The 2025 update highlights a growing crisis in the assessment and care of autism and Attention-Deficit/Hyperactivity Disorder (ADHD) in England. The situation has worsened since the Child of the North autism report, with delays in diagnosis continuing to rise. Â The 2024 update showed that around 306% more children are now waiting for the assessment of autism compared to pre-pandemic levels. By March 2025, only around 4.5% of children are expected to be referred for this assessment within the recommended timeframe. ADHD assessment faces the same issue, with waiting times increasing by 22% by June 2024. The number of children waiting for more than 2 years has now doubled.
Geographical differences are severe. Median waiting times in South and Mid Essex are under 2 months, while in South Yorkshire they exceed 1000 days. Children in the North of England may therefore wait up to 3 years longer than those in the South.
Inequalities by gender and ethnicity are also apparent. Many autistic girls are undiagnosed, with 80% missing a diagnosis. Data from the Born in Bradford study reveals that girls of Pakistani heritage are 11 times less likely to receive an autism diagnosis than White British boys. ADHD demonstrates similar patterns, where White British boys are 5 times more likely to be diagnosed than South Asian boys, with significant gaps between White British and South Asian girls. This shows the double disadvantage for the minority ethic girls.
The long waiting periods place immense stress on families. Parents are often stuck in a cycle where they should demand the diagnosis before accessing support, but delays prevent timely help. Families face repeated referrals, poor service coordination, and children struggling both socially and academically. In the North, where the waiting times are longest, the strain on families is particularly severe, contributing to increased stress, family tension, and a negative community impact.
Early identification of the needs of children can improve school outcomes, reduce exclusions, protect mental health, and improve long-term education and jobs. The lifetime cost of unmet needs for an autistic person is approximately ÂŁ1.5 million, disproportionately affecting northern areas. Teachers are well-positioned to recognize the early signs of autism through daily observation and tools like the Early Years Foundation Stage Profile. Yet, these insights are not adequately used in the current system.
The 2024 report made three key recommendations: to combine health and education to provide school-based assessments, increase professional training to improve autism diagnosis, and build local autism-friendly partnerships. The 2025 update requires strong action to reduce regional inequalities by enhancing accountability, improving data systems, and transitioning from a diagnosis-first model to a needs-led approach.
The system is approaching collapse due to increasing waiting time, lack of support, and persistent inequities. This crisis is not avoidable, but it is a result of political choices, inadequate services, and systemic failures. Early detection is cost-effective, improves outcomes, and leverages teachers’ expertise in identifying children’s needs. By strengthening education, health, and social care, England can establish a fair, timely, and needs-based system. Without urgent reforms, thousands of children will continue to experience preventable harm and reduced quality of life.
References:Â Child of the North. Autism Assessment and Support Update: The Crisis Is Worsening. N8 Research Partnership; 2025. Autism Assessment and Support Update: The Crisis Is Worsening
