Age of identification of autism or ADHD and economic outcomes: findings from a UK birth cohort

Background

Autism and attention deficit hyperactivity disorder (ADHD) are often associated with poorer economic outcomes. Due to rising demand for diagnostic assessments, the UK government is considering the role of diagnoses in determining outcomes. This study aimed to understand the association between age of formal identification and economic outcomes in early adulthood .

Methods

This work uses the Millennium Cohort Study, a UK birth cohort of children born between 2000 and 2002. Multinomial and ordinal logistic regressions were used to estimate the associations between age of identification and self-reported economic outcomes at age 23, using non-autistic/ADHD adults as the reference.

Results

All identification ages had significantly higher odds ratios (OR) of being not in employment, education or training (NEET) at age 23, with the highest OR for those identified at age 14-17 (6.52, 95% CI = 4.14, 10.27), and lowest for those identified at age 5-7 (4.13, 95% CI = 2.65, 6.45). All ages had higher odds of being in receipt of state benefits, with those diagnosed at age 17-23 having the lowest OR (4.36, 95% CI 3.46, 5.50) compared to those never diagnosed. However, of those in employment, those identified at age 17-23 had significantly lower OR of a higher income (0.71, 95% CI = 0.54-0.93), but those identified at age 14-17 saw no significance (1.007, 95% 0.55-1.86).

Discussion

These results suggest those identified in early adulthood have better odds of favourable outcomes compared to adolescence, whilst still having lower odds than the wider population. We hypothesise that the age 14-17 group may have greater access to support that enables maintenance of NEET status, compared to the age 17-23 group, rather than taking lower paid jobs. In the context of policy changes aiming to alleviate demand for diagnoses, and reduce the number of NEETs, these analyses suggest that these are interrelated and should be considered together.

Key messages

• Young adults who identify as autistic and/or ADHD have typically higher odds of less favourable economic outcomes, regardless of the age they were identified as autistic or ADHD.

• Adults identified as autistic/ADHD in adolescence see higher odds of poorer economic outcomes than those identified in adulthood, suggesting age of identification may predict later economic outcomes.