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NEURODIVERSITY

This page is a copy of the Neurodiversity@Cornell webpage, a virtual hub of information and resources related to Neurodiversity for the Cornell University community.
Possible academic and occupational accommodations were added separately.

What is neurodiversity?

Neurodiversity was coined in the 1990s by Judy Singer, Australian sociologist who is on the autism spectrum. She redefined it in 2020. In short, it is:

The virtually infinite neuro-cognitive variability within Earth’s human population.
 

Thus, the human species is neurodiverse: As a population, humans comprise individuals with a unique brain created by genes as well as culture and experiences. This diversity has been present in humans since the beginning and has been crucial for humans' expansion and survival.

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Neurodiversity is:

  • A state of nature to be respected

  • An analytical tool for examining social issues

  • An argument for the conservation and facilitation of human diversity

 

It is NOT a synonym for “neurological disorder.”

The Neurodiversity Movement

It is a social justice movement that includes various neurological minorities, or neurominorities. Some common goals are:

  • Acceptance and in society of people with neurologically-based disabilities.

  • Replace negative, deficit-based stereotypes of neurominorities with a more balanced valuation of their gifts and needs

  • Find valued roles for marginalized neurominorities

  • Show that all of society benefits from the inclusion of neurominorities

It also advocates against finding a cure, or eliminating neurodivergent types of minds.

 

The Neurodiversity movement asks us to move away from the deficit-based, medical model, to a strengths-based, social model of disability. The disability exists because our society demands a certain type of interaction, functioning and being. These models are discussed next, along with a newly proposed "neutral" model.

Neurotypical and Neurodivergent/Neurominority/Neuroatypical

Neurodivergent is an umbrella term for different types of brains; most have been defined and are diagnosed under the Diagnostic and Statistical Manual of Mental Disorders (DSM, now in its 5th edition). These include:

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People can have been diagnosed or may self-identify as having one or more of these conditions. There is controversy regarding their definition as a disorder, which creates the idea of an illness that one can overcome, can be cured or prevented. It also implies such conditions are undesirable.

Someone who has not been diagnosed with any condition would be considered neurotypical. However, there is no screening that can prove that someone is definitely neurotypical. Many people have been diagnosed with one or more neurological conditions late in life, meaning that they spent the majority of their life believing they were neurotypical.

Many neurodivergent people also have other traits such as sensory processing disorder, synesthesia, hyperlexia, which could increase the challenges they face in a neurotypical world.

Are there more neurodivergent people now than a few years ago?

One may feel that there are more neurodivergent people than before. It's possible you never heard about autism or dyscalculia until a few years ago, or knew a person with those neurotypes. Some non-profits use increases in estimated prevalence rates to alarm the population and increase their funding. However, prevalence rates likely don't mean there are more dyslexic people, for instance.

 

Currently, the estimated prevalence rates for different neurotypes include:

  • 8.8% of children aged 3-17 years have been diagnosed at some point with ADHD according to CDC data for 2021.
     

  • 2.8% of 8-year old children have an autism diagnosis, according to the latest report from the CDC (March 23, 2023).
     

  • Learning disabilities: According to the National Center for Education Statistics, in 2020-2021 fifteen percent of all K-12 students. received special education services. Of these,

    • 33% were classified as having a specific learning disability (meaning a disorder that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations; this would include dyscalculia, dysgraphia, dyslexia, slow processing tempo, etc.)

  • Mental Health. The most recent estimates by the Substance Abuse and Mental Health Services Administration (SAMHSA) of the US Department of Health and Human Services show:

    • 33.7% of adults (18 years old or older) were identified as having a mental illness. This rate decreases to 28.1% for people 26-49 years old and 15% for those older than 50.

    • 18.6% of adults (18 years old or older) have had at least one major depressive episode. This age group shows the highest prevalence, dropping to 9.3% for those 26-49 years old and 4.5 for people 50 years old or older.

    • 11.3% of adults (18 years old or older) who report regular feelings of anxiety, nervousness or worrying, according to the National Center for Health Statistics for 2019-2021.

 

Other reasons prevalence rates may increase include:

  • Some diagnoses did not exist, or have significantly changed. For example, the Diagnostic and Statistical Manual of Mental Disorders (DSM) has changed the concept for:

    • Autism. The DSM-II, published in 1968 considered autism as a form of childhood schizophrenia. The DSM-III, in 1980, changed autism to a "pervasive developmental disorder." In 1987, the DSM-III revision added specific criteria. Another revision in 1987 added "Pervasive Developmental Disorder Not Otherwise Specified" or PDD-NOS as a condition. The DSM-IV included Asperger's Disorder, PDD-NOS and Childhood Disintegrative Disorder and Rett Syndrome, as well as Autism. Finally, the DSM-5 grouped all of them into Autism Spectrum Disorder. The diagnostic criteria has changed as well (this Spectrum News article has additional information)

  • Misdiagnoses are unfortunately not rare. 

