A new paper by developmental psychologist Uta Frith claims that the diagnostic threshold for autism has become ‘too broad’, to the point where it has ceased to be considered useful. Are too many people calling themselves autistic?
I’m intrigued less by this than the ever-increasing scorn at the rise in autism assessments, particularly from a polestar of clinical authority. It’s notable that this new burst of diagnoses has
been disruptive specifically to how psychology as an institution has traditionally worked. In that tradition, labels are assigned, their recipients shrink away into disordered shame and if they
are ‘lucky’, receive treatment. The desire to know and understand oneself is not novel, but this collective urge to share and describe the autistic experience en masse feels relatively new. When the power shifts to a community owning the language, there is profound discomfort in medical spaces and beyond. I question whether Frith’s resistance relates to greater systemic imbalances within the field around power and withholding permission. There is an obsession with autism through the lens of ‘disorder’, where a medical model focused on perceived ‘deficits’ in the individual is favoured over the social model of disability, which names the structures of society themselves as disabling. It’s this disconnect between clinical and the community that seemingly operate within different realms: those with credentials form a self-assured canopy above, whilst their dubious speculations and theories harm those on the ground.
Frith’s desire to steer autism into subcategories could be viewed as an attempt at restorative control. Separating autistic people into restrictive groups would likely lead to lack of support for those presenting without non-verbal or intellectual disabilities, rather than tailored, individualised care. We see this within mental health provision, where clinicians are forced to slash resources based on level of need due to barriers around funding. Whilst support for autistic adults remains scarce, narrowing criteria will only increase the rationale for abandoning those who present as ‘high-masking’ or ‘high-functioning’ from the outset. We know our support requirements fluctuate throughout a lifetime, as all health does and will. Striving to capture a consistent degree of need is as about fruitless as pouring milk into a colander, as it changes from month to year or day to day, in many cases. That’s without mentioning the co-occurring medical conditions that flare up over time due to cumulative stress, our unique genetic profile and as our bodies grow and age.
I worked in mental health services as an autistic person for nearly six and a half years. In that time I encountered some very good psychologists, and also those evidently in disbelief that I might understand aspects of the autistic experience with more nuance than they do. I don’t possess their comprehensive knowledge of various psychiatric conditions, their unique specialisms or level of skill. I wouldn’t undermine theirs, but they would routinely underestimate mine. There remains a lack of acknowledgement for the internal and unverifiable, and what cannot be seen. Lived experience as a slice of credible wisdom is all too often discarded, for we are seen as subjects to be studied rather than treated as experts in our own discovery.
This attitude appears to be one mirrored amongst various leading experts. Frith describes a new- found ‘magnetic attraction’ to the autism label, like flies around a fermented orange. Perhaps if we were forced to file in a queue of arthropods for three to four years, buzzing furiously on an NHS waiting list, they might listen to lived experience more closely. Frith’s concern with self-reporting seems to be that it lacks behavioural evidence. I’m sure there are teens on social platforms prematurely concluding they’re autistic, ADHD or otherwise without ample investigation. Crucially, however, ‘the rise of autism’ on social media stresses the longing to communicate an understanding of the autistic experience from within the community rather than how it is observed. In long form we see this in autism memoir, which has surged in popularity in recent years.
There’s also the generations who have been woefully overlooked and forgotten. When so many get missed for so long, there is going to be a corrective resurgence – likely one that makes
systems uncomfortable. We don’t see those who lose out, only those who visibly claim the label for themselves. Beyond the algorithmic waterfall of Tiktok, there are those confined in prisons, pupil referral units and psychiatric institutions. In 2025, National Autistic Society found that 73% of those with learning disabilities in mental health inpatient hospitals are autistic. Since 2015, the number of autistic people without a learning disability detained in mental health hospitals has increased by 144%.
The fact is that autism isn’t some precious rarity, like a hidden tree in a video game. There is obviously need for formal diagnosis and assessment, but self-identification as a step inevitably
comes first. Research from a major recent 2023 study by Elizabeth O’Nions suggests delayed diagnosis remains significant, particularly in women and adults. I don’t believe we can begin to
accurately speculate on the possibility of over-diagnosis until autistic people are altogether accommodated for. Especially when right now, the most likely outcome of an adult autism
diagnosis is ‘Not Getting’. I received more follow-up for my Kellogg’s 20m swimming badge. If I’d been offered support through my schooling without fully meeting the diagnostic threshold for autism, the catastrophic fallout might have meant that I’d have coped a bit better.
There was never concern I was being impeded by a label before autism proved a possibility, back when I was living in pass-the-parcel mode between mental health teams. Autism formed the layer that subsequent experiences would wrap around, and then compound. My late diagnosis has been the only one family and relatives have ever thought to interrogate, likely because I declared it rather than hid it. People rarely panic you’re being put in a box until you announce your neurodivergent carton of choice fits quite comfortably, actually. Then they immediately start trying to turf you out, like some overindulged feline that’s claimed a Tumi trolley bag.
Are we adrift, or are we sailing in the right direction? I don’t claim to be a psychologist or autism expert – I wrote this piece as a writer. Hopefully one day, the label of ‘expert’ might matter just a little less when the subject in question is our lives. Research tends to lean towards scepticism around need, to retract rather than deliver, because more will always cost money. Asking ‘Is autism being over-diagnosed?’ points at a reluctance to demand more complex, open-ended questions like, ‘How can we support autistic people? And why are we spending so much energy avoiding doing it?’ Perhaps we won’t like the answer.
About Elsa Williams
Elsa Williams is an autistic writer and comedy writer.