Autism Being over diagnosed?

My news feed seems to be overflowing with autism articles today and this one caught my eye:

https://www.theguardian.com/commentisfree/2025/jul/21/rise-autism-diagnoses-neurodiversity

It covers the fact that psychological conditions are viewed less sympathetically than medical conditions when it comes to diagnosis in general.

Some interesting facts in there.

I just noticed this one and half hour talk between Dr Simon Baron-Cohen and Jordan Peterson.

https://youtu.be/SDWZa_7WrFg

Title: why is autism rising.

I have not watched it yet. Will maybe watch later today.

I have seen some other stuff related to this.

It suggested the main reasons for increases are women and older people.

There is no particular reason to think ASD is a male thing. The realisation women present slightly differently has changed the ratio from 10 to 1, to 3 to 1. If you consider a lot will have been missed or misdiagnosed in the past, you would expect a lot of women.

If you think prevalence has not really changed, and if you think children are not being excessively over diagnosed at present,  then a lot got missed on the past. This means there are lots of older people . It is estimated maybe 90% of autistic people over 50 may be undiagnosed.

If you consider minorities might be underrepresented for whatever reason, you would also expect them to contribute additional number if they have access.

You can make a case for increasing the numbers, even if the criteria had not changed.

So the question really becomes where  do you draw the line and what is the point of diagnosis.

In any other area of medicine diagnosis is separate from treatment. You don't refuse to diagnose conditions people can manage with. If knowing allows the person to live more comfortably what is the harm. It only really seems a problem if people are looking to use it as an easy way out.

One possibility worth considering is that the speaker may themselves be neurodivergent and not yet fully aware or accepting of it. This kind of internal conflict is not uncommon and has been observed in various contexts—it’s a familiar pattern where individuals may struggle to recognize traits in themselves that they critique in others.

Yeah I'd agree with him. DSM-5 autism diagnosis criteria is very broad and overlaps alot with other mental health issues. Particularly, I think traumatised kids commonly get labelled autistic.

I agree with you! If someone has lower needs, does not mean, that they don't have them at all. I was lucky to be saved from taking my life in the past. Nobody recognised thst I need support, although many commented on me, that there is something wrong with me. I always heard, that I should do something with myself, change etc. But nobody told me how and eventually I got furious,  that it's only me hearing these things and I rebeled out. So according to this man I and people like me should not get any support. He would maybe say: "Commited suicide? Sorry, well, happens. Was unstable etc"

It was not that difficult to let me have sensory breaks at school, I hope that next generations will have it easier. But with people like this doctor,  it would go back. 

I see, that maybe fir some people it's fashion, for others business... for me it's a peace with myself and better understanding.  

Autism is a spectrum condition, This means that individuals on it will have varying traits and problems. I have been diagnosed with ASD, generalised anxiety disorder and social phobia. I am married with two children (one an ASDer and the other autistic). I have never had a particular problem with making friends, though their number tends to be small.

On the other hand, touching any nylon textile leaves me a quivering sensory wreck for minutes afterwards, I, relatively often, have to get off a bus at a random stop, because another passenger's perfume is unbearable. I cannot follow conversations if there is background noise. Sudden loud noises make me jump, even if I am expecting them. Noisy environments make me very tense. If I am interrupted when working, I cannot start again until some time has passed - usually 20-30 minutes. I get very anxious in most social situations, though I appear calm. I am always fully ready at least two hours before necessary for appointments or travel. If I have an appointment anywhere new, if possible, I will scout out the location beforehand, in order to reduce uncertainty. If I am in a crowded situation, particularly crowded streets, I get more and more tense until I feel like lashing out at people, to create some space around me. I never do so, but the urge to do so is strong. In moments of dysregulation, thankfully very rare, I have been known to thump my head or bite my hand.

Though my traits are not the same as yours I am fully convinced that my ASD diagnosis was valid.

I score between 37 and 40 on the AQ50 (depending on how I interpret ambiguous or contextual questions) and 167 on the RAADS-R test. On the monotropism test I score  212 / 235 , the general average is 4.51; I am more monotropic than about 86% of autistic people and about 99% of allistic people.

