As awareness of neurodiversity and AuDHD grows, there’s a push to rethink psychiatric terminology. Critics argue that terms like ‘disorder’ and ‘deficit’ are counterintuitive, suggesting instead ‘condition,’ ‘sensitivity,’ and ‘difference.’ This shift aims to foster a deeper understanding and acceptance of neurodiversity.
With evolving research about the co-occurrence of Autism and ADHD (now emerging as a neurodiverse spectrum known as AuDHD), more and more people affected by marginalisation and clinical misdiagnoses are confronting traditional stereotypes that have come to define their sense of worthiness in society.
Inclusivity hype or cognitive enlightenment?
Rooted in biodiversity and eclecticism, neurodiversity emerged as a social rights movement in the mid-90s as a successor to deficit-based terminology, such as ‘disorder’. Since then it has been embraced by individuals diagnosed with a range of neurodevelopmental conditions — from autism and attention deficit hyperactivity disorder (ADHD), to dyslexia and various learning difficulties.
For neurominorities, this multi-spectrum term has helped to recognise neurological diversity from a ‘biopsychosocial’ perspective — encompassing biology, psychology and socio-environmental factors that arise when a neurodivergent person interacts in a neurotypical world.
Contributing to this transdisciplinary impetus is the widespread view about comorbidity between autism and ADHD — an observation backed by research at Duke University indicating frequent co-occurrence of these interrelated spectrums in clinical populations.
Originally thought to be mutually exclusive, this shift in understanding of the two conditions is leading to controversial consensus about a possible fusion toward a more holistic spectrum, known as ‘AuDHD‘.
In a world conditioned by neurotypical behaviour — dating back to the industrial age and the rise of capitalism, where social engineering spawned the ’empire of normality’ — individuals with nuanced cognition have been pigeon-holed into neurodevelopmental categories that, at times, prove dysfunctional in identifying and treating long-term underlying conditions.
Whether in classrooms, at workplaces, or among social gatherings, stigmas have persisted about abnormal behaviour — marginalising neurodivergent individuals who’s cognitive functioning operates somewhat differently with a tendency to encounter sensory overload from environmental factors such as noise, temperature and lighting. Rather than deducing “something wrong” in the brain, as is the commonly-held belief for learning disorders, the irregularity observed in highly sensitive individuals may, in fact, be a manifestation of the psychosocial friction encountered in neurotypical settings.
As Professor Francesca Happé explains, the unfolding ‘change of ethos and tone’ indicates a cultural change in the systemic thinking of navigating neurodevelopmental conditions. ‘We no longer talk about curing or treating autism, for example, but we do try and improve the things that go along with it, like anxiety and depression, bad sleep and epilepsy, intellectual disability and language impairment.’
But could the growing neuroinclusivity movement be a phenomenon of normalisation or romanticisation?
Molecular and developmental neurobiologist, Moheb Costandi, has critiqued the movement as exhibiting ‘good intentions, but it favours the high-functioning and overlooks those who struggle with severe autism’. Author from Cambridge and autism self-advocate, Tom Clements, expands on this critique, stating: ‘the fashion for celebrating “neurodiversity” ignores those with debilitating severe autism’, asserting that ‘many people now self-identify as autistic as though it were a fashion label rather than a debilitating disorder’.
As both Costandi and Clements highlight, this worrying trend of self-diagnosis, in which the idea of autism is romanticised as a ‘variation of normal’ and ‘internalised ableism’, does not echo scientific understanding of the condition — pointing out that consensus among neuroscientists is positioned on neurodevelopmental abnormalities in brain functioning and genetic variation.
So, is the neurodiversity movement merely a result of a progressive mindfulness about diversity, equity and inclusion (DEI), or perhaps something deeper: a transition toward an enlightened ‘biopsychosocial’ understanding of nuanced cognition?
