Neurodiversity

Put simply, neurodiversity is the fact that all our brains process information in different ways. This means there are differences in how we take in information from the world around us and in how we put that information together in our brains. In turn, these “information processing” differences lead to differences in how we act, and how we are.

For example, in a classroom, children need different things to concentrate. Some children need to fidget and move - maybe with a fidget toy or sitting on a bouncy chair. Others need complete silence to concentrate. Some children work well in both scenarios.

Likewise, during the COVID19 pandemic, many people were forced to work from home. Some people found no commute and less social interaction difficult and hindered their work output. While others found this new setup helped their productivity.

Neurodiversity includes everyone – the whole human race is neurodiverse.

Neurodiversity includes everyone – the whole human race is neurodiverse.

While we are all individually and subtly unique, that diversity also gives rise groups of people, or “neurotypes”.  A person might find their brain’s information processing works in a similar way to other people of the same neurotype, whereas there may be big differences between them, and someone from another group.

Probably the biggest group of people is “neurotypical” people. In fact, we call them neurotypical specifically because we think this is the most common type of information processing.  Neurotypical people will tend to thrive more easily in school or in work – because they are in the majority, the systems for learning and working will often have been set up by other neurotypical people.  This means that their needs are easily met by stuff that’s available as standard. They need a pen and paper to write an essay, and the school gives them a pen and paper.  They need a phone to call clients at work, and their office provides a phone.

Other groups are “neuro-minorities” – these groups are smaller than the neurotypical majority.  For example, about 1 in 100 people are autistic, and about 1 in 10 people have dyslexia. However it is possible that if we added up everyone in a neuro-minority – all the autistic and dyslexic and dyspraxic people and so on - they could be the biggest group!

Examples of neuro-minorities include: autistic people, dyslexic people, people with ADHD, people with developmental language disorder, people with Tourette syndrome. We can also refer to individuals in these groups as “neuro-atypical” or “neurodivergent”.

The language of neurodiversity is very helpful when talking in general terms, as on these webpages.  However when speaking to or about a specific individual you should always remember to find out what language they prefer and try to replicate that.

Because many systems (schools, hospitals, offices) were set up by neurotypical people, they may not always meet the needs of neurodivergent people too. For example, you might need to wear comfortable clothing in order to be able to concentrate, but your school uniform or office dress-code makes it hard to feel comfy. You might need to take regular breaks to move around to help you concentrate, but the length of a school lesson – or just disapproval from colleagues at work – could make this hard to achieve. This means that neurodivergent people, ideally with support from their families, will often have to ask for adjustments to be made to enable them to be at their best.

It is also important to be aware that people of different neurotypes may have different communication styles, which may lead to the occurrence of misunderstandings between them. Autistic people, for instance, may find understanding each other easier than understanding neurotypical people. At the same time, neurotypical people tend to experience fewer miscommunications with other neurotypical people than with neurodivergent persons. Therefore, it is important to remember that there is no one right communication style, and a breakdown of communication is not one person’s fault.

Lots of diagnoses are associated with neurodivergence. Examples include:

• ADHD, or “attention deficit hyperactivity disorder”
• autism, or “autism spectrum disorder”
• developmental language disorder
• Down syndrome
• dyscalculia
• dysgraphia
• dyslexia
• dyspraxia or “developmental co-ordination disorder”
• fragile x syndrome
• hyperlexia
• learning disability (also called intellectual disability in the USA)
• synaesthesia
• Tourette syndrome

If you want to learn more, you can read about the clinical definitions and latest research findings relating to many of these specific diagnostic labels here. In addition, increasingly psychiatric diagnoses like schizophrenia or bipolar disorder are also being considered examples of neurodivergence.

Some neurodivergent people will go through a process to seek a diagnosis. This is when a doctor or other professional conducts a series of assessments to check if that person fits the definition of that diagnosis. Some will not want or need a doctor to provide this kind of label. Some will have one diagnosis, some will have many. It is also a personal choice whether you tell other people about your diagnosis. 

