Neurodiversity: Beyond the Medical and Social Myths

While we binge all the content available to us, you must have come across the Good Doctor, Atypical, or even Dr. Virginia Dixon in Grey’s Anatomy. Something they all have in common is autism, which comes under the broad term of neurodiversity. In the following article, we talk about how we can understand neurodiversity.

 In the evolution of human race, neurodiversity emerges as this beautiful variance, challenging traditional perceptions and encouraging a broader understanding of the human mind. Understanding of atypical development commences with the medical model which views disabilities as pathological conditions (Dwyer, 2022), talking about how disabilities and disorders are medical diseases of both the body and the mind, which leads a person to have impairments and face functional disabilities. Hence, the aim of the model is to transform impaired people into able bodied and typically developed people.

The term of neurodiversity emerged from the inspiration Judy Singer derived from the term biodiversity, emphasizing the importance of cultural stability. Neurodiversity offers an alternative model for understanding atypical development (Fullington & Tillier, 2023). However, Dwyer (2022), aptly argues that defining neurodiversity is difficult. In the most direct way, we may understand neurodiversity as the celebration of cerebral pluralism (Tougaw, 2020). Factually, one may argue that everyone is neurodiverse as no two brains are the same. So, we come to understand neurodiversity as a concept stating that all individuals have variability in their neurocognitive skills, acknowledging us all having strengths and limitations. But for some of us, this variability is a little more perceptible, highlighting that they experience and interact with the world in different ways.

However, it is important to note moving forward, that there is no right way of thinking, learning, acting, and that these variations are not shortcomings (Chilton, 2022).   

Medical model

Thinking of the term ‘medical’ we automatically connect it to doctors, and members of the medical field come from a biological perspective, hence understanding disability to be a biological product. Further, disability is understood as the consequence of physical and mental impairments and are seen as medical issues that need to be treated so individuals can participate fully in society. Autism has traditionally been classified in the medical model of neurodevelopmental disorders, where it’s perceived as a negative attribute.

An interesting observation by Anderson-Chavarria (2021) suggests that parents of autistic individuals have considerably contributed to the distribution of the medical model, mainly in western countries. This can be attributed to the parents’ perceived obligation to advocate for their children in a world that lacks sufficient resources to support their well-being and achievements.

Nevertheless, the medical model focuses on ‘removing’ or ‘correcting’ the impairment (Haegele & Hodge, 2016), instead of focusing on its advantages. It surpasses distinctive traits of autistic individuals like high visual-spatial sensitivity and strengths in identifying patterns. Emphasising deficits also aggravates the difficulties that many autistic individuals encounter in their social world and constructing an identity beyond their diagnosis. Alongside, it may also impact their autonomy of engaging in political and social worlds that they get excluded from as they are perceived to have deficits (Anderson-Chavarria, 2021).

Social Model

In contrast to the medical model, we have the social model that rejects the emphasis on deficits, and rather frames disability as a social construct and as the result of social oppression. For instance, a person feels disabled because the society treats them like that. The model differentiates between ‘impairment’ and ‘disability,’ with the former representing biological deficits and the later representing experience of societal oppression and exclusion experienced individuals with disabilities (Anderson-Chavarria, 2021).

As human beings, we tend to compare and categorise ourselves to make our identities. But it also builds a socio-cultural understanding of disability. Viewing some traits of autism, we start to see them less as medical symptoms and rather behaviours that society simply rejects. For instance, rocking, a behaviour frequently observed amongst autistic individuals, which helps them self-soothe, does not need to be interpreted negatively. Instead, we can interpret it as a different form of communication.

Now, this model also comes with its critiques, one of them being the needless creation of dichotomies, the distinction between impairment and disability, leading to further marginalisation of people with disabilities. There is a consequence of the social model emphasising ‘us vs. others’ on the representation and identity of autistic individuals because further isolating the community makes social involvement a larger challenge (Anderson-Chavarria, 2021).  

It is notable that both models adopt rigid, polarised stances. By stating that barriers related to disability are products of society, the social model disregards the interventions that support and teach skills to autistic individuals; neglecting the efforts that are needed to support people with disabilities. For instance, autistic people may still come across social barriers even after social inclusion. For example, in the show, ‘Good Doctor,’ Dr. Shaun encounters certain difficulties in social situations despite his inclusion in the hospital working environment. By dismissing the need for certain interventions, we dismiss the challenges of autistic individuals who are in need of higher support along with their caregivers who also go through challenges (Dwyer, 2022). Whereas the medical model overlooks the strengths and the unique perspectives of neurodivergent individuals. For instance, whenever I address myself as neurodivergent, people often say, “Oh, that must be so hard.” However, I would not trade my mind for the world. By saying this, I also acknowledge that life can be difficult at times, yet this is who I am, it is what makes me unique.

The emphasis on “transforming” is frustrating to someone who is a neurodivergent and has loved ones who are too. Steve Silberman argues in his book, Neuro-Tribes: The Legacy of Autism and the Future of Neurodiversity, that instead of viewing neurodiversity as an error in the nature, or a problem to be solved, society should regard it as a valuable part of humanity while enhancing parts of autism that can be profoundly disabling without adequate support (Tougaw, 2020).

Dwyer (2022) proposes a middle ground approach, asserting that disability arises from interplay between the characteristics of disabled person and their surrounding environment. Disability can be addressed by modifying the environment and/or the individual, for instance adaptive skills, example, since I am fidgety, I was taught ways in which I could calm myself down in class. Alongside, the environment was difficult in school, but university has been inclusive, so, awareness and acceptance from environment helps. The decision does not have to be based on whether the individual or the environment is the cause, but rather what will best enhance quality of life.

Dwyer (2022) posits that the intent should not be to solve or normalise the disabled person. But diversity of minds should be valued and accepted as they are and embrace the individualised experiences of neurodivergent individuals. We must allow space for a more nuanced understanding of neurodiversity. The understanding we possess and ultimately move towards cannot be aptly encompassed within the medical or the social model. Rather than perceiving it as a disease or a social status, a more comprehensive understanding can lead to positive identity creating and representation.

Coming to an end, I ask, what exactly is neurodivergence? Is it better to not have a precise definition? Perhaps that provides us the opportunity to erase and rebuild the concepts that dominate our minds.

References

Anderson-Chavarria, M. (2021). The autism predicament: Models of autism and their impact on autistic identity. Disability & Society, 37(8), 1–21. https://doi.org/10.1080/09687599.2021.1877117

Chilton , V. (2022). What is neurodiversity? I oxford open learning. www.ool.co.uk. https://www.ool.co.uk/blog/what-is-neurodiversity/

Dwyer, P. (2022). The neurodiversity approach(es): What are they and what do they mean for researchers? Human Development, 66(2). https://doi.org/10.1159/000523723

Fullington, J., & Tillier, B. (2023, March). Neurodiversity, neurodivergence. www.positivedisintegration.com. | https://www.positivedisintegration.com/Neurodiversity.htm

Haegele, J. A., & Hodge, S. (2016). Disability discourse: Overview and critiques of the medical and social models. Quest, 68(2), 193–206.

Tougaw, J. (2020, April 18). Neurodiversity: The movement | psychology today. www.psychologytoday.com. https://www.psychologytoday.com/us/blog/the-elusive-brain/202004/neurodiversity-the-movement#:~:text=The%20term%20neurodiversity%20was%20coined