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Not Just England: Autism Assessment Waits Run to Years in Many Countries

Published 2026-09-22

England's autism assessment backlog is not an outlier. In Scotland, Wales, Northern Ireland, Ireland, Australia, New Zealand, Canada, the US and beyond, people wait many months, often years, for an assessment that guidelines, where they exist, say should begin within weeks. In several of those places, no one publishes a regular count of how long the wait is.

A parent who can see that school is not working for their child joins a list with no date attached. An adult who has spent decades feeling out of step finally asks for help, and finds the service closed to new referrals or open only to people in crisis. This piece gathers the evidence country by country, and records where it is missing, because a waiting list nobody counts is easier to ignore.

76 weeksthe average of Scottish health boards' median waits for a children's neurodevelopmental assessment, March 2025: more than twice the 36 weeks Scotland's national implementation team suggests for the whole journey from referral to diagnosis[1].
23 monthsthe average time taken to complete a disability Assessment of Need in Ireland in January to March 2026, according to HSE figures reported by BreakingNews.ie. The legal process is meant to take about six months[2][3].

The benchmark is measured in weeks; the waits are measured in years

In England, NICE's quality standard says that when someone is referred to an autism team for a diagnostic assessment, it should be started within 3 months of referral[4], and its guideline for children and young people says the same[5]. England itself is well short of that: in June 2026, 256,017 of the 294,792 open referrals for suspected autism (86.8%) had been open for at least 13 weeks[6]. That story is covered in The Autism Assessment Backlog.

Other systems set their own benchmarks. Scotland's National Autism Implementation Team (NAIT) suggests no more than 36 weeks from referral to the diagnosis being shared[7], and Sweden's strengthened care guarantee for child psychiatry aims for 30 days to a first assessment plus 30 more to an in-depth assessment or treatment[8]. The table sets each benchmark against the latest verified figure, and shows how that figure reaches the public.

WhereBenchmarkLatest verified figure: who is counted, what is measured, whenHow the figure surfaces
EnglandAssessment started within 3 months (NICE)[4]86.8% of 294,792 patients with an open referral for suspected autism waiting 13+ weeks; mental health services data (community paediatrics excluded), June 2026[6]Official statistics, published regularly
Scotland36 weeks, referral to diagnosis (NAIT)[7]Average of board median waits for people on the list for a neurodevelopmental assessment (autism, ADHD and related): 76 weeks, children and adults, March 2025[1]One-off parliamentary request; before that, Freedom of Information only[1]
Wales80% of children start within 26 weeks; no adult target[9]67% of children on the list for an autism or ADHD assessment had waited 26+ weeks, June 2023[9]Judged "not suitable for publication"; collection retired 2026[10]
Northern Ireland13 weeks, as reported by The Irish News[11]17,205 children on the list for an autism assessment, October 2025[12]; time bands for children and adults, February 2026, as reported by The Irish News[11]Answers to Assembly questions; no regular statistical release found
IrelandAbout 6 months in law[3]21,782 children overdue an Assessment of Need (any disability), Q1 2026; 10% of reports completed that quarter within the legal timeline[2]HSE quarterly figures, as reported by BreakingNews.ie and RTÉ; all disabilities, not autism alone
Sweden30 + 30 days in child psychiatry[8]71% of children queuing for a child-psychiatry in-depth assessment past the 30-day guarantee, February 2026[13]Private-provider trade body's analysis of national waiting-time data; not autism-specific
Australia, New Zealand, Canada, USNone identified in this reviewSurveys only: Australian parents and carers (2025), New Zealand parents (2019), Canadian paediatricians (published 2018); no comparable US figure (see below)No routine national count found

Every UK nation has a queue; only England publishes regular official figures

Scotland. When the Scottish Parliament's health committee asked every health board for figures in March 2025, thirteen of the fourteen could count their children's list. Between them, more than 42,000 children were waiting for a neurodevelopmental assessment (autism, ADHD and related conditions), along with 23,339 adults[1]. Median waits for children ranged from 22 weeks in the Western Isles to 141 weeks in Ayrshire and Arran; these medians describe people still on the list at that date, not completed waits. The longest single wait reported was 342 weeks, over six years[1][14]. Adult medians ran from 24 weeks in Orkney to 146 weeks in Tayside[1]. For many adults the problem comes before the queue: Parliament's researchers estimated that over 1.3 million adults, just under 30% of the adult population, cannot get a neurodevelopmental assessment on the NHS[14].

