Neurodiversity

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The neurodiversity paradigm is a framework for understanding human brain function that considers the diversity within sensory processing, motor abilities, social comfort, cognition, and focus as neurobiological differences. This diversity falls on a spectrum of neurocognitive differences.[1] The neurodiversity paradigm argues that diversity in neurocognition is part of humanity and that some neurodivergences generally classified as disorders, such as autism, are differences with strengths and weaknesses as well as disabilities that are not necessarily pathological. Neurotypical individuals are those who fall within the average range of functioning and thinking.
The neurodiversity movement started in the late 1980s and early 1990s with the start of
Neurodivergent individuals face unique challenges in education and the workplace. The efficacy of accessibility and support programs in career development and higher education differs from individual to individual.[9][10] Social media has introduced a platform where neurodiversity awareness and support has emerged, further promoting the neurodiversity movement.[11]
The
History and developments
The word neurodiversity first appeared in publication in 1998, in an article by American journalist Harvey Blume,
Blume was an early advocate who predicted the role the Internet would play in fostering the international neurodiversity movement.
The Neurodiversity Movement grew largely from online interaction. The internet's design lent well to the needs of many autistic people.[33] People socialized over listservs and IRCs. Some of the websites used for organizing in the Neurodiversity Movement's early days include sites like Autistics.Org[34][35] and Autistic People Against Neuroleptic Abuse.[36][37] Core principles were developed from there. Principles such as advocating for the rights and autonomy of all people with brain disabilities with a focus on autism. The main conflicts from the beginning were about who the real experts on autism are, what causes autism, what interventions are appropriate, and who gets to call themselves autistic.[38] During the 2000s, people started blogs such as Mel Baggs' Ballastexistenz[39] and Kevin Leitch's Left Brain Right Brain.[40] Eventually, Autistic Self Advocacy Network (ASAN) was started by Ari Ne'eman and Scott Robertson to further align the Neurodiversity Movement with the greater disability rights movement. ASAN led the Ransom Notes Campaign[41][42] to successfully remove stigmatizing disability ads posted by the NYU Child Study Center. This was a massive turning point for the Neurodiversity Movement.[43]
From there, the Neurodiversity Movement continued to grow with the formation of more organizations in the early 2010s such as Autistic Women & Nonbinary Network[44] and The Thinking Person's Guide to Autism.[45] More autistic people were appointed to federal advisory boards like Interagency Autism Coordinating Committee and National Council on Disability. There were various campaigns like the ongoing #StopTheShock related to the use of aversive treatment at Judge Rotenberg Center and various protests against Autism Speaks. Various flashblogs[46][47] popped up during the 2010s to support campaigns. Annual traditions were formed such as Disability Day of Mourning[48] and Autistics Speaking Day.[49]
Damian Milton notes that, in 2014, Nick Walker attempted to define neurodiversity, the neurodiversity movement, and the neurodiversity paradigm. Walker tied neurodiversity to the idea that "all brains are to a degree unique". She also defined the movement as a rights movement, and the paradigm as a broader discussion of diversity, cultural constructions and social dynamics.[50][51]
An important question is which neurodivergences traditionally viewed as disorders should be depathologized and exempt from attempts to remove them.[51] Autistic advocate Nick Walker suggested preserving "forms of innate or largely innate neurodivergence, like autism" while conditions like epilepsy or traumatic brain injury could be removed from the person without fundamentally changing the person because these are not pervasively linked to the individual's personality or perception of the world.[51]
Scientific debates, research findings, and neurodiversity-based reforms
In recent years, the concept of neurodiversity and many related findings that challenged traditional knowledge and practices in the autism field have gained traction among many members of the scientific and professional communities,
Moreover, researchers have found that psychoeducation based on the medical model is associated with higher stigma.