There are various barriers to getting a diagnosis that neurodivergent people have to contend with.  These include:

• gender: some diagnoses may be more associated with one gender, meaning people with other genders are more likely to miss out on a diagnosis
• ethnicity: some diagnoses are more common among White people, even though we know the underlying condition should be evenly distributed regardless of ethnicity.  This suggests systemic racism which prevents Black, Asian and Minority-Ethnic people from accessing a diagnosis
• language: in the UK, most information about neurodivergence and about specific associated diagnoses will be circulated in English, which can prevent people in non-English speaking immigrant communities from accessing that information.
• deprivation: some diagnoses depend on the postcode where the individual lives.  Again, there’s no true reason why diagnosis depends on where you live, and so it suggests a systemic inequality in access to diagnosis
• diagnostic overshadowing: sometimes a person receives one diagnosis (e.g. autism) and service providers assume that is the whole story.  However the same person might also be eligible for another diagnosis (e.g. dyspraxia) which they don’t get, because people stop looking for it
• pressure to fit in: neurodivergent people may use “camouflaging” to mask their differences in an effort to fit in. Camouflaging may be both conscious and unconscious, and may impede diagnosis when a person becomes very skilled at “blending in” with neurotypical norms.

There are lots of reasons, then, why you might not know who is neurodivergent.  Their diagnosis might be hidden from you and, due to inequalities in the system, they might not even be sure themselves.

One of the powerful things about the concept of neurodiversity is that it reminds you that anyone could have a different neurotype than you. It reminds us that we are different from each other, in ways that may be hidden, but are also important. It reminds us to be patient and kind, when someone reacts or behaves in a way we don’t easily understand, did not expect or are not used to.

Content warning: this page includes information about mental ill-health, suicide and self-harm, bullying and trauma.

There are two main ways that the concept of neurodiversity interacts with mental health.

First, neurodivergent people are vulnerable to mental ill-health.  This encompasses increased likelihood of a mental health diagnosis – such as an eating disorder, anxiety or depression – but also higher rates of sub-clinical problems, relative to rates in the population generally. Neurodivergent people are also more likely than the general population to self-harm, to feel suicidal and to die by suicide.

The reason why being neurodivergent is so strongly linked to mental ill-health is not entirely understood, but important factors are:

• minority stress: the stress that comes from being in a minority group
• stigma: a negative association linked to being neurodivergent, which drive prejudice and discrimination
• bullying: cruel and sometimes violent behaviour directed at neurodivergent people
• masking: a neurodivergent person changing their behaviour or the way they are to “fit in”
• normalisation: neurodivergent people feeling pressure that they should be “more neurotypical”
• pathologisation: the process of describing minority neurotypes in medical terms – as “disorders” with “symptoms”.

One of the aims of the neurodiversity movement is to remove these kinds of influences from the lives of neurodivergent people.

The second way in which neurodiversity interacts with mental ill-heath is through trauma. By definition, neurodivergent people process information in ways that are different from the information processing of neurotypical people.  This means neurodivergent people may:

• experience events as traumatic that neurotypical people do not find traumatic
• express their trauma in unexpected ways
• be at risk of trauma as a direct result of being neurodivergent – e.g. if they are bullied

It is important that we consider past-trauma when providing support to anyone – this is called “trauma informed care”. Events or language that seem neutral may act as “triggers”, causing people to remember past trauma and react with distress or anger.

When two people who have different neurotypes are interacting, these triggers may be hard to anticipate, and the reactions may be hard to interpret. Being conscious of this can be helpful for all concerned.

Neurodivergent people access healthcare for reasons directly linked to being neurodivergent, such as seeking a prescription for ADHD medications, and in general.  Neurodivergent people get pregnant and have babies, break bones, need surgeries, catch the flu and require screening for cancer. Neurodiversity is also, of course, present among healthcare workers too.

As a result, any and all healthcare professionals should be aware of neurodiversity and prepared to think creatively to overcome the gaps in understanding which may arise between two people of different neurotypes.

Specific issues to consider when providing healthcare include:

• clarity of communication: try to use precise literal language and allow time for processing. Invite people to ask questions. Check their understanding.
• predictability and honesty: try to provide clear information about what will happen next.  Don’t promise something, such as a pain-free procedure, that you can’t confidently deliver.
• sensory environment: remember that not everyone experiences the same sensory input in the same way. Check that lighting, background noise, tactile sensations (e.g. hospital bedsheets) are not causing distress and make any adjustments that you can.
• pain response: different neurotypes may both experience and express pain differently. Make sure you have fully understood your patient’s pain levels and provided adequate pain relief.
• accessibility: consider the ways in which people access your service – e.g. by phone, by letter, via an online video consultation, in-person at a clinic.  Consider whether you can offer more choice and flexibility in those options, especially for people making first contact.
• family context: genes play a role in determining neurodivergence.  This means that a neurodivergent child might also have neurodivergent parents – even though those parents might not have a diagnosis or identify in that way.  When working with neurodivergent children it’s important to pay attention to the particular communication, sensory and mental health needs of their parents too.

with thanks to Luis Zambrano Hernandez, Neurodiversity Network, University of Glasgow for authorship of this section

It is important to remember that while neurodiversity manifests at the individual level, its effect expands into different social domains, including family, friends, caregivers, and close relatives. Neurodiversity can provide a helpful way of understanding and shaping sibling relationships and parenting.