People waiting for a neurodevelopmental assessment in Scottish health boards that could supply 2020 figuresChildren waiting in Ayrshire and Arran, Fife, Lothian and Tayside rose from 2,475 in 2020 to 14,943 in March 2025. Adults waiting in Forth Valley, Highland, Lothian and the Western Isles rose from 543 in 2020 to 12,974 in March 2025.2020March 20250400080001200016000Children (4 health boards)2,47514,943Adults (4 health boards)54312,974
People waiting for a neurodevelopmental assessment (autism, ADHD and related conditions). The child and adult rows cover different health boards, so should not be added together. Source: SPICe briefing SB 25-25, June 2025.

A NAIT study of 408 assessments completed in 2021–22 by 30 teams in 10 of the 14 boards found a median of 525 days from referral to diagnosis for children and 252 days for adults. Only 20% of children's assessments met the 36-week standard, against 47% of adults'[7]. The adult figure is less reassuring than it looks: adults usually reach assessment through specialist mental health services, which typically requires a moderate to severe mental illness; in the authors' words, this "restricts adults from accessing diagnosis unless they are in crisis"[7].

Wales. The latest all-Wales figures we could verify, for June 2023, show that 67% of children and young people waiting for an autism or ADHD assessment had waited 26 weeks or more, and 45% had waited over a year. The number waiting had risen 87% between February 2022 and December 2023[9]. Adults seeking a diagnosis through Wales's Integrated Autism Service faced an average wait of 95.1 weeks in January to March 2023[9]. According to the Senedd's researchers, the returns were "not considered of a suitable quality to publish" because health boards applied the definitions inconsistently[9]. In April 2026 the collection was formally retired as "not suitable for publication"; a new template is meant to capture waits across the whole pathway[10].

Northern Ireland. Here the numbers surface through Assembly questions; we found no regular statistical release. In October 2025 the Health Minister reported 17,205 children waiting for an autism assessment, from 1,681 in the Southern Trust to 5,923 in the Northern Trust. The Minister acknowledged that waits are "lengthy and growing" and that autism services "do not currently have the capacity to meet this need"[12]. A later answer, which we could not find on the Assembly website but which The Irish News reported in March 2026, put 5,380 children and 1,050 adults at two to three years on the list in February 2026, and a further 2,665 children and more than 700 adults at over three years[11]. That is more than 8,000 children past two years, against a thirteen-week target, as the paper reported it.

Ireland: a timeline set in law, and more than 21,000 children overdue

Under Ireland's Disability Act 2005, the HSE should arrange a referral for assessment within three months of an application, and the assessment and report are usually completed within a further three[3]. An Assessment of Need covers any disability, so this is not an autism-only list. HSE figures for the first three months of 2026, as reported by BreakingNews.ie, show 21,782 children overdue an assessment. Of the 1,528 reports completed in that quarter, only 10% were finished within the legal timeline, and the average process took 23 months[2]. RTÉ, reporting the HSE's final roadmap report, put the number overdue when the roadmap launched in mid-2023 at over 7,600[15]. The backlog has nearly tripled since, and 3,814 new applications arrived in that single quarter[2]. We could not find the HSE's own quarterly report online.

Unable to meet its own deadline, the state now buys private capacity: its Targeted Waitlist Initiative, launched in 2024, outsourced assessments to private clinicians. About 6,000 were expected in 2026 "with a specific focus on autism spectrum disorder at a fixed cost of €2,900 per assessment"[15].

Beyond these islands: long waits, and often no national count at all

Australia. We found no official national figure; the clearest evidence comes from families. In Autism Awareness Australia's 2025 survey of more than 1,200 parents and carers, 32.3% said they had waited more than two years for a diagnosis, up from 19% in the charity's 2014 survey. Only 26.3% had received a diagnosis within six months, down from 58%[16]. The figures are from the charity's media release; the full report is available only on request. The surveys are self-selected and the two samples are not directly comparable, but the direction is stark.

