How this aligns with the neurodiversity paradigm
My philosophy aligns with the social model of disability, and with the neurodiversity paradigm.
These philosophies are in stark contrast to the pathologization of divergent brains and bodies.
Where the pathology paradigm asks questions such as “what is wrong with the individual?”, the social model of disability asks questions such as “what are the barriers to accessibility and inclusion?”
The pathology paradigm places the onus on the individual to adapt to the typical majority; their differences are medicalized, and seen as problems to overcome.
In terms of being Autistic and ADHD, the medical model sees them only as “disorders” which leads to harmful behavioural approaches, in which the individual is expected to adapt and change — sometimes suppress the very essence of who they are — in order to please the neurotypical majority.
The social model and neurodiversity paradigm see divergent neurotypes as a benefit to our society in many ways, including — but not limited to — innovation, creativity, divergent thinking, and artistic talents, among many others.
When an individual encounters difficulties, the social model does not ask what is wrong with the person. Instead, this model evaluates the context and surrounding environment, and how they may be negatively impacting that person.
The social model seeks to uncover and change how institutions and cultural norms disable individuals due to lack of understanding, acceptance, and accommodation.
Pathologization versus the social model
The word pathologization is derived from the Greek pathos — “to suffer” — and refers to the process by which an experience is seen and approached as something that elicits suffering.
For example, I have asthma. I am fortunate that it is well-controlled and does not impact my life significantly. However, it is something that is purely negative for me, there is no way in which it adds to the richness or quality of my life. If I have asthmatic symptoms, or an asthma attack, this can be very unpleasant, scary, and even dangerous.
I am also Autistic and ADHD. These are differences in the way my brain developed, is wired, and in the way it operates when compared to the statistical majority. Some aspects of my divergent brain can be frustrating or annoying, such as when I have difficulty focusing, or the fact that I have very poor working memory.
There are also a significant number of positive traits I associate with being neurodivergent, such as creativity and nonconformity.
Any existing neurotype in the universe comes with its pros and cons. If neurotypicals (NTs) also have costs and benefits to the way their brains are wired, then why is an ADHD and Autistic brain considered disabled, while theirs is not?
Another example I’ve used is intellectual giftedness. While the IQ of approximately 95% of the population falls within the “average” range, those who are considered highly gifted make up only about 2% of the population.
A personal example
When my son was younger, he really needed to move his body during class. He was only 6–7 years old, so that shouldn’t have been all that surprising, but apparently our education system expects children that young to sit still for significant portions of the day.
Anyway, I digress.
What happened was he was first chastised for not sitting quietly and listening, then for disrupting the learning of others, and for causing a distraction in class. The school’s idea of a “solution” was to have him go out of the classroom for a walk with an EA following behind.
A 6 year old child needs to move in order to learn and wants to be included with his peers. Instead of meeting the need, they separated him from his peers and removed him from the classroom where he received no instruction.
Also, walking the halls with an adult trailing you is really boring… and kind of annoying.
That is an example of pathologizing my son’s need to move in order to learn, and accommodating the needs of the adults and the institution over the needs of the individual.
The assumption was that he was in the wrong for having this need, and he needed to adjust his behaviour to conform to the school’s expectations, regardless of whether they were developmentally appropriate.
“Hours of sitting still, less and less recess all of the time, one size fits all instruction and assessments, and a culture of compliance are probably the worst-case scenarios for educating ADHDers… The assumption is typically made that the child is at fault for this mismatch, not the environment.” — Nicole Biscotti
The social model would ask, what are the barriers to accommodation and inclusion, and how can we adapt the environment to meet the child’s needs?
- A fidget cushion, rocker chair, or wobble stool.
- Leg bands.
- A stand desk.
- A designated space within the classroom where children are allowed to walk around, where they won’t disrupt others.
- Fidget tools.
Let’s pretend we meet all of these needs. We provide non-stigmatizing movement breaks within the classroom in a designated area, an assortment of fidget tools, and a wobble chair. If the student is then able to utilize these tools, regulate, and pay attention without disrupting class, is his ADHD still disabling?
If he only needs appropriate and reasonable accommodations to succeed, and does well once given them, was it really his ADHD that was disabling him in the first place, or was it the incompatible and inflexible environment?
“Within in the social model of disability, when we say that a person is disabled, we mean that society isn’t properly set up to enable their participation, and instead is often set up in a way that creates barriers to their participation.” — Dr. Nick Walker
An adult example
As an autistic adult, I have a lot of sensory issues. I get overstimulated by what my nervous system perceives as excessive noise, activity, and bright lights — or worse, those flickering fluorescent lights!
I am somewhat sensitive to scents, but there are others who are even more so, to the point of suffering migraines from strong perfumes. As a result, a lot of workplaces have established a scent-free policy, wherein staff and visitors are asked not to wear perfume or strongly-scented products.
If I am significantly less productive in an environment that is loud, bright, or busy, does this mean I’m a less valuable employee because I’m autistic?
My employer could provide accommodations such as having softer lighting installed in my workspace, being moved to a quieter location, or to work from home 2–3 days per week to give my nervous system a break.
Given that my brain works differently from the majority, wouldn’t it be highly beneficial for employers to accommodate me, to allow my creativity and innovation a venue? I may come up with ideas and solutions that others don’t think of because their brains all work similarly.
If I am provided these accommodations and excel at my job, then was it really being autistic that disabled me, or the environment centred around the needs of its neurotypical workers?
Inclusion is moving from “we tolerate your presence” to “we WANT you here with us”.
© Jillian Enright, ADHD 2e MB
Biscotti, N. (2021). I Can Learn When I’m Moving: Going to school with ADHD. EduMatch.
de Vries, B. (2021). Autism and the Right to a Hypersensitivity-Friendly Workspace. Public Health Ethics, 14(3), 281–287. https://doi.org/10.1093/phe/phab021
Liebert, R. (2014). Pathologization. In: Teo, T. (ed.). Encyclopedia of Critical Psychology. Springer. https://doi.org/10.1007/978-1-4614-5583-7_572
Walker, N. (2021). Neuroqueer Heresies: Notes on the neurodiversity paradigm, Autistic empowerment, and postnormal possibilities. Autonomous Press.