Neurodevelopmental Pathways and Waiting Times in Scotland

Author: Ben Adam

PDF Published: Tuesday 24 Jun 2025 (SB 25-25)

A diagram showing that for a given trait, neurotypical people fall within the usual statistic range whereas neurodivergent people fall outside this range. Falling outside this range increases the likelihood of having a neurodevelopmental condition. Neurodiversity refers to the entire range.

Image: Figure 1: Definitions of neurodiversity and neurodivergence

A bar chart showing the number of children waiting for neurodevelopmental assessments across health boards in Scotland. NHS Greater Glasgow and Clyde, NHS Lanarkshire and NHS Lothian have the longest waiting lists, with over 7000 people in each, whereas NHS Shetland, NHS Orkney and NHS Western Isles have the shortest.

Image: Figure 2: Number of children waiting for neurodevelopmental assessments in Scotland, March 2025

Line graphs showing the number of children waiting for a neurodevelopmental assessment in six different health boards. The number of children waiting in each health board has increased dramatically since 2020.

Image: Figure 3: Increases in size of the waiting lists for child neurodevelopmental assessments.

A map of regions where adult neurodevelopmental assessments are available for patients who don't meet the criteria for referral to secondary mental health services. Assessments are available in Lothian, Lanarkshire, Tayside, Greater Glasgow and Clyde, Highland and Western Isles, and in Aberdeen City and Moray HSCPs in NHS Grampian.

Image: Figure 4: Map of regions where adult neurodevelopmental assessments are available.

A figure showing the number of adults on waiting lists for neurodevelopmental assessments across health boards in Scotland. Lothian and Greater Glasgow and Clyde make up the vast majority of the total.

Image: Figure 5: Number of adults waiting for neurodevelopmental assessments across health boards in Scotland, March 2025

The number of adults waiting for a neurodevelopmental assessment in six different health boards has increased dramatically since 2020.

Image: Figure 6: Increases in waiting lists for adult neurodevelopmental assessments.

A plot showing the median and longest waiting times for children to receive a neurodevelopmental assessment in twelve NHS boards. NHS Ayrshire and Arran, NHS Highland and NHS Orkney report the longest median wait times of over two years. NHS Ayrshire and Arran, NHS Highland, NHS Orkney and NHS Lothian also report longest wait times of over five years.

Image: Figure 7: Median and longest waiting times for children to receive a neurodevelopmental assessment in NHS Scotland health boards.

A plot showing the median and longest waiting times for adults to receive a neurodevelopmental assessment in ten NHS boards. NHS Tayside and NHS Forth Valley report the longest median wait times of over 130 weeks, while NHS Greater Glasgow and Clyde, NHS Highland and NHS Lothian all report longest wait times over seven years.

Image: Figure 8: Median and longest waiting times for adults to receive a neurodevelopmental assessment in NHS Scotland health boards.

A bar chart showing that men and women with autism and ADHD have life expectancies six to eight years less than their neurotypical peers.

Image: Figure 9: Life expectancies of neurodivergent men and women

O'Nions, E., Petersen, I., Buckman, J.E.J., Charlton, R., Cooper, C., Corbett, A., … Stott, J. (2023). Autism in England: assessing underdiagnosis in a population-based cohort study of prospectively collected primary care data. The Lancet Regional Health - Europe, 29. doi: 10.1016/j.lanepe.2023.100626

Rang, Y., Yang, C.J., Jin, Y., & Wang, Y. (2021). Prevalence of attention-deficit/hyperactivity disorder in individuals with autism spectrum disorder: A meta-analysis. Research in Autism Spectrum Disorders, 83. doi: 10.1016/j.rasd.2021.101759

Buck, T.R., Viskochil, J., Farley, M., Coon, H., McMahon, W.M., Morgan, J., … Bilder, D.A. (2014). Psychiatric Comorbidity and Medication Use in Adults with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 44, 3063-3071. doi: 10.1007/s10803-014-2170-2

Autism Rights Group Highland, ., Autistic Mutual Aid Society Edinburgh, ., Scottish Ethnic Minority Autistics, ., & Scottish Autism, . (2025). Experiences of Autism Assessment and Diagnosis in Scotland. : (in press).

