RECAP Guest Blog: SEND, diagnosis, and the “overdiagnosis” debate

Dr Kim Collett holds a PhD in Education and is an Associate Lecturer, researcher and advocate specialising in inclusive education and special educational needs and disabilities (SEND). Her passion for inclusion comes from her own experiences of being a child with a label of SEND and from navigating life as a neurodivergent and disabled parent in a neurodiverse household. Kim has worked in universities for over 15 years after her early career saw her working in the charity sector supporting neurodiverse and disabled people, and raising awareness of the importance of an inclusive society. 

There have been lots of headlines and conversations suggesting that too many children are being diagnosed with additional needs. This is causing concern as it implies that children are being labelled unnecessarily or that support is being misused.

But when we look more closely, we can see that these headlines are misleading. Rather than too many diagnoses, the evidence suggests that many children aren’t being identified or supported early enough.

First things first: does a child actually need a diagnosis?

This is a question many parents ask and the answer isn’t always straightforward. In the UK, schools are supposed to provide support based on need, not on whether a child has a formal diagnosis. In theory, this means your child shouldn’t have to wait for an official label before getting help in the classroom.

In practice, though, it doesn’t always work like that.

A diagnosis can be helpful because it:

●      Opens doors to certain services and specialist support

●      Helps teachers understand your child more consistently

●      Gives a shared language for discussing strengths and challenges

●      Provides reassurance for children and families

There can also be confusion as some schools or services may believe (incorrectly) that a diagnosis is required before offering support. This often leads to delays, with families feeling stuck waiting for assessments rather than seeing immediate help. So while a diagnosis isn’t technically required, it can make a difference in how easily and quickly support is put in place.

What happens when children aren’t identified?

One of the most important things to understand is that not recognising a child’s needs can have consequences.

Children may:

●      Lose confidence in their abilities

●      Start to believe they are “not good enough”

●      Feel frustrated or overwhelmed at school

●      Be misunderstood as disengaged, lazy, or disruptive

Difficult experiences in education can also shape how a person feels about learning, work, and themselves well into adulthood. For many getting a diagnosis isn’t about labels but helps explain patterns, reduces self-blame, and provides a way forward.

So, are children being “overdiagnosed”?

It’s true that more children are being diagnosed with things like dyslexia, ADHD, and other neurodivergent profiles than in the past. But this doesn’t necessarily mean diagnoses are being handed out too easily. A more accurate way to think about it is that we’ve simply got better at noticing what was always there.

One useful comparison is with astronomy. When telescopes improved, scientists suddenly “discovered” many more stars. But those stars hadn’t appeared overnight, we just didn’t have the tools to see them before. The same idea applies here. With improved awareness, training, and assessment methods, differences in how children learn and process information are easier to identify than they used to be.

In other words, the increase in diagnoses reflects better understanding not a sudden surge in children having needs.

The bigger issue - underdiagnosis

While public conversations currently focus on “too many” diagnoses, the evidence suggests many children are still being missed.

Take dyslexia as an example. Estimates suggest that around three children in an average classroom may be dyslexic but less than a quarter of those children are formally identified. That delay can make learning much harder than it needs to be and has been shown to impact grade as well as confidence.

ADHD shows a similar pattern. A large number of people in the UK are thought to have ADHD without a diagnosis. Certain groups, particularly girls and children from marginalised backgrounds, are especially likely to be overlooked. This is often because their traits don’t match outdated stereotypes of what ADHD “looks like.”

When children are not recognised, the consequences can include:

●      Lower academic outcomes

●      Higher stress and anxiety

●      Being misunderstood by adults and peers

The importance and limits of labels

It’s completely normal to have mixed feelings about diagnoses. On one hand, they can be empowering. They can offer clarity, validation, and access to support. Many children and families feel relief when they understand why things have felt difficult.

On the other hand, labels can sometimes come with downsides.

These might include:

●      Other people making assumptions about what a child can or can’t do

●      Negative stereotypes or stigma

●      Risk of bullying or exclusion

●      Reduced expectations from adults

That doesn’t mean diagnoses are a bad thing. It just means they need to be handled carefully.

A diagnosis should be a starting point for understanding and supporting your child better, not a box they’re placed into.

So what should parents take from all of this?

If you’re worried about your child, or navigating the world of SEND support, here are a few key takeaways to hold onto:

1. Trust your instincts

You know your child best. If something doesn’t feel right, it’s worth exploring.

2. Support shouldn’t have to wait

Even without a diagnosis, schools can and should put support in place. Don’t feel you have to wait for an assessment before asking for help.

3. A diagnosis can be helpful but it’s not everything

It can unlock support and understanding, but it’s just one piece of the puzzle.

4. Earlier identification can make a big difference

The sooner a child’s needs are recognised, the easier it is to put helpful strategies in place and protect their confidence.

5. Keep the focus on your child as a whole person

A diagnosis doesn’t define your child. Their strengths, interests, and personality matter just as much as any challenges.

Moving beyond the myth

The idea that children are being widely overdiagnosed can sound convincing but when we look closely, it isn’t supported by the evidence.

A more accurate story is this:

●      We’re getting better at spotting differences in how children learn

●      Many children are still slipping through the cracks

●      Diagnosis can be helpful, but it isn’t a magic solution

●      What matters most is understanding, support, and acceptance

And perhaps the most important thing to remember is this:Children don’t need to be “fixed” they need to be understood and supported in the way that works for them.

Read more from Dr Kim Collett: SEND crisis: overdiagnosis - fact or fiction? | OpenLearn - Open University