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Neurodiversity Theory and Its Discontents: Autism, Schizophrenia, and the Social Model of Disability

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... Neurodiversity is a conceptual paradigm and disability movement that invites us to conceive autistic neurology and other neurodevelopmental differences as contributing to overall human neurological and cultural diversity [19]. It is often seen as a response to the medical model of autism, originating as an online grassroots movement in the late 1990s and the term initially coined by sociologist Judy Singer [20,21]. The movement celebrates autism as an integral part of individual identity and as something that should not be altered [22]. ...
... The movement celebrates autism as an integral part of individual identity and as something that should not be altered [22]. Its adherents oppose the pathologization of autism and incorporate the social model of disability into the conceptual framework [20,22,23]. The underlying idea of the social model is that disability arises from social, attitudinal, and environmental barriers rather than from the impairments themselves [16]. ...
... According to Walker, there are three axioms to the neurodiversity paradigm, which are paraphrased as follows [20,24]: (1) Autism is a form of human diversity and is worthy of value. (2) A "normal" or "healthy" mind or brain are social and cultural constructions and are in a similar category as a "normal" or "right" ethnicity, gender, or culture. ...
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Background Research with cerebral organoids is beginning to make significant progress in understanding the etiology of autism spectrum disorder (ASD). Brain organoid models can be grown from the cells of donors with ASD. Researchers can explore the genetic, developmental, and other factors that may give rise to the varieties of autism. Researchers could study all of these factors together with brain organoids grown from cells originating from ASD individuals. This makes brain organoids unique from other forms of ASD research. They are like a multi-tool, one with significant versatility for the scope of ASD research and clinical applications. There is hope that brain organoids could one day be used for precision medicine, like developing tailored ASD drug treatments. Main body Brain organoid researchers often incorporate the medical model of disability when researching the origins of ASD, especially when the research has the specific aim of potentially finding tailored clinical treatments for ASD individuals. The neurodiversity movement—a developmental disability movement and paradigm that understands autism as a form of natural human diversity—will potentially disagree with approaches or aims of cerebral organoid research on ASD. Neurodiversity advocates incorporate a social model of disability into their movement, which focuses more on the social, attitudinal, and environmental barriers rather than biophysical or psychological deficits. Therefore, a potential conflict may arise between these perspectives on how to proceed with cerebral organoid research regarding neurodevelopmental conditions, especially ASD. Conclusions Here, we present these perspectives and give at least three initial recommendations to achieve a more holistic and inclusive approach to cerebral organoid research on ASD. These three initial starting points can build bridges between researchers and the neurodiversity movement. First, neurodiverse individuals should be included as co-creators in both the scientific process and research communication. Second, clinicians and neurodiverse communities should have open and respectful communication. Finally, we suggest a continual reconceptualization of illness, impairment, disability, behavior, and person.
... On this view, autism should not be counted as a mental disorder but, rather, as a natural manifestation of neurological diversity (Singer, 1999). Neurodiversity proponents have argued in great detailconvincingly, in my viewthat at least a significant proportion of distress and disablement associated with autism can be accounted for in terms of marginalization and oppression (Chapman, 2019a;Robertson, 2010). Given this, neurodiversity advocates take the classification to indicate a marginalized minority rather than a medical condition, making it more in line with political identities such as 'trans' or 'gay' than something that we should attempt to treat or cure. ...
... This would be much as, say, "black" or "gay" may be valid political classifications despite lacking validity as biological classifications. Curiously, although there is now a wealth of literature written by autistic researchers analyzing autistic disablement in light of marginalization and oppression (e.g., Milton, 2016a;Robertson, 2010;Booth, 2016;Chapman, 2019a), there hasn't been any systematic attempt to draw on analyses of the social metaphysics of race, gender, or sexuality in order to rigorously analyze the nature of autism in line with the neurodiversity perspective. 1 I aim to fill this lacuna by drawing on feminist analyses of the metaphysics of gender to propose a new way of understanding the nature and reality of autism. 2 My core positive aim is to show that autism is a politically useful classification indicating something real, in line with the neurodiversity view, and to provide a framework for understanding this reality. ...