Home environments are the main arena in which neurodivergent people, and their families, make sense of a diagnosis and confront its implications. Households can be a source of great support and safety during times of difficulty, but home environments can also be imbued with intense emotions. Challenges at home can arise both for neurodivergent people and their neurotypical family members, when it is hard to understand each other, and to access support and services outside the home.

Embracing neurodiversity at home can help challenge mainstream stigmas and help to raise awareness among those closest to neurodivergent individuals. This, in turn, can help open the door to celebrate neurodivergent individuals for their alternative way of thinking. The mantra of acceptance and inclusiveness has always been the goal of the neurodiversity movement. Yet this vision can be obscured in the daily lives of neurodivergent individuals who sometimes do not get to be appreciated and celebrated for who they are, regardless of how much help they need.

In Scottish education “additional support needs” are reported in 20% of children in Scotland, meaning that in a classroom in a mainstream school, approximately 6 children could be neurodivergent.

Classrooms should embrace neurodiversity by providing as flexible a learning environment as possible. The education system and curriculum is largely based on neurotypical expectations of what best enables children to learn, but these assumptions will not necessarily apply to neurodivergent young people. Educators should value the diversity brought to their classroom by pupils in neuro-minorities as well as implementing specific measures to support neurodivergent pupils to learn and thrive.

In addition, school experiences have a huge influence on a child’s knowledge, beliefs and experiences. Most children, neurodivergent included, will at some point absorb some information about neurodiversity through the educational institution into which they are socialised. The opinion of teachers and peers matters when it comes to perpetuating or disrupting prejudice against neuro-minorities. However, the social skills and intelligence measures of neurodivergent children are judged solely on their interaction with neurotypical peers, which can sometimes give an incomplete or misleading picture of individual capabilities. Such a misleading developmental timeline can lead to the conscious and unconscious inequitable treatment of neurodivergent individuals.

We know that neurodivergent young people are at risk of bullying in school. Too often the response to this is encourage for the neurodivergent child to fake "normality" or behave in a more neurotypical way. This fails to address the culprit – the bully – and also teaches the neurodivergent child to be more obedient and compliant, often leading to depression and burnout many years later. Therefore, if we want to challenge the issue of prejudice and discrimination against neurodiversity, we must make an honest accounting of how deep social constructs like disability and illness pervade every corner of our social landscape and how this is reflected in the classroom.

Advocating for neurodiversity in school means:

• challenging the assumption that all individuals learn in a linear and stepwise manner.
• creating a flexible environment so that neurodivergent individuals can access learning in the way that works best for them.
• encouraging meaningful interactions between neurotypical and neurodivergent individuals, to counter prejudice based on erroneous information about neuro-minority groups.

One of the common misconceptions about neurodiversity is that it emphasises “mere” differences between people and therefore denies disability, and also support.

This is incorrect. Neurodiversity recognises differences between people, and uses that recognition to promote acceptance, understanding and accommodation. This process fully embraces the fact that those differences may be large, and have a major impact on people’s lives.

Sometimes the impact will be beneficial, as when a neurodivergent person finds something very easy relative to neurotypical norms. Sometimes the impact will be negative, and the neurodivergent person might need an adjustment to enable them to access a service, or flourish at school or at work.

Very often, neurodivergence will yield differences that are both advantageous and challenging, depending on the context.  For example, hyperactivity might make someone an asset on their football team, but lead to challenges in the classroom. Sensitive hearing might help someone become a wonderful musician, and also make noisy environments hard to bear.

Neurodiversity also incorporates learning disability. The clinical definition of learning disability is based on having a very low IQ score when formally tested. In reality, people with a learning disability may find some kinds of learning – like reading, writing or maths – near-impossible. Other kinds of learning, like learning to ride a bike, learning to make a cup of tea, or learning the journey to school, may be much easier - though these can also take a long time to master. People with a learning disability are also neurodivergent, and all of the information we have shared about neurodiversity applies to their experience too.

