Waiting Times and Influencing Factors in Children and Adults Undergoing Assessment for Autism, ADHD, and Other Neurodevelopmental Differences.

Only 10 of 14 health boards participated, and teams volunteered, so teams under severe pressure may have opted out. Cases were selected using team quotas and reverse chronological order, not random sampling, so the sample may not represent all services. Adult services were assessed using children's quality standards because adult standards were absent. Adult services may be more restrictive, often requiring moderate to severe mental illness, so adult waiting times may not reflect broader access. The models did not include age, parental education or income, and missing data were handled by dropping cases from the models. Ethnic minorities were very few, so demographic risk analysis was limited. The study did not examine referrals dismissed rather than placed on waiting lists. This was an observational case note review, so links between factors and waiting times are not proof of cause.

The Scottish Government funded the National Autism Implementation Team, which authored the study; the authors declared no conflicts of interest.

Do not read the shorter waits linked to higher quality-standard adherence as proof that enforcing standards will reduce waiting times. This was a retrospective case note review with voluntary teams and no randomisation, so the associations may reflect service or case differences.