I thought the same, I don’t see how a person can be fully observed on a computer screen, my assessment was with two people, a language specialist and an autism specialist, as well as being interviewed, they watched what my hands and legs were doing, if and how I stimmed, it was noticed that I don’t use my hands to accentuate when talking.

I was the appointment for the two assessors for that day, it’s not a big team but it  covers two counties, my private opinion locally is £2500 and follows a similar diagnostic procedure , I don’t see how some charging under £1000 are as thorough. The NHS can’t obviously keep up with demand, the private sector is needed, I do wonder though if some are trying to see more people in order to make more money.

A lot of the rise in diagnosis is due to generations of people who are now realising they are autistic, they never had a chance to be heard.

The Doctor in the article is suggesting we go back to the DSM-4, only people with severe needs would be diagnosed autistic. I don’t find autism trendy, sometimes it’s quite horrible, it’s not trendy to be nine times more likely to end your own life.

People are diagnosed blind who aren’t 100% blind, we know that with impaired vision they will still need support, we wouldn’t remove support because a rethink has decided, they aren’t blind enough.

Forgot to mention that I have also never had any friends, got bullied, never been in relationships etc so don’t know if that counts towards autism but who knows, guess you have to trust the psychiatrist if you had that good rapport 

I do wonder about some of the private places that charge 40% of others. The requirements seem clear, so you would think they would take roughly the same time and cost similar. I do wonder if they are all quite so thorough.

I asked my consultant psychologist and she also does not know and has suspicions..

I'm not sure all are accredited the same, which suggests some maybe tell you what you want to hear.

But I can't really see why you would want to get a diagnosis for the sake of it, unless some see it as a way to get benefits. But this does not fit with wealthy people doing it for fun.

I must admit I can’t say I really know the answer to this one. But I do feel I should mention this, when it comes to the nhs I failed the AQ10 which I didn’t score high on but when I did the AQ50 I scored very high even on the scores of the AQ10 questions if that makes sense but I was only able to get an AQ50 from a psychiatrist and I only got to see them because I actually got lucky with a GP. But when I got the referral for the autism assessment via the local centre, I wasn’t even told how long I had to wait for but everyone had said they felt like they weren’t listened to, some say they didn’t think they were autistic though they got diagnosed and visa versa. When the right the choose thing was available I was able to get to speak with the nice GP who used my right to choose thing I was able to go with psych uk and I only waited like 5 months with them and I was lucky to get a very nice psychiatrist who even mentioned that we had built a good rapport during our session. When my parents had work done on their house, one of the workmen had three children and they were all diagnosed with autism but they all went privately. I’m in no way medically qualified in anyway to say this but those kids got diagnosed as children (all in their 20s now) but they were all able to socialise, mix, make friends, have romantic relationships etc where as I am only level 1 autistic but I suffer with sensory issues, racing thoughts, irritated super easily like I can go from 0-100 in the split second. Personally I wouldn’t say those kids were autistic at all but there again I have eupd and ptsd so maybe that’s why I struggle more. I guess my point is you just have to be lucky these days in the hope you get a good psychiatrist. If non of what I said is related to this post then please do forgive me I am still nervous with forums and speaking here is challenging in itself for me. If you managed to read this thank you 

As getting an autism assessment takes either pestering often unsympathetic GPs, then waiting for years on the NHS waiting list, or paying out a considerable amount of money, if 'going private', I do not see that anyone pursues an autism diagnosis on a mere whim. The people who jump though hoops and wait, often in desperation, for years, or who cough up a thousand pounds or so, are desperate to get answers about why they are the way they are and why they have problems in life that others do not seem to have. If the answer to their bewilderment is that they are autistic then they should be diagnosed and to Hell with the nay-sayers!

Ok I watched it. It is largely opinion; there are limited facts.

He is thinking only level 2-3 type people should have the label.

He suggests ASD rates have risen in the wealthy as they can afford private diagnosis. You could say, so what. If they meet the criteria it means they are not using up NHS diagnostic bandwidth. If they are using up support bandwidth then is this so terrible,? If people need help they need help. It should not be a class issue. It is this animosity towards wealthier people which seems to be his real issue. Ideally everyone who needs it would get support.

He also suggest the diagnostic criteria are too broad. I suppose it could be better to have more than one name depending on symptoms, so those who need the most help are more visible. Perhaps merging things under ASD may have been a mistake.

