Why ‘No Evidence for Neurodevelopmental or ADHD Screening’ Isn’t the Same as ‘What’s Best for Children’

29 Jan

This week, many of us received the Government’s response to the petition calling for mandatory neurodevelopmental screening for all children. On the surface, the response sounds reasonable, evidence‑based, and reassuring. It acknowledges delays, recognises rising demand, and repeatedly refers to the importance of early intervention.

But when you read it carefully, a troubling gap appears between what the Government says it wants, and what the current system actually delivers.

This blog isn’t about ignoring evidence. It’s about asking whose evidence counts, what outcomes are being measured, and who pays the price while we wait for perfect data.

“The evidence does not support universal screening”

This sentence sits at the heart of the Government’s response.

What it really means is this: existing research has not yet proven that universal screening leads to better clinical outcomes than current referral‑based pathways. In particular, the focus is on symptom reduction, diagnostic accuracy, and long‑term health measures.

But families, educators, and frontline services are not seeing a system that works.

Children are not failing because screening is imperfect. They are failing because support only arrives once things have already gone wrong.

The problem with “wait and see” identification

Current pathways rely on someone noticing that a child is struggling enough.

That usually means:

Behaviour has escalated
Learning has already been impacted
Anxiety or low self‑esteem has taken hold
Exclusion, school avoidance, or mental health crisis is already present

This is not early intervention.

It is late reaction.

And it disproportionately affects:

Children who mask
Girls and non‑stereotypical presentations
Children from marginalised communities
Families without the time, confidence, or resources to push

When identification depends on visible failure, the quietest children wait the longest.

Screening is not diagnosis — and this matters

One of the biggest misunderstandings in this debate is the assumption that screening automatically means diagnosis.

It doesn’t.

Screening is about noticing patterns, flagging needs, and starting conversations. It can sit alongside observation, professional judgement, and graduated support.

What many families and professionals are calling for is not a label for every child — it is:

Earlier recognition of neurodevelopmental differences
Support before distress becomes entrenched
Environments that adapt sooner, not later

Right now, we are using diagnostic thresholds as gatekeepers to basic understanding.

That is not a health‑led approach. It is a crisis‑led one.

The outcomes we’re not measuring

Government responses repeatedly refer to a lack of evidence for improved outcomes. But the outcomes being measured are narrow.

What isn’t being counted?

School exclusions
Persistent absence
Anxiety and depression in undiagnosed children
Family breakdown
Youth justice involvement
Substance misuse
Lifelong mistrust of systems that were meant to help

By the time a child finally reaches assessment, the damage has often already been done.

If we only measure success by symptom scores and diagnostic precision, we miss the human cost of delay.

A system under pressure — and children absorbing the strain

The Government acknowledges that demand for autism and ADHD assessments has risen significantly, and that waiting times are severe.

But refusing to rethink identification while pathways are overwhelmed means the pressure doesn’t disappear.

It is simply pushed:

onto schools
onto families
onto children’s mental health

Children absorb that strain quietly, until they can’t anymore.

Early intervention should not require harm first

True early intervention does not wait for repeated failure.

It does not rely on behaviour being misinterpreted long enough to become entrenched.

And it does not accept long‑term harm as a necessary step toward support.

We don’t need perfect screening tools to know that earlier understanding leads to better experiences, even if it doesn’t immediately produce neat clinical graphs.

What needs to change

This isn’t about forcing one model onto every child.

It’s about:

Graduated identification
Support‑first thinking
Trusting lived experience alongside research
Recognising that “no evidence yet” is not the same as “no harm being done”

Until policy reflects the reality families are living every day, children will continue to fall through gaps that were never neutral to begin with.

The risks of leaving ADHD unidentified

When ADHD is missed or dismissed, the impact rarely stays small or short‑term.

Children and adults who grow up without understanding their ADHD often internalise years of confusion. They are more likely to experience persistent anxiety, low mood, and a deep sense of shame rooted in being told they are lazy, careless, disruptive, or not trying hard enough. Over time, this erodes self‑esteem and can shape how someone sees themselves well into adulthood.

In education, unidentified ADHD is strongly linked to disengagement. This may show up as school avoidance, internal truancy, repeated sanctions, or exclusion. Not because the child does not want to learn, but because the environment is demanding skills their brain is still developing, without support or adjustment.

As young people move into adolescence and adulthood, the risks widen. Undiagnosed ADHD is associated with higher rates of substance misuse, greater contact with the criminal justice system, unstable employment, and ongoing financial difficulty. These are not extreme or rare outcomes; they are patterns that emerge when neurodevelopmental needs are misunderstood or left unsupported for too long.

Early understanding does not remove ADHD. But it does reduce secondary harm. It gives children and families a framework to make sense of experiences before frustration, failure, and distress become embedded.

What screening looks like in practice

Much of the resistance to screening comes from a misunderstanding of what screening actually is.

In practice, screening is not diagnosis. It is a way of noticing patterns, identifying areas of need, and opening the door to earlier support. In my own work, screening is voluntary, non‑diagnostic, and rooted in understanding both strengths and challenges. It is used to inform support, adjustments, and next steps — not to label or limit.

Screening tools can help families and professionals make sense of behaviours and experiences that may otherwise be misinterpreted or dismissed. Used ethically, they sit alongside observation, professional judgement, and lived experience.

Crucially, screening does not need to be universal to be effective. It can be offered to anyone who needs it, at the point where questions are emerging, rather than years later when harm has already occurred. For many families, this early understanding has been the first time their experiences have felt coherent — and that clarity alone can be protective.