Are we getting better at identifying and diagnosing neurodivergent girls and women? Insights into sex ratios and age of diagnosis from clinical population data in Scotland / Donald MACIVER in Autism, 30-2 (February 2026)  

Public ISBD [article]  inAutism > 30-2 (February 2026) . - p.375-389 Titre : Are we getting better at identifying and diagnosing neurodivergent girls and women? Insights into sex ratios and age of diagnosis from clinical population data in Scotland Type de document : texte imprimé Auteurs : Donald MACIVER, Auteur ; Anusua SINGH ROY, Auteur ; Lorna JOHNSTON, Auteur ; Marie BOILSON, Auteur ; Eleanor CURNOW, Auteur ; Victoria JOHNSTONE-COOKE, Auteur ; Marion RUTHERFORD, Auteur Article en page(s) : p.375-389 Langues : Anglais (eng) Mots-clés : ADHD  adults  autism  diagnosis  health services  school-age children  sex differences Index. décimale : PER Périodiques Résumé : This study examined differences in referral and diagnosis based on sex recorded at birth (hereafter, ‘sex’), using case notes from 408 individuals diagnosed by 30 multidisciplinary teams across Scotland. Analyses focused on male-to-female ratios and median ages at referral and diagnosis across attention-deficit/hyperactivity disorder, autism and intellectual disability. The lifespan male-to-female ratio across all diagnoses was 1.31, varying by category and age. In autism, the male-to-female ratio was 2.21 for children under 10 years, but there were more females in adolescence (male-to-female ratio = 0.79) and adulthood (male-to-female ratio = 0.94). Across the lifespan, combining all diagnoses, females were referred later (median ages: 14.4 vs 19.7 years; p < 0.001) and diagnosed later (median ages: 15.2 vs 20.2 years; p < 0.001), indicating a 5-year delay. Among autistic children and adolescents, females were referred later (median age: 7.5 vs 10.5 years; p = 0.002) and diagnosed later (median age: 9.3 vs 11.9 years; p = 0.003). However, no significant differences were found in age of referral or diagnosis for autistic adults. Overall, the results indicate increasing balance in sex ratios with age, greater asymmetry in younger age groups, and consistent delays in referral and diagnosis ages for females.Lay abstract This article looks at how males and females are diagnosed with neurodevelopmental differences including autism, attention-deficit/hyperactivity disorder (ADHD) and intellectual disabilities. It studies the case notes of 408 people (adults and children) assessed by 30 different teams during their diagnosis process. The results show overall that more males were diagnosed with neurodevelopmental differences and that males are diagnosed at younger ages compared to females. The increased diagnosis of males compared to females is most common in younger ages, but and as people get older, the number of males and females diagnosed becomes more equal, showing that more women are coming forward for and being diagnosed, for example with autism and ADHD. This research shows that although there are increasing amounts of females diagnosed, that girls and women are still missed when they are young, with more boys gaining a diagnosis as children. It seems there is a pattern of females being diagnosed at later ages (meaning less access to support and self-understanding). The study calls for better diagnostic practices and more research to address these gender differences. En ligne : https://dx.doi.org/10.1177/13623613251383343 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=579 [article] Are we getting better at identifying and diagnosing neurodivergent girls and women? Insights into sex ratios and age of diagnosis from clinical population data in Scotland [texte imprimé] / Donald MACIVER, Auteur ; Anusua SINGH ROY, Auteur ; Lorna JOHNSTON, Auteur ; Marie BOILSON, Auteur ; Eleanor CURNOW, Auteur ; Victoria JOHNSTONE-COOKE, Auteur ; Marion RUTHERFORD, Auteur . - p.375-389. Langues : Anglais (eng) in Autism > 30-2 (February 2026) . - p.375-389 Mots-clés : ADHD  adults  autism  diagnosis  health services  school-age children  sex differences Index. décimale : PER Périodiques Résumé : This study examined differences in referral and diagnosis based on sex recorded at birth (hereafter, ‘sex’), using case notes from 408 individuals diagnosed by 30 multidisciplinary teams across Scotland. Analyses focused on male-to-female ratios and median ages at referral and diagnosis across attention-deficit/hyperactivity disorder, autism and intellectual disability. The lifespan male-to-female ratio across all diagnoses was 1.31, varying by category and age. In autism, the male-to-female ratio was 2.21 for children under 10 years, but there were more females in adolescence (male-to-female ratio = 0.79) and adulthood (male-to-female ratio = 0.94). Across the lifespan, combining all diagnoses, females were referred later (median ages: 14.4 vs 