He feels having high functioning people, for want of a better phrase, on tv does not help. Although you don't know what hidden issues they have.

I don't know that just anyone could meet the criteria, as he suggests. But it is not necessarily wrong to question if pathologising lower level needs is helpful to the individuals.

His suggestion people just need some time with a psychologist kind of misses the point that I ended up looking for diagnosis due to seeing a psychologist. It also misses the point that treatments can be different depending on whether you are ASD or not, so knowing helps.

If it is trendy, as he suggests then rates should drop in a few years. I am not sure they have in the year since this video was done.

Overall, I am not sure he is that knowledgeable. It seems more of a complaint that limited resources are not used on those with the most needs. But I am not sure whether that is true.

It's more likely under-diagnosed. There are lots of people like me who only found out later in life. 

I have enough evidence such as the tests you mentioned. Uploaded in my profile result of RAADS, Toronto alexithumia test and "Aspie Quiz", I also made tests for emotion recognition from the facial expressions and aq50. I compared myself to the diagnostic criteria ICD11 and was actually amazed how these traits describe my problems. I'm not sure if I identify myself... I just found out accidentally about High functioning autism and it hit me since the first time... how much its me. I got it kinda confirmed by professional, he also suspects that. It's very unlikely that I would get the diagnosis,  because nobody in my family would support me with that, they say I'm just weirdo and should accept it as it is. I also lack significant medical information from my early childhood, my mom is withholding it from me. School reports don't say anything other than notes which show some kind of spikey skill set. And tge only info about my behaviour was "compliant, well behaved". So with this information I don't think I can prove anything to  a diagnostician. And honestly I overcame so many problems in my life, that this diagnosis wouldn't have changed anything for me. I prefer explaining people with my own words, what is my problem,  why I can't do this or that. 

Someone who's actively seeking answers, who has identified the traits, and perhaps has take the various questionnaires to identify if it is Autism I personally think it is perfectly valid for them to self-describe as autistic if that's what they suspect.

However, there are those out there who will self-diagnose with none of the basis, evidence, or consideration. For my part it is those people I am sceptical on. 

In either case it takes nothing away from me, or I feel anyone else to signpost to support and advice. Similarly, it takes nothing from anyone to allow access to support. I know that some schools and universities have begun to open out disability support services to those who are awaiting diagnosis. I personally think this is amazing! One school at which I worked allowed us to put in place support if certain needs were observed without any other diagnosis. This to me is great too!


Where the problems likely lie however are with the politicians and policy makers. In the US we're seeing people just like us have a political appointee claiming that autism isn't a thing. Peddling the same [insert swear word here] about 'causes'. I do genuinely think that going back to the original post and the video those who are paying for diagnoses, could well provide ammunition for a ruthless MP to suggest cutting support for those of us who need it.

While, I don't blame you for this Alien0n3arth and for the record I find no problems with you either self-diagnosing or self-identifying on a personal level, it is important to recognise that again an MP with a motive could conceivably use people like yourself if the numbers are significant enough. My conclusion though would not be 'let's cut support for those with Autism'. Personally, I'd counter with 'let's revise the diagnostic process to make it more accessible.'

Kvothe said:

i see people sometimes talking about  self diagnosing ADHD and AUT i tend not to believe it.

Are you referring to people who suspect having the condition or people, who despite not having the diagnosis are 100% sure that they have it?

I don't have the diagnosis and I'm not sure, if I have enough power to go through the process, I also don't think it would change anything right now, because my childhood is over long time ago and I found my own ways and strategies to cope. So I'm here in the forum, because it helps me a lot, ifound here some pen palls and this place is very important to me. Some would refer to me as "self identifying". I myself used to use the term "self diagnosis" but I understood it was wrong. 

you got me thinking about those doing the diagnosis if they are not properly trained or misinterpret what the diagnostic criteria is then that could throw up some misdiagnosis..

I was deeply offended by the video at first but looked at it like well if people are being over diagnosed then that takes away resources from those that do need help, but you are right if there is 'over diagnosis' or malpractice then that needs looking at..

I have black and white thinking too and i see people sometimes talking about  self diagnosing ADHD and AUT i tend not to believe it.

