Is neurodivergence a disability?
For some of us, our neurodivergence is a super power that we can use to our advantage to achieve things that others never have done. For others it’s crippling and stops us from moving forward with every day life. How can neurodivergence be so disabling for one group of people and not at all for others? Let’s find out.
Firstly, this blog today is based on a YouTube video I put out. If you would prefer to watch instead of read, you can find the video here:
I am someone who is neurodivergent neutral, I don’t think of my neurodivergence as either a good or a bad thing, although I certainly have days where it feels like both of these things, but rather as something that just is. It’s a part of me and who I am and it’s an important part of me, so I embrace it because what’s the alternative?
I do however find a lot of the discourse online by both neurotypicals but also our neurodivergent community as well tends to trend negative and so I do find myself overcompensating for this a bit by spending more of my time talking about neurodivergent strengths because I find it heartbreaking how many of us are given up on just because of this part of us when we are such amazing, valuable people in our own right.
But today I’m not here to convince you that your neurodivergence is better than you give it credit for, I have other videos on this topic already, but instead I want to talk about the different ways we view our neurodivergence and suggest a model which more accurately represents a wider range of experience.
Last week I put out a post discussing neurotypicalness and what this actually means given the whole concept is based on not being neurodivergent, rather than being a thing in its own right. If you haven’t done so already, I’d definitely recommend checking that out because it provides motivation for today’s topic but to summarise, I left off at the idea of what if neurodiversity is just that, a natural diversity where all our brains work in their different unique ways rather than those of us who are neurodivergent being stigmatized for it.
I regularly find myself scrolling through stock images for some abstract concept of diversity for this blog
But there is an issue with this way of thinking, namely that if we conclude that everything is just natural diversity and it’s cultural and societal aspects that are causing us to be stigmatised and struggle then that risks minimising the effects of neurodivergence on people who do really struggle in a big way and can trivialise others’ hardship.
That is something I very much don’t want to do, in fact the moment I started to suspect I might have ADHD, I stopped reading up on the topic because I didn’t want to accidentally claim an identity that wasn’t mine, therefore minimising and trivialising others’ experiences of this neurodivergence. I want to make the world a more fair and even place for people of all neurotypes, so how do I balance this against the fact that I consider my own neurodivergence hard at times, but am overall neutral to it?
In order to tackle this subject, we need to look into models of disability, and understand more of the theory of this world.
Throughout the rest of this video I’ll be referring to the book “Neurodiversity Studies: A New Critical Paradigm”, edited by Hannah Bertilsdotter Rosqvist, Nick Chown and Anna Stenning. Specifically, I’ll be using as my main reference Chapter 4, Neurodiversity, disability, wellbeing by Robert Chapman.
I’ll be honest, this topic has been making me uneasy for a long time because while I do lean towards the idea that neurodivergence is a natural difference, I’ve been very uncomfortable rationalising that with the fact that some people’s neurodivergence is just straight up harder to deal with than my own, so reading this chapter was a bit of a lightbulb moment for me in my own conceptualisation of my own neurodivergent identity.
So in order to dive into the question of whether or not neurodivergence is a disability, we need to gain an understanding of what disability actually is and the various models around it.
For the general population, the most obvious definition of disability fits that of the medical model, which is sometimes referred to ideologically as the ‘personal tragedy model’ where disability is framed as ‘objectively bad, and thus something to be pitied, a personal tragedy for both the individual and her family’ (Carlson, 2010) but is also the framework used to understand disability from a medical perspective where it refers to conditions that deviate from the norm.
I include stock images to break up the otherwise massive wall of text but this subject matter doesn’t really lend itself to visual content so here is a representation I managed to drag out of “deviating from the norm”
When we generalise that concept out to cognitive disability, including neurodivergence, it’s often categorised as a tendency towards lower wellbeing or a limited capacity to flourish.
