Counseling chats with Dr. Rida Solrac You, PhD, SLP about Neurodiversity.
What does being neurodivergent mean and what is the medical model of disability?
At the end of the 1960s, a paper was published that led to an international debate about the conditions under which people with disabilities were living. Titled “The Normalization Principle and its Human Management Implications,” the paper originated from the fact that many persons with intellectual disabilities were, at the time, living in institutions under almost inhuman circumstances. The basic tenet of the author, Bengt Nirje, was that people with disabilities had the right to live and be treated like others, like human beings. That is, to be allowed to participate in large and small decisions concerning their own lives, by living in a society normally accessible to them. Although more than 60 years have passed since Nirje’s paper, there is still much to be done to reach the proposed ideals.
Since mostly the last decade, discussions have been raising trying to expand the boundaries of ‘normal diversity’ from different models, ‘medical’ ‘social’ and ‘individual’. Therefore, terminologies have been used to describe, for example, the medical model diagnostic criteria for “Neurodevelopmental disorder.” Some of these terms include “Neurotypical”/“Neurodivergent,” “Spectrum,” and “Condition.” The term ‘Neurodivergent’ was introduced for the first time by Judy Singer, a sociologist, in the 1990s. Judy, who identified as a woman “somewhere on the autism spectrum,” stated in her book “Neurodiversity: The Birth of an Idea”. Like many other skilled neurodivergent individuals, Judy grew up feeling like “a weird person,” not fitting societal norms despite her brilliant intelligence. Judy was a pioneer who emerged in the 20th century with a new paradigm within the disability rights perspective, known as the ‘social model of disability’. She has since contributed to the neurodiversity movement, advocating for the recognition and acceptance of neurological differences “as a natural and valuable aspect of human diversity.”
Why do we hear about neurodiversity being experienced on a spectrum?
Autism community research started to use the term “Neurotypical” in studies in contrast with “Autism Spectrum Disorder.” The idea of the spectrum was recently determined in the diagnostic criteria in 2013, relating to three different levels of severity in social communication and adaptive behavior in society. The concept of ‘spectrum’ leads to the assumption that each person with autism is ‘unique,’ even sharing common core symptoms with different levels of functioning. In popular language, we say that there is not one “Autism” but many “Autisms.” Aligned with this assumption, genetic studies have demonstrated more than 1,000 genes related to ASD, explaining the complexity of this neurodivergent condition.
The term “condition” rather than a ‘disorder’ or ‘illness’, first used by Prof. Simon Baron-Cohen, a British specialist in social cognition on the autism spectrum, aligns with the neurodiversity concept that autism is a variation in human neurology that comes with its own unique strengths and challenges, rather than something inherently negative that needs to be ‘cured’. Taking into account the factors mentioned previously, we should consider neurodiversity as describing “a person whose brain works differently, encountering challenges in life but with a good capacity for adaptation and independence, including great talents.” On the other hand, it also means “a person whose brain works differently and faces deeper challenges in achieving independence.” The “medical” model is based on a universal international classification of “disorders,” essential to offer an objective description allowing professionals to make diagnoses. However, this classification, although has undergone significant updates over the decades, still highlights mostly the lack of skills observed in the individual compared to a ‘normative’ group, including intellectual, language, communication, social, academic, and adaptive functioning.
Unfortunately, there is no checklist classification highlighting the “talents” in the diagnostic criteria. It is already known that ‘neurodivergent’ persons have unique talents (such as in music, drawing, and computing with incredible detailed perception) and are often the “loyal” and “honest” individuals. Therefore, neurodivergent persons in the ‘individual model’ advocate the idea that they are not ‘disabled’ but have a different way to “think,” “feel,” “act,” and “be” compared to the ‘typical spectrum.’The “typical spectrum” is also related to the capacity of the individual to be independent and to fit with societal norms.
Why do we need more awareness and more conversations around neurodiversity and how do we create more inclusivity for those neurodivergent children and adults?
It is essential to provide individuals considered “neurodivergent” with the same opportunities in society (e.g., school, health care, leisure, employment, workplace, friendships, sexuality) by better understanding their specific needs. Sensory integration particularities in autism are one of the landmarks of neurodiversity. Studies have well demonstrated some hypoactivation or hyperactivation in specific sensory brain areas in persons with ASD.
For example, some studies showed hypoactivation for speech sounds contrasting with hyperreaction for music (non-speech sounds). Or a hyperactivation for visual objects with a hypoactivation in areas responsible for processing facial expressions in children with ASD.
What does sensory input/our sensory system have to do with neurodiversity?
Persons on the autism spectrum feel and react differently to sensory stimuli from the environment. Social settings with loud sounds, strong lights, close distances, strong smells, etc., can be overwhelming for neurodivergent persons. Neuroscience studies have contributed to a better understanding of how the brain works in autism and other neurodivergent conditions, revealing unique and common skills within the highly heterogeneous profile of neurodivergent people. These insights offer the community ways to promote more acceptance, inclusion, and encourage individualized support.
The social model locates the responsibility for ‘disability ’in the way that society is structured. It affirms that although we cannot change the way that we and other people are as individuals, we can change the way that support is provided and services are structured. We can change the way for example that people have access to health services, education and employment, and we can change the language that we use to talk about and address each other and our needs. We all have a responsibility to help to break down the barriers (societal and attitudinal) that exclude people. We invite the society to redefine the ‘normality concept’, seeing beyond a medical classification, in order that neurodivergent and typical spectrums can better live side by side, engaging in a supportive relationship and each claiming their right to full participation in a lifestyle of their choosing. This also contribute to improve the sense of self, sense of personal power, self-esteem, replacing the system that highlight and perpetual a position of powerlessness for neurodivergent people.
What can parents, teachers, caregivers, fellow students and friends do to be advocates for those with neurodiversity?
“Neurotypical” or “Neurodivergent”, we are all human beings with our own differences, genetic backgrounds, cultures, educations, and philosophies. Regardless of the ‘medical model’, ‘societal model’, or ‘individual model’, the key to a successful peaceful society is accepting differences, understanding others’ perspectives, being empathetic, and seeking solutions to support personal or group needs. We also need to celebrate diversity in learning styles. Schools, communities, medical services, and families together have the power to promote awareness of neurodiversity. To achieve this, we can develop a model that redefines the concept of ‘normality’.