19.7 years; p < 0.001) and diagnosed later (median ages: 15.2 vs 20.2 years; p < 0.001), indicating a 5-year delay. Among autistic children and adolescents, females were referred later (median age: 7.5 vs 10.5 years; p = 0.002) and diagnosed later (median age: 9.3 vs 11.9 years; p = 0.003). However, no significant differences were found in age of referral or diagnosis for autistic adults. Overall, the results indicate increasing balance in sex ratios with age, greater asymmetry in younger age groups, and consistent delays in referral and diagnosis ages for females.Lay abstract This article looks at how males and females are diagnosed with neurodevelopmental differences including autism, attention-deficit/hyperactivity disorder (ADHD) and intellectual disabilities. It studies the case notes of 408 people (adults and children) assessed by 30 different teams during their diagnosis process. The results show overall that more males were diagnosed with neurodevelopmental differences and that males are diagnosed at younger ages compared to females. The increased diagnosis of males compared to females is most common in younger ages, but and as people get older, the number of males and females diagnosed becomes more equal, showing that more women are coming forward for and being diagnosed, for example with autism and ADHD. This research shows that although there are increasing amounts of females diagnosed, that girls and women are still missed when they are young, with more boys gaining a diagnosis as children. It seems there is a pattern of females being diagnosed at later ages (meaning less access to support and self-understanding). The study calls for better diagnostic practices and more research to address these gender differences. En ligne : https://dx.doi.org/10.1177/13623613251383343 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=579

Contextual factors influencing neuro-affirming practice: Identifying what helps or hinders implementation in health and social care / Anna GRAY in Autism, 29-12 (December 2025)  

Public ISBD [article]  inAutism > 29-12 (December 2025) . - p.3111-3123 Titre : Contextual factors influencing neuro-affirming practice: Identifying what helps or hinders implementation in health and social care Type de document : texte imprimé Auteurs : Anna GRAY, Auteur ; Donald MACIVER, Auteur ; Eleanor CURNOW, Auteur ; Lorna JOHNSTON, Auteur ; Marion RUTHERFORD, Auteur Article en page(s) : p.3111-3123 Langues : Anglais (eng) Mots-clés : ADHD  adults  assessment  autism  diagnosis  health services  neurodivergent  pathway  psychoeducational support  qualitative research Index. décimale : PER Périodiques Résumé : There has been limited research to date into contextual factors hindering or supporting the successful implementation of neuro-affirming practice in support for Autistic and otherwise neurodivergent adults. We used a Realist Evaluation approach to explore key contexts affecting neuro-affirming practice. A preliminary programme theory of key aspects of support was developed. Views on current practice were sought through structured interviews with 32 senior professionals in leadership roles within Health and Social Care services in Scotland. This study identified important contexts shaping the implementation of neuro-affirming practice for adults. Results indicate widespread professional support for modifying practice to better accommodate neuro-affirming ideas, and scope to achieve this. However, some contexts, including limited resources, restrictive eligibility criteria and rigid service structures, hinder progress. Growing demand for services was often viewed as a restrictive context, but it also offered a chance to rethink conventional, one-size-fits-all models and adopt neuro-affirming approaches. The study is important in addressing a current gap in research into professional perspectives of the contexts required to develop transdiagnostic, neuro-affirming approaches and pathways for Autistic and neurodivergent adults. The insights from this study may offer transferable practice approaches, applicable across different countries with similar healthcare contexts.Lay abstract Delivery of neuro-affirming adult support pathways for Autistic and other neurodivergent adults by Health and Social Care institutions can be affected by different contexts. However, there is limited research to date into the most supportive contexts for effective neuro-affirming practice. This study aimed to explore the most beneficial contexts for neuro-affirming approaches, and barriers to this. We did this by using existing research to develop a theory about the most helpful approaches to support for Autistic adults, then gathering the views of 32 senior professionals in leadership roles within Health and Social Care services to explore supports and challenges they experience in implementing these approaches. The