Living with ADHD or autism can be difficult for people who experience the world differently in an environment which is built for the majority. For example, sensory sensitivities can seriously impact neurodivergent people therefore noisy or bright environments can be more stressful. There may be differences in social interaction and understanding which can result in neurodivergent people giving offence with a misunderstood comment or behaviour. This can lead to social isolation and, in some cases, bullying. Additionally, people often have issues with organising and carrying out tasks and estimating how long they will take. Prioritising or grouping information can be difficult and these kinds of issues can lead to issues in work or education. Neurodivergent people may experience mental health issues and/or feel overwhelmed because social and physical environments are designed without sensitivity to their needs. Indeed the Social Model of Disability would see neuro divergent people as disabled by the lack of inclusive design or organisation rather than by characteristics associated with ADHD or autism or any other neurodivergent condition. By the same token, according to the social model of disability, a wheelchair user is disabled by physical environments that are not inclusive of people travelling seated on wheels rather than by physical issues.
How can a formal diagnosis help?
- A formal diagnosis can form the evidence that is required for reasonable adjustments at work or in education.
- It can help the individual better understand why they have struggled with certain things and what their current strengths and weaknesses may be. Many people feel relieved when they get a diagnosis as it is a validation of what they may have been struggling to communicate to others about the issues that they face.
- It can help people understand which strategies might be helpful for them.
- In the case of an ADHD diagnosis there is medication which is effective in treating some of the issues people face with attention, impulsiveness and emotional reactivity. A diagnosis is essential to gain access to this medication.
- While many people may already have a good idea of what their diagnosis would be, this is not the case for all as there can be overlaps between diagnoses and a formal assessment can clarify this more precisely.
How can people get a formal diagnosis of Autistic Spectrum Conditions or ADHD?
The routes via the NHS would usually involve a referral to psychiatric or clinical psychology services. To access them you would need a referral from the appropriate professional – often the GP. Not all GPs have a good understanding of ADHD or autism and there is also an overlap with other conditions so it can sometimes be hard to persuade GP that this is the most appropriate referral. It can help if you prepare for the appointment and one way you can do that is by completing a self-assessment tool that is acceptable in an NHS context.
Once referred for an NHS assessment, waiting times are long and it is difficult to get clear information on how long you may wait.
It’s reported that in some NHS areas waiting lists are closed for assessments of neurodivergent adults – especially those who have no other conditions that commonly can co-occur with ADHD or Autistic Spectrum Conditions.
A Scottish Parliament briefing was published in June 2025 (Neurodevelopmental Pathways and Waiting Times in Scotland) which looked at the availability of assessments across Scotland. The information gathered is incomplete since not all NHS Health boards responded, but page 17 of this document shows a map of NHS Health Board areas in Scotland and shows which areas have access to adult neurodivergent assessments. In the following local authorities, there was no access to assessments for an adult who does not meet the requirement for any other mental health services:
Aberdeenshire
Ayrshire and Arran
Dumfries and Galloway
Fife
Forth Valley
Orkney
Scottish Borders
Shetland
In addition, NHS Tayside only offers adult autism assessments. Â Govan Law Centre has started a legal case against NHS Tayside to challenge their failure to carry out ADHD assessments for adults without additional mental health conditions. You can read about that here:
It can be hard to get clear information on access to assessments across Scotland, but what is clear is that where assessments are available, long waiting times are the norm.
What then are the options if you want assessment for ADHD or Autism but cannot get an NHS assessment?
This will depend on what you hope to gain from the assessment. To have reasonable adjustments made in education or in the workplace you do not necessarily need to have had a formal diagnosis but you may need to have some evidence of your condition.
You can read more about reasonable adjustments here:
Adjustments for neurodiversity – Reasonable adjustments at work – Acas
Some educational institutions such as universities may even offer screening for ADHD or autism. Keeping any reports produced may also help you get support in the workplace. You may be able to get written evidence from health or education professionals who are aware of some of the issues you face. Â These can help support your case that you have a long-term condition regardless of whether you have a formal diagnosis or not.
Doing without an NHS diagnosis can be particularly difficult for people with ADHD because, unlike for autism, there are effective medications which can make a massive difference, but these can only be prescribed by a psychiatrist and only with a diagnosis.
Private neurodivergent assessments
Some people opt to pay for their own assessments privately. Prices range from about £1500 to £2,500 for a full assessment. These could be assessments for ADHD, Autism or both combined. Some assessors offer shorter screening reports which may form part of initial assessment. If you opt for a private assessment then do:
- Research the credentials of the assessors/organisation to ensure they are properly qualified to assess you.
- Ask for details of all costs involved and make sure nothing is hidden.
- If you require the report for a specific purpose such as reasonable adjustments at work then make sure the report will be suitable for that purpose.
Caution choosing private ADHD assessment
If you are seeking an ADHD assessment so that you can access medication, make sure you check the situation in relation to prescribing before you commit to this. NHS Boards in Scotland used to offer Shared Care where a private diagnosis could lead to NHS prescriptions for ADHD medication. Few if any NHS Boards will offer this now. Do ensure you clarify the situation before paying for an assessment if access to NHS prescriptions is the main reason you want the diagnosis as private prescriptions may cost between £50 and £150 monthly.
In summary
Clear information on availability of NHS Autism and/or ADHD assessments and timescales is hard to come by and waiting times are long. The situation is far from ideal but does not mean that people cannot access some supports such as reasonable adjustments in education or the workplace. Private assessments are expensive but can have some benefits if you can afford them.
If you need help with finding out what is available where you are in Scotland and what your options may be then do contact our helpline. We are not experts in all the information, but we do know how to search out reliable information and can research issues for you.
You can call the Disability Information Scotland Helpline on 0300 323 9961
Photo by Julia Taubitz on Unsplash