It is widely accepted that there is a SEND crisis in schools, with the support needs of children outstripping the resources available. There have been recent suggestions by high profile figures that an overdiagnosis of specific learning difficulties and neurodiversity is to blame. However, the data tells us a different story; in fact, there is a problem with underdiagnosis instead.

Is a diagnosis necessary?

While a child in the UK doesn’t need a formal diagnosis to access support at school, identification still plays a significant role. A formal diagnosis can allow access to certain services and resources as well as offering more clarity on a child’s strengths, ways of learning, and needs. It also helps with consistent understanding and support across classrooms, staff and services. There is also misunderstanding about support for children, with some schools, services and families incorrectly believing that a formal diagnosis is a prerequisite. Therefore, a diagnosis is sought before any support offered. 

Research also shows that a lack of diagnosis can have a significant impact on individual lives. This ranges from lower grades to lower self-esteem and many things in between. And these impacts are not just felt in childhood but have a lasting impact on adulthood too. 

So what is the truth about overdiagnosis? 

It is true that there has been an increase in diagnosis of specific learning difficulties and neurodiversity. However, it is important to recognise why this is the case. It is not because it is being incorrectly diagnosed, or used as an excuse, but because there is more awareness and understanding of how the brain works as well as better ways of identifying these differences. An analogy that’s often used is that when telescopes improved, we suddenly saw more stars in the sky. These stars were always there but we couldn’t see them without better equipment.

However, even with increases in diagnosis there are still issues with underdiagnosis. The British Dyslexia Association, for example, explain how on average three pupils in every classroom will be dyslexic, yet only 20% of these pupils will be identified as such, and this diagnosis often happens later in a child’s educational journey. This contributes to feelings of frustration and self-blame. Figures show us that only 20% of these children will achieve grade 5 or above in their exams compared with 50% of their peers. 

There is a similar story for ADHD where there are an estimated two million people with ADHD who are undiagnosed in the UK, according to ADHD UK. This is particularly prevalent for girls and ethnic minorities where misconceptions about ADHD prevents accurate identification in groups outside of white males. This leads to various issues including lower grades and being labelled as lazy or disruptive by others. 

Evidence shows us that despite public narratives, the claim of overdiagnosis is unsubstantiated with underdiagnosis being a bigger problem in ensuring all children can succeed academically and in protecting their wellbeing. 

A word of caution

Although diagnosis is often an important step, the negative labels can bring must also be tackled. In the 1960s, Becker introduced the labelling theory. This theory explains how labels can have both positive and negative consequences. When applied to the SEND context, labelling can provide the positives of greater understanding, access to support, and validation (amongst other things). However, it can also provide the negatives of stigma, incorrect assumptions about ability, and bullying (plus more). This means that diagnosis itself is not a magic fix. It needs to also be accompanied by more awareness, education and acceptance of difference so that labels don’t create even more problems to be solved. 

The narrative of overdiagnosis is not supported by the evidence which instead shows a problem with underdiagnosis and explains the significant impacts this has. Diagnosis matters as it can open support and understanding leading to improved grades and improved self-worth. Yet diagnosis alone is not enough, as we need to also ensure that diagnosis is empowering and not accompanied by stigma or incorrect assumptions. Only then can we move beyond the myths and ensure all children can thrive in their education.