An increasing number of people in Scotland are seeking neurodevelopmental assessments for conditions such as autism and ADHD. Experts think that this surge in demand is driven mostly by increased awareness of neurodivergence and how it presents, rather than an increase the number of neurodivergent people.
NHS services, however, are struggling to cope with this increased demand and the number of people waiting for these assessments has grown dramatically in the last five years. In many cases, people are waiting years to be seen, and services are being withdrawn altogether in some areas.
Conditions such as ADHD and autism are not mental health conditions. However, due in part to the stigma and discrimination that neurodivergent people experience, these people are far more likely to develop mental health conditions. Most strikingly, the life expectancies of people with neurodevelopmental conditions such as autism and ADHD are six to eight years less than that of their neurotypical peers.
This has led some to describe the current state of neurodevelopmental services in Scotland as a ‘system in crisis’ and it has attracted widespread interest within Parliament and beyond.
This blog will summarise some of the key points of the SPICe briefing on neurodevelopmental pathways and waiting times in Scotland. More information is available in other blog posts about the terminology surrounding neurodiversity and waiting times data. Â
Where are we now?
A recent survey of NHS health boards in Scotland found:
- Child and Adolescent Mental Health Services (CAMHS) and secondary adult mental health services provide neurodevelopmental assessments only if patients present with significant mental health problems.
- While children who don’t meet these criteria can obtain neurodevelopmental assessments in thirteen of the fourteen NHS health board areas (the exception being NHS Tayside, which has stopped taking new referrals), the provision for adults is far sparser. 30% of adults in Scotland live in areas where they are unable to receive a neurodevelopmental assessment through the NHS, unless they have significant co-occurring mental health conditions.
- There were over 42,000 children and 23,000 adults waiting for a neurodevelopmental assessment as of March 2025. This number has increased dramatically since 2020, with increases of over 500% for children and 2200% for adults in some areas.
- Children and adults are frequently waiting multiple years for assessments, with waiting times of over 5 years reported in many cases. In almost all health boards, less than 50% of patients are being seen within the National Autism Implementation Team’s recommended standard of 36 weeks from referral.
- A range of practices exist for accepting private diagnoses for ADHD and entering shared care agreements for ADHD medication. These issues are explored in a separate SPICe blog.
The responses from Health Boards highlighted a lack of consistency and completeness in data collection. There have been calls for a ‘step change’ in how data is collected, to better understand demand and capacity and improve neurodevelopmental pathways.
Current policy and funding
Various policies have affected the provision of assessment and support for neurodivergent people in Scotland.
The National Neurodevelopmental Specification for Children and Young People sets out the support that children with neurodevelopmental conditions should receive. It falls within the Getting It Right For Every Child (GIRFEC) framework. The Scottish Government is funding a number of pilot programs to support the implementation of the specification. One of the key points is that support should be available for neurodivergent people without a formal diagnosis. The Specification states that:
understanding of support needs can be enhanced by diagnosis but should not wait for diagnosis.
Scottish Government, National Neurodevelopmental Specification for Children and Young People, 2021
The Scottish Government also funds the Autistic Adult Support Fund, and the National Autism Implementation Team (NAIT). This is a partnership between researchers and practitioners working to improve evidence-based practice in neurodevelopmental services and to establish neurodevelopmental pathways for both children and adults across Scotland.
NAIT endorses a move towards using multi-disciplinary and multi-agency teams to carry out neurodevelopmental assessments, comprising of nurses, therapists, psychologists and GPs as well as clinicians. They provide resources to support the professional development of these teams.
Legislation on hold
In 2023-24, a consultation took place on a new Learning Disabilities, Autism and Neurodiversity (LDAN) Bill. It was anticipated that this Bill would:
- provide a mechanism to better support neurodivergent people
- improve awareness of neurodevelopmental conditions
- help deliver better training for people working with neurodivergent people
- improve the collection and reporting of data on neurodivergent people
- promote independent advocacy
However, the Bill was not taken forward in the Programme for Government for 2024-25, to the disappointment of its supporters. The announcement cited the ‘strong and diverse’ views on many of the key issues as one of the reasons for this delay, as well as a fast-changing legislative landscape in this area.
Support for neurodivergent people
At present, a range of support is available for neurodivergent people in Scotland, access to which is not dependent on diagnosis.