The neurodiversity paradigm is controversial in autism advocacy. A prevalent criticism is that autistic people with higher support needs would continue to have challenges even if society was fully accommodating and accepting of them. Some critics of the neurodiversity paradigm, such as family members that are responsible for the care of such an autistic individual, think it might lead to overlooking or downplaying these challenges.[2] In response, it has been stated that neurodiversity does not deny disability and support needs[2] and that not having certain abilities or needing support is not intrinsically a bad thing, because notions of normal functioning are culturally and economically relative[87] and historically contingent and there are cultures in which questions like "Will my child ever be able to live independently?" or "Who will care for my child after I die?" do not arise because support is provided by other members of the community as a matter of course.[88]
Autistic self-advocate and researcher Ari Ne'eman has suggested a trait-based approach, where elements of the medical (or pathology) model can be applied in treating certain traits, behaviors, or conditions that are intrinsically harmful (e.g. self-injury behaviors, epilepsy, or other co-occurring health conditions), while neurodiversity approaches can be applied to non-harmful or sometimes adaptive autistic traits (e.g. some stimming behaviors that do not result in self-injury, intense interests) of the same individual.[89][90] Relatedly, some neurodiversity researchers, as well as autistic people, advocates and researchers, have advocated for application and sometimes integration or combination of both neurodiversity approaches and biomedical research plus practice.[2][17][18][1][19][20][91]
In recent years, researchers, providers of various support services, and neurodivergent people have advocated for more neurodiversity-affirming interventions, with both new intervention strategies being developed and advancements or reforms of existing intervention strategies (e.g. social skills training, ABA interventions, occupational therapy) informed by experiences, strengths, interests, preferences, and feedback of autistic people as well as neurodiversity approaches and findings, with some evidence for beneficial effects.[92][93][94][95][96][97][98][99][100][101][102][103][68][104][105][106][107][108][excessive citations] In addition, some researchers and advocates have called for more neurodiversity-affirming psychoeducation and stigma reduction methods.[109][110][111][112][113]
Neurodivergent and neurotypical/neuroconforming

According to
Under the neurodiversity framework, these differences are often referred to as "neurodivergences", in an effort to move away from the medical model of disability (sometimes referred to in the neurodiversity community as the "pathology paradigm"[122]). This term provided activists a way to advocate for increased rights and accessibility for non-autistic people who do not have a neurocognitive functioning that is considered typical.[123]
Neurotypical (an abbreviation of neurologically typical, sometimes NT) is a
Neuroscience writer Mo Costandi views terms like "neurotypical" as not being of use in neuroscience,[129] while others, including Uta Frith and Francesca Happé,[130] use the term freely. Ginny Russell mentions that there is no clear bimodal distribution separating autistic and non-autistic people because many non-autistic people have some autistic traits.[131] Another criticism, that "neurotypical" was a dubious construct because there is nobody who could be considered truly neurotypical,[131] has been said by Nick Walker to reflect a misunderstanding of the term because it is meant to describe those who can adapt to society's norms without much effort, not to imply that all neurotypical people's brains are the same.[132]
Early definitions described neurotypicals as individuals who are not autistic.[133][134] Early uses of NT were often satirical, as in the Institute for the Study of the Neurologically Typical,[35][23] but it has been adopted by the neurodiversity movement too, and is now used in a serious manner.[135]
In contrast to some of the shortcomings of terms like "neurotypical" (such as its underlying assumption that neurodivergent experiences are an anomaly, i.e. not typical), a growing group of advocates in the neurodivergent movement prefer other terms such as "neuroconforming".[136] The term "allistic" is also used, meaning "not autistic".[137]
Double empathy theory

The theory of the double empathy problem argues that autistic people do not inherently lack empathy as often supposed by people who see autism as pathological, but most autistic people may struggle in understanding and empathizing for non-autistic people whereas most non-autistic people also lack understanding and empathy for autistic people. It was originally conceived in 2012 by autistic scholar Damian Milton.[139] The theory argues that characteristics and experiences of autistic and non-autistic people are so different that it is hard for one to understand how the other thinks and empathize with each other; for example, non-autistic people may not understand when an autistic person is overwhelmed.[140]
