neurodiversity – do all great minds think alike?

When Camilla Pang was five, she was diagnosed with autism spectrum disorder (ASD). Then later, as an adult, she was diagnosed with attention deficit hyperactivity disorder (ADHD) as well as generalised anxiety (GAD).

In her book Explaining Humans, Pang describes how as a child:

‘I felt like a stranger within my own species; someone who understood the words, but couldn’t speak the language; who shared an appearance with fellow humans but none of the essential characteristics.’

As she got older, Pang became fascinated with what it meant to be human and was drawn to the sciences for answers, leading her to complete a PhD in biochemistry. She used that knowledge to try and understand what it means to be human on a biological and physical level, giving her a window into understanding what it means to be human more broadly.

As a result of her research, Pang realised that being neurodiverse could be an asset. She now believes that, while being neurodiverse in a world that has been designed for neurotypical people can be challenging, the things that make her ‘different’ are also the things that give her unique intellectual advantages.

‘Living like this is frustrating, but also completely liberating. Being out of place also means you are in your own world—one where you are free to make the rules. What’s more, over time I have come to realise that my curious cocktail of neurodiversity is also a blessing, one that has been my superpower in life—equipping me with the mental tools for fast, efficient and thorough analysis of problems. ASD means I see the world differently, and without preconceptions, while anxiety and ADHD allow me to process information at rapid speed … My neurodiversity created so many questions about what it means to be human, but it also gave me the capacity to answer them.’

What is neurodiversity?

We hear this term bandied around a lot, but what does it actually mean, and what forms of diversity fall under this banner?

According to the Mental Health Academy, neurodiverse brains differ from neurotypical brains in both structure and function.

For example, they describe how in brains impacted by ADHD, parts of the prefrontal cortex, which are used to ‘problem-solve, make decisions, control impulses, and utilise logic’, can be underdeveloped. People with ADHD can also have structural differences within their white matter (part of the limbic system) which can impact on ‘learning, memory, and regulating emotions’.

Neurotransmitters (the chemicals that help send messages), particularly dopamine and norepinephrine, can also work differently in neurodiverse brains.

This means that people with neurodiverse brains may process information differently and interpret the world in unique ways. They may also experience emotions differently to people with neurotypical brains.

For some people, being differently-abled can present challenges and they may need supports and adjustments. For others, being neurodivergent can lead to opportunities and insights that aren’t available to neurotypical people.

‘It is powerful to realise that neurodivergence has to do with how someone’s brain is structured and functions. It’s a part of the variability in humans and life, and it makes life on earth exciting and interesting and beautiful,’ says Annette Estes, director of the University of Washington (UW) Autism Center.

Common types of neurodiversity

Currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM) recognises autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and dyslexia as forms of neurodivergence, but the more widely accepted definition seems to be somewhat broader. Generally, the following are considered to be types of neurodiversity:

• autism spectrum disorder (ASD)
• attention deficit hyperactivity disorder (ADHD)
• specific learning disabilities (SLD) including dyslexia, disgraphia and dyscalculia
• dyspraxia
• Tourette syndrome

Acquired brain injuries (ABIs) and mental health conditions like anxiety, depression, obsessive compulsive disorder (OCD), amongst others, are also sometimes considered to be forms of neurodiversity, because they can change the chemical composition of the brain.

Sometimes the following conditions are also included under the banner of neurodiversity:

• Meares-Irlen Syndrome
• intellectual disabilities
• synesthesia.

Some people also consider ‘giftedness’, or people with extremely high intellectual/creative capacities, as neurodivergent.

Ideas and understanding about neurodiversity are developing and changing all the time, but broadly, neurodiversity is understood to include any condition that impacts on the structure or function of the brain.

Why it’s important for us to be thinking about neurodiversity

It’s estimated that approximately 15-20% of people are neurodiverse.

Not everyone who is neurodiverse will have a diagnosis or ‘label’. In every classroom, group or therapeutic setting, we are likely to be working with people who identify as neurodiverse. We will also work with clients, students or colleagues who think differently, or whose brains work differently to neurotypical brains, but who don’t identify with a particular form of neurodiversity.