How long Australian families say they waited for an autism diagnosis, 2014 and 2025 surveysIn Autism Awareness Australia's parent and carer surveys, the share of families receiving a diagnosis within six months fell from 58% in 2014 to 26.3% in 2025, while the share waiting more than two years rose from 19% to 32.3%.2014 survey2025 survey0%20%40%60%Diagnosed within sixmonths58%26.3%Waited more than two years19%32.3%
Share of parents and carers of autistic children responding to Autism Awareness Australia's self-selected surveys (more than 1,200 in 2025), as published in the charity's media release; not a representative sample. Source: Autism Awareness Australia, April 2025.

New Zealand. The latest national evidence we could verify is a 2019 survey of 458 parents and 70 autistic adults (published 2021). In the public system, over a third of children waited seven months or more for an initial assessment appointment[17]. We could not find a routinely published figure from Health New Zealand.

Canada. In a survey of Canadian paediatricians published in 2018, the 57 respondents who diagnose autism reported a median total wait of 7 months (interquartile range 4–12) from referral to the family being told the diagnosis[18]. In a survey of 145 Canadian developmental paediatricians published in 2024, 23% planned to retire completely within three to five years[19].

United States. Again, we found no national count. A 2016 review describes "long wait-lists and evaluations that result in a 2-year difference between the earliest signs of ASD and mean age of diagnosis", citing time-consuming evaluations, cost of care and a lack of providers[20]. A 2018 survey of the US developmental-behavioural paediatrics workforce reported long waits for new appointments[21].

Sweden and the Nordic countries. Even Sweden's far shorter goal is being missed. An analysis of national waiting data by Vårdföretagarna, the association of private care providers, found that in February 2026, 71% of children queuing for an in-depth child-psychiatry assessment (just over 5,300 children) had waited longer than the guarantee[13]. The figure is not autism-specific and comes from a body with a stake in private provision, so treat it as indicative; the official statistics pages show these data only as charts[8]. For the other Nordic countries and most of Europe, we could not find a verifiable published series for autism assessment waits.

What the wait costs, and who can pay to skip it

A diagnosis is rarely wanted for its own sake, but for what it explains and unlocks, so the longer the wait, the later everything else arrives. In a UK survey of 1,047 parents, the average delay from first raising concerns with a professional to a confirmed diagnosis was about 3.5 years, and just over half were dissatisfied with the process[22]. That survey predates the recent growth in lists. In New Zealand, children were on average diagnosed 1.9 years after their families first raised questions[17]. Our piece on age at diagnosis around the world looks at that longer delay.

People on these lists often need help now. A small longitudinal study of 27 young people and their parents found a range of clinically significant mental health difficulties while they waited. It did not find that waiting for and going through assessment made those difficulties worse, and the authors concluded there is "no good reason to delay autism assessment for fear of worsening mental health symptoms"[23]. The honest reading is not that waiting lists cause crises, but that people are often already struggling when they join, and the wait postpones the support assessment should unlock. In a study of six NHS childhood assessment services, families and clinicians described rising demand and too few specialist staff, and supporting families through the whole process "was often not possible"[24]. For adults, the Scottish finding that assessment is often reached only through crisis[7] fits a wider pattern that we explore in diagnosed in adulthood.

Where public queues stretch into years, families who can pay go private. In Australia, 76.6% of children in the 2025 survey had been diagnosed by a private provider and only 20.4% through government-funded services. A quarter of families (25.9%) cited money as a reason their child's diagnosis was delayed[16]. In New Zealand, 70% of children's first private assessment appointments came within six months, against 30% in the public system, and parents who paid reported an average cost of NZ$907[17]. The Scottish Parliament's researchers warn that the move to private assessment "may lead to financial hardship"[1]. In Wales, a private diagnosis carries "no guarantee" of acceptance by GPs or education providers[9]. The result is a two-tier system: speed for those who can pay, years of waiting for those who cannot.

Children's first autism assessment appointments within six months, New Zealand, public vs privateIn a 2019 national survey of New Zealand parents, 70% of children's initial autism assessments in private practice happened within six months, compared with 30% in the public system.0%25%50%75%100%Private practice70%Public system30%
Children's initial diagnostic appointments within six months, by setting. Survey of 458 parents, August 2019. Source: van der Meer & Evans, Autism CRC, 2021.

What the evidence asks of us

The figures point to a few clear demands.

  • Count the queue, and publish it. Wales retired a collection judged unfit for publication[10]; Scotland's numbers previously surfaced only through Freedom of Information requests and one-off publications[1]. Every health system should publish regular, comparable waits for children and adults, from referral to diagnosis.
  • Measure against the standard that already exists. Every benchmark in the table was set by the system now missing it. Adults need one too; Wales has none[9].
  • Fund the workforce, not just waiting-list sprints. Studies in the UK and the US point to too few specialists[20][24], and North American surveys find roughly a quarter to a third of them planning to retire within five years[19][21].
  • Redesign the pathway where evidence shows it helps. In Scotland, closer adherence to best-practice standards was associated with shorter waits for children[7]. A US service that brought assessment into primary care reported a latency of 55 days from first concern to diagnosis among the 119 children it saw[25]. Neither proves the approach would work everywhere.
  • Don't make support wait for the label. People on waiting lists already have needs[23]. NICE says assessment should happen as soon as possible "so that appropriate health and social care interventions, advice and support can be offered"[4]; until it happens, support at school, at work and for mental health should follow need, not a diagnostic letter.
  • Close the two-tier gap. State-bought private assessments, as in Ireland[15], should be free to families and quality-assured, and clear standards should mean a sound private diagnosis is recognised by schools and GPs[9].

Language: this piece uses identity-first language ("autistic people", "autistic children"), the preference of most autistic-led organisations, and uses clinical terms such as "autism spectrum disorder" only when quoting a study, guideline or official source.

Why we're publishing this

Health Insurance UK is a commercial health-insurance resource, not a charity and not a campaign. We published this because autistic people, families and the organisations that fight for them are often told that long waits are a local problem or a temporary surge. The evidence says otherwise, and several systems do not even count the wait properly. We have put the verified numbers in one place, with the gaps marked, so charities and autistic-led organisations can put them before a commissioner, minister or journalist.

How to read this data

These figures are not directly comparable between countries, and we have not ranked them. Some count everyone on a list on one date (England, Scotland 2025, Northern Ireland, Sweden, and Ireland's overdue count); others measure completed assessments (the NAIT study, Ireland's completion times, Canada). Some stop the clock at a first appointment (Wales, NICE), others when the diagnosis is shared (NAIT, Canada). Four figures are second-hand because we could not open the primary document (Ireland, Northern Ireland's time bands, Australia and Sweden); each is labelled where it appears. Several cover all neurodevelopmental assessments, or, in Ireland and Sweden, disability or child-psychiatry assessments generally. Australian, New Zealand and older UK figures come from families who chose to answer surveys, who may have had harder experiences. Some figures are years old because nothing newer is published; each is dated. Where a country has no national figure, we describe that absence rather than filling it. This is analysis of published data, not new research.

Use this data

Free to cite with attribution to Health Insurance UK. Charities, campaigners and journalists are welcome to reuse the figures, table and charts. For the underlying figures as a spreadsheet, get in touch. More autism and health evidence is in our Autism & Health research library.

Suggested citation: Health Insurance UK (2026). Not Just England: Autism Assessment Waits Run to Years in Many Countries. https://www.healthinsuranceuk.net/research/autism-assessment-waits-international

Important: This article summarises published research and official data for general information. It is not medical advice and cannot be used to diagnose, treat or predict anything about an individual. If you have concerns about your own or someone else's health, please speak to a qualified health professional.

Sources

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  2. More than 21,700 children overdue for disability assessments (reporting HSE Assessment of Need figures, Q1 2026). BreakingNews.ie, 6 May 2026. breakingnews.ie/ireland/…1895946.html
  3. Health Service Executive. Assessment of Need (Disability Act 2005). HSE, accessed 2026. www2.hse.ie/services/disability/…/assessment-of-need/
  4. National Institute for Health and Care Excellence. Autism: Quality standard QS51, Quality statement 1: Diagnostic assessment by an autism team. NICE, 2014. nice.org.uk/guidance/qs51/…
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