10/03/2026
Recently there has been a lot of discussion following comments from Uta Frith suggesting that the widening of autism diagnosis has made the label less meaningful. I think that it is important to be aware of opinons for all sides of the debate, else you risk living in an echo chamber. https://www.tes.com/magazine/teaching-learning/general/uta-frith-interview-autism-not-spectrum
As both a counsellor working with neurodivergent clients and a psychology student currently writing about diagnostic frameworks, Iâve been thinking about this debate quite a lot.
In psychology there is a growing movement to move away from diagnostic labels altogether. Psychologists such as Peter Kinderman and Lucy Johnstone have been influential in questioning the traditional diagnostic model used in psychiatry. Instead, they advocate approaches such as the Power Threat Meaning Framework, which shifts the question from âWhatâs wrong with you?â to âWhat has happened to you?â and âHow have you made sense of it?â Here's a link to the PTMF, https://www.bps.org.uk/member-networks/division-clinical-psychology/power-threat-meaning-framework
From a psychological perspective, there are some compelling reasons to rethink diagnostic labels. Labels can reduce complex human experiences into categories and can sometimes obscure the social, relational, and environmental factors that shape distress.
However, the situation becomes much more complicated when we look at autism in the real world.
In practice, diagnostic labels are often the gateway to support. Without a diagnosis, many people struggle to access educational accommodations, workplace adjustments, or specialist services. At the same time, autistic people continue to face significant structural barriers. For example, research consistently shows that autistic adults experience some of the lowest employment rates of any disability group.
In my work with clients, I rarely see people seeking an autism diagnosis lightly. For many, it follows years of confusion, masking, burnout, or feeling fundamentally misunderstood. The label can provide a framework for understanding their experiences and a language that allows them to advocate for themselves.
So while psychology may be moving toward models that emphasise context and meaning rather than diagnosis, we have to ask an important question: what happens if the label disappears but the barriers remain?
If diagnostic categories are reduced or dismissed without meaningful changes to how support is provided, we risk leaving people in a worse position, without labels that unlock support, but still facing the same social and structural challenges.
This debate also connects to what Lucy Johnstone has described as the neurodiversity paradox: as recognition of neurodivergence grows, so too does the tension between medical diagnosis and social understandings of difference. Here's a link to the first part of four, but be warned, it's not an easy read https://www.madintheuk.com/2024/12/part-1-neurodiversity-what-exactly-does-it-mean/
Perhaps the real question is not whether autism should be defined more narrowly or more broadly, but how we create systems that support neurodivergent people regardless of where they fall within a diagnostic boundary.
And crucially, those conversations must involve autistic people themselves.
Because ultimately, decisions about autism and all aspects of neurodiversity should follow a simple principle: nothing about us without us.