  • Late diagnoses. People can have struggled for a long time and may have been considered as "difficult," "lazy," "unreliable," and more throughout their lives. They were identified as different, but not identified as having a particular neurotype. Learning differences are lifelong; however, if a person is not diagnosed early, those other labels cause shame and become part of what the person believes is just their personality. For people who are both autistic and ADHDers, many times ADHD is diagnosed earlier and masks some of the characteristics of autism. Also, an autism diagnosis prevented ADHD diagnosis; a double diagnosis was not allowed until 2013. People diagnosed before then would possibly not undergo diagnostic evaluations for the additional diagnosis. 

  • Stigma, and living in a culture that does not support disclosure. It is possible that you interact with neurodivergent people every day, both at work and in your personal life, and that those people have not disclosed their disability or neurotype to you.

  • Masking and camouflaging – this is somewhat common for people who are autistic and/or ADHDers. Some interventions/treatments encourage masking. Masking is correlated with mental health issues and with suicidal ideation.

 

Accurate data telling us how many people have a particular neurotype helps us design our teaching styles, rubrics, learning strategies interventions and much more. Creating environments that foster disclosure and open dialogue will likely improve the way we support students and our peers.

Screening Tools for Autism

Ritvo Autism & Asperger Diagnostic Scale (RAAS-R and RAADS-14): 

An autistic researcher, member of the College Autism Network mentioned in an email:
“As an autistic person, I have found that the RAADS-R is more accepted than the AQ by many autistic people. There is an abbreviated form of the RAADS-R called the RAADS-R 14 that might be better depending on the [research] study… As an autistic person who has taken both the AQ and RAADS, I still think the RAADS is better. Iit does touch on sensory environment and experiences - which is great. I also think that the statements make more sense for what they are measuring and just in logic.”
Link to RAADS-14: https://psychology-tools.com/test/raads-14 and RAADS-R: https://embrace-autism.com/raads-r/ 

 

Aspie-Quiz:

Developed by Leif Ekblad, who is autistic. The quiz is well liked by autistic adults and is fairly nuanced.
Link: https://rdos.net/eng/Aspie-quiz.php 

 

Autism Quotient:
Comment from an autistic researcher in College Autism Network:
“The AQ has been shown to have statistical issues including the specificity and the relationships among different subscales of the AQ. Some researchers have even recommended using subscales separately for this reason. There has also been an abbreviated form of the screening called the AQ-10 that has been developed. Overall, though, many autistic adults don't like any form of the AQ.”
The AQ was developed by Simon Baron-Cohen, whose research has been at odds with the autistic community and allies. He crafted the “extreme male brain” theory that posits that autism comes from too much testosterone during gestation (without proof). I (Flor) find this theory extremely simplistic and without basis – to me is the Men are from Mars… of autism (https://pubmed.ncbi.nlm.nih.gov/12039606/). 

Link: https://psychology-tools.com/test/autism-spectrum-quotient 

 

Comprehensive Autism Trait Inventory (CATI): 

Comment from the researcher mentioned above:
“I also recently saw an autistic researcher talking about the Comprehensive Autism Trait Inventory (CATI) which is long and very new, but might have new potential in its usage… CATI is super new. I found out about it in a group of autistic academics. It appears more logical. I agree. I also think it's great that they incorporated subscales for masking/camouflaging and sensory sensitivities - which are big areas of challenge for autistic individuals. This would eliminate the need for the CATQ and other metrics for these features. So, perhaps if you are using either the RAADS or the AQ and the CATQ etc (not fully aware of how deep the CATI goes). The CATI could replace all of that as well and just do it at once. However, it is extremely long. I think longer than the full AQ, so it has its downsides. I guess you could use just certain scales and eventually if the CATI catches on, there might be a shortened version. Too early to tell.”

Link: https://mike-ology.github.io/CATI-questionnaire/ 

 

Empathy quotient (EQ):

Issues with this test come from the idea that autistic people lack empathy, so this test is not very liked in the autistic community. Both of these links have the same questions, only have a different format.

Links: https://psychology-tools.com/test/empathy-quotient and https://embrace-autism.com/empathy-quotient/

 

Camouflaging Autistic Traits Questionnaire (CAT-Q): 

Measures the amount of social camouflaging (masking) in adults, which could prevent them from being accurately diagnosed.