... I propose that autism is a serial collective and that this notion can capture the reality of autism without encountering the various issues noted above. To understand the utility of this proposal, it's worth first considering the social model of disability as applied to autism (Chapman, 2019a). Although I won't offer a detailed defense of the social model as applied to autism here, it will be helpful to give a few examples of wider factors, both physical and normative, that seem to have systematically contributed to autistic disablement. ...
Preprint
Typically, although it is notoriously hard to define, autism has been represented as a biologically-based mental disorder that can be usefully investigated by biomedical science. In recent years, however, problematic findings regarding the biological underpinnings of autism; historical research examining the shifting nature of the categorisation; and a lack of biomedical utility, has led some to suggest abandoning the concept of autism. My interest here is the possibility that autism may remain a meaningful and helpful classification even if it lacks scientific validity and biomedical utility. After arguing that accounts of autism as a psychiatric classification are unsustainable, I draw on feminist philosopher Iris Marion-Young’s distinction between groups and serial collectives in order to account for the reality of autism as a social category, best framed in terms of a social model of disability. When taken as a serial collective, I argue we can coherently understand autistic people as forming a marginalised minority, disabled in relation to the specific material and social contexts. Autism is thus real and valuable for political and ethical, rather than biomedical, reasons.
... The debate between neurodiversity proponents and medical model proponents is often carried out more at the ideological level. For instance, neurodiversity proponents find representations of cognitive disability as something inherently tragic to be dehumanising, whereas critics of the neurodiversity perspective think that the latter overlooks the harsh realities of living with cognitive disability (Chapman 2019a). However, underlying such disagreements are (often tacit) commitments to different models of disability in the more restricted philosophical sense. ...
... Not much has been made of the fact that his theory rests on this presupposition in the academic literature (although see Amundson 2000), but it is worth noting that Varga's point precisely fits with the core claim made by neurodiversity proponents, which is to deny the assumption that there is such a level of uniformity in the neuro-cognitive functioning of our species. On the neurodiversity view, this would be like assuming dogs have enough uniformity across the species to assess the functions of different breeds in relation to the statistical norm, leading us to, say, consider all pugs physically dysfunctional and all Labradors cognitively dysfunctional-that is, it would be somewhat absurd and based on a category error (Chapman 2019a). ...
... Milton 2016; Roberton 2010). I have argued for this position in detail elsewhere, with a particular focus on schizophrenia and what psychiatrists called "severe" autism (Chapman 2019a). To the extent such accounts are convincing, the social model thus builds on the criticisms of the concept of dysfunction that we have already covered, in challenging the notion that those ways of functioning that fall below the species-norm are harmful. ...
Preprint
Cognitive disability has traditionally been framed on a medical model, which takes individual impairment to be the primary cause of distress and disablement among the cognitively disabled. This is often accompanied by the notion that cognitive disability is inherently at odds with living a good life. In recent decades neurodiversity paradigm proponents have contested this, typically albeit not necessarily by drawing on various forms of the social model of disability to show that distress and disablement are the product of wider social factors more than individual impairments. Here I argue that the concept of impairment, which is central to each model, both runs into conceptual problems and contradicts the very concept of neurodiversity. Moreover, neither manages to strike a nuanced balance between admitting that cognitive disability can be accompanied by varying degrees of individual hardship, and recognising that it is compatible with living a good life. I argue the recently proposed value neutral model, which distinguishes between local and global wellbeing, can avoid these problems, and may prove more useful for conceptualising cognitive disability and its relationship with wellbeing.
... While this is one dominant view, it has been challenged by proponents of the neurodiversity conception of autism. This recasts autism as a minority neurocognitive type that is primarily disabled and devalued under current social conditions, instead of it being a medical pathology (Chapman, 2019a;Singer, 1999). In de-pathologising, and instead politicizing, autistic disablement, and distress, this view opens the possibility that rather than autism being inherently at odds with living a good life, autistic wellbeing is impeded by contingent factors. ...