Karmiloff-Smith, A., Casey, B.J., Massand, E., Tomalski, P., & Thomas, M.S.C. (2014). Environmental and Genetic Influences on Neurocognitive Development: The Importance of Multiple Methodologies and Time-Dependent Intervention. Clinical Psychology Science, 2(5), 628-637. doi: 10.1177/2167702614521188

Shah, P.J., Boilson, M., Rutherford, M., Prior, S., Johnston, L., Maciver, D., … Forsyth, K. (2022). Neurodevelopmental disorders and neurodiversity: definition of terms from Scotland's National Autism Implementation Team. The British Journal of Psychiatry, 221(3), 577-579. doi: 10.1192/bjp.2022.43

National Records of Scotland. (2025). Population estimates time series data. Retrieved from https://www.nrscotland.gov.uk/publications/population-estimates-time-series-data/ [accessed 17 April 2025]

Jellet, R., & Muggleton, J. (2022). Implications of Applying "Clinically Significant Impairment" to Autism Assessment: Commentary on Six Problems Encountered in Clinical Practice. Journal of Autism and Developmental Disorders, 52(3), 1412-1421. doi: 10.1007/s10803-021-04988-9

Radley, A., Melia, B., Maciver, D., Rutherford, M., & Boilson, M. (2024). An analysis of prescribing data in attention-deficit hyperactivity disorder for adolescents and adults in Scotland. British Journal of Psychiatry Open, 10(5). doi: 10.1192/bjo.2024.722.

Scottish Government. (2023). Learning Disabilities, Autism and Neurodivergence Bill: consultation. Retrieved from https://www.gov.scot/publications/learning-disabilities-autism-neurodivergence-bill-consultation/ [accessed 14 April 2025]

NHS England. (2023). Neurodiversity. Retrieved from https://www.hee.nhs.uk/our-work/pharmacy/transforming/initial/foundation/resources/edi/neurodiversity [accessed 14 April 2025]

Maciver, D., Rutherford, M., Johnston, L., & Roy, A.S. (2023). Prevalence of neurodevelopmental differences and autism in Scottish primary schools 2018–2022. Autism Research, 16(12), 2403-2414. doi: 10.1002/aur.3063

British Dyslexia Association. (2014). Dyslexia. Retrieved from https://www.bdadyslexia.org.uk/dyslexia [accessed 14 April 2025]

British Dyslexia Association. (2022). About dyscalculia. Retrieved from https://www.bdadyslexia.org.uk/dyscalculia/how-can-i-identify-dyscalculia [accessed 14 April 2025]

Scottish ADHD Coalition. (2025). ADHD in Scotland. Retrieved from https://www.scottishadhdcoalition.org/adhd-in-scotland/ [accessed 14 April 2025]

Faraone, S.V., & Biederman, J. (2005). What is the prevalence of adult ADHD? Results of a population screen of 966 adults. Journal of Attention Disorders, 9(2), 384-391. doi: 10.1177/1087054705281478

Hirota, T., & King, B.H. (2023). Autism Spectrum Disorder: A Review. The Journal of the American Medical Association, 329(2), 157-168. doi: 10.1001/jama.2022.23661

Curnow, E., Rutherford, M., Maciver, D., Johnston, L., Prior, S., Boilson, M., … Meff, T. (2023). Mental health in autistic adults: A rapid review of prevalence of psychiatric disorders and umbrella review of the effectiveness of interventions within a neurodiversity informed perspective. PLoS One, 18(7). doi: 10.1371/journal.pone.0288275

Chen, M.H., Wei, H.T., Chen, L.C., Su, T.P., Bai, Y.M., Hsu, J.W., … Chen, Y.S. (2015). Autistic spectrum disorder, attention deficit hyperactivity disorder, and psychiatric comorbidities: A nationwide study. Research in Autism Spectrum Disorders, 10, 1-6. doi: 10.1016/j.rasd.2014.10.014

Martin, J. (2024). Why are females less likely to be diagnosed with ADHD in childhood than males?. The Lancet Psychiatry, 11(4), 303-310. doi: 10.1016/S2215-0366(24)00010-5

Mowlem, F., Agnew-Blais, J., Taylor, E., & Asherson, P. (2019). Do different factors influence whether girls versus boys meet ADHD diagnostic criteria? Sex differences among children with high ADHD symptoms. Psychiatry Research, 272, 765-773. doi: 10.1016/j.psychres.2018.12.128

Quinn, P., & Wigal, S. (2004). Perceptions of Girls and ADHD: Results From a National Survey. Medscape General Medicine, 6(2).