study identified important contexts for delivery of neuro-affirming practice and how these might be achieved. Some contexts, such as limited resources, restrictive eligibility criteria and inflexible service structures, could limit progress. However, although these were often seen as barriers, they also offered a chance to rethink one-size-fits-all models and adopt neuro-affirming approaches. This study is important in addressing a current gap in research into professional perspectives of the ways neuro-affirming approaches can be developed in practice, to support Autistic and neurodivergent adults. The insights from this study may offer transferable lessons, applicable across different regions and countries. En ligne : https://dx.doi.org/10.1177/13623613251360275 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=572 [article] Contextual factors influencing neuro-affirming practice: Identifying what helps or hinders implementation in health and social care [texte imprimé] / Anna GRAY, Auteur ; Donald MACIVER, Auteur ; Eleanor CURNOW, Auteur ; Lorna JOHNSTON, Auteur ; Marion RUTHERFORD, Auteur . - p.3111-3123. Langues : Anglais (eng) in Autism > 29-12 (December 2025) . - p.3111-3123 Mots-clés : ADHD  adults  assessment  autism  diagnosis  health services  neurodivergent  pathway  psychoeducational support  qualitative research Index. décimale : PER Périodiques Résumé : There has been limited research to date into contextual factors hindering or supporting the successful implementation of neuro-affirming practice in support for Autistic and otherwise neurodivergent adults. We used a Realist Evaluation approach to explore key contexts affecting neuro-affirming practice. A preliminary programme theory of key aspects of support was developed. Views on current practice were sought through structured interviews with 32 senior professionals in leadership roles within Health and Social Care services in Scotland. This study identified important contexts shaping the implementation of neuro-affirming practice for adults. Results indicate widespread professional support for modifying practice to better accommodate neuro-affirming ideas, and scope to achieve this. However, some contexts, including limited resources, restrictive eligibility criteria and rigid service structures, hinder progress. Growing demand for services was often viewed as a restrictive context, but it also offered a chance to rethink conventional, one-size-fits-all models and adopt neuro-affirming approaches. The study is important in addressing a current gap in research into professional perspectives of the contexts required to develop transdiagnostic, neuro-affirming approaches and pathways for Autistic and neurodivergent adults. The insights from this study may offer transferable practice approaches, applicable across different countries with similar healthcare contexts.Lay abstract Delivery of neuro-affirming adult support pathways for Autistic and other neurodivergent adults by Health and Social Care institutions can be affected by different contexts. However, there is limited research to date into the most supportive contexts for effective neuro-affirming practice. This study aimed to explore the most beneficial contexts for neuro-affirming approaches, and barriers to this. We did this by using existing research to develop a theory about the most helpful approaches to support for Autistic adults, then gathering the views of 32 senior professionals in leadership roles within Health and Social Care services to explore supports and challenges they experience in implementing these approaches. The study identified important contexts for delivery of neuro-affirming practice and how these might be achieved. Some contexts, such as limited resources, restrictive eligibility criteria and inflexible service structures, could limit progress. However, although these were often seen as barriers, they also offered a chance to rethink one-size-fits-all models and adopt neuro-affirming approaches. This study is important in addressing a current gap in research into professional perspectives of the ways neuro-affirming approaches can be developed in practice, to support Autistic and neurodivergent adults. The insights from this study may offer transferable lessons, applicable across different regions and countries. En ligne : https://dx.doi.org/10.1177/13623613251360275 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=572

Waiting Times and Influencing Factors in Children and Adults Undergoing Assessment for Autism, ADHD, and Other Neurodevelopmental Differences / Anusua Singh ROY ; Lorna JOHNSTON ; Marie BOILSON ; Eleanor CURNOW ; Victoria JOHNSTONE-COOKE ; Marion RUTHERFORD in Autism Research, 18-4 (April 2025)  

Public ISBD [article]  inAutism Research > 18-4 (April 2025) . - p.788-801 Titre : Waiting Times and Influencing Factors in Children and Adults Undergoing Assessment for Autism, ADHD, and Other Neurodevelopmental Differences Type de document : texte imprimé Auteurs : Anusua Singh ROY, Auteur ; Lorna JOHNSTON, Auteur ; Marie BOILSON, Auteur ; Eleanor CURNOW, Auteur ; Victoria JOHNSTONE-COOKE, Auteur ; Marion RUTHERFORD, Auteur Article en page(s) : p.788-801 Langues : Anglais (eng) Mots-clés : assessment  autism  diagnosis  neurodevelopmental  pathway Index. décimale : PER Périodiques Résumé : ABSTRACT This study explored waiting times and the factors influencing them in child and adult populations undergoing assessment for autism, ADHD, and other neurodevelopmental differences. The analysis focused on a retrospective review of 408 cases with assessments completed between October 2021 and May 2022, conducted by 30 diagnosing teams in Scotland. Data included age, final diagnosis, demographics, medical and developmental history, contact frequency, and assessment service adherence to best-practice standards. Waiting times were calculated, and relationships were analyzed using linear regression. Median waiting times were 525 days (IQR 329 857) for children/adolescents and 252 days (IQR 106 611) for adults. Only 20% of children's and 47% of adult assessments met the proposed 252-day diagnostic time target. Autism and ADHD were the most common diagnoses. Receiving > 1 neurodevelopmental diagnosis on completion was uncommon. Demographic factors did not significantly affect waiting times. Children/adolescents with more complex developmental and medical histories experienced longer waits (100.3 weeks vs. 67.7 weeks; p?< 0.001), while adults with similar histories had shorter waits (32.7 weeks vs. 57.4 weeks; p 0.016). Adults with ADHD experienced longer waits than autistic adults (63.4 weeks vs. 38.6 weeks, p 0.002). Adherence to best-practice quality standards was associated with shorter waits for children (? 0.27, p 0.002), but the relationship between standard adherence at different stages and for adults was less clear. More frequent appointments correlated with shorter adult waits (33.7 weeks vs. 59.2 weeks, p 0.015). Gender distribution was balanced among adults, but children's services included more boys. The study highlights long waits and the need for improvement in processes. En ligne : https://doi.org/10.1002/aur.70011 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=554 [article] Waiting Times and Influencing Factors in Children and Adults Undergoing Assessment for Autism, ADHD, and Other Neurodevelopmental Differences [texte imprimé] / Anusua Singh ROY, Auteur ; Lorna JOHNSTON, Auteur ; Marie BOILSON, Auteur ; Eleanor CURNOW, Auteur ; Victoria JOHNSTONE-COOKE, Auteur ; Marion RUTHERFORD, Auteur . - p.788-801. Langues : Anglais (eng) in Autism Research > 18-4 (April 2025) . - p.788-801 Mots-clés : assessment  autism  diagnosis  neurodevelopmental  pathway Index. décimale : PER Périodiques Résumé : ABSTRACT This study explored waiting times and the factors influencing them in child and adult populations undergoing assessment for autism, ADHD, and other neurodevelopmental differences. The analysis focused on a retrospective review of 408 cases with assessments completed between October 2021 and May 2022, conducted by 30 diagnosing teams in Scotland. Data included age, final diagnosis, demographics, medical and developmental history, contact frequency, and assessment service adherence to best-practice standards. Waiting times were calculated, and relationships were analyzed using linear regression. Median waiting times were 525 days (IQR 329 857) for children/adolescents and 252 days (IQR 106 611) for adults. Only 20% of children's and 47% of adult assessments met the proposed 252-day diagnostic time target. Autism and ADHD were the most common diagnoses. Receiving > 1 neurodevelopmental diagnosis on completion was uncommon. Demographic factors did not significantly affect waiting times. Children/adolescents with more complex developmental and medical histories experienced longer waits (100.3 weeks vs. 67.7 weeks; p?< 0.001), while adults with similar histories had shorter waits (32.7 weeks vs. 57.4 weeks; p 0.016). Adults with ADHD experienced longer waits than autistic adults (63.4 weeks vs. 38.6 weeks, p 0.002). Adherence to best-practice quality standards was associated with shorter waits for children (? 0.27, p 0.002), but the relationship between standard adherence at different stages and for adults was less clear. More frequent appointments correlated with shorter adult waits (33.7 weeks vs. 59.2 weeks, p 0.015). Gender distribution was balanced among adults, but children's services included more boys. The study highlights long waits and the need for improvement in processes. En ligne : https://doi.org/10.1002/aur.70011 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=554

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