Reframing Neurocognitive Differences: What the Neurodiversity Movement Means for Public Health and Equity

Content Warning: Some linked resources contain medicalized or deficit-based language. Some resources include glossaries, which contain ableist slurs in the context of defining them and explaining their impact.

When I first came across the concept of neurodiversity in 2015, I was in the middle of navigating a new diagnosis and was utterly exhausted with the constant pressure from providers to achieve a level of “normalcy” that I didn’t find possible or desirable. I wasn’t looking for the language to describe my frustration. I just stumbled across the term “neurodiversity”—completely out of context—on some random Tumblr. The word jumped out at me immediately.

Neurodiversity articulated something I had long grappled with: Yes, I am disabled and I have disordered thoughts, behaviors, moods, and patterns, but the uniqueness that comes from my disability and neurodivergence is an intrinsic part of who I am. These things make me who I am, and while I constantly work to better myself, I wouldn’t trade my difference for anything.

Since then, neurodiversity has become quite the buzzword. From corporate hiring initiatives and workplace inclusion programs, to neurodivergent peer mentors on college campuses, and robust sections in Equity, Diversity, and Inclusion (EDI) plans, neurodiversity has finally begun to emerge in our collective consciousness. Despite the attention, however, many people are left with the most basic questions unanswered: What is neurodiversity? How does one know if they’re neurodivergent? How does neurodiversity fit in with disability rights and mental health advocacy? Understanding what neurodiversity is (and isn’t), and how the movement fits in with existing advocacy and disability rights, is critical to advancing equitable health and well-being.

What Is Neurodiversity and Where Did it Come from?

Neurodiversity is the diversity of human brains and minds. The term was coined by autistic Australian sociologist, Judy Singer, in 1998, but neurodiversity itself has existed for millennia. It describes the idea that people experience and interact with the world around them in many different ways. There is no one "right" way of thinking, learning, or behaving, and differences are not equivalent to deficits. The concept of neurodiversity is meant to shift dialogue on neurocognitive and mental differences away from the exhaustive focus on deficiencies, medical interventions, and “cures,” and towards acceptance. In the current model of care and diagnosis, even positive traits of conditions are automatically described and treated as negative. At its core, neurodiversity is about acknowledging these positive traits and celebrating the infinite variation of human thoughts, processes, abilities, and identities.

One of the most important things to keep in mind when learning about neurodiversity is its vastness. Neurodivergence encompasses an expansive array of very different conditions, disorders, disabilities, and identities. Neurodivergence can refer to people with neurological and mental differences like:

Autism
ADHD
Dyslexia, Dyscalculia, and/or Dysgraphia
Visual, Auditory, and/or Sensory Processing Disorders
Synesthesia
Down Syndrome
Obsessive Compulsive Disorder
Schizophrenia
Antisocial Personality Disorder
Bipolar Disorder
Dissociative Identity Disorder
And dozens more conditions, disorders, and disabilities.

Neurodiversity gained traction within the disability rights and autism self-advocacy movements in the 1990s, where it was a natural complement to the communities’ existing platforms. It blossomed amidst the backdrop of abusive conservatorships, mass institutionalization giving way to mass incarceration, and eugenicist efforts to erase disability from the world through forced sterilization and human gene editing. These movements shined a spotlight on what disabled activists had been saying for decades: disabilities don’t make people less valuable. In fact, many disabled communities have their own unique cultures, which would disappear if their disabilities were “cured.” Lauding the erasure of disability as progress means denying a person’s right to exist simply because they don’t fit into a clinically predetermined ideal. Rebecca Cokley, a disability activist with achondroplasia—the most common form of dwarfism—explains how damaging it is to hear discussion of the "end" of disability:

I remember clearly when John Wasmuth discovered fibroblast growth factor receptor 3 in 1994. He was searching for the Down Syndrome gene and found us [people with dwarfism]. I remember my mother’s horrified reaction when she heard the news. And I remember watching other adult little people react in fear while average-height parents cheered it as “progress.” How, if you are an average-height parent, do you explain to children whom you’ve spent years telling are beautiful the way they are, that if you could change them—fix them in a minute—you would? –Rebecca Cokley

The disability rights movement has been fighting against erasure, medicalization, paternalism, stigma, othering, discrimination, and violence since the 1800s. The neurodiversity movement—focused specifically on neurocognitive differences—builds on these ideas. It asserts that neurodivergent people—people whose brain or mind functions differently than what is considered “normal” or “typical” in our society—not only deserve inclusion and equity, but actually deserve to be celebrated without the prerequisites of intervention, conformity, or masking. Neurocognitive differences like sociability, mood, attention, and learning can (and should) be accepted and respected like any type of human variation. Being different—neurodivergent, autistic, disabled—is a valid way to exist and is inherently valuable.

