Neurodiversity and the Neurodiversity Movement: Everything You Need to Know
Neurodiversity can mean a lot of different things to different people. More than just a name for a group of developmental brain conditions, it typically refers to one of two Neurodiversity models - either how a brain works and how that can deviate from a "norm", or how all humans exist with different abilities, skills, sensitivities, and functioning patterns. – Here is everything you need to know about Neurodiversity and the Neurodiversity Movement.
Diversity, or variety, is a part of life. The variation we see in plants, animals, and people is coined "biodiversity", which is short of biological diversity. There are 3 components of biodiversity - genetics, species, and ecosystem, all of which cannot and should not be viewed in isolation from each other, as they each interact and influence each other.
The Neurodiversity Model
The neurodiversity model then, at its simplest, is the idea that brains, thought patterns, and the rules by which we function are diverse. Neuro refers to our brain, and diversity refers to variation.
From there, you get 4 different terms that refer to different ideas. I've described them very briefly below, and shared some more resources for further research and quick additional points.
Neurodiversity Movement
The neurodiversity movement is a social justice movement that moves away from only pathologizing neurodiversity, i.e. viewing something from the belief that it is a disease. It focuses on the idea that differences in mental, developmental, and cognitive abilities are just that - differences. The same way we celebrate biodiversity in plants and animals should be the same way we view differences in human brains. There is no one size fits all.
This term was first coined by Dr. Judy Singer in 1990. She argued that we should do more than just tolerate these differences, we should celebrate them as they are necessary for our species. The movement forces us to recognize that the assumption that all humans "more or less see, feel, touch, hear, smell, and sort information" the same way is incorrect.
This is easiest to recognize in someone with Autism, but as a reminder, the movement stipulates that is more than a condition. It is part of human biology. And that is not to say certain conditions cannot be disabilities , they certainly are and can be, but more so to recognize that neurodiversity is not, inherently, a bad thing or disability.
Neurodiversity Paradigm
Building off the neurodiversity movement, the neurodiversity paradigm again argues that moving away from the typical human experience and brain should not be pathologized (i.e. something that is not healthy). The idea, coined in 2012 by Dr. Nick Walker, argues that "instead of being labelled medically normal or abnormal, those who are more enabled in a given society are considered more neurotypical, while those who diverge further from functional norms are more neurodivergent." Again, it builds on the idea that these differences in neurotype are not inherently a bad thing. Certain conditions can and should be diagnosed, but the way they are viewed now often results in stigma, trauma, abuse, humiliation, and lack of autonomy for those that are diagnosed. Differences should be respected and worked with accordingly.
Neurodivergent (ND)
Neurodivergent, often abbreviated ND, is the idea or label that someone diverges from the dominant cultural standards that exist in how we think and perceive. It is, in a way, synonymous with neurominority - the idea that someone is in a minority group for how their brain is acting, and thus, usually at the disadvantage. Their brain is, for all intents and purposes, atypical i.e. divergent.
While everyone experiences things differently, the real challenges that ND people experience comes from living in a society that is, by definition, NOT designed for them. This can manifest with different mental health conditions. For example, people who are autistic, a classic ND condition, experience depression at a rate 4x that their non ND peers, and people who have ADHD are at greater risk for suicide.
Many people certainly experience the positives of their neurodivergency, but because of how individualized each experience is, some people experience a net positive and others a net negative. Often times, these may be different on different days.
For example, some ND people are at the forefront of innovation and disrupting industries as they view patterns, notice details, or question the status quo in a way most people don't. While this can certainly be a great thing, especially for businesses, if you're in a position to make changes.... it can also lead to increased stress, sadness, or frustration if you're in a position where you can't do anything about it.
Additionally, some people who are neurodivergent cannot filter out extraneous (i.e. not useful) information that other people can, be that noise, smells, lights, thoughts, etc. This can be an incredibly exhausting experience, and is why something as typical as grocery shopping, going to a sports event, or attending a party can leave someone overwhelmed or anxious, which can often translate to perceived grumpiness or sensitivity.
Neurotypical (NT)
Neurotypical (NT) then, refers to the idea that someones brain or cognitive patterns are more typical to their cultural society. They are able to function easier in a society that is more adept to their needs. Both ND and NT are morally neutral terms, though it should be noted that some ND people who are frustrated with their experiences may use NT negatively, just like some NT people who are skeptical the ND movement use neurodivergent condescendingly.
Final thoughts
As we move forward in society, we decide how to view and work to adapt to ND people and patients. The most important idea for me, as a physician who is also ND (an ND ND if you will), is summed up below:
Treat the distress, not [the] difference. - Dr. Joel Salinas
And as Jillian Enright put,"distress is defined by the individual, not their parents, co-workers, employer, teacher, or anyone else." If someone wants to learn how to function more in line with neurotypicality, that is their own decision.
I often get discouraged when I tell people I am a primary care provider for people who are neurodivergent, or, if they are unfamiliar with that term, summarize it as a PCP for people who are autistic, have ADHD, or other similar conditions. People typically assume that means I am treating the actual autism or ADHD, which I am absolutely not doing unless requested by the patient. I am more so helping an individual address their other health conditions, while consciously making a treatment plan with them that works best with their brain. I hope one day, very soon, this line of thinking will become common place and that all physicians will become neurodivergent friendly.
Here are some more thoughts and considerations if you're hungry for more info:
Why using terms like severe autism or saying we're all a little autistic can be hurtful or unproductive: a consideration
That being said, there is increasing recognition of the Broader Autism Phenotype, or autistic traits in people whom do not meet the DSM-V criteria for diagnosis. Specifically the Broader Autism Phenotype (BAP) is commonly seen in families where someone (ex. a child) has clinically diagnosed Autism Spectrum Disorder (ASD).
Aspergers is no longer an official diagnosis, and falls under Autism.
"Asperger's syndrome was named for an Austrian pediatrician, Hans Asperger, who in 1944 described four children who were highly intelligent but socially awkward and physically clumsy."
However, not only is not an officially diagnosis anymore, it is also named after someone linked to the Nazi period.
Although it is an outdated term, if a patient still identifies with their initial diagnosis, it is best to respect their wishes and use that terminology.
Similarly, ADD is not an official diagnosis anymore, and has not been since 1994. It falls under ADHD, inattentive or combined type. Again, although it is an outdated term, if a patient still identifies with their initial diagnosis of ADD, it is best to respect their wishes.
Using the term Autistic Person vs Person with Autism: perspectives
While I personally use autistic, as I view person first language akin to saying "I am person with Mexican", I firmly believe in respecting how people prefer to refer to themselves and would never presume to correct someone. As always, it is about respecting how someone identifies.
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