Tierney, S., Burns, J., & Kilbey, E. (2016). Looking behind the mask: Social coping strategies of girls on the autistic spectrum. Research in Autism Spectrum Disorders, 23, 73-83. doi: 10.1016/j.rasd.2015.11.013

Maciver, D., Roy, A.S., Johnston, L., Boilson, M., Curnow, E., Johnstone-Cooke, V., … Rutherford, M. (2025). Waiting Times and Influencing Factors in Children and Adults Undergoing Assessment for Autism, ADHD, and Other Neurodevelopmental Differences. Autism Research, 1-14. doi: 10.1002/aur.70011

Diverse Diagnostics. (2022). Fees and Flexible Payment Plans at Diverse Diagnostics. Retrieved from https://diversediagnostics.co.uk/fees/ [accessed 11 April 2025]

Primrose Autism Specialists. (2025). Payments. Retrieved from https://primroseautismspecialists.co.uk/payment/ [accessed 11 April 2025]

Neurodevelopmental Assessment Clinic Stirling. (2024). Full Neurodevelopmental Assessment. Retrieved from https://neurodevelopmentalassessmentstirling.com/full-neurodevelopmental-assessment/ [accessed 11 April 2025]

The Edinburgh Practice. (2024). Combined Autism & ADHD Assessments (5-17 years old). Retrieved from https://edinburghpractice.com/service/adhd-assessments/combined-autism-adhd-assessments/ [accessed 11 April 2025]

ADHD Scotland. (2025). ADHD/ASD Assessments in Edinburgh. Retrieved from https://www.adhdscotland.co.uk/assessments-edinburgh/ [accessed 11 April 2025]

Jaicks, C.C.D. (2024). Evaluating the Benefits of Occupational Therapy in Children With Autism Spectrum Disorder Using the Autism Behavior Checklist. Cureus, 16(7). doi: 10.7759/cureus.64012

Adamou, M., Asherson, P., Arif, M., Buckenham, L., Cubbin, S., Dancza, K., … Young, S. (2021). Recommendations for occupational therapy interventions for adults with ADHD: a consensus statement from the UK adult ADHD network. BioMed Central Psychiatry, 21. doi: 10.1186/s12888-021-03070-z

Paul, R. (2008). Interventions to improve communication in autism. Child and Adolescent Pyschiatric Clinics of North America, 17(4), 835-856. doi: 10.1016/j.chc.2008.06.011

The Muir Practice. (2025). Services. Retrieved from https://www.themuirpractice.co.uk/services/ [accessed 24 April 2025]

Safren, S.A., Otto, M.W., Sprich, S., Winett, C.L., Wilens, T.E., & Biederman, J. (2005). Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behaviour Research and Therapy, 43(7), 831-842. doi: 10.1016/j.brat.2004.07.001

Sprich, S.E., Safren, S.A., Finkelstein, D., Remmert, J.E., & Hammerness, P. (2016). A randomized controlled trial of cognitive behavioral therapy for ADHD in medication-treated adolescents. The Journal of Child Psychology and Psychiatry, 57(11), 1218-1226. doi: 10.1111/jcpp.12549

NHS Lothian | Child and Adolescent Mental Health Services. (2025). Autism Spectrum Disorder. Retrieved from https://services.nhslothian.scot/camhs/autism-spectrum-disorder/ [accessed 11 April 2025]

NHS Inform. (2024). Life as an autistic person. Retrieved from https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/autism/life-as-an-autistic-person/ [accessed 6 May 2025]

Scottish Autism. (2025). Services and Support. Retrieved from https://www.scottishautism.org/services-support [accessed 11 April 2025]

National Autism Implementation Team. (2024). Support for Neurodivergent Adults in Scotland Before, During and After Diagnosis: A Scoping Review of Provision in Health and Social Care Partnerships. Edinburgh: National Autism Implementation Team.

Fredriksen, M., Dahl, A.A., Martinsen, E.W., Klungsøy, O., Haavik, J., & Peleikis, D.E. (2014). Effectiveness of one-year pharmacological treatment of adult attention-deficit/hyperactivity disorder (ADHD): An open-label prospective study of time in treatment, dose, side-effects and comorbidity. European Neuropsychopharmcology, 24(12), 1873-1884. doi: 10.1016/j.euroneuro.2014.09.013

Miller, J.S., Bilder, D., Farley, M., Coon, H., Pinborough-Zimmerman, J., Jenson, W., … McMahon, W.M. (2013). Autism Spectrum Disorder Reclassified: A Second Look at the 1980s Utah/UCLA Autism Epidemiologic Study. Journal of Autism and Developmental Disorders, 43, 200-210. doi: 10.1007/s10803-012-1566-0

Hill, C. (2025, March 26). "Rising ADHD and Autism rates reflect education - not a crisis". Retrieved from https://www.additudemag.com/why-is-autism-increasing-neurodiversity-awareness/?srsltid=AfmBOor8uJC81hHciT0Y-vrqZFFgZ1rzqP5pgyKkIAjNqS1xTlg3CjqF [accessed 17 April 2025]

Hedley, D., & Uljarevic, M. (2018). Systematic Review of Suicide in Autism Spectrum Disorder: Current Trends and Implications. Current Developmental Disorders Reports, 5, 65-76. doi: 10.1007/s40474-018-0133-6

Ljung, T., Chen, Q., Lichtenstein, P., & Larsson, H. (2014). Common etiological factors of attention-deficit/hyperactivity disorder and suicidal behavior: a population-based study in Sweden. Journal of the American Medical Association Psychiatry, 71(8), 958-964. doi: 10.1001/jamapsychiatry.2014.363

Donaghy, B., Moore, D., & Green, J. (2023). Co-Occurring Physical Health Challenges in Neurodivergent Children and Young People: A Topical Review and Recommendation. Child Care in Practice, 29(1), 3-21. doi: 10.1080/13575279.2022.2149471

Ward, J.H., Weir, E., Allison, C., & Baron-Cohen, S. (2023). Increased rates of chronic physical health conditions across all organ systems in autistic adolescents and adults. Molecular Autism, 14. doi: 10.1186/s13229-023-00565-2

Casale, R., Atzeni, F., Bazzichi, L., Beretta, G., Constantini, E., Sacerdote, P., … Tassorelli, C. (2021). Pain in Women: A Perspective Review on a Relevant Clinical Issue that Deserves Prioritization. Pain and Therapy, 10, 287-314. doi: 10.1007/s40122-021-00244-1

Chakraborty, P., Carpenter, K.L.H., Major, S., Deaver, M., Vermeer, S., Herold, B., … Dawson, G. (2020). Gastrointestinal problems are associated with increased repetitive behaviors but not social communication difficulties in young children with autism spectrum disorders. Autism, 25(2), 405-415. doi: 10.1177/1362361320959503

Baeza-Velasco, C., Cohen, D., Hamonet, C., Vlamynck, E., Diaz, L., Cravero, C., … Guinchat, V. (2018). Autism, Joint Hypermobility-Related Disorders and Pain. Frontiers in Psychiatry, 9. doi: 10.3389/fpsyt.2018.00656

O'Nions, E., Lewer, D., Petersen, I., Brown, J., Buckman, J.E.J., Charlton, R., … Stott, J. (2024). Estimating life expectancy and years of life lost for autistic people in the UK: a matched cohort study. The Lancet Regional Health Europe, 36. doi: https://doi.org/10.1016/j.lanepe.2023.100776

O'Nions, E., El Baou, C., John, A., Lewer, D., Mandy, W., McKechnie, D.G.J., … Stott, J. (2025). Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: matched cohort study. The British Journal of Psychiatry, 1-8. doi: 10.1192/bjp.2024.199

Loomes, R., Hull, L., & Mandy, W.P.L. (2017). What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466-474. doi: 10.1016/j.jaac.2017.03.013

Posserud, M.B., Skretting Solberg, B., Engeland, A., Haavik, J., & Klungsøyr, K. (2021). Male to female ratios in autism spectrum disorders by age, intellectual disability and attention-deficit/hyperactivity disorder. Acta Psychiatrica Scandinavica, 144(6), 635-646. doi: 10.1111/acps.13368

Hartung, C.M., & Lefler, E.K. (2019). Sex and Gender in Psychopathology: DSM–5 and Beyond. Psychological Bulletin, 145(4), 390-409. doi: 10.1037/bul0000183

McCrossin, R. (2022). Finding the True Number of Females with Autistic Spectrum Disorder by Estimating the Biases in Initial Recognition and Clinical Diagnosis. Children, 9(2), 272. doi: 10.3390/children9020272

