Intended for healthcare professionals

Rapid response to:

Clinical Review State of the Art Review

Autism spectrum disorder: advances in diagnosis and evaluation

BMJ 2018; 361 doi: (Published 21 May 2018) Cite this as: BMJ 2018;361:k1674

Rapid Response:

Re: The rise in autism - this is how the Department of Health replied in 2000. What about now?

My MP has now forwarded a response from minister Caroline Dinenage which goes no further than noting my concerns and stating what the policy is: i.e. if the Department of Health and Social Care is attending to the problem I have indicated at any level they are not yet saying so. Meanwhile, a report has appeared in the Belfast Telegraph about a crisis in special needs spending for Northern Ireland where as we have seen the autism rate is now 2.9% (in Belfast 4.7%) [1]:

"The financial crisis in education is now "at a make or break point", a teaching union official has warned.

"Jacquie White, the deputy general secretary of the Ulster Teachers' Union, was responding to comments by Department of Education permanent secretary Derek Baker, who says the education system here is facing unprecedented financial pressures.

"Mr Baker's remarks come in newly published departmental accounts for 2017-18, which reveal the Education Authority overspent its budget by £18.9m, due mainly to increased expenditure on schools and pupils with special educational needs.

"Mr Baker added that the absence of an Education Minister has resulted in "significant and unique challenges" in relation to budgets, policy development and delivery, which won't be fully addressed until there is significant transformation of the sector.

"But Ms White says the funding crisis in education is now "personal" to every child in Northern Ireland.

""Mr Baker isn't telling us anything we or sadly the parents and children at the sharp end of the education crisis don't know already," she said."

The stories are repeated endlessly across the United Kingdom [2]. A rough calculation suggests that if 2.9% is a normal rate of ASD for the UK population there should be about 1.9m cases all told, whereas even the National Autistic Society only project 0.7m [3]. Moreover, as of August 2013 the Department of Works and Pensions recorded only 128,950 case of Autism Spectrum Disability on Disability Living Allowance (36,870 with Asperger Syndrome, 92,080 with "Autism") and many of these (perhaps preponderantly) will have been minors [4]. We have far too many cases and no one is giving any answers.

[1] Lauren Harte, 'Northern Ireland schools funding ‘at make or break point’ after £19m overspend', Belfast Telegraph 3 August 2018,

[2] Responses to Viner RM, 'NHS must prioritise health of children and young people',

[3] National Autistic Society 'Autism Facts and History'

[4] Freedom of Information request 2014-722 ,

Competing interests: No competing interests

08 August 2018
John Stone
UK Editor
London N22