It is also important to understand that the impacts of neurodiversity can be profound for some people.

For example, the Mental Health Academy says that people with ADHD have a life expectancy up to 21 years lower than people without it, ?as ADHD can lead to increased risk-taking behaviours, reduced capacity for decision-making, increased risk of accidents and substance misuse.

The World Health Oganisation states that people with ASD,? ‘…are at greater risk of violence, injury and abuse’. They also note that, ‘…autistic people are often subject to stigma and discrimination, including unjust deprivation of health care, education and opportunities to engage and participate in their communities’.

In his article, ‘Neurodiversity can be a workplace strength, if we make room for it’, editor at The Conversation, Misha Ketchell, describes how, ‘Unemployment rates for people with some forms of neurodiversity are also significantly higher than for people who are neurotypical, or for people with physical disabilities.’

Additionally, people who are neurodivergent may be more prone to experiencing poor mental health. As McKenna Princing from UW Medicine notes, ‘Neurodivergent people can also be diagnosed with other mental health conditions. In fact, two of every three people with ADHD have another condition such as anxiety, depression or OCD, and autistic people are at higher risk for mental health conditions.’

However, people who are neurodiverse also bring many unique insights, skills, experiences and perspectives to the table. In a world that is desperately seeking solutions to a raft of challenges, it may well be people with unique perspectives that provide solutions that neurotypical people would never consider.

Some things to consider

It is important to remember that even if someone has a particular diagnosis, their experiences and needs may be unique compared to others with the same diagnosis. As such, asking good quality questions that enable the person to express their needs and preferences is a valuable way to ensure they feel included and supported.

How you ask the questions, and the types of questions you ask, may vary depending on the person and the type of neurodivergence. For example, some people on the autism spectrum may struggle to understand metaphors and abstract concepts, so it can be worth making sure that language is kept direct and concrete. Some forms of humour may also be challenging for people with ASD to understand, especially if it relies on word play or abstract ideas.

Of course, many neurodiverse people, including those with ASD, enjoy using metaphors and humour, which is why it’s important to ask the person what works for them and how they would like to communicate.

Here are a few things to think about when creating safe and inclusive environments for neurodiverse children and adults:

• Ask about preferences for communicating. For example, some people may prefer to communicate using visual cues, others may prefer to use different forms of technology to aid communication.
• Ask what spaces feel safe—what is it about those spaces? How can you replicate elements of those spaces during interactions, for example, offer low sensory input (or quiet) spaces; provide visual instructions and descriptors as well as written instructions; include different types of learning experiences and activities that appeal to different types of learners, e.g. action-oriented, tactile, mindful and reflective, conversation-based, visual, audio, etc.
• Develop a support plan with the person and any support people they rely on, e.g. family members, friends, support workers or aids, social workers, psychologists, etc.
• Wherever possible, invite the neurodiverse person to be at the centre of the process and give them as much agency in deciding the ‘when/where/who/why’ of any meeting and how it is to be conducted/recorded. Also, aim to include the person in any discussion that is about them and make decisions with them.
• Do your own research. Like any area of diversity, it up to all of us who work in human service and educational spaces to educate ourselves about how others may experience the world and what inclusion might look like.
• Support people to consider the different ways that their neurodiversity could be seen as a strength. Invite them to think about how their differences gives them insights, skills and awareness others may not have.
• The more people understand themselves and their particular form of neurodiversity, the more they are likely to feel confident to advocate for themselves. Encourage them to develop a deeper understanding of their neurodiversity and the different ways it impacts their lives. They may do this by researching other people with similar forms of neurodiversity, connecting with individuals or groups (in person or online), engaging with media content created by neurodiverse people, etc.
• Support people to advocate for themselves.

In every group, we are likely to have people from different cultural, social and gender groups, so too, we are likely to have a mix of neurotypical and neurodiverse people.

By considering how we can make spaces more welcoming, and conversations more inclusive for neurodiverse people, we are enabling them to feel more respected, valued, ‘seen’ and understood.

?

Sue King-Smith