Neurodiversity and Mental Health: Shifting Paradigms (Yerim)

When it comes to the human brain, there is no such thing as the standard, “correctly-shaped” brain. No single brain has the exact same bumps (gyri) and folds (sulci) in place as another one. 

For years, research has been conducted on elucidating the relationship between the morphological, functional differences in the brain and the variations in human behavior. Despite all this work, there remains a question left to be answered: Is there such a thing as a normal human brain and mind? If so, how do we decide on it? 

Conventional medicine has been dominated by the pathology paradigm, viewing neurodiversity and mental health as deficits and medically abnormal. However, whether a certain human behavior or traits fall within the “normal” human variation or pathology remains elusive. 

Pathology vs. Neurodiversity Paradigm

The conventional medical paradigm (or so-called pathology paradigm), as briefly mentioned above, is a model of disability. It focuses on deficits and compares to a “normal” range held to an “ideal state of health.” In this paradigm, anything that falls outside of “normal” is undesirable, and neurodivergence is diagnosed as a disorder. 

Much research in academia, including diagnostic criteria and manuals such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-11), describe neurodivergence as disorders, deficits, impairment, and dysfunction. However, we must recognize that there is no such thing as “normal”, but rather most of us are “neurotypical”, defined as having neurocognitive functioning that is within the societal standards of “normal” — belonging in the largest part of the population distribution on certain measures. 

The neurodiversity paradigm is a novel topic of scholarship and is a viewpoint that diversity among human brains and minds is natural; said another way, the brain differences between individuals are “normal”, not “deficits”. Unlike the pathology paradigm, the neurodiversity paradigm considers varying human brains, behaviors, and different states of human minds on a continuum (like a circle, with no endpoints) rather than discrete units of “normal/correct” and “abnormal/wrong”. In particular, the neurodivergent paradigm acknowledges that neurodivergent people interact and interpret the world in their own unique ways. This shift in paradigm can help reduce the stigma around neurodivergent people and come up with systems that can better support their personal growth and integration into society. 

Barriers to Accommodation

Neurodivergence is often invisible, and thus, the validity and requests for such accommodations in places like school and work are questioned. For instance, neurodivergent students might feel uncomfortable explaining to their instructors and peers why they need accommodations for assignments and exams. Often, there is a lack of flexibility that is offered to neurodivergent people, and the resources allocated to support the needs of neurodivergent people are limited. 

Especially in university settings, neurodivergent students face documentation barriers to accommodations. These students are required to provide documentation confirming their neurodivergence to receive appropriate academic considerations and accommodations. Valid documentation includes, but is not limited to, a certificate of disability and psychoeducational or neuropsychological assessments. However, this is a long, expensive process. These assessments and reports cost on average around $2,000 to $5,000, which istoo costly for most students to afford, therefore hindering them from receiving deserved academic accommodations.

Need for Strength-Based Models

There needs to be a shift from the pathology paradigm to the neurodivergent paradigm. Not only are the thinking and behavioral differences that we see in neurodivergent people a natural variation of the human brain, there are also strengths and valued traits that are accompanied in neurodivergent people. 

For example, research has demonstrated that people with attention deficit hyperactivity disorder (ADHD) and bipolar disorder show greater creativity and novelty-seeking behavior. In addition, people with autistic spectrum disorder (ASD) often have good memory and mathematical and technical abilities. 

Especially in research and academia, more studies that refrain away from “normalizing” traits and behaviors based on diagnostic criteria (e.g. DSM-5) are needed; more research should focus on taking a holistic approach, investigating the strengths of neurodivergent people. More and more studies focusing on the strengths and weaknesses that neurodivergence brings and this variation in human minds as a positive feature of the human brain are necessary to drive this paradigm shift in both academia and our society. We need to acknowledge that people learn and think differently, but these are simply differences and not deficits.

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