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Between 2008 and 2023, the share of students at UK universities who reported having a disability doubled from 8 to 16 per cent. At the elite institutions of Oxford and Cambridge, far from bucking the trend, the increase was even steeper, with rates quadrupling from 5 per cent to around 20 per cent.
This trend is not unique to Britain, as disability services and resources in education come under increasing strain from rapidly expanding criteria. In the US, research by Rose Horowitch for the Atlantic magazine found that 38 per cent of undergraduates at Stanford this year are registered as having a disability, as are 21 per cent at Harvard — both up from 5 per cent in 2009. My analysis of data from 19 European countries finds similar trends, with health impairments among students doubling on average over the past decade.
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Nor is this issue confined to higher education. In virtually every country I looked at from the UK and US to Finland, France, Italy and Spain, the share of school-age students receiving special support for their education needs has been marching upwards.
One could argue these figures tell a positive story of improved identification and care for young people who previously lacked help and support — and certainly there are elements of this in places. But deeper interrogation of the data paints a less rosy picture, particularly in the UK and US. It lays bare systems that benefit few and frequently fail those most in need.
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The evidence points to a perfect storm of overlapping problems. First, the applications of systems designed for fixed and clearly defined categories of impairment to (often invisible) conditions that sit on a spectrum and leave room for interpretation. The bulk of the rise in special support for youngsters is cases of non-profound autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) plus anxiety and mental health, all of which have flexible diagnostic criteria. Where detailed data is available, we consistently see mild, not severe, cases driving the rise.
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The additional assistance provided for students in these categories often includes extra time in exams and additional classroom support, and has been shown to significantly boost scores. There is no question that this is a huge help to most of the young people with less acute cases, but the expansion of the definitions in this direction is far from cost free.
In the UK, the ballooning special education needs and disability (Send) caseload exacerbates a funding crisis in local councils; demand far outstrips both forecasts and resources. The results are predictably dire. As the number of more mild cases receiving support has climbed over the past decade, average funding per child (including the most severe cases) has fallen by a third in real terms: outcomes for those receiving support have deteriorated and councils describe a system on the brink.
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There are also consequences far beyond education. The conspiracy-laden crusades by US health secretary Robert F Kennedy Jr and others to discredit vaccines, blaming them for rising autism rates, would have less success had diagnosis rates not been inflated by expanded diagnostic criteria. Careful analyses using consistent definitions show little to no change in underlying prevalence.
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Another issue is the presumption that support is deployed strictly according to need. To be clear, the vast majority of these young people do have a genuine requirement for extra help. But by defining need increasingly loosely (and in some cases providing support even where criteria are not met) these systems create room for exploitation. Sure enough, on both sides of the Atlantic parental resources seem to play an outsize role in who gets help, as some jump diagnostic waiting lists.
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In 2010, 1 per cent of American young people from the poorest school districts were on plans that provide special support, and today that figure is unchanged. But among those in the richest areas, it has tripled from 2 to 6 per cent. In the UK, students at state-sector secondary schools and private schools used to be equally likely to get extra time in exams; since then the latter have streaked ahead.
Managing young people’s cognitive and behavioural challenges, and their mental health, is an incredibly thorny problem. Reducing stigma and expanding support are admirable. But definitions that result in as many as 40 per cent receiving assistance are proving to be unsatisfactory, and expensive, for almost everyone.
john.burn-murdoch@ft.com, @jburnmurdoch