... In light of this we suggest that a shift toward what's been called the neurodiversity paradigm (Walker, 2012) will place the possibility of autistic-and perhaps other forms of-flourishing on the map, making them visible and moreover salient through acknowledging that we are a neurologically diverse species. Beyond challenging dominant conceptions of normal functioning as it is standardly taken to (Chapman, 2019a;Singer, 1999;Walker, 2012), our argument will serve the further purpose of showing that neurodiversity also challenges us to radically broaden our conceptions of the good human life. ...
... The medical deficit framing has been challenged in recent decades by neurodiversity activists. Neurodiversity proponents (Chapman, 2019a;Walker, 2012) have suggested the neurodiversity paradigm as an alternative to the dominant medicalized framing of psychiatric and cognitive disabilities. On the medicalized framing, there's a relatively restricted species-standard norm in terms of mental functioning (Boorse, 1975): if an individual falls outside of this norm and is also distressed or disabled to a "clinically significant" (APA, 2013) level, they will be taken to have a mental disorder. ...
... On this view, autism should not be counted as a mental disorder but, rather, as a natural manifestation of neurological diversity (Singer, 1999). Neurodiversity proponents have argued in great detailconvincingly, in my viewthat at least a significant proportion of distress and disablement associated with autism can be accounted for in terms of marginalization and oppression (Chapman, 2019a;Robertson, 2010). Given this, neurodiversity advocates take the classification to indicate a marginalized minority rather than a medical condition, making it more in line with political identities such as 'trans' or 'gay' than something that we should attempt to treat or cure. ...
... This would be much as, say, "black" or "gay" may be valid political classifications despite lacking validity as biological classifications. Curiously, although there is now a wealth of literature written by autistic researchers analyzing autistic disablement in light of marginalization and oppression (e.g., Milton, 2016a;Robertson, 2010;Booth, 2016;Chapman, 2019a), there hasn't been any systematic attempt to draw on analyses of the social metaphysics of race, gender, or sexuality in order to rigorously analyze the nature of autism in line with the neurodiversity perspective. 1 I aim to fill this lacuna by drawing on feminist analyses of the metaphysics of gender to propose a new way of understanding the nature and reality of autism. 2 My core positive aim is to show that autism is a politically useful classification indicating something real, in line with the neurodiversity view, and to provide a framework for understanding this reality. ...
... I propose that autism is a serial collective and that this notion can capture the reality of autism without encountering the various issues noted above. To understand the utility of this proposal, it's worth first considering the social model of disability as applied to autism (Chapman, 2019a). Although I won't offer a detailed defense of the social model as applied to autism here, it will be helpful to give a few examples of wider factors, both physical and normative, that seem to have systematically contributed to autistic disablement. ...
Article
Typically, although it’s notoriously hard to define, autism has been represented as a biologically-based mental disorder that can be usefully investigated by biomedical science. In recent years, however, problematic findings regarding the biological underpinnings of autism; historical research examining the shifting nature of the categorization; and a lack of biomedical utility have led some to suggest abandoning the concept of autism. My interest here is the possibility that autism may remain a meaningful and helpful classification even if it lacks scientific validity and biomedical utility. After arguing that accounts of autism as a psychiatric classification are unsustainable, I draw on feminist philosopher Iris Marion-Young’s distinction between groups and serial collectives in order to account for the reality of autism as a social category, best framed in terms of a social model of disability. When it is taken as a serial collective, I argue, we can coherently understand autistic people as forming a marginalized minority, disabled in relation to the specific material and social contexts, yet in a way that avoids neuro-centric commitments. Autism is thus real and valuable for political and ethical rather than biomedical reasons.
