People With ADHD/Autism Diagnoses Have Changed In 1 Decade

According to a paper published in JAMA Psychiatry, the types of people who get diagnosed with ADHD or autism have changed in the past decade or so.

Compared to people diagnosed with these forms of neurodivergence a decade or more ago, a Danish study found that children and adolescents with ADHD or autism now have more characteristics in common with the general population.

Until 2012, young people with either diagnosis tended to have been born at lower birth weights, while their parents were more likely than those of undiagnosed kids and teens to have lower education rates and less household income.

But those links seem to have become “weaker” over the years, with more recently-diagnosed young people increasingly presenting similarly to their neurotypical peers.

Here, we asked Professor Laura Crane, a Chair in Autism Studies at the University of Birmingham and Director of the Autism Centre for Education and Research (ACER), to weigh in on these findings.

Let’s start with what researchers don’t think is happening here.

The study authors stressed that these results “do not show that these conditions are being overdiagnosed or that they have become less severe”, though they could help explain why ADHD and autism diagnoses have risen so sharply.

Instead, the study may “indicate that the population receiving these diagnoses has changed over time, and this needs to be taken into account when interpreting current trends”.

One explanation, Prof Crane said, is that we’re simply getting better at spotting autism and ADHD in cases that would have previously been missed.

“Historically, diagnoses were often reserved for people whose differences and support needs were quite specific and quite overt,” she told us.

“Greater awareness of autism – among the general public as well as healthcare professionals – means that many individuals who may previously have gone unrecognised (e.g., autistic women and girls, who have been shown to internalise or mask their autistic characteristics) are now being identified”.

That could mean more people, including those whose “day-to-day experiences appear more similar (at least on the surface) to those of their non-diagnosed peers”, are no longer going under the radar.

The authors of the paper write that differences in who gets diagnosed do not mean the neurodivergent experiences they live with are “less impairing on the individual level”.

Interestingly, Professor Crane says, “researchers are recognising that the difficulties neurodivergent people face arise not simply from characteristics within the individual, but from the interaction between those characteristics and the environment the person is in”.

Therefore, the “severity” of a person’s ADHD or autism might not rely entirely on static conditions within the person diagnosed. The professor pointed to research that argues the world around that person can make their neurodiversity more or less challenging.

For instance, the UCL paper suggests that workplaces and schools are becoming more results-driven and demanding.

“As such, people with less overt autistic characteristics may still experience significant difficulties – across a range of areas of their life – because of the mismatch between their characteristics and what their environment expects of them,” Prof Crane suggested.

“Overall then, I think these findings likely reflect a combination of factors, including broader recognition of autism and ADHD and changes in who receives a diagnosis,” she ended.

“But they don’t necessarily mean that these diagnoses have become less significant or impairing. Often due to the mismatch between the person and the environment, many neurodivergent people continue to face substantial barriers across education, employment, healthcare and everyday life.”