Neurodiversity is more than a scientific fact with consequences for daily life.  Neurodiversity also has implications for society as a whole. The neurodiversity movement – a generalised community force without a centralised leadership or manifesto – pushes for the recognition of these implications and of the rights of neurodivergent people.

One of the key implications of neurodiversity is that differences between neurotypes are naturally occurring, and that there is no one way to be that is inherently right or better. Just as there are many types of people, there are many types of flowers. Daffodils, roses, lilies, daisies, orchids – all different and all beautiful. We do not consider any one type of flower superior to any other. We do not try to make the rose more daffodil‑like because we consider daffodils the best sort of flower. Flowers are not expected to be the same; this natural variation is accepted and celebrated as part of biodiversity. Similarly, all people have equal value and an equal right to live a good life. Neurodiversity calls us all to accept without judgement the fact that we are not all the same.

A second implication of neurodiversity is that a lot of the experiences of neurodivergent people can be best understood in terms of social dynamics. As described in the section above on neurodiversity and mental health, neurodivergent people experience stigma, bullying and discrimination.  While this is not the same as the discrimination experienced by other minority and marginalised groups (e.g. racism, sexism, homophobia, ageism) it can be understood in a similar way.

Ableism specifically describes the prejudice and discrimination experienced by disabled people.  Neurodivergent people, while not all would describe themselves as disabled, are subject to the influence of ableism both at a systematic and an interpersonal level. For example, despite advances in our understanding of neurodiversity, this natural diversity of information processing is not yet recognised by our education and other systems. Some ways of being are currently considered ‘inferior’. They are not yet seen as a natural aspect of human variation to be accepted and expected.

Although individual neurodivergent people may be disadvantaged in specific environments, the is strength in neurodiversity itself.  By bringing different past experiences and different information processing approaches into a situation, people can work together to achieve more. If faced with a specific problem, a neurodiverse group will have a broader range of interpretations of that problem, and as a result come up with more, and more creative, solutions. There is an increasing recognition of the value of neurodiversity in the workplace. Likewise, neurodiversity provokes us, collectively, to innovate and to empathise – two things that have driven much of human progress.

Neurodiversity is a property of the whole human race.  Therefore there is no aspect of human life that is not experienced by, and therefore influenced by, neurodivergent people. However there are also ways in which neurodiversity intersects specifically with other aspects of human society which are worth highlighting.

Most recently, the lockdown measures enforced by the ongoing Covid-19 pandemic meant that neurodivergent individuals faced unique challenges such as increased anxiety and disruption to their routine, social isolation and reduced or suspended services.

We know that neurodivergent people are more likely to identify as LGBTQ+ than neurotypical people. Specifically, most of the evidence on this comes from studies of autistic people’s gender and sexual identities – we don’t know as much about sexuality and gender diversity for other neurotypes. In any case, it is important to remember that neurodivergent people may be a part of multiple minority and / or marginalised groups. 

More generally, the intersectional experience of (for example) Black neurodivergent people, older neurodivergent people, or Gypsy / Traveller neurodivergent people should always be considered. What this means, is that the experience of a Black neurodivergent person will be different to both the experience of a Black neurotypical person, and a White neurodivergent person. For example, we already know that Black neurodivergent people face barriers to diagnosis.  In addition, in the USA there is evidence that Black neurodivergent people may be particularly vulnerable to police violence. The same logic applies to any combination of identities which are marginalised or disempowered within systems set up by the people with the greatest power – White, cisgender, straight, neurotypical, abled men – and their close associates.

Neurodivergent people tend to have less power in society, and in a specific situation, than neurotypical people. While this is changing, neurodivergent people are still under-represented in leadership positions, such as in government, as company chief executives, or in public service and third sector management. This is largely because the qualifications needed to rise to those positions – in terms of education, professional experience and personal networks – are not fully accessible to neurodivergent people. That said, there are some wonderful examples of neurodivergent people who are at the top of their field, like MSP Daniel Johnson (who has ADHD), comedian Josh Widdicome (who is dyslexic), actor Sarah Gordy (who has Down syndrome) and author of the Geek Girl series, Holly Smale (who is autistic). Less famous neurodivergent people achieve amazing things every day.

We can all play a part in recognising the disadvantages experienced by neurodivergent people and working to dismantle exclusive systems. Neurodivergent people should always direct this work, though neurotypical people can act as important allies and contribute their labour to the work.