... Nonetheless, in recent decades the pathologization of many psychiatric, cognitive, and learning disabilities has been increasingly challenged by the rise of the neurodiversity movement. The neurodiversity movement is primarily a socialjustice movement aiming to end what proponents see as the default pathologization of neurodivergence (i.e., divergence from normal mental functioning) and to instead promote the acceptance and accommodation of human neurodiversity (Armstrong, 2015;Blume, 1998;Chapman, 2019b;Singer, 1999). Instead of being conceived as medical pathologies, a range of disabilitiesincluding autism, attention-deficit hyperactivity disorder, dyspraxia, and bipolar disorder-have been reconceptualized as manifestations of humanity's "natural variation" (Jaarsma & Welin, 2012) or "dispositional diversity" (Milton, 2017). ...
... Instead of being conceived as medical pathologies, a range of disabilitiesincluding autism, attention-deficit hyperactivity disorder, dyspraxia, and bipolar disorder-have been reconceptualized as manifestations of humanity's "natural variation" (Jaarsma & Welin, 2012) or "dispositional diversity" (Milton, 2017). From this perspective, these cognitive styles are integral to different kinds of selfhood (Chapman, 2019b;Walker, 2014). Neurodiversity proponents (Pellicano & Stears, 2011) thus prefer identity-first language (e.g., "autistic person") rather than personfirst language (e.g., "individual with autism") to emphasize how one's neurocognitive style is integral to one's selfhood-a terminological preference I shall adhere to throughout the current article. ...
... Although views among neurodiversity proponents vary, perhaps the core theoretical underpinning of the movement comes from using social-relational models of disability. These models take at least a significant amount of neurodivergent disablement and distress to be primarily caused by social barriers and ableist norms more centrally than by the cognitive traits associated with a given disability (Chapman, 2019b). Ari Ne'eman, an autistic self-advocate who has been highly influential in the movement, stated that "none of this is meant to deny the very real fact" of disability (Ne'eman, 2010, para. ...
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In psychiatry mental dysfunction is typically framed in relation to models that seek to be continuous with evolutionary biology, and which measure individual fitness in comparison to a broader functional norm. Against this, proponents of the neurodiversity movement challenge the pathologisation of minority cognitive styles, and argue that we should reframe neuro-cognitive diversity as a normal and healthy manifestation of biodiversity. So far, neurodiversity proponents have drawn on the social model of disability to challenge the medical model of disability, but they have not developed an alternative functional analysis to replace conceptions of neurological dysfunction or impairment. Here I clarify and defend the neurodiversity perspective by drawing on ecological functional models, which takes contributions to collectives, and group functioning, into account alongside individual functionality. Applying this to human mental functioning though the example of autism as well as recent developments in the study of cognitive diversity, I argue that what I call the Social Ecological Analysis has greater utility for research and practice than the leading evolutionary functional analyses of mental functioning.
... Nonetheless, in recent decades the pathologization of many psychiatric, cognitive, and learning disabilities has been increasingly challenged by the rise of the neurodiversity movement. The neurodiversity movement is primarily a socialjustice movement aiming to end what proponents see as the default pathologization of neurodivergence (i.e., divergence from normal mental functioning) and to instead promote the acceptance and accommodation of human neurodiversity (Armstrong, 2015;Blume, 1998;Chapman, 2019b;Singer, 1999). Instead of being conceived as medical pathologies, a range of disabilitiesincluding autism, attention-deficit hyperactivity disorder, dyspraxia, and bipolar disorder-have been reconceptualized as manifestations of humanity's "natural variation" (Jaarsma & Welin, 2012) or "dispositional diversity" (Milton, 2017). ...
... Instead of being conceived as medical pathologies, a range of disabilitiesincluding autism, attention-deficit hyperactivity disorder, dyspraxia, and bipolar disorder-have been reconceptualized as manifestations of humanity's "natural variation" (Jaarsma & Welin, 2012) or "dispositional diversity" (Milton, 2017). From this perspective, these cognitive styles are integral to different kinds of selfhood (Chapman, 2019b;Walker, 2014). Neurodiversity proponents (Pellicano & Stears, 2011) thus prefer identity-first language (e.g., "autistic person") rather than personfirst language (e.g., "individual with autism") to emphasize how one's neurocognitive style is integral to one's selfhood-a terminological preference I shall adhere to throughout the current article. ...