Link: https://embrace-autism.com/cat-q/#test

Possible Academic and Occupational Accommodations for Persons with ADHD

Possible Academic Accommodations:

  • Testing accommodations (extended time and alternate location)

  • Extended time for assignments

  • Class attendance accommodations

  • Copy of presentations and class notes

 

Possible Occupational Accommodations:

 

Speaking Communicating

  • Allow employee to provide written response in lieu of verbal response

  • Allow employee to bring an advocate to performance reviews and disciplinary meetings

 

Time Management

  • Provide a visual checklist of assignments

  • Use a wall calendar to emphasize due dates

 

Memory

  • Use post-it notes and visual reminders of important dates or tasks

  • Encourage employee to email work-related questions

  • Provide a visual “cheat sheet” of high-priority activities, projects, people, etc.

 

Physical space

  • Modification or purchase of equipment (i.e. noise canceling headsets, white noise machine)

  • Reduce excess visual stimuli

  • Work from home is recommended, modification of work schedule and location

 

Multi-tasking

  • Provide specific feedback to help employee target areas of improvement

  • Supply proper working equipment to complete multiple tasks at one time, such as workstation and chair, lighting, and office supplies

 

Issues of Change

  • Recognize that a change in the office environment, job tasks, or of supervisors may be difficult

  • Maintain open channels of communication between the employee and the new and old supervisor in order to ensure an effective transition

  • Provide weekly or monthly meetings with the employee to discuss workplace issues and production levels

 

Stress Management

  • Provide praise and positive reinforcement

  • Refer to EAP or FSAP and allow for weekly counseling and mental health appointments

  • Allow employee to make telephone calls for support during work hours

 

Social Skills

  • Offer positive reinforcement

  • Provide clear expectations and the consequences of not meeting expectations

  • Give all assignments in writing

  • Assist employee in assigning priority to assignments

  • Establish long term and short term goals for employee

  • Adjust supervisory method by modifying the manner in which conversations take place, meetings are conducted, or discipline is addressed

  • Allow alternative forms of communication between coworkers, such as email

Recommended Readings

Books, blogs and comics about neurodiversity:

 

  • Uniquely Human, by Dr. Barry M. Prizant. Speaks about the autistic experience as part of our shared human experience, and was one of the first books trying to destigmatize the label, and advocating for understanding.

  • Neurotribes, by Steve Silberman. He digs deep into the history of the autism diagnosis. He explains some of his findings in this interviewLinks to an external site.. He is very much liked by autistic people. 

  • We're not broken: Changing the autism conversation. By Eric Garcia, who is autistic. Based on his experiences, Eric talks about the need for better social and policy supports for autistic people.

  • Look me in the eye, by John Elder Robison. John Elder Robison's memoir; he has had a very interesting life--he worked as a special effects designer for electric guitars for KISS, and owns a classical cars repairs shop. He is a Scholar in Residence for William & Mary. He was diagnosed as autistic as an adult.

  • The Reason I Jump, by Naoki Higashida (here is a summary). Naoki communicates using facilitated communication, and talks about his experience as an autistic teen. His memoir, written in Japanese was translated to English, became a hit, and then it was made into a movie.

  • Loud Hands: Autistic People, Speaking. It is an anthology of essays written by autistic people for autistic people. This is a project of the Autistic Self Advocacy Network. 

  • All the weight of our dreams: On Living Racialized Autism, edited by Lydia X. Z. Brown, E. Ashkenazy, Morénike Giwa Onaiwu. Anthology of poetry, short fiction, photography, drawings of autistic people of color. 

  • ADHD comics by Dani Donovan. A collection of comics that are help explain the ADHD experience (as well as general executive function issues).

  • Born on a Blue Day: Inside the Extraordinary Mind of an Autistic Savant, by Daniel Tammet. Daniel is a queer autistic savant who also experiences synesthesia. His savant abilities are related to memory (e.g., memorizing 22,000 digits of pi) and math.

  • Living Independently on the Autism Spectrum by Lynne Soraya

  • Typed Words, Loud Voices, edited by Amy Sequenzia and Elizabeth Grace. This book is an anthology of writings by autistic people who communicate by typing.

  • Unstrange Minds: remapping the World of Autism, by Roy Richard Grinker. Dr. Grinker is an anthropologist who travelled the world to gather information about the autism experience around the world.

 

 

Some books NOT HIGHLY RECOMMENDED OR DATED are:

  • Temple Grandin's books. She grew up before autism was a diagnosis, and tend to be a bit ableist. While she's still considered as a person crucial in changing the perspective on what autistic people can achieve, she tend to believe that autistic people need to act as neurotypical people in order to achieve their dreams.

  • In a different key: the story of autism by John Donvan and Caren Zucker. This book was not well received by the autistic community, and several advocates have written critiques about it.

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Some helpful articles:

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