Neurodiversity and changing brains - why is this very important?

Life is changeable and so are we!

“Live as if you were to die tomorrow. Learn as if you were to live forever.”

―?Mahatma Gandhi

?? The brains we have when we are born are not the same ones 60 years later! Our teen brains go through enormous changes in emerging adulthood, especially the pre-frontal cortex. The prefrontal cortex (PFC) plays a central role in?cognitive control functions, and influences our ability to attend, inhibit impulse behaviour, working memory, and cognitive flexibility.If you have ever lived with teens you will know that they are just like toddlers all over again- emotional, hate switching to tasks of less interest to them ( such as tidying their bedroom) and often impulsive. ( See Youtube about this from Sarah-Jayne Blakemore)

For some neurodivergent people, some of the challenges they had in childhood seem to have less impact in adulthood. Understanding what and why this happens for some people and not for others is important and to me really interesting. One condition that seems to change during teens is BECTS ( Rolandic epilepsy, also known as benign childhood epilepsy with centrotemporal spikes (BECTS)). I published a study about this and Developmental Coordination Disorder /Dyspraxia 5 years ago and found 47% of children with BECTs had DCD. What I thought was interesting is that most children with BECTs grow out of it in teens and so may be we could think about what is happening during that time and learn from it.

What happens when our brains change (and they can and do throughout life)? Why do they? What does this tell us?

See how some of our brains change over time. In Nature a study reported changes over time following scanning 10s of 1000s' of people of all ages.The research team "aggregated 123,894 MRI scans from 101,457 people, including fetuses 16 weeks after conception to 100-year-old adults". The scans included brains from neurotypical people, as well as people with a variety of medical conditions, such as Alzheimer’s disease, and neurocognitive differences, including autism spectrum disorder.

BUT and a big BUT is a problem with these results. The sample although large was not very diverse at all so cannot be generalised.The brain scans also came mainly from North America and Europe, and disproportionately white, university-aged, urban and affluent people.

Neurodiversity is the way we think, move, process, act, hear, see and communicate. Our brains are all different. Some of us diverge from a social norm and understanding why that is and the benefits and challenges have been my life work.

??Our brains change in response to our environment and the things we do day to day.?

The work showing how the brains of London taxi drivers change when they learn 'the knowledge ' was a fascinating insight into this. Previous studies have shown that taxi drivers have a larger hippocampus compared to non-taxi drivers. A study is now looking at what happens to these people as they age and whether are they protected from having Alzheimer's disease.

Sometimes we consider neurodivergent traits as if these stay static and don't change over time. The reality is that we are a live organism reacting with our world. The environment we are in and what we do can make a difference in how our brain adapts and evolves over time. Head Trauma can impact brain function and can present with similar traits to ADHD. Our amazing brains can relearn skills sometimes too. Doing exercises like speech and language therapy in a stroke patient can help bring strength back to someone's speech.

We know that the majority of individuals diagnosed with ADHD in childhood still have symptoms and/or challenges sufficient for a diagnosis in adolescence and early adulthood (Breda et al., 2021; Faraone, Biederman, & Mick, 2006).?

A recent study has shown for some people with ADHD that certain traits can improve over time.There are specific areas of the brain that can be seen to change too. The question we need to ask... What are some individuals doing that can result in these brain changes?

One recent meta-analysis provides some promising evidence 'that targeting ADHD-related challenges such as emotional self-regulation or other executive function challenges ( e.g.planning, organization, time management), can reduce some of the ADHD symptoms (Shephard et al., 2022).

??Learning what helps - could be a game changer

The Journal of Child Psychology and Psychiatry did a review of ADHD over the ages and what we have learned over time published in October 2022 and discussed this in more depth.

Environmental demands changes over time too

We are realizing now that the presentation of ADHD (and other conditions such as BECTS) may change over a lifespan. The support you get at home and at school will differ from person to person and from place to place enormously. This bumpy profile may be the result of an interplay between 'time-varying environmental demands and underlying genetic vulnerability (Sibley et al., 2021)'.

Until a few years ago we never considered there was a 'thing' called 'late onset' ADHD (i.e.presenting in adulthood) at all. In this article, they consider how people with late-onset ADHD might differ from their childhood-onset counterparts in important ways. One consideration may be the level of scaffolding/support they have and whether they may have lived in more supportive families during childhood and/or have higher cognitive abilities.It may be a combination of parental support and skills that may mean you are less likely to being diagnosed with ADHD (Asherson & Agnew-Blais, 2019). But once the young person leaves home and has less support and also increased demands in university then the balance can tip.

Our understanding is constantly changing.

We recognize today more girls have ADHD than we thought. We may have missed many girls because they may be better at masking their challenges until demands increase and they can no longer cope. Our brains also change during puberty and we increasingly recognize the impact sex hormones may play (Hinshaw et al., 2022).

The good news the potential to change our brains and our bodies persist throughout life and this is exciting to understand more. We know more today about how to optimise our physical wellbeing and we need to understand more about how to do this for our psychological wellbeing to ensure we can be our best selves.

All I know is we still have a lot to learn.

"We learn something every day, and lots of times it's that what we learned the day before was wrong.” said Bill Vaughan

The blog author

I am Amanda Kirby, CEO of?Do-IT Solutions?a tech-for-good company that delivers web-based screening tools and training that help 1000s of people deliver person-centered solutions relating to neurodiversity and wellbeing.

I am a mixed bag of experiences and skills and have 25+ years of working in the field of neurodiversity. I am a medical doctor, Professor, and have a Ph.D. in the field of neurodiversity; parent and grandparent to neurodivergent wonderful kids and am neurodivergent myself (bits of me I share!).

Theo Smith and I wrote the award-winning book?Neurodiversity at Work?Drive Innovation, Performance and Productivity with a Neurodiverse Workforce. We have also been shortlisted for an international book award. I have my 10th book coming out called Neurodiversity in Education coming early in 2023. I was also voted one of the top 20 Thinkers by?HR magazine for 2022! I won a lifetime diversity award this month too!