... Although views among neurodiversity proponents vary, perhaps the core theoretical underpinning of the movement comes from using social-relational models of disability. These models take at least a significant amount of neurodivergent disablement and distress to be primarily caused by social barriers and ableist norms more centrally than by the cognitive traits associated with a given disability (Chapman, 2019b). Ari Ne'eman, an autistic self-advocate who has been highly influential in the movement, stated that "none of this is meant to deny the very real fact" of disability (Ne'eman, 2010, para. ...
Article
Full-text available
In psychiatry, mental dysfunction is typically framed in relation to models that seek to be continuous with physiology or evolutionary biology and that compare individual fitness to a broader functional norm. Proponents of the neurodiversity movement, however, challenge the pathologization of minority cognitive styles and argue that we should reframe neurocognitive diversity as a normal and healthy manifestation of biodiversity. Neurodiversity proponents have thus far drawn on social-relational models of disability to challenge the medical model of disability, but they have not developed an alternative functional analysis to replace conceptions of neurological dysfunction or impairment. Here I clarify and defend the neurodiversity perspective by drawing on ecological functional models that take relational contributions to collectives, and group functioning, into account alongside individual functionality. Using the example of autism as well as recent developments in the study of cognitive diversity, I apply these models to human mental functioning and argue that what I call the ecological model has greater utility for research and practice than the leading psychiatric functional analyses of mental functioning.
... For example, take the identity prejudice that people with mental 4 Proponents of the neurodiversity movement champion terms such as "those with neurocognitive differences" and "neurominorities," as opposed to "those with mental disorders"' or "mental illness," as they consider the latter to reinforce pathologizing models. In addition, the term "neuro-typical" is opted for in place of "normal" or "sane" (Chapman 2019). 5 Similar arguments have been made in the philosophy of disability and in disability studies. ...
... We are not, of course, suggesting that all attempts at depathologization are wrongful. Indeed, powerful voices within the neurodiversity movement and Mad Pride advocate depathologization as a social justice goal (Chapman 2019;Graby 2015;Rashed 2019;Walker 2013). The decisive factors are the presence or absence of trivializing and the identity of the one doing the depathologizing. ...
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This article develops the concept of wrongful depathologization, in which a psychiatric disorder is simultaneously stigmatized (because of sanist attitudes towards mental illness) and trivialized (as it is not considered a “proper” illness). We use OCD as a case study to argue that cumulatively these two effects generate a profound epistemic injustice to OCD sufferers, and possibly to those with other mental disorders. We show that even seemingly positive stereotypes attached to mental disorders give rise to both testimonial injustice and wilful hermeneutical ignorance. We thus expose an insidious form of epistemic harm that has been overlooked in the literature.
... Specifically, Neurodiversity advocates pose that autism is a natural form of being without needing to be cured. Additionally, they encourage self-advocacy and personal agency in all aspects of autistic life, including education, diagnosis, and treatment (Chapman, 2019;Fenton & Krahn, 2007;Walker, 2020). ...
... In summary, the lack of evidence-based instructional practices combined with the absence of autistic voices constitutes a need for reform in music education research for people with ASD. First, there exists a need to shift the cultural perspective from the pathology paradigm to the neurodiversity paradigm (Chapman, 2019). The identities, objectives, and skills of persons with ASD will remain hidden as long as we focus on what they cannot do rather than what they can do. ...
... Conversely, the neurodiversity paradigm (Singer, 1999) describes autism in terms of a neurodivergence, as an alternative way of thinking or a variant of the human neurology. The assumption is that there is a natural diversity in human neurological development, and autism is one of the possible developmental paths (Baron-Cohen, 2017;Bluhm & Chapman, 2019;Chapman, 2020;den Houting, 2018;Kapp et al., 2013). Thus, what individuals with ASC need, is finding the environmental niche right for them by minimizing barriers, maximizing potential, and optimizing person-environmental fit (Lai et al., 2020). ...