Alaghband-rad, J., Hajikarim-Hamedani, A., & Motamed, M. (2023). Camouflage and masking behavior in adult autism. Frontiers in Psychiatry, 14. doi: 10.3389/fpsyt.2023.1108110

Kirby, A.V., Conner, C.M., & Mazefsky, C.A. (2024). Are autistic females at greater risk of suicide? A call for clarity to advance suicide prevention for the whole community. Autism Research, 17(5), 898-905. doi: 10.1002/aur.3120

Mandell, D.S., Wiggins, L.D., Arnstein Carpenter, L., Daniels, J., DiGuiseppi, C., Durkin, M.S., … Kirby, R.S. (2009). Racial/Ethnic Disparities in the Identification of Children With Autism Spectrum Disorders. American Journal of Public Health, 99(3), 493-498. doi: 10.2105/AJPH.2007.131243

Farzana, S. (2025). Personal Communication. : .

Cohen, S.R., Joseph, K., Levinson, S., Blacher, J., & Eisenhower, A. (2022). “My Autism Is My Own”: Autistic Identity and Intersectionality in the School Context. Autism in Adulthood, 4(4), 315-327. doi: 10.1089/aut.2021.0087

Gottardello, D., Calvard, T., & Song, J.W. (2025). When Neurodiversity and Ethnicity Combine: Intersectional Stereotyping and Workplace Experiences of Neurodivergent Ethnic Minority Employees. Human Resource Management, 1-19. doi: 10.1002/hrm.22286

Mandell, D.S., Ittenbach, R.F., E Levy, S., & Pinto-Martin, J.A. (2006). Disparities in Diagnoses Received Prior to a Diagnosis of Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 37(9), 1795-1802. doi: 10.1007/s10803-006-0314-8

Shalaby, N., Sengupta, S., & Williams, J.B. (2024). Large-scale analysis reveals racial disparities in the prevalence of ADHD and conduct disorders. Scientific Reports, 14. doi: 10.1038/s41598-024-75954-5

Cummings, J.R., Ji, X., Allen, L., Lally, C., & Druss, B.G. (2017). Racial and Ethnic Differences in ADHD Treatment Quality Among Medicaid-Enrolled Youth. American Academy of Pediatrics Selective Deposit, 139(6). doi: 10.1542/peds.2016-2444

Turnock, A., Langley, K., & Jones, C.R.G. (2022). Understanding Stigma in Autism: A Narrative Review and Theoretical Model. Autism in Adulthood, 4(1), 76-91. doi: 10.1089/aut.2021.0005

Nevill, R.E.A., & White, S.W. (2011). College students' openness toward autism spectrum disorders: improving peer acceptance. Journal of Autism and Developmental Disorders, 41(12), 1619-1628. doi: 10.1007/s10803-011-1189-x

Jensen, C.M., Martens, C.S., Nikolajsen, N.D., Skytt Gregersen, T., Heckmann Marx, N., Goldberg Frederiksen, M., … Hansen, M.S. (2016). What do the general population know, believe and feel about individuals with autism and schizophrenia: Results from a comparative survey in Denmark. Autism, 20(4), 496-508. doi: 10.1177/1362361315593068

Broady, T.R., Stoyles, G.J., & Morse, C. (2017). Understanding carers' lived experience of stigma: the voice of families with a child on the autism spectrum. Health and Social Care in the Community, 25(1), 224-233. doi: 10.1111/hsc.12297

Öz, B., Yüksel, T., & Nasiroglu , S. (2019). Depression-Anxiety Symptoms and Stigma Perception in Mothers of Children with Autism Spectrum Disorder. Noro psikiyatri arsivi, 57(1), 50-55. doi: 10.29399/npa.23655

Masuch, T.V., Bea, M., Alm, B., Deibler, P., & Sobanski, E. (2019). Internalized stigma, anticipated discrimination and perceived public stigma in adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11, 211-220. doi: 10.1007/s12402-018-0274-9

McKechnie, D.G.J., O'Nions, E., Dunsmuir, S., & Petersen, I. (2023). Attention-deficit hyperactivity disorder diagnoses and prescriptions in UK primary care, 2000–2018: population-based cohort study. British Journal of Psychology Open, 9(4). doi: 10.1192/bjo.2023.512

Last Updated: 5/12 6:51pm

An error occured while loading, please try again in a few minutes.