Chapman pulls out this heartbreaking quote from Bovell’s 2015 thesis “Is the prevention and/or cure of autism a morally legitimate quest?” which says: “even if the word suffering is not always used, much of the discourse in both academic and lay communities implicitly or explicitly relates to the relationship between autism and suffering or autism and reduced wellbeing relative to a neurotypical norm” which implied an inherent association between autism and suffering in both academia and society at large.
With this in mind, Chapman looks to explore how new thinking around this topic challenges these perceptions and our views of neurodiversity as a whole and examining how much of neurodivergent suffering is caused by societal exclusion and marginalization instead of being an inherent part of neurodivergence.
Let’s start by diving a little further into the medical model of disability, and specifically Cristopher Boorse’s biostatistical theory of health. According to Chapman, this is one of the most nuanced and robust medical models of dysfunction and given that dysfunction is the term used by the DSM-5 when describing a mental disorder, this seems a reasonable place to start.
Boorse’s medical model is based around the concept of function, that the human mind and body has goal-oriented systems for functioning. For example, each part of the human body has a specific role in enabling the human to function and their ultimate biological goals of survival and reproduction. The heart pumps blood, the lungs take in oxygen, all of these combine towards our overall functioning.
This captions represent the fact that I’m writing this at 11pm on Good Friday evening and am beyond ready to go to bed. I hope this brings great amusement to whoever reads this. I’m clearly not masking right now.
Thus with this “normal functioning” in mind, we can identify whether a particular organ is functioning naturally by comparing it to the standard functioning, called the “reference class” of those that are naturally uniform with each other. Therefore the functioning of a given organism’s systems should be measured with those of the same species, age and sex, those that are biostatistically similar.
In this case, health is normal functioning and dysfunction is sub-optimal functioning of a given organ or system. There are many ways in which this method is valid and appropriate, and Chapman references the symptom of baldness, which can be considered biologically normal to start to occur in a man in his 60s and is normal functioning, but could be a cause for concern if a seven-year-old girl is balding.
The power of this model is that it comes with an objective measure of what is normal functioning versus dysfunction and does not require subjective judgements.
We can apply the same logic to cognitive functioning by comparing whether an individual is functioning suboptimally in reference to the biostatistical norm. So for example, when it comes to executive functioning, those of us with executive function challenges are behaving in a way that is sub-optimal when compared to our peers in a reference group, and therefore can be considered dysfunctional.
However, when it comes to something like neurodivergence, this model has limitations. To start with, how you measure sub-optimal performance versus the reference class really depends on how you define the reference class. While age, sex and species make sense as parameters for the reference class, what makes them more valid parameters than say sexuality or neurotype.
This is important because it defines who we consider dysfunctional or not. The majority of people are heterosexual, so by comparing a lesbian to a majority heterosexual reference class, we can conclude that being lesbian is dysfunctional, a social stance that I’m glad most people would agree with me now is as ridiculous as it is offensive.
Neurodivergence is actually more common in the LGBTQ+ community, likely because we don’t conform to social norms. If you don’t support this community then you are likely in the wrong place.
The other problem with the reference class is that it has an inbuilt assumption that the reference class is uniform enough that it can be suitably used to identify dysfunction. In reality, most groups are diverse in themselves and so a deviation from the norm of the group may be well within the diversity of the reference group itself.
With this in mind, the objectivity of what is dysfunctional doesn’t sound quite so objective anymore.
So without even discussing the stigmatising nature of this model applied to neurodivergence, we’ve managed to find ways in which the model isn’t fit for purpose when applied to the case of neurodivergence, and alternative approaches are needed.
This is where the social model of disability comes in. On a high level, this is the view that individuals can be impaired by their neurodivergence, but it’s not the impairment that is disabling, rather it is the politics of society itself that is disabling to an individual. For example, a person in a wheelchair is not inherently disabled by the fact that they are in a wheelchair, rather it is the lack of ramps and general inaccessibility of society that causes this.