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Background Given the high prevalence of mental health comorbidities in autism spectrum conditions, the psychological well-being is one of the most pertinent issues in autism research, but it is encumbered with difficulties regarding its assessment in the ASC population and understanding the causes behind the increased risk of problems. This study aimed to explore the subjective assessment of psychological well-being in adolescents with ASC – whether it differs from the reports of their caregivers and which factors may be important in shaping it. Specifically, we hypothesized that different ways of perceiving autism – as a disorder or as a neurodivergence – may contribute to the way autistic adolescents feel about their own well-being. Method We tested 27 dyads of adolescents with ASC and normal intellectual ability; and their mothers. We assessed the child’s depressive symptoms and attitudes towards autism; we controlled the child’s IQ and autism severity (by ADOS-2). Results We found large discrepancies between adolescent’s and mother’s reports of adolescent’s depressive symptoms and their predictors. Higher maternal distress and lower autism severity predicted an increased level of depressive symptoms in the child, only in the mother’s report. Attitude towards autism was not a significant factor in predicting the child’s depressive symptoms, but it leaned toward significance in the child’s self-assessment. Conclusions Given the differences between adolescents and maternal perspectives, the subjective experiences of adolescents with ASC should be taken into account to a greater extent. It is worth exploring whether adolescents with ASC might benefit from perceiving autism as a neurodivergence.
... They point to evidence in the research literature suggesting that without early and ongoing intervention, there are significant developmental consequences that can ultimately limit opportunities, the likelihood of desirable personal outcomes, and associated quality of life for individuals on the spectrum (see Fuller &Kaiser, 2019, andLanda, 2018 for a recent review and meta-analysis). Proponents of the neurodiversity movement, on the other hand, maintain that autism (and other forms of neurocognitive differences like ADHD and dyslexia) are simply dimensions of the rich diversity of the human experience, characterized by a different means of experiencing, processing, understanding, and interacting with the world (Chapman, 2019). While there is important variability in the perspectives of neurodiversity advocates-as the neurodiversity movement is decentralized and continuously evolving through dialogue (Chapman, 2020;Singer, 2020)-there is a general consensus that the unique attributes associated with autism and other neurocognitive disabilities should not be distilled down to a set of symptoms and vulnerabilities in need of correction. ...
Article
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Proponents of autism intervention and those of the neurodiversity movement often appear at odds, the former advocating for intensive treatments and the latter arguing that autism must be accepted as a form of diversity. The history of behavioral intervention has understandably outraged many in the Autistic community, though many still value supports focused on quality of life. This commentary argues that Naturalistic Developmental Behavioral Interventions (NDBIs) hold promise for bridging the gap between early intervention and the neurodiversity movement. However, we recognize NDBIs have much room to grow and suggest multiple strategies for improvement. We believe these updates are not only feasible for clinicians and researchers to implement but will ultimately lead to improved quality of life for Autistic individuals. This commentary was the result of a collaboration and synthesis of ideas between Autistic and non-Autistic co-authors spanning different roles, affiliations, and perspectives.
... However, western culture is still largely dominated by the medical model of disability (Arehart, 2008) and, as a result, proponents of the neurodiversity movement have argued that neurological differences are all too often treated as a disorder rather than as a naturally occurring variation (Armstrong, 2010;Singer, 2017 Despite this, the neurodiversity movement is not without its detractors. Opponents have criticized the movement for its focus on individuals who are "high functioning," suggesting that viewing neurological conditions as a difference rather than a disorder/disability overlooks the real suffering that some individuals with neurological conditions and their families experience (Chapman, 2019). Such concerns are particularly prevalent in the autism community, in which there is a divide between those who are "pro-cure" and those who are "pro-autistic" (i.e., those who are for versus against medicalizing autism; Ortega, 2009). ...
