"an identity rather than a disorder": how some people are (wrongly) framing ADHD and more

"Some people now regard ADHD [attention-deficit hyperactivity disorder] as “an identity, rather than a disorder”, with the result that many obtain assessments from poor quality private providers, which lead them to “believe they have a condition needing treatment”, said the psychiatrist Dr Marios Adamou, the founder of the UK Adult ADHD Network." https://www.theguardian.com/society/2026/aug/18/great-adhd-myth-rising-diagnosis-without-treatment

If there is one voice who is 'tellin' it like it is' in the context of serious and disabling neurodevelopmental disorders like ADHD and autism, that voice is psychiatrist Marios Adamou. 

And not only is he talking sense in the media, he's also got the research record to back it up in terms of his studies on triage models of adult autism assessment (see here), bringing reality to bear on the concept of 'masking' across various neurodevelopmental disorders such as ADHD (see here) and autism (see here) (hint: it's probably not compatible with said disabilities), the hows-and-whys people seek ADHD and autism assessments (see here) and what can happen when professionals say 'it 'aint ADHD or autism' (see here). 

And I for one, want to hear a lot more of his professional and research-informed opinions over and above the neurobabble - often impossible neurobabble - that some have spouted in these days of (social media) trainers and coaching. Reality is re-entering the room. And not a moment too soon, particularly for those who are genuinely disabled by what are disabling behaviourally-defined neurodevelopmental disorders (and the c**p they've had to endure at the hands of identity politics and its purveyors).

Next up: the conversations needed around who is actually qualified to assess for and diagnose ADHD or indeed, related diagnostic labels like autism (see here) (hint: probably not someone who just as a certificate in one or more assessment tools but no clinical qualifications, skills and experience) and just how forensic assessments need to be (see here), particularly keeping mind that ADHD and/or autistic traits are probably not the sole domain of a clinical diagnosis of ADHD and/or autism according to the ICD-11 diagnostic criteria. Oh, and as per our recent contribution to autism science, an appreciation that autism (and ADHD and more) are rarely stand-alone conditions (see here) thus introducing yet more clinical complexity. If in doubt, seek out an expert.

Autism spectrum disorder: has it lost its meaning and is it leading to misdiagnosis?

Autism spectrum disorder: has it lost its meaning and is it leading to misdiagnosis? https://www.cambridge.org/core/journals/psychological-medicine/article/autism-spectrum-disorder-has-it-lost-its-meaning-and-is-it-leading-to-misdiagnosis/AF834026D004D42B1963BEA515495AC6

A new paper from Prof. Uta Frith that is already making some media headlines including "Academic warns that ‘almost magnetic attraction’ to having condition means term is being misused." This follows recent previous headlines based on what she's said. Now, there'll all in a science paper.

And what a paragraph this is: "Among drivers for the increase in prevalence are cultural changes, such as the desire for inclusion, harm avoidance, reliance on self-report, and the acceptance of masking. These have all led to a lowering of the diagnostic threshold. Furthermore, the popularity of the concept of autism boosted numbers via self-diagnosis and a search for identity."

That's going to be absolute garlic to some (particularly where (neuro)marketing, training and other livelihoods are part-and-parcel of the social media age in which we live). But actually, she's probably right as per what's been said by quite a few other notable people and what the data seem to be telling us. By saying that I actually also believe we are seeing a part real increase in (childhood) autism as per what various stats from various geographies have been telling us for quite a few years.

Talk about 'masking' - it's actually reputation management - and the myriad of 'self-diagnosing' - but not self-diagnosing other less palatable conditions which very much overlap with autism - are receiving some well-deserved scrutiny these days. Not least in the context that according to the ICD-11 criteria, autistic traits are not the sole domain of a diagnosis of autism on the basis of those boundary conditions that accompany clinical descriptions, and to decipher what is what takes (medical) professional and multidisciplinary examinations and not some random who just holds a certificate on one or more autism assessment - that's assessment not diagnosis - instruments. 

When eminent people such as Prof. Frith are writing an article like this, it's probably time to start listening. That won't make an iota of difference to some who are already invested in stuff like 'self-diagnosis is 100% valid' and the like. But for everyone else, a correction is starting to happen and happen not a moment too soon. And too her media quote: "Splitting up the spectrum would ultimately prevent misdiagnosis" is already happening as per the rise and rise of profound autism and the realisation that 'heterogeneous' is not just a word.

Next up: the Fonagy review is probably due to report soon here in Blighty (https://www.gov.uk/government/collections/independent-review-into-mental-health-conditions-adhd-and-autism) and what its found around autism, ADHD and more. I can probably guess that they won't be disagreeing with Prof Frith...

