Children present for diagnosis in later childhood when their behaviours become problematic as ‘social demands exceed limited capacities’, according to DSM- 5.19 This change may be due to changes in circumstances, such as moving to a new school.20 Our analysis of attention deficit hyperactivity disorder (ADHD) diagnoses in the UK showed a distinct spike during the period of transition from primary to secondary school, 21 presumably because parents wanted more support for their children in the less- supported learning environment of secondary school. This is reminiscent of the Foucauldian ‘surface of emergence’22– the field in which an object first arises. Foucault writes that pre- existing fields, such as family, social group or school, are always normative to some degree and will have developed a ‘margin of tolerance’ that roughly defines the field of what it considers unacceptable.22 The field may be secondary school, the object is diagnosable autism, because for an autism diagnosis to be considered there must be a negative impact on children and their carers; perhaps a child’s behaviour only becomes problematic
in the secondary school environment, where there are more demands. Between younger childhood, older childhood and adolescent childhood groups, it was in secondary school- aged children, that we saw the biggest increases in the recording of new autism diagnosis between 1998 and 2018.