... Moreover, there is a higher level of skepticism regarding both autism carers and self-representing autistics (rather than just the latter) when it comes to representing nonrepresenting autistics in the cure/acceptance debate. 2 In offering this alternative analysis, we do not mean to dismiss the many positive more general insights about partial representation from McCoy and colleagues, or indeed the voices and input of autism carers. The cure/acceptance issue is far from settled, (Chapman 2019a) and we acknowledge that our analysis may raise more questions than it answers. In the meantime, we urge that future contributions follow us in putting the voices of nonverbal self-representatives at center stage. ...
... While biomedical models of autism regard the obvious variation of mental characteristics as symptoms, activists and socially or politically oriented scholars refute the label of disorder and highlight the need to accommodate the social environment of the affected persons (e.g. Chapman, 2019). Second, disagreements remain as to how and where the boundaries between sanity and illness/disorder should be drawn. ...
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Background Mental health and mental illness have been contested concepts for decades, with a wide variety of models being proposed. To date, there has been no exhaustive review that provides an overview of existing models. Aim To conduct a quasi-systematic review of theoretical models of mental health problems. Methods We searched academic databases, reference lists, and an electronic bookshop for literature that proposed, endorsed, reviewed, or critiqued such models. Papers, book chapters, and books were included with material by researchers, clinicians, non-medical professions, and service users writing between 2000 to June 2020 being considered. The study was registered with the Open Science Framework (No. osf.io/r3tjx). Results Based on 110 publications, we identified 34 different models which were grouped into five broader categories. Many models bridged two or more categories. Biological and psychological approaches had the largest number of models while social, consumer and cultural models were less diversified. Due to the non-empirical nature of the publications, several limitations in terms of search and quality appraisal apply. Conclusions We conclude that mental health care needs to acknowledge the diversity of theoretical models on mental health problems.
... There have only been a limited number of investigations into the ethics of eradicating autism to date (e.g. Anderson, 2013;Barnes & McCabe, 2011;Chapman, 2019;Pellicano & Stears, 2011;Walsh, 2010). These authors all take an anti-discriminatory, anti-eradication stance except for Barnes and McCabe,3 whose work is an investigation of the issue of choice (whether a cure should be made available for those who want one), and Barnbaum who writes that there is 'something intrinsically limiting in an autistic life' and appears to support the eradication of autism (Barnbaum, 2008, p. 154). ...
... There have only been a limited number of investigations into the ethics of eradicating autism to date (e.g. Anderson, 2013;Barnes & McCabe, 2011;Chapman, 2019;Pellicano & Stears, 2011;Walsh, 2010). These authors all take an anti-discriminatory, anti-eradication stance except for Barnes and McCabe,3 whose work is an investigation of the issue of choice (whether a cure should be made available for those who want one), and Barnbaum who writes that there is 'something intrinsically limiting in an autistic life' and appears to support the eradication of autism (Barnbaum, 2008, p. 154). ...
... Whilst we applaud the underscoring of the risks attached to person-first language, we feel a significant detail has been misunderstood. A neurodiversity approach proposes not a 'cultural shift' but a paradigm shift (Chapman, 2019, Walker, 2012: away from one that pathologises neurological difference. Person-first language belongs to the pathology paradigm and, as such, 'implicitly accepts and reinforces the assumption that Autism is intrinsically a problem, a Something-Wrong-With-You' (Walker, 2012: np). ...
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In response to Vivanti’s ‘Ask The Editor…’ paper (2020), we argue that the use of language in autism research has material consequences for autistic people including stigmatisation, dehumanisation, and violence. Further, that the debate in the use of person-first language versus identity-first language should centre first and foremost on the needs, autonomy, and rights of autistic people, so in to preserve their rights to self-determination. Lastly, we provide directions for future research.
... For instance, the 5 implementation of ramps and disabled parking spaces stemmed from shifting the focus from the individual to the environment. However, neurodiversity proponents have applied the social model to autism, highlighting how attitudes, practices, and structures contribute to autistic disablement (Chapman, 2019a). For instance, when it comes to physical structures, it may be that workspaces are designed in such a way that they are disabling to autistic individuals with heightened sensory sensitivity (Booth, 2016). ...