The only worry for me is the government taking this seriously and attempting to move the criteria of what autism is

This video leaves me with mixed feelings. On one hand, it is possible, that people who are not on the spectrum, or even have no disorder at all, just got left behind for some reason,  get the diagnosis.  On other hand, people who are not severely autistic, but have their traits impact their life significantly,  also struggle. In my opinion a solution could be to split these diagnoses up. I don't want to reduce someone's ability to get help they need, but I also don't want to bottle up my own struggles and want to be understood. If someone who has never experienced strong social issues such as bullying, isolation, violence, because of an impairment in communication and perception, tells me, that im fine, just little weird and oversensitive,  overreacting etc, it feels to me like a slap on my face. I think that ASD got maybe too wide, but gaslighting people, forcing them to shut up and conform is not a solution. 

Just my opinion. 

I would reject anything which claims 'over-diagnosis' outright.

There are clear descriptors and diagnostic processes for almost every recognised condition, disease, and disorder. In the case of Autism it's the ICD or the DSM. If a doctor is diagnosing people with Autism outside of those processes then it's malpractice. Pure and simple. So either Dr. Pemberton is accusing his peers of malpractice on a massive scale, or he is not fit to be a Doctor due to a lack of understanding of his field.  

Now, where the interview has some points is the area of people paying some mickey-mouse outfit to diagnose them with autism. This I believe is a legitimate point. We have a name for this though - malpractice. These organisations are not acting ethically and if they are Doctors they should in my opinion be struck off.

Likewise is manipulation of evidence. One would hope that the processes present might be able to catch and identify manipulation of information by patients. Presumably that is the point of family members also reporting as part of the process. Likewise, one would assume that all clinicians take an approach which include differential diagnosis. That I cannot speak to. If however, there is evidence of manipulation in these forms then yes again they have a point. 

There are descriptors in the ICD which do preclude a diagnosis of autism if someone has a different diagnosis that could better explain their challenges and support needs. As an example if an individual has a diagnosis of, or their challenges can be better explained by developmental learning disorders, the ICD-11 states that they ought not to be given a diagnosis of Autistic Spectrum Disorder. Now, I can imagine how this would feel to some people and I imagine there would be an uproar from some here about the overlap and boundaries. And in fairness, the ICD does consider those overlaps and tries to make the issue clear. 'Autism spectrum disorder may be diagnosed in individuals with disorders of intellectual development if deficits in initiating and sustaining social communication and reciprocal social interactions are greater than would be expected based on the individual’s level of intellectual functioning.' In short - you can only have both conditions if the social impacts are more pronounced than would be otherwise expected in IDD.  [Side note, I despise the descriptor Intellectual Development Disorder I use it solely because it's the ICD's terminology.]


If we separate out malpractice though, then there is no overdiagnosis. And in fact I would argue that this in not what he was claiming.

The interview instead was claiming, in my view at least, that there are individuals out there who are misrepresenting the facts or carrying out widespread malpractice such that it undermines legitimate diagnosis.

That is something I feel we should all be worried about. By all means, I think inclusivity is important. However, it does highlight some challenges we face in appearing legitimate to politicians and policy-makers. If they see a wide range of people either self-diagnosing or purchasing a diagnosis with no evidence, they may begin to simply claim that Autism is not a condition and not disabling. In the worst case they may even begin to claim that autism isn't real and that the diagnosis should be banned. If there's a big enough weight of people who can be pointed to that are 'faking' that's all politicians need to deny support and adaptations to those who are autistic.

Again I feel the need to point to the simple idea that inclusivity is important. I wouldn't try to police other people's opinions on themselves. My brain personal runs very black and white. You are or you aren't. If a friend claims they are autistic but don't yet have a diagnosis, I will internally disbelieve their claim unless they have evidence like a high score on the AQ50, CAT-Q, RAADS-R or suchlike. In public, I'll accept them and point them toward support of course. 

With radicals like RFK Jr. in the USA making wild claims like adults not be able to have autism, or that autism is something that can be outgrown, I do think we need to be cautious and defend against those who are manipulating diagnosis processes. It doesn't take much for a politician to get an idea in their head and push ahead despite how ill conceived an idea they might be - see the welfare 'reforms' that Labour are trying to push through.