"In 2024, the prevalence reached 21.1‰ among boys": Autism in France

Part of the title to this post - "In 2024, the prevalence reached 21.1‰ among boys" - represents a detail from a recent paper titled: Epidemiology of Autism Spectrum Disorders in French Children Aged 8 https://link.springer.com/article/10.1007/s10803-026-07433-x

Alongside the observation that 21.1 per 1000 boys aged 8 years old may have autism in France (registry-based prevalence), the additional headline is that "ASD at age 8 increased markedly ranging from 2.1‰ in 2003 to 13.5‰ in 2024." 

Around a third of kids with autism also had an intellectual (learning) disability and about a fifth had comorbid attention-deficit hyperactivity disorder (ADHD) according to this data. Oh and the sex ratio was 5:1 boys:girls.

I dunno. Is it perhaps time to starting worrying about how many children are presenting with clinically relevant behaviours leading to being diagnosed with a serious neurodevelopmental disability like autism? Y'know worrying to the extent that the old 'all better awareness' is basically a call for inaction rather than action around hows-and-whys? Worrying about what those figures mean for children (and no, they weren't 'masking' or other stuff), their families, education and healthcare systems and society more widely when it comes to adult outcomes like social care and employment et al?

Added to data from other geographies such as Northern Ireland (see here) where over the last 5 years, they've registered an increase in school-aged autism from 4.2% in 2019/2020 to 6.2% in 2025/2026 and now affecting 8.6% of boys, it's getting a bit concerning don't you think?

'Profound autism' defined: moving closer to compartmentalising the heterogeneous 'autisms'

 A short post to bring a new paper to your attention: Developing a consensus research definition for profound autism using a modified Delphi method https://link.springer.com/article/10.1186/s13229-026-00727-y 

Follows on from the INSAR conference proceeding that moved things on from the previous US CDC definition that moved things on from the Lancet introduction.

Highly likely that there'll be more honing of the term and what it covers but the reasons for not using it (or using some other word salad) are getting smaller and smaller and smaller...

Elevated microbially-derived metabolites in autism: a possible diagnostic screening test for a distinct ASD phenotype

A quick entry to note that a new paper which yours truly had a small role to play in has been recently published: https://www.nature.com/articles/s41380-026-03620-5

There's been some media around it e.g. https://nypost.com/2026/05/27/health/new-urine-test-could-diagnose-autism-in-children-study/ and how after several years of collaborative research, some potentially important findings in relation to gut bacterial metabolites present in urine *might* be important to some autisms. I've stressed *might* because there's still more to do in this area and indeed, work is still continuing.

There's a couple of things that are standout in the new paper including (i) how mass spectrometry really is a top-notch method in relation to the science of metabolomics https://pharmaceutical-journal.com/article/research/in-search-of-biomarkers-the-science-of-metabolomics-in-pharmacy (particularly when one more than system are independently at work), (ii) gut and yeast related metabolites present in urine are detectable and potentially quite important to some autisms and perhaps beyond as part of that gut-brain axis, and (iii) the Easter egg in the paper was around how some autisms seemed to be linked to various previously undetected inborn errors of metabolism (most screens of IEM via the baby blood spot measurement are done with mass spectrometry too).

I'm not going to bore you with the details particularly when the rather fantastic Dr Jim Adams is going to be hosting a talk about it in the coming days - register here: https://us06web.zoom.us/webinar/register/3617798965724/WN_RBm7QCaFRceTq1EjU8HFsQ#/registration If you're so inclined, register and have a watch.

Childhood autism in Northern Ireland: 6.2% for 2025/2026 (still relentlessly increasing)

The school-aged autism prevalence rate in Northern Ireland for 2025/2026 is 6.2% https://www.health-ni.gov.uk/sites/default/files/2026-05/asd-children-ni-2026.pdf 

Last year - 2024/2025 - it was 5.9%.

The prevalence rate of autism in boys in Northern Ireland for 2025/2026 is 8.6%. Last year (2024/2025) it was 8.3%.

The sustained upwards trend of childhood autism continues. It's now 1 in 16 if my maths are correct. 1 in 16 school-aged children in Northern Ireland has a diagnosis of autism. An avalanche of children presenting with clinically relevant autism and being diagnosed as such. And even more needs waiting in the wings as per the huge waiting lists for autism assessment.

Reasons? Well 'all better awareness' is something best left for the 1990s. It would be a brave (or stupid) person who takes up that gauntlet. 'Expanding diagnostic criteria' will probably have played a role, but bear in mind these figures have already included the change in data collection that happened in 2019/2020 which accounted for this. 

No, there is something else driving this tsunami of disability. And there's no such thing as a genetic epidemic...