... Whilst we recognise that Vivanti's (2020) original editorial was not designed to be a comprehensive examination of the literature, we would like to note one serious limitation in its lack of engagement with the literature produced by autistic scholars addressing these issues (such as Arnold 2017;Chapman 2019Chapman , 2020Chown 2019;Graby 2015;Milton in Milton and Timimi 2016;Woods and Waldock 2020;Sinclair 2013;Singer 1999Singer , 2017Walker 2012). Our response, in part, attempts to add to that body of (already substantial) work. ...
Article
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In response to Vivanti’s ‘Ask The Editor…’ paper [ Journal of Autism and Developmental Disorders, 50 (2), 691–693], we argue that the use of language in autism research has material consequences for autistic people including stigmatisation, dehumanisation, and violence. Further, that the debate in the use of person-first language versus identity-first language should centre first and foremost on the needs, autonomy, and rights of autistic people, so in to preserve their rights to self-determination. Lastly, we provide directions for future research.
... However, western culture is still largely dominated by the medical model of disability (Arehart, 2008) and, as a result, proponents of the neurodiversity movement have argued that neurological differences are all too often treated as a disorder rather than as a naturally occurring variation (Armstrong, 2010;Singer, 2017 Despite this, the neurodiversity movement is not without its detractors. Opponents have criticized the movement for its focus on individuals who are "high functioning," suggesting that viewing neurological conditions as a difference rather than a disorder/disability overlooks the real suffering that some individuals with neurological conditions and their families experience (Chapman, 2019). Such concerns are particularly prevalent in the autism community, in which there is a divide between those who are "pro-cure" and those who are "pro-autistic" (i.e., those who are for versus against medicalizing autism; Ortega, 2009). ...
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Estimates suggest as much as 17% of the U.S. workforce may be neuroatypical (CIPD, 2018; Sargent, 2019), a term used to describe individuals whose neurological functioning is at the tail ends of the distribution of naturally occurring variation. Although the neuroatypical population has a history of under- and un- employment (Roux et al., 2015; Taylor & Seltzer, 2011; Austin & Pisano, 2017), their inclusion in the modern workplace (i.e., promotion of neurodiversity within organizations) is gaining recognition by scholars and organizations as an important dimension of organizational diversity (Brinzea, 2019). Despite this burgeoning interest in examining neuroatypicality in the context of organizational diversity, surprisingly little research has been conducted that bridges these two research areas. The literature that does exist is scattered across several different academic disciplines, largely outside of industrial-organizational psychology, and rarely examines the employment of neuroatypical workers explicitly from a diversity perspective. In this article we argue that as the nature of work evolves and jobs continue to become more specialized, neurodiversity will become an increasingly relevant dimension of organizational diversity, and is likely to play a key role both in terms of individual employees’ well-being and performance outcomes, as well as organizational success.
... Here I follow a recent tradition of taking the harms faced by the autistic population to be primarily caused by contingent social factors, such as stigma and disabling barriers (Robertson 2010). I have recently argued elsewhere that there are a number of reasons to favour this alternative framing (Chapman 2019). The case made in the present article will surely not settle the dispute; but it can be taken as adding to these reasons. ...
Article
Autism is often taken to be a specific kind of mind. The dominant neuro‐cognitivist approach explains this via static processing traits framed in terms of hyper‐systemising and hypo‐empathising. By contrast, Wittgenstein‐inspired commentators argue that the coherence of autism arises relationally, from intersubjective disruption that hinders access to a shared world of linguistic meaning. This paper argues that both camps are unduly reductionistic and conflict with emerging evidence, due in part to unjustifiably assuming a deficit‐based framing of autism. It then develops a new Wittgensteinian account—autism as a different form of life—which avoids these issues. Rather than autistic systemising being the basis of autistic cognition, it is taken to be a reaction to pre‐epistemic and semantic anxieties that come with developing as a minority within a different form of life. This re‐framing can provide a coherent account of the autistic mind, and has significant conceptual, practical, and ethical implications.
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The Rosetta Wheel framework is a framework for design teams to guide the development of games for health behaