Neurodivergence remains a priority within health and care systems worldwide due to rising concerns around prevalence and the impact of unmet neurodevelopmental needs in education and through the lifespan. In the UK, headlines state increasing wait times and report on crisis situations occurring in schools. But what is the true picture, and, more importantly, what can we do about it?

Thankfully, there seems to be an emerging shift towards early intervention (including pre-diagnosis) and proactive approaches across policy and practice.

Across the UK, there have been extensive waiting times for neurodevelopmental assessments for several years. It is now acknowledged that demand for assessment significantly exceeds service capacity, with capacity having remained static despite referral rates increasing^1,2.

In June 2025, there were 236,225 individuals waiting for an NHS autism assessment in England. When compared to the previous year, this reflects a 15% increase and a significant 53% increase compared to 2023³. Within the National Institute for Health and Care Excellence (NICE) autism assessment guidelines, it is recommended that an assessment be accessed within 13 weeks of referral⁴. The current rate of referrals is such that, of those waiting, 89% had been waiting over 13 weeks, with the average waiting time reported to be 17 months³.

Linked to the long waiting times for a diagnostic assessment, a significant number of individuals do not receive a diagnosis until adolescence or even adulthood. Waiting lists aren’t, however, the only contributor to this – for some individuals, needs are either not recognised or are misunderstood, resulting in further delays in accessing a neurodevelopmental assessment².

The current context around neurodevelopmental assessments and diagnoses, including non-identification of developmental differences and ‘late’ diagnosis, is associated with an increased occurrence of long-term poor outcomes and impairments in functioning. The following difficulties arise, in part, due to support not being provided in a timely manner^3,5:

• a higher rate of mental health difficulties and contact with associated services.
• an increased likelihood of experiencing education-related difficulties (e.g. persistent absence, exclusions, attainment difficulties etc) due to needs not being understood and/or accommodated.
• higher rates of unemployment in adulthood.

Our understanding of autism has changed over time, with the neurodiversity paradigm growing in popularity. This neuroaffirmative understanding sees autistic characteristics as neurological differences rather than impairments or deficits. It does not negate that autistic individuals can experience challenges because of their neurodivergence but instead acknowledges the significant variation in behavioural presentation and support needs^8,9.

The main autistic characteristics required for a diagnosis can be grouped as follows using neuroaffirmative language:

• social and communication differences, including differences in use of verbal and non-verbal communication behaviours, alongside differences in social interaction interest;
• a preference for predictability and routine, associated with repetitive behaviours and highly focused interests;
• sensory processing differences.

The variation in how these traits present is such that a holistic, individualised approach to assessment is required; one that seeks to understand the individual’s strengths and areas of need¹⁰. It is important that assessment considers the person’s communication behaviours, language skills, emotional literacy skills and sensory processing differences. Together, this enables person-centred support and intervention plans, with timely input facilitative of the child achieving their potential^10,11.

Within the UK, the NHS 10 Year Health Plan and associated reviews are guiding a move towards a needs-led, holistic model that emphasises early identification, coordinated cross-sector care and support based on functional need, recognising the prevalence of co-occurring and transdiagnostic presentations^1,2,6. The Department of Health and Social Care recently launched a consultation calling for evidence to inform the development and implementation of a cross-government strategy as the next stage of the 10 Year Plan. This will inform recommendations to support a transition from a diagnosis-led mental health system to an early, proportionate service as a means of improving engagement in education and employment to contribute to improved mental and emotional wellbeing⁷.

At Hogrefe, we have a range of products that can support clinicians of various professional backgrounds to assess and understand a child’s early development in relation to age-related trajectory.

The following are two examples of standardised, transdiagnostic assessments that help with early identification of atypical development often predictive of neurodevelopmental conditions and/or learning disorders, highlighting where further assessment and/or targeted intervention can be provided.

Early Sociocognitive Battery: The ESB is a fun, quick assessment of sociocognitive skills, which are precursors for language development and communication behaviours found to be impaired in autistic individuals.

The Griffiths III offers a comprehensive assessment of a child’s overall development from birth to 6-years. It captures these 5 areas: Foundations of Learning, Language and Communication, Eye and Hand Coordination, Personal-Social-Emotional, and Gross Motor.

The results of tools such as the ESB and Griffiths III can be used to support system-wide understanding of the individual’s strengths and needs to inform decision-making around health and educational support needs. This person-centred approach enables the individual to thrive and achieve their potential across settings.

1. NHS England. (2023). A national framework to deliver improved outcomes in all-age autism assessment pathways: guidance for integrated care boards.
2. Department of Health and Social Care. (2026a). Independent review into mental health conditions, ADHD and autism: interim report.
3. National Autistic Society. (2025, August 14). Autism assessment waiting times. https://www.autism.org.uk/what-we-do/news/autism-assessment-waiting-times-11 
4. National Institute for Health and Care Excellence. (2021). Autism spectrum disorder in adults: diagnosis and management [CG142]. https://www.nice.org.uk/Guidance/CG142 
5. Children’s Commissioner’s Office. (2024). Waiting times for assessment and support for autism, ADHD and other neurodevelopmental conditions. https://assets.childrenscommissioner.gov.uk/wpuploads/2024/10/CCo-report-on-ND-waiting-times_final.pdf 
6. NHS England. (2023). Operational guidance to deliver improved outcomes in all-age autism assessment pathways: Guidance for integrated care boards.
7. Department of Health and Social Care. (2026). Informing the mental health strategy for England: call for evidence document. https://www.gov.uk/government/calls-for-evidence/informing-the-mental-health-strategy-for-england/informing-the-mental-health-strategy-for-england-call-for-evidence-document?utm_campaign=2280286_DCP%20in%20Focus%20-%20May%202026&utm_medium=email&utm_source=DotDigital&dm_i=6MRE,1CVHA,3OHIJ9,6DCYZ,1,0,0,0
8. Edgar, H. & Adkin, T. (2025). Embracing neurodiversity affirmative practice: A path to inclusive support for autistic people. https://www.autism.org.uk/learn/knowledge-hub/professional-practice/embracing-neurodiversity-affirmative-practice 
9. Walker, N. (2021). Neuroqueer heresies: Notes on the neurodiversity paradigm, autistic empowerment, and postnormal possibilities. Autonomous Press.
10. Lord, C. Et al. (2022). The Lancet Commission on the future of care and clinical research in autism. Lancet, 399, 271-334. https://www.thelancet.com/action/showPdf?pii=S0140-6736%2821%2901541-5 
11. Sandback, M., Bottema-Beutel, K., Crowley LaPoint, S., Feldman, J.I., Barrett, D.J., Caldwell, N., Dunham, K., Crank, J., Albarran, S. & Woynaroski, T. (2023). Autism intervention meta-analysis of early childhood studies (Project AIM): updated systematic review and secondary analysis. BMJ, 383, e076733. https://doi.org/10.1136/bmj-2023-076733