Neurodivergence: Condition, Disorder, Disability, or Identity?

One of the most prominent misconceptions of neurodiversity is that it is at odds with disability, or that it will disrupt benefits, care access, therapeutic support, the advancement of effective interventions, and healthcare in general. This stems from the belief that celebrating difference and using asset-focused or strength-based language to describe a disability completely replaces all discussions of disorders, disabilities, health concerns, harmful symptoms, and treatment. However, this apparent dichotomy is actually a byproduct of ableism—discrimination against disabled people in favor of able-bodied people. In reality, we already focus on the positives of disability all the time (applauding disability as inspiration porn) and don’t find this to be in conflict with discussions of disabilities or disorders themselves. The primary difference between the framing currently accepted by society and the language proposed by the neurodiversity movement is that the first is characterized by abled outsiders looking in, and the second comes from people with lived experience deciding how they want to be discussed.

Almost all neurodivergent people would agree that there are disordered parts of their condition, such as increased anxiety, unpredictable energy levels, PTSD symptoms, and unwanted intrusive thoughts. The core drive of the neurodiversity movement isn’t to ignore disordered behaviors, thoughts, and feelings, or to stop receiving medical and therapeutic care for harmful symptoms. The purpose is simply to recognize that the disordered aspects of neurodivergence and disability don’t define the entire neurodivergent or disabled experience. They are only part of it and, as such, should be treated as part of a whole. Neurodivergent and disabled experiences also include assets, strengths, uniquenesses, and identities that are all valuable and deserve to be acknowledged, embraced, and celebrated with just as much (or more) fervor as we seek to eliminate disordered symptoms. The goal of the neurodiversity movement is not to erase disability or health care. It is meant to disrupt ableism in care systems and not the idea of care itself.

Neurodivergence can be part of one’s identity (just like gender, race, orientation, religion, language, and culture) and redesigning care systems for and by neurodivergent people means accepting this fact. It means acknowledging that to remove or “cure” neurodiversity is to remove or erase the neurodivergent person. It means rejecting the idea that neurodivergence itself must be cured, eliminated, valued against a clinical ideal, forced to conform to popular perceptions of “normality,” or coerced to comply with neurotypical (non-neurodivergent) norms of communication and behavior. None of this involves refuting medical interventions that limit harmful symptoms, or sidelining health care. It is about shifting our focus to asset-oriented practices, patient-centered care, effective accommodations, improved communication, and better assistive technologies, occupational training, and independent living support.

Leveraging Neurodiversity to Advance Well-Being for All People

While engaging people with lived experiences and EDI aren’t new concepts, social justice activism and equity work often fails to include people with disabilities or neurocognitive differences. The truth is that neurodivergent and disabled people—especially those who are LGBTQ+, living in poverty, Black, Indigenous, and/or People of Color—often have the greatest care needs and the greatest assets to contribute to public health. Neurodiversity is powerful because it conceptualizes disability and difference in a way that automatically centers people with lived experience, creating space for them to drive dialogue, culture shift, and solutions.

In addition to advancing well-being for neurodivergent and disabled people, intersectional neurodiversity provides an entry point for deeper accessibility, equity, and well-being for all people. This is because neurodiversity-based solutions prioritize lived experience, universal design, and targeted universalism.

Centering neurodiversity creates equity by:

Addressing issues that arise due to difference and lack of supports, instead of focusing on “fixing” the individual experiencing the issues.	Example: Addressing sensory and processing issues for autistic people at a public health conference creates a more inclusive conference experience for people with all learning styles and processing needs.
Tackling barriers to accessing care on a systemic and community level, instead of focusing on pushing individuals into uncomfortable or inappropriate care situations, which may re-traumatize them.	Example: Offering trauma-informed training to dentists can help people with PTSD and medical trauma access dental care, but also improves care for all patients experiencing anxiety or fear at dentists’ offices.
Expanding our understanding of how disabilities and neurodivergences interrelate, which can improve diagnosis and treatment as a whole.	Example: Self-advocacy from people with co-occurring autism and ADHD has revealed that these two conditions can mask each other, leading to more accurate diagnostic procedures for both conditions.
Correcting misconceptions and misinformation about disabilities and diagnoses, which improves diagnostic accuracy and reduces diagnostic gate-keeping for people with all types of disabilities, neurodivergences, and health conditions.	Example: Self-advocates with ADHD and autism have identified that the DSM-V almost completely excludes criteria for diagnosing girls and nonbinary children with ADHD or autism. This is now leading to improved diagnostic practices for these conditions, while also furthering critical examination of gender biases in healthcare in general.
Normalizing care for “rare” disorders, which in turn, normalizes care for all mental health conditions and disabilities.	Example: Self-advocates speaking out about Dissociative Identity Disorder reduces stigma and improves care access for all people experiencing dissociation, whether from a mental health condition or medical condition.
Creating space for multiply-marginalized sub-groups, which improves well-being for all marginalized people and their communities.	Example: BIPOC and LGBTQ+ autistic self-advocates fight for the racial justice and LGBTQ+ rights movements to center disabled queer, transgender, and People of Color, which creates safer spaces for all people withing these movements.

By adjusting our health and equity practices to center neurocognitive differences, we build toward solutions that honor all human differences. By accepting all types of mental, psychological, developmental, and emotional diversity, we move toward accepting and celebrating all humans.

Action and Allyship for Neurodiversity

While disabled and neurodivergent people have championed their own movements for decades, there is still much work to do. We need dedicated allyship and action to move forward entrenched issues, many of which are left over from centuries of genocide and abuse against the disabled community.

To support neurodivergent people on an individual and organizational level, start with:

Using disability-first language to discuss disability in general and asking disabled people in your life if they prefer to be addressed with person-first or disability-first language
Adjusting your language to unlearn ableist terms and avoid euphemisms to describe disability and neurodivergence
Promoting neurodivergent-friendly and equitable workplaces, which include an emphasis on accessibility, robust accommodations policies, and health and mental healthcare
Adopting hiring practices which are inclusive and equitable for neurodivergent, disabled, LGBTQ+, and BIPOC people
Improving digital accessibility for all websites, communications, online tools, portals, forms, and documents—both for people with neurocognitive conditions and those with physical disabilities
Embracing neurodiversity in history, minimizing the idea that autism (or any type of neurodivergence) is new
Creating self-advocacy groups on college campuses and looking to them to inform accessibility and equity improvements
Supporting self-advocates representing conditions like autism, down syndrome, Dissociative Identity Disorder, and all other types of neurodivergence
Centering and amplifying neurodivergent perspectives, individuals, and organizations throughout all aspects of life, including social media, activism, and donations

To support the neurodiversity movement at scale, advocate and push for:

An emphasis on asset-based care and a reduction of deficit-focused language, treatments, and care culture
Neurodivergent and disabled peoples’ autonomy and right to know, understand, and choose their own treatment options
Better conditions for neurodivergent and disabled people in care facilities, including improving conditions for care workers to reduce burnout and attract talent
Supporting community integration for people with disabilities through policy change and accessible transportation and housing
Ending abusive conservatorships and overhauling outdated, ableist conservatorship laws
Banning forced sterilization in all states that still allow it
Centering the perspectives of disabled people in discussions of human gene editing
Alternatives to arresting and incarcerating people exhibiting symptoms of crisis or mental, behavioral, and neurocognitive conditions
Centering neurodivergent people in all policy—even if it is not directly about disability or neurodiversity—through targeted universalism

Let us know of any resources or concrete actions you think should be included on this page or on Community Commons in general. We would love to hear from you!

by: Serin Bond-Yancey (they/any). Serin is a Disabled, queer, nonbinary, multiply-neurodivergent, antiracist accomplice. Serin serves as the Executive Director of the Transgender Health and Wellness Center of Washington (Trans-Wa), and works with a diverse portfolio of nonprofits as an Impact, Equity, and Accessibility Consultant.