Evaluating the effects of the growing and uneven diagnosis of autism among young people in England

“Understanding what changes when a child receives an autism diagnosis can help us understand the connection between rising diagnosis and growing demand for SEND provision.”
— Dr David Frayman, Reserch Economist

This study is led by Dr David Frayman (LSE) whose extended research looks at the drivers and impacts of SEND provision. It began in 2025 and is expected to finish in 2028.

‍This project was reviewed and approved through ECHILD's data access process. Learn how ECHILD data is kept safe.‍

  • We want to find out how being identified as autistic affects the educational provision and outcomes of children and young people in England.

  • The number of children and young people in England diagnosed as autistic has increased substantially in recent decades, but we still know little about how receiving an autism diagnosis affects a child’s education. This project explores the impact of being identified as autistic on educational provision and educational outcomes. This can help us understand the relationship between rising diagnosis and growing demand for SEND provision.

  • We exploit variation in autism diagnosis from differences between assessment providers in how likely they are to diagnose children as autistic. We then use this variation to estimate the effects of being identified as autistic on the educational provision children receive and on their educational outcomes.

Find out more

  • Why does this matter?

    The number of children and young people in England diagnosed as autistic has increased substantially in recent decades. This is reflected in the growing proportion of pupils receiving special educational needs and disabilities provision for autism-related needs. However, we still know little about how receiving an autism diagnosis affects a child’s education. Furthermore, if educational provision responds to diagnostic labels, this may create incentives that influence decisions by families about whether to pursue assessment.

    What do we want to find out?

    We want to find out how being identified as autistic affects the educational provision and outcomes of children and young people in England.

    What we will do

    We will study children and young people who were referred to Child and Adolescent Mental Health Services for a suspected autism assessment. Among this group, we will examine the effects of being identified as autistic. We will make use of differences between assessment providers in how likely they are to diagnose children as autistic. These differences generate variation in whether children are subsequently identified as having autism-related special educational needs, which we interpret as reflecting variation in autism diagnosis. We will use this variation to estimate the effects of being identified as autistic on the educational provision children receive and on their educational outcomes.

  • Introduction

    Rates of autism diagnosis among children and young people have increased substantially, alongside rapid growth in the number of pupils receiving SEND provision for autism-related needs. However, relatively little is known about how receiving an autism diagnosis itself affects children’s education. This project asks whether being identified as autistic changes the educational provision pupils receive and their educational outcomes. This can help us understand the relationship between rising diagnosis and growing demand for SEND provision.

    Methods and analysis

    We use linked health and education records in ECHILD to identify pupils referred to NHS Child and Adolescent Mental Health Services for suspected autism assessment and follow their subsequent educational provision and participation. Because pupils who receive a diagnosis may differ in important ways from referred pupils who do not, a simple comparison of diagnosed and non-diagnosed pupils would not identify the effect of diagnosis itself.

    We therefore use differences between local autism assessment providers in their propensity to diagnose referred children. Pupils living in different local health service areas could be referred to providers with different diagnostic practices while facing similar education systems. We use this variation to estimate the effect of being identified as autistic for pupils around the diagnostic margin. Outcomes include level of SEND provision, attendance at special schools, school absence and exclusion. This allows us to examine whether diagnosis acts as a gateway to additional educational support and affects pupils’ participation in education.

    ECHILD data used

    • HES: Accident & Emergency (2007-2019), Admitted Patient Care (2006-2022), Birth Notification, Civil Registration data, Emergency Care Data Set (2017-2022), Maternity Services Data Set (2015-2021), Mental Health & Learning Disabilities Data Set, Mental Health Minimum Data Set and Mental Health Services Data Set (2016-2022) + Mother-baby link

    • NPD: Absences (2006-2019, 2022), Alternative Provision Census (2008-2022), Autumn Census (2007-2022), Spring and Summer Census (2006-2022), Early Years Census (2008-2022), EYFSP (2003-2019), Exclusions 2002-2021, Key Stage 1 (1998-2019, 2022), KS2 (1996-2019, 2022), KS3 (1999-2013), KS4 (2003-2021), KS5 (2003-2021), National Client Caseload information (2013-2021), PLASC (2002-2005), Pupil Referral Unit Census (2010-2013)