- Various forms of therapy (such as Occupational Therapy and Speech and Language Therapy) are available through the NHS and private providers, although waiting times for accessing specialised individual support can be long.
- Third sector support is available from a range of national and local organisations. While third sector organisations cannot provide clinical support such as neurodevelopmental assessments, they can provide support in the form of training, specialist educational services, peer support networks and supported living arrangements. Demand is high for these services, and in some cases there may be waiting lists.
- Neurodivergent people may also be eligible for reasonable adjustments in the workplace under the Equality Act, additional support in education through Getting It Right For Every Child (GIRFEC) policy, and in social security mechanisms, where they may be eligible for disability payments.
Despite the range of support offered to neurodivergent people without a diagnosis, many feel a diagnosis is important. A recent report from Scottish Autism, written in conjunction with three Autistic People’s Organisations, noted that:
receiving an autism diagnosis can be a pivotal moment in the life of an autistic
Scottish Autism, Experiences of Autism Assessment and Diagnosis, June 2025
person. It can be an important step in a person’s self-understanding; it may be
the point at which a person feels able to access a wider community of autistic
people; and it should be a step along the pathway to someone receiving the
support and services that they need in order to thrive.
The report also highlights the challenges faced by people seeking an assessment, including the stress and anxiety of waiting and the financial hardship faced should they decide to seek a private assessment.
Additional challenges facing neurodivergent groups
Certain groups of neurodivergent people experience additional challenges, particularly when seeking a diagnosis.
Historically, autism and ADHD were thought to be far more prevalent in males than in females. Recent evidence suggests this isn’t the case; instead, it is now thought that women and girls experience neurodevelopmental conditions differently and are better at ‘masking’ their behaviours. However, undiagnosed neurodevelopmental conditions can have significant impacts on neurodivergent women and girls, and organisations such as SWAN Scotland provide support specifically to these groups.
A similar phenomenon is seen in ethnic minority neurodivergent people. This group experiences higher rates of misdiagnosis, due in part to diagnostic criteria that are unsuited to detecting neurodivergent traits in ethnic minorities. Scottish Ethnic Minority Autistics works to foster a better understanding of neurodivergence within the ethnic minority community and combat discrimination.
Neurodivergent people also experience additional challenges when transitioning from childhood to adulthood. This is a time at which they may move between education environments, social security mechanisms and healthcare services.
What happens next?
The Royal Society of Psychiatrists in Scotland have called for a re-structuring of neurodevelopmental pathways for adults, implementing a national approach with significant third sector involvement. This would move away from the current model, whereby services are delivered by NHS health boards or Health and Social Care Partnerships, depending on the area. This division of responsibility and lack of national pathway has resulted in different services being available in different areas, which some have called a ‘postcode lottery’.
The Minster for Social Care and Mental Wellbeing made a statement entitled ‘Ensuring the Right Support for Young People’s Neurodivergence, Mental Health and Wellbeing’ on 26 June 2025. This included plans for a cross-sector Taskforce to address the provision of neurodevelopmental services for children and young people in Scotland, supported by £500,000 of additional funding to deliver improvements in these services.
This statement accompanied the publication of a review of the implementation of the National Neurodevelopmental Specification. Among the review’s findings were that:
- there was a mixture of views as to whether the Specification met the needs of children, young people and families
- while some praised the increased focus on a neurodevelopmental and multidisciplinary approach, the majority of people surveyed felt that the Specification had had limited impact
- there were major challenges to implementation, including increasing demand, limited funding and poor communication between partners in the Specification’s delivery
- the intended move to a needs-based model had not reduced the demand for diagnostic services
- there was a lack of clarity over who was responsible for different aspects of implementation, including diagnosis and assessment.
It also set out short, medium and long-term actions to help improve neurodevelopmental support for children and their families.
Scottish Parliament intends to carry out further work in this area, with calls for a cross-party summit on waiting times for neurodevelopmental support and a number of petitions under consideration. In addition, the Health, Social Care and Sport Committee and Equalities, Human Rights and Civil Justice Committee have both has agreed to carry out inquiries into neurodivergence and neurodevelopmental pathways in 2025-26.
Ben Adam, Researcher, SPICe
Cover image of Scottish Parliament.