However, similar to the biostatistical model, this model is not without its criticisms as well, the first one being, how do you define impairment? In order to define something as impaired, there needs to be a concept of unimpaired, something that suggests a “norm” that we can compare to for an objective measure of impaired or unimpaired. Does this sound familiar?
This suffers from the same problems in defining the norm as the biostatistical model, it’s just that the cause of the disabling is different; society in this case, instead of being inherent in the impairment or dysfunction instead.
Now we can work around this by removing the concept of impairment, instead considering it a natural variation within neurodiversity. However, this brings us to the problem I posed at the beginning of this video, that by considering neurodivergence solely as natural neurodiversity, we run the risk of minimising or overlooking people that are genuinely struggling much more with their neurodivergence.
The thought process here is that this pretty flower is a “natural variation”. I’m scraping the bottom of my intellectual barrel here.
Instead, Chapman suggests looking at the work of Elizabeth Barnes’ disability theories for an alternative approach and her value-neutral model of disability.
In Barnes’ theory, disability and impairment are one in the same and are made up of two aspects, one of which is social construct, one is objective difference in how we operate. In this theory, disability is value neutral only in effects on wellbeing, ie that disability in itself should be neutral to wellbeing in a world without ableism.
The important distinction in this model is the difference between local wellbeing, wellbeing in some specific time and context, versus global wellbeing, which is wellness on the whole. By separating these two concepts we allow for things that are locally good or bad without global wellbeing itself being good or bad.
This enables us to see both sides of the argument - that disabilities can come with local bads like not being able to enter a building due to no wheelchair accessibility, without being inherently globally bad; it is not inherently bad to be in a wheelchair. The disability does not make global wellbeing worse but the stigma and marginalization do.
This enables us to see both sides, recognising that a disability can be locally bad and people do experience direct hardship in many situations. But globally, disability is neutral and not objectively bad.
And we can apply this exact same log to neurodivergence and in fact there are studies to support this. A 2006 study by Renty and Royers found that wellbeing among the autistic population was not predicted by how severely impaired the individual was, but rather whether they felt well-supported. It depended on the context, not the individual’s autism.
Another study by Palmer and colleagues in 2014 looked at wellbeing in the schizophrenic population and found that the happiness levels of schizophrenic patients were correlated with psychological traits that are unrelated to schizophrenia. So whether the schizophrenic traits manifested as good or bad depended on other internal factors, such as how optimistic they were.
I don’t have any witty statements about whether this glass is half full or half empty.
This explains why I can see my ADHD as neutral and even good at times while others see it as totally bad. Fortunately, my unique circumstances usually leave me in a place where my neurodivergence is locally neutral, and while circumstances do occur where I face local bads myself, I can appreciate that there are others out there who may face more local bads than I do and their experience does not contradict the global value neutrality of our ADHD.
This also allows us to combine both sides of the argument into one: yes our neurodivergences exist and under certain circumstances they are objectively locally bad. It is important that us neurospicies get help, support and acceptance to mitigate as much of these locally bads as we can. But this doesn’t mean that neurodivergence itself is inherently bad.
Because it is also a natural part of human diversity and we are amazing, diverse human beings in our own right.
And thus concludes this examination of neurodivergence and models of disability. I hope this has been an interesting examination of what is unquestionably a controversial topic in the neurodivergent community and for me personally the value-neutral model philosophy is one that I feel comfortable with but it might not be for you and as our views on neurodivergence continue to evolve over time it will be interesting to see how our understanding of these topics change over time.
References:
Neurodiversity Studies: A New Critical Paradigm, (Rosqvist et al., 2020)
The faces of intellectual disability, (Carlson, 2010)
The Minority Body: A Theory of Disability (Barnes, 2016)
Wellness within illness: happiness in schizophrenia (Palmer et al., 2014)
If this resonates with you and feel you would be interested in talking to an adhd and autism-friendly coach, feel free to get in touch. If you’re looking for more blog posts, you can find them here.
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