According to Dr Nancy Doyle, who co-directs the Centre for Neurodiversity at Work (Birkbeck), ‘the status quo for neurodivergent people is needless exclusion’. As conventional knowledge about psychosocial variation progresses, professor Doyle emphasises the need for a fresh perspective that moves ‘beyond the gatekeeping approach of the medical model, beyond the individual approach of the social model and into a biopsychosocial model where workplace environments and workflows are personalised to maximise performance for all employees, rather than the homogenous automatons of the industrial era’.
In essence, a paradigm shift in psychology toward transdiagnostic mapping of an individual’s complex condition as a means to treating overall well-being that may be affected by dynamic interactions — from molecular to societal.
Crucially, could the pervasive ‘homogeneity complex’ be a sign that our social model in schooling and workplace environments is primed for dysfunction?
With approximately 15-20% of the global workforce categorised as neurodiverse, and increasing awareness about cognitive complexity, neuroatypicality is destined to hold more weight as a dimension of organisational diversity, both in relation to individual well-being and organisational success.
Abolishing the double D’s: The DSM’s dirtiest words
Medical diagnoses of the human mind have come a long way since the development of psychology during the post-industrialisation era. But labelling atypical human behaviour with negative connotations of ‘disorder’ and ‘deficit’ is proving counterproductive to treating neurological nuances.
Amid growing awareness about neurodiversity, psychiatric terminology (involving neurodevelopmental dysfunction) finds itself at a crossroads with calls for enlightened domain introspection — relinquishing counterintuitive notions of ‘disorder’ and ‘deficit’ in place of constructive nomenclature: ‘condition’, ‘sensitivity’ and ‘difference’.
The World Health Organisation defines a mental disorder as characterised by ‘a clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour’. While this definition is resolute in encompassing the holistic psychiatric healthcare perspective, the word ‘disorder’ — described broadly as ‘an illness or condition that disrupts normal physical or mental functions’ — stirs problematic connotations of treating irregular neurodevelopmental sensitivity as requiring a cure for lacking psychological organisation.
Moreover, the word ‘deficit’ in attention deficit hyperactivity disorder (ADHD), which has divided medical practitioners as to the relevance of such ambiguous labelling, appears to be on the verge of semantic remedy with calls for distinct terminology: variable attention stimulus trait (VAST).
Should the notions of ‘disorder’ and ‘deficit’ be scrapped from Psychiatry’s Diagnostic and Statistical Manual of Mental Disorders (DSM)?
Ontological disparity between the language used by medical experts and the lived experience of patients appears to be culminating in widespread dissent about the need for constructive nomenclature in ‘psychiatry’s bible’.
To advocates of neurodiversity, clinical perception of atypical brain functioning appears to be skewed by stigmatic terminology that insinuates impairment or deviation from the norm. Such word associations, which, after all, are socio-environmental catalysts, can be counterintuitive to treating underlying ‘disturbances’ of the mind — intensifying cognitive friction for individuals who experience heightened sensitivity to external stimuli.
With growing sentiment about transdiagnostic spectrums such as AuDHD, it is time for the psychiatric domain to probe deeper into abnormal neurodevelopment as a baseline equivalent to neurotypical cognition, not a ‘dis-order of magnitude’ that fuels social stigma.
Finally, should the baseline for mental diagnosis really be comparing people by normative deviation, or by some form of sensitivity spectrum? And, are all types of neurodivergent information processing truly a result of brain deficiency, or rather a form of nuanced cognition requiring heterogenous taxonomy and further transdiagnostic research?
While the words ‘disorder’ and ‘deficit’ are clinically approved in the medical domain, they appear to provoke negative associations of deviance and deficiency for patients seeking strength-based therapy. Replacing superannuated terms with the premises of ‘condition’, ‘sensitivity’ and ‘difference’ could unleash a greater understanding about the intricacies of the human mind — paving the way for enlightened cognition and neurodivergent acceptance in classrooms and workplaces.
Neurodiversity, it seems, should not merely be a convenient justification for neurological minorities. Rather, it could steer humanity towards a ‘biopsychosocial’ right of passage — unshackling our collective mindset from the polarising legacy of post-industrialist psychoanalysis.
