Our response to the Health, Social Care and Sport Committee’s Inquiry on Autism and ADHD ‘pathways’ and support

The Donaldson Trust warmly welcomes the recent parliamentary focus on existing assessment and support provisions in Scotland for autistic people and people with ADHD.

Earlier this year, Future Trends for Scotland, a Scottish Government ‘horizon scan’, identified demand for neuro-developmental assessment as a key theme for Scotland over the next two decades. We know that its prominence has been driven by inadequacies in existing provision for autistic people and people with ADHD, the ripple effect that has on public services, and a sense that something needs to change.

The ever-increasing relevance of neurodivergence, and neurodivergent lived experiences, can be seen in our politics, too; for example, there has been an eight-fold increase in mentions of “neurodivergence” at Holyrood from 2022 to 2024. Additionally, a recent Motion and debate, Addressing the Inadequate Provision for Neurodevelopmental Conditions, that set out the extent of challenges, had strong cross-party support.

All neurodivergent people deserve inclusive, accessible support on their own terms. We support a stepped care, ‘pathways’-style approach – in keeping with a recent paper by the Royal College of Psychiatrists and the work of the National Autism Implementation Team at Queen Margaret University. A holistic approach towards assessment and supports, where a diagnosis is one element of a broader package, is key to addressing the challenges of system capacity and quality of support.

A long-term plan from government – with input from neurodivergent people, charities experienced in supporting neurodivergent people, and healthcare professionals – is needed to address significant rises in demand for neuro-developmental assessment.

In order to better identify current service gaps, inform the design of service interventions that address unmet needs, and enable genuine system-level accountability, the Scottish Government should ensure the collection, collation, analysis and quarterly publication of autism and ADHD assessment data. That must include data on current waiting times.

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Whilst preparing our response, we had input from members of our Advisory Board, colleagues in services and support roles, parents of those we support, and neurodivergent people being supported in service. The insights gained from people with lived experience guided the development of our response.