An increasing number of studies in the 2010s and 2020s found support for double empathy theory and related concepts such as bidirectional social interaction.[141][142][143] One study comparing the conversations and socialization of autistic groups, non-autistic groups, and mixed groups found that autistic people were more able to build rapport with other autistic people than with non-autistic people, and at a level similar to the purely non-autistic group.[144] A systematic review published in 2024 found that most autistic people have good interpersonal relations and social-communication experiences with most autistic people, and interactions between autistic people are associated with better quality of life across multiple domains, including mental health and emotional well-being.[142]
The double empathy problem theory implies there is no simple fix that can help each group better empathize with each other, but it is worthwhile to bridge the double empathy gap through more equal contact and enhancing public understanding and empathy about autistic people based on neurodiversity-affirming approaches.[112] The advantage of the theory is reducing pathologization of autistic people by identifying that most people struggle to empathize with people with different neurotypes. It can also help neurotypical individuals to better understand how neurodivergent people think and empathize and to recognize their own limitations in empathizing with autistic people.[145] Jaswal and Akhtar (2019) highlight the difference between being socially uninterested and appearing socially uninterested, and challenge preconceived notions of a lack of social motivation. For example, testimonies from autistic individuals report that avoiding eye contact serves an important function of helping them to concentrate during conversation, and should not be interpreted as expressing social disinterest.[146]
Within disability rights movements
Neurodiversity paradigm |
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The neurodiversity paradigm was developed and embraced first by autistic people,[147][148] but has been applied to other conditions such as attention deficit hyperactivity disorder (ADHD), developmental speech disorders, dyslexia, dysgraphia, dyspraxia,[149] dyscalculia, dysnomia, intellectual disability, obsessive–compulsive disorder (OCD), Tourette syndrome,[150] and sometimes mental illnesses such as schizophrenia,[8][151] bipolar disorder,[152] schizoaffective disorder, and, somewhat more controversially, personality disorders such as antisocial personality disorder.[153] Neurodiversity advocates and organizations like the Autistic Self Advocacy Network (ASAN) do not agree with using medical interventions as a way to remove neurodevelopmental differences that are fundamentally linked to the personality and perception of the world, such as autism.[154][155] Rather, they promote support systems such as inclusion-focused services, accommodations, communication and assistive technologies, occupational training, and independent living support.[103][154] The intention is for individuals to receive support that honors human diversity and feel that they are able to freely express themselves. Other forms of interventions may cause them to feel as though they are being coerced or forced to adapt to social norms, or to conform to a behavioral standard or clinical ideal.[156][157]
Proponents of neurodiversity strive to reconceptualize autism and related conditions in society by acknowledging that neurodivergence is not something that needs to be cured and that the idea of curing it makes no conceptual sense because differences like autism are so pervasive that removing the autistic parts of the person is tantamount to replacing the autistic person by a different person.[8] An important aim is also changing the language from the current "condition, disease, disorder, or illness"-based nomenclature, "broadening the understanding of healthy or independent living", acknowledging new types of autonomy, and giving neurodivergent individuals more control over their interventions, including the type, timing, and whether there should be interventions at all.[31][8]
Activists such as
A 2009 study[159] separated 27 students with conditions including autism, dyslexia, developmental coordination disorder, ADHD, and having suffered a stroke into two categories of self-view: "A 'difference' view—where neurodiversity was seen as a difference incorporating a set of strengths and weaknesses, or a 'medical/deficit' view—where neurodiversity was seen as a disadvantageous medical condition". They found that, although all of the students reported uniformly difficult schooling careers involving exclusion, abuse, and bullying, those who viewed themselves from the "difference" view (41% of the study cohort) "indicated higher academic self-esteem and confidence in their abilities and many (73%) expressed considerable career ambitions with positive and clear goals".[159] Many of these students reported gaining this view of themselves through contact with neurodiversity advocates in online support groups.[159]
A 2013 online survey which aimed to assess conceptions of autism and neurodiversity suggested that conception of autism as a difference, and not a deficit, is developmentally beneficial and "transcend[s] a
Neurodiversity advocate John Elder Robison argues that the disabilities and strengths conferred by neurological differences may be mutually inseparable. "When 99 neurologically identical people fail to solve a problem, it's often the 1% fellow who's different who holds the key. Yet that person may be disabled or disadvantaged most or all of the time. To neurodiversity proponents, people are disabled because they are at the edges of the bell curve, not because they are sick or broken."[161]
Higher education
There are several models that are used to understand disability. There is the medical model of disability that views people as needing to be treated or cured.[162] Another model is the social model of disability, which puts emphasis on the way that society treats people with disabilities.[162] Through the social model of disability, the experiences of neurodivergent students in higher education are partially influenced by the reactions and attitudes of other students and the institution itself.[9]
Experiences of neurodivergent students
The emotional experiences of neurodivergent students in higher education depend on a combination of factors, including the type of disability, the level of support needs, and the student's access to resources and accommodations.[9] A common difficulty for neurodivergent students is maintaining social relationships, which can give rise to loneliness, anxiety, and depression.[9] There is also the added stress and difficulty of transitioning into higher education, as well as the responsibilities and task management required in college.[9] Many neurodivergent students may find that they need added support.[9] As for academics, neurodivergent students may experience difficulties in learning, executive function, managing peer relationships in the classroom or in group work, and other difficulties that can affect academic performance and success in higher education.[9] However, neurodivergent students may find that their differences are a strength and an integral part of their new social roles as adults.[9]
Higher education institutions
The typical curriculum and format of higher education may pose as a challenge for neurodivergent students, and a lack of support and flexibility from staff may further complicate the university experience.[9] Thus, reasonable adjustments are available to students who disclose their disabilities.[9] However, these adjustments or accommodations may put an emphasis on academics, and less on the various challenges of higher education on neurodivergent students.[9] For instance, neurodivergent students in higher education also report a need for non-academic supports, such as social mentorships and resources for strength-based interventions in order to further assist neurodivergent students in the social aspects of college life.[9] Similarly, career preparation that is specifically targeted for neurodivergent students is lacking. There are several programs, such as supported employment, that exist to help assist neurodivergent individuals in finding and obtaining a job. However, many of these programs do not exist in schools. This can make it difficult for neurodivergent students to find a career path that they feel is attainable for them.[162] Another consideration is the implementation of a universal design approach (UDL) when building learning spaces or communal areas that considers the needs of neurodivergent students. A UDL design incorporates a design that accommodates the needs of all students, including the neurodivergent population.[10]
According to an article published in 2023, universities and post-secondary establishments would show more tolerance towards neurodivergent people. A tolerant environment can increase autonomy, leading to kindness and understanding among students.[163] Higher education institutions offer counseling and support services to students. However, neurodivergent students face particular challenges that impair their ability to receive consistent support and care. Additionally, counseling and support services face a lack of funding, personnel, and specialists that can adequately support neurodivergent students. Overall, these services work for some students and not for others.[9]
Nachman and colleagues reviewed several articles published by two-year community colleges and found some discrepancies in the way that they perceived and categorized "disabled" students and "non-disabled" students. They found that all of the articles were attempting to normalize disability. Many of them put a distinct separation between typical and atypical learners as well as their potential academic achievement. Nachman also found that many of the articles showed a lack of autonomy for neurodivergent students. They had little power in regard to academic choices and classroom management.[164]
In the workplace
Neurodivergent individuals are subjected to bias when applying and interviewing for job positions.
In a
A study conducted during the COVID-19 pandemic suggested that neurodivergent individuals would benefit from remote work as it allowed them to engage in their interests, but that social engagement is still necessary for productivity and performance.[172] Another study supported these findings and stressed the need for redesigned work and social conditions to be more inclusive for autistic individuals.[173]
In social media
The increase in representation of the neurodiversity movement in the media came about with changes in the technology of the media platforms themselves.[103] The recent addition of text-based options on various social media sites allows disabled users to communicate, enjoy, and share at a more accessible rate.[103] Social media has a two-fold benefit to the neurodivergent community: it can help spread awareness and pioneer the neurodiversity movement, and it can also allow members of the communities themselves to connect.[174][175]
Social media as a platform
Media platforms allow the connection of individuals of similar backgrounds to find a community of support with one another.[174] Online networking and connections enable users to determine their comfort level in interactions, giving them control over their relationships with others. For the neurodivergent community, social media has proven to be a valuable tool for forming relationships, especially for those who find social situations challenging.[176] By connecting neurodivergent users, media platforms provide "safe spaces" that are helpful in forming relationships.[176] Some media developers have created platforms like Blossom that are designed specifically to connect neurodivergent users and families.[177]
Social media as a driving force
Social media also allows users to spread awareness about the neurodiversity movement.[178] Increasing awareness about mental conditions has been shown to increase the amount of factual information spread.[178] The spread of information through social media exposure can assist the neurodiversity movement in educating the public about understanding disabilities such as autism and sifting out misinformation.[175] By sharing neurodivergent experiences from a first-hand perspective, social media can educate the public and destigmatize certain conditions. Still, negative portrayals of neurodivergence can have an obstructive impact on members of the community.[178][179]
Higher awareness and acceptance through social media can lead people to self-identify as neurodivergent.[180] Generally, self-diagnosis is discouraged in psychiatry because it is thought to be wrong more often than a professional assessment and because it is said that it trivializes challenges by turning them into fashion labels.[180] Robert Chapman, in contrast, questions the reliability of professional autism assessments as they often overlook the experiences of individuals who are not white cisgender male children and states that self-identification is not done for fashion purposes but because it helps understanding one's strengths and challenges.[181] Sue Fletcher-Watson argues that because autism should not be classified as a disorder and no treatment should follow a diagnosis, autistic individuals should have the autonomy to self-identify as autistic, liberating them from the power of medical professionals in defining autism and determining who belongs to the autistic community.[182] A group of researchers created a preliminary self-report questionnaire for autistic people.[183]
Challenges within media
Although representation of the neurodivergent community has grown with the help of social media platforms, those users are often criticized and misunderstood.[184] Social media has not entirely removed the social barriers that restrict inclusion of neurodivergent people. Some have reported needing to conform to the mainstream view of their disability to be seen as "authentic" users.[184] Doing so has indirectly made it more difficult for neurodivergent users to grow platforms.[184][185] Non-disabled users assessing the authenticity of neurodivergent individuals based on stereotypes indicates that the neurodiversity movement has not achieved its goal of inclusion.[184]
Clinical setting
Medicine and healthcare
Medical and healthcare professionals have begun to acknowledge neurodivergence among employees.
