercial pressures are creating an environment where premature or inaccurate diagnoses are becoming increasingly common.
The consequences of this are significant. A diagnosis should be meaningful, accurate and grounded in a deep understanding of developmental history. When it is not, individuals may be left with labels that do not fit, and services become overwhelmed by referrals that do not reflect genuine need.
Environmental pressures and the modern world
Alongside changes in diagnostic practice, we are also seeing profound shifts in the environments children and adults are growing up in. Our modern lifestyle places extraordinary demands on attention, regulation and cognitive load. Technology is designed to capture and hold our attention. Notifications, rapid content cycles, constant stimulation and the pressure to be always available create an environment that is fundamentally different from the one our brains evolved to manage.
For some individuals, this constant overload can mimic or amplify ADHD‑like difficulties. For others, it can exacerbate underlying vulnerabilities. Children are spending less time in unstructured play, less time outdoors, and more time in environments that demand rapid switching, instant responses and continuous engagement. Adults are experiencing similar pressures, often alongside work demands, stress and reduced downtime.
None of this means that ADHD is caused by screens. But it does mean that our environment is shaping how attention develops, how regulation is maintained and how difficulties present. The rise in ADHD diagnoses cannot be understood without acknowledging the role of modern technology and lifestyle pressures.
Neurodiversity, evolution and the disruption of human variation
The rise in autism and ADHD diagnoses cannot be understood without acknowledging the broader history of neurodiversity. As explored in Neurotribes, neurodivergent traits have always existed within human populations. Many of these traits — intense focus, pattern recognition, creativity, divergent thinking, persistence, and unconventional problem‑solving — have likely offered evolutionary advantages. Human societies have always depended on cognitive diversity. Communities thrive when they include people who think differently.
But the natural distribution of neurodivergent traits has not remained untouched. Across the twentieth century, eugenic policies in Europe and the UK deliberately targeted people with disabilities, learning differences and neurodevelopmental conditions. Under Nazi rule, autistic people, people with intellectual disabilities and those who would now be recognised as neurodivergent were sterilised, institutionalised or killed. These atrocities disrupted the natural transmission of neurodivergent traits across generations.
The UK also participated in eugenic practices, including the institutionalisation and sterilisation of people labelled as “feeble‑minded”, “mentally defective” or “unfit”. Many of these individuals would today be understood as autistic, ADHD, learning disabled or otherwise neurodivergent. These policies were based on prejudice, not science, and they significantly altered the demographic landscape of neurodiversity.
Understanding this history matters. It helps explain why neurodivergent traits may appear to be increasing now: not because they are suddenly emerging, but because society is finally recognising them — and because the suppression of neurodiversity across the twentieth century created artificial gaps in visibility, diagnosis and generational continuity
A need for regulation, clarity and clinical depth
The increase in autism and ADHD diagnoses is not inherently negative. Many people benefit enormously from understanding their neurodevelopmental profile. But the current landscape — shaped by long waiting lists, commercial incentives and inconsistent clinical standards — is creating risks that cannot be ignored.
We need regulation. We need clearer standards. We need assessments carried out by clinicians with genuine expertise. We need person‑centred practice, not production‑line diagnosis.Until that happens, families will continue to face a confusing and uneven system, where the quality of assessment varies dramatically and the likelihood of unnecessary diagnosis continues to rise.
Cerebro 