Spotting the Spectrum: Why the Rise in Autism Diagnoses Reflects Progress, Not Panic

22nd August 2025

We are delighted to share this Voices blog by Kirsty Jacques who is a Health Visitor Clinical Lead for SEND for Hertfordshire Community NHS Trust and iHV Expert Advisor for Special Educational Needs and Disabilities (SEND).

Kirsty Jacques, Health Visitor Clinical Lead for SEND for Hertfordshire Community NHS Trust and iHV Expert Advisor for SEND

Introduction

Autism diagnosis rates in children have steadily risen over the past decade, prompting some professionals and policymakers to ask, “Are we seeing more autism, or just recognising it more effectively?”

My experience, working closely with children with autism and their families, suggests that we are not witnessing an epidemic of autism, but an encouraging shift towards early recognition, better understanding, and more equitable access to support. These developments are critical if we are to improve long-term outcomes for neurodivergent children and their families.

Understanding the Numbers

According to NHS England, autism referrals in children and young people more than doubled between 2019 and 2023 — from around 15,000 per month to over 35,000 by the end of 2023¹. Similarly, in the US, the US Centers for Disease Control and Prevention report that 1 in 36 children are now identified as autistic — compared to 1 in 150 just two decades ago.

Most experts agree that the increase is not necessarily a surge in actual cases, but instead a reflection of improved awareness, expanded diagnostic criteria, better screening tools, reduced stigma, and recognition of masking of autistic traits by some autistic people. While genetics play a major role, there is ongoing research to understand the impact of other potential factors that may interact with genetic predisposition to autism – for example, preterm birth, parental age, and exposure to potential environmental factors (these are still widely debated, with research ongoing). Importantly, vaccines have been repeatedly ruled out as a cause across numerous studies.

This growth in autism rates is less about prevalence than progress. Multiple factors contribute:

Wider public and professional awareness.
Expanded diagnostic criteria – Since the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) revision in 2013, autism is now understood as a spectrum. This includes individuals with milder traits who might not have been diagnosed under older definitions.
Greater willingness to refer, assess and support.
Reduced stigma and improved self-advocacy by autistic individuals.

Early Identification Leads to Better Outcomes

Autism is a lifelong neurodevelopmental difference, not a disorder to be “cured”. But when it is recognised early — ideally before school age — families can access meaningful support sooner.

Evidence shows that early support leads to:

Improved language and communication outcomes.
Greater emotional wellbeing and behaviour regulation.
Reduced stress and anxiety for families navigating complex systems.

This is especially important in mitigating secondary challenges that arise from unmet needs — such as exclusion from early years settings, the use of restrictive practice, or escalation into crisis services later in life.

The Critical Role of Health Visitors

Health visitors play a pivotal role in early identification and support of autism, or suspected autism. As trusted, universal health professionals, they are uniquely positioned to:

Proactively and systematically reach all babies, young children and families – improving access to health care and providing a safety net.
Observe developmental patterns through regular contact.
Build relationships with families – gaining insight over time. Alongside supporting the child, health visitors play a key role in engaging and supporting parents – this includes the period when they are waiting for diagnosis.
Enabling early identification – using structured tools like the Ages and Stages Questionnaire (ASQ-3), ASQ Social and Emotional (SE) and Schedule of Growing Skills (SOGs), alongside direct observation and conversations with parents/carers to gain a full picture of a child’s development and behaviours.
Coordinate early referrals to Community Paediatrics , Speech and Language Therapy (SALT), and Early Help to enable diagnosis and early support.
Champion neurodiversity-informed practice in multi-agency forums.

Despite this, the health visiting workforce in England has shrunk by over 40% since 2015. Caseloads are increasingly unmanageable; continuity of carer has been eroded in some services and time for meaningful developmental observation and conversation is being squeezed.

If the government is serious about addressing wait times, health inequalities, and school readiness, it must invest in this foundational workforce. Health visitors are the first line of recognition — and the earlier we notice, the better we support.

Recognition Is Not Over-Diagnosis

We must challenge the idea that rising diagnosis rates represent over-medicalisation. Autism is not “new” — it has always been here. But we are now better equipped to recognise children whose needs may previously have been misunderstood, missed, or mislabelled.

This is especially important for:
– Girls, whose presentation often diverges from male-based diagnostic norms.
– Children in minoritised ethnic groups, where cultural assumptions can obscure recognition.
– Children in disadvantaged or temporary housing, where developmental concerns may be deprioritised.

Each new diagnosis is not a failure of parenting or education — it’s often a moment of relief, clarity, and access.

And It’s Not Just Children:

Alongside children, we’re also seeing an increase in autism diagnoses among adults — particularly women, LGBTQ+ individuals, and those who were previously misdiagnosed or masked their traits to fit in. Many adults describe receiving a diagnosis as transformative: not a label, but an explanation. It offers a framework for self-understanding, access to adjustments at work or in education, and validation after years of feeling “different”. This rise reflects a growing recognition that neurodiversity is lifelong — and that it’s never too late to understand yourself better.

What Next? A Call for Sustained Investment and Holistic Support

To turn this diagnostic momentum into meaningful change, we need:

Consistent professional development on neurodiversity across health, education and social care
Recognition of autism as a public health and inclusion issue — not a behavioural problem
Integrated, co-produced post-diagnosis pathways
National and local investment in Health Visitors and Early Years SEND capacity.

Let’s ensure that recognition leads to support — not waiting lists. Let’s make the rise in diagnosis the beginning of better outcomes, not the end of the road.

Further resources and information:

iHV Training: Changing Conversations: Autism & Supporting Behaviour Ambassadors
In January 2025, the iHV provided a written submission to the Education Committee’s major inquiry focused on finding solutions to the special educational needs and disabilities (SEND) crisis. The iHV submission is now publicly available and published on the UK Parliament website. You can read the full iHV SEND Inquiry submission here.