Dave Clements, author of The Crisis in the Classroom, has warned that Britain is increasingly 'medicalising childhood' as ADHD and autism diagnoses become the 'currency' of an overwhelmed education system. Speaking on the Care Visions Talks podcast, he argued that diagnoses are now the gateway to support and funding, rather than addressing the underlying reasons why children are struggling.
Record Numbers of Children with Special Educational Needs
Department for Education figures show that more than one in five children—1.86 million pupils—are now identified as having special educational needs, up from around one in six a decade ago. The number of children with Education, Health and Care Plans (EHCPs), which guarantee additional support, has almost tripled from 240,183 in 2015 to 718,838 today.
'If one in five children has special educational needs, are they still special?' Mr Clements asked. He stressed that while many children have genuine neurodevelopmental conditions, others are being wrongly diagnosed, and the system is leaving children with the most complex needs competing for scarce resources.
Exclusions and Suspensions Surge Among Pupils with EHCPs
Permanent exclusions among pupils with EHCPs more than tripled from 347 in 2014/15 to 1,198 in 2024/25, while suspensions rocketed from 33,544 to 116,188 over the same period. This comes despite an overall fall in exclusions, according to figures published by the Department for Education.
Mr Clements said: 'We can't go on like this. We cannot diagnose our way out of the crisis. Support should be based on children's needs rather than an ever-growing list of labels.'
Diagnoses Driven by Resource Constraints
Mr Clements argued that the explosion in diagnoses has been fuelled by a system that ties support to formal labels. Schools receive extra resources for children with EHCPs, while parents often see diagnosis as the only realistic route to getting help.
'If a school has four or five children whose needs are complex enough... you may well be able to afford a teaching assistant. I think schools who are struggling in terms of resources will go for that... Parents do the same because they think it might help them,' he said.
The result, he argues, is that children with the greatest needs are forced to compete with a rapidly growing number of others entering the system. 'We've got the system being overwhelmed by questionable needs, and then you've got genuine, really difficult needs that need to be addressed.'
Underlying Causes Often Overlooked
Rather than questioning the existence of ADHD or autism, Mr Clements believes Britain has increasingly turned to medical diagnoses to explain a much wider range of childhood struggles. He said: 'We want to explain away children's problems by medicalising them. I don't think that's helpful for most children. I think for most children, there are likely to be other explanations.'
He pointed to anxiety, trauma, family breakdown, poor sleep, excessive screen use and changing social environments as factors that are too often viewed through a medical lens. 'I try not to dismiss some of the issues that children and families face. Often these are real needs, but naming them doesn't necessarily help. You need to understand why those needs emerged in the first place,' he said.
Government Review Launched
Mr Clements' warning comes as ministers launch an independent review into whether soaring diagnoses reflect genuine unmet need or a wider trend towards the medicalisation of childhood. He also questioned the growing influence of what he sees as the 'neurodiversity movement', which he believes has drifted far beyond its original purpose of reducing stigma.
'It's become institutionalised. It's become medicalised,' he said. He warned schools are increasingly being expected to tailor teaching around an ever-growing number of individual diagnoses, which 'inevitably becomes very difficult.'
Instead of asking, 'What condition does this child have?', Mr Clements believes Britain should spend more time asking, 'Why is this child struggling?' He argues children today spend less time outdoors, enjoy less independence and face pressures previous generations never experienced. 'I don't think children themselves have changed particularly. I think we've put them in a very difficult situation. It's an adult problem. We've created an environment where those risks are no longer open to them,' he said.
The Care Visions Talks podcast with Dave Clements will be aired on Wednesday 29th July.