Similarly, healthcare systems may benefit from hiring neurodivergent individuals to gain a unique perspective when caring for patients.[188] Some healthcare staff agree that inviting neurodivergent individuals to join patient advisory groups or hiring them as staff are essential steps to acceptance and integration in the workforce. Neurodivergent people's unique strengths can be vital to health system innovation and improvement efforts.[188] One example of the push toward this is the Stanford Neurodiversity Project, in which one of their goals is to discover the strengths of neurodivergent individuals and make use of their talents to increase innovation and productivity of their society, such as working in the field of healthcare and medicine.[189]
Neurodiversity has also recently been investigated as a new way of working within neurodevelopmental clinics in the UK.[190] A team of researchers in Portsmouth, England, have created an approach in aiding neurodivergent individuals known as PANDA, or the Portsmouth Alliance Neurodiversity Approach. This approach may help medical and healthcare professionals facilitate understanding, communication and early support for children who may identify as being neurodivergent.[190]
Therapy
Neurodiversity and the role it plays in therapeutic settings has been a central focal point in recent years. Many therapists and mental health professionals have pushed for more inclusive psychotherapeutic frameworks appropriate for neurodivergent individuals.[191][192] One example is neurodivergence-informed therapy, which reframes dysfunction as interconnectedness among society rather than strictly individual, advocating for acceptance and pride in the neurodiversity community, and the push for therapists to pursue humility regarding the knowledge and education associated with individuals who identify as neurodivergent.[191] Similarly, neurodiversity affirming therapy supports neurodivergent differences, rather than viewing them as something that should be eliminated, and to offer ways to support the individual with difficult areas, while still appreciating their needs and strengths.[192]
Therapeutic programs and interventions are also being investigated for the neurodivergent community.[96][193] Self-determination programs to help neurodivergent individuals achieve goals in their life have been found to be successful, with neurodivergent participants finding it to be "appropriate, acceptable, and feasible".[96] Various approaches (e.g., eye-tracking, longitudinal data, computational modeling) in understanding perceptual decision-making in neurodivergent individuals are also being studied and the implications it may have in the therapeutic environment in working with the neurodivergent population.[193]
Another form of therapeutic intervention in that has been investigated in neurodivergent individuals is the use of Naturalistic Developmental Behavioral Interventions (NDBIs).[68] NDBIs have been shown to have positive effects on language and social-communication while, at the same time, respecting individuals' needs and autonomy. One of the key goals in this type of intervention is putting the focus of therapy on the neurodivergent individual themselves in the creation of intervention goals, procedures, and outcomes. In doing so, they are likely to be seen as more acceptable, useful, and effective to that individual.[68]
In addition to support from neurodiversity advocates for affirming therapies, concerns have been raised about the role of certain approaches such as applied behavior analysis. Neurodivergent individuals and activists tend to emphasize that these interventions aim to enforce conformity with expectations of society rather than addressing the needs of the person receiving the intervention.[194] While a large body of research on the role of ABA seems to support its efficacy in cognitive and behavioral outcomes, a meta-analysis by Sandbank et al. challenges the evidence.[195] Additionally, there are concerns regarding long-term mental health impacts and with the measures used in determining social validity by those who have raised these concerns. In addition to advocates from within the neurodivergent community, some behavioral analysts have begun to reconsider the role of these therapies with the context of a neurodiversity framework.[196][194]
See also
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Further reading
- Smith T, Kirby A (2021). Neurodiversity at Work: Drive Innovation, Performance and Productivity with a Neurodiverse Workforce. London: Kogan Page Limited. ISBN 978-1-3986-0024-9.
- Omeiza KA (2024). Autistic and Black: Our Experiences of Growth, Progress, and Empowerment. London: Jessica Kingsley Publishers. ISBN 9781839976209.
- Armstrong T (2010). Neurodiversity: Discovering the Extraordinary Gifts of Autism, ADHD, Dyslexia, and Other Brain Differences. Boston: Da Capo Lifelong. p. 288. ISBN 978-0-7382-1354-5.
- Armstrong T (2011). The power of neurodiversity: unleashing the advantages of your differently wired brain (1st Da Capo Press paperback ed.). Cambridge, MA: Da Capo Lifelong. OCLC 760085215.
- Armstrong T (2012). Neurodiversity in the Classroom: Strength-Based Strategies to Help Students with Special Needs Succeed in School and Life. Alexandria, VA: Association for Supervision & Curriculum Development. p. 188. ISBN 978-1-4166-1483-8.
- Dinh A (2024). Don't Mourn for Us: The Autistic Life of Jim Sinclair and an Extraordinary Story of Neurodiversity. Independently published. ISBN 979-8338157381.
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