Diagnostic Overshadowing in Healthcare: Insights from Individual Advocacy Group

In clinical settings involving mental health and developmental disability care, what a clinician expects to see can shape what they look for. When a person already carries a psychological, intellectual, or developmental diagnosis, new or changing symptoms may be interpreted through that existing framework rather than assessed as distinct clinical concerns. Individual Advocacy Group (IAG) notes that this dynamic, known as diagnostic overshadowing, can limit clinical curiosity, delay treatment, and diminish a person's sense of being fully seen.

As a nonprofit dedicated to empowering individuals with complex needs, IAG sees diagnostic overshadowing as an issue felt every day by individuals and families navigating layered healthcare systems. "Diagnostic overshadowing shows up in people's daily lives and affects real decisions and dignity," says Dr. Charlene Bennett, co-founder and CEO of IAG. "Our role is to elevate the voices of those most impacted and help drive changes that improve care now and in the long term."

Research on autism spectrum disorder (ASD) shows that rising prevalence among children, estimated at 1 in 36 eight-year-olds in 2023, makes accurate diagnosis increasingly challenging. Comorbid conditions and diagnostic overshadowing can obscure the full clinical picture, illustrating the importance of IAG's advocacy for assessments and care that address each person's unique needs.

The implications of diagnostic overshadowing become more visible when viewed through its effects on individuals. "When symptoms are repeatedly reframed rather than explored, people may experience delays in appropriate care or feel uncertain about whether their concerns will be taken seriously," Dr. Bennett states. "For people who already navigate complex support needs, these experiences can compound feelings of being reduced to a diagnosis rather than recognized as whole persons."

It's significant to recognize that responses to diagnostic overshadowing are emerging. IAG has observed a growing emphasis on bias awareness, diagnostic reasoning, and disability competence. "Some academic programs have started incorporating discussions of diagnostic overshadowing into their coursework, which we interpret as an indication that parts of the medical and psychological communities are increasingly recognizing the issue," Dr. Bennett shares. From the nonprofit's perspective, this reflects broader efforts to understand how diagnostic bias may contribute to missed or delayed care and illustrates that diagnostic overshadowing is a topic deserving of ongoing attention within healthcare contexts.

While these developments point toward progress, IAG challenges the idea that future-oriented solutions are sufficient on their own. "Training the next generation is essential," Dr. Bennett says, "but people are receiving care right now. The question is how we support them while systems are still evolving." She notes that the conversation must include current practitioners as well as students. Continuing education offers one practical avenue, allowing clinicians to revisit assumptions and integrate updated insights into everyday practice without framing the process as corrective or punitive.

This leads naturally to the topic of accountability. Within IAG's work, accountability is viewed as responsibility shared across systems. "If diagnostic overshadowing is acknowledged within the literature, then addressing it becomes part of ethical care delivery," Dr. Bennett remarks. Education alone, without mechanisms that encourage reflection and application, may struggle to translate into meaningful change. Accountability, in this sense, reinforces trust by signaling that learning is ongoing and that patient experiences are taken seriously.

IAG emphasizes that the human cost remains central. Individuals affected by diagnostic overshadowing are often part of families, workplaces, and communities, and their support networks feel the ripple effects when care is delayed or fragmented. "Does delaying solutions pause these experiences? I believe not. It prolongs them. If a problem can be identified and studied, what does it mean to defer action?" Bennett states.

By grounding its advocacy in both research and lived experience, Individual Advocacy Group seeks to keep that question visible. For the nonprofit, diagnostic overshadowing is neither a personal failure nor a simple oversight but a systemic pattern that calls for attention and care. Moreover, it notes that addressing the issue requires commitment to both long-term reform and responsive action. Dr. Bennett concludes, "In re-centering care around the whole person, the goal is presence, a willingness to see beyond diagnoses and respond to what is unfolding in front of us."