Autism and ADHD prevalence estimates: balancing concerns about overdiagnosis with the history of under-detection

Authors

Abstract

Where global prevalence of autism and ADHD is assumed stable, increasing incidence of referrals, referral requests and recorded diagnoses have evoked concerns that autism and ADHD are overdiagnosed, i.e. that diagnoses are bestowed without sufficient justification to individuals who might be incentivised to seek diagnosis. While there is presently little evidence to support these assertions, methodological limitations demonstrably contribute to the systematic under-detection of certain sub-groups, like older adults, marginalized minorities and people assigned female at birth, within these diagnostic categories. As such, rising demand for autism and ADHD diagnosis can be understood in light of historic underdiagnosis. While strains on diagnostic systems require urgent solutions, failure to diagnose legitimate cases precludes provision of appropriate support and has severe individual and socioeconomic repercussions. Given the limitations which underlie current prevalence estimates, we draw attention to the equally problematic issue of underdiagnosis and the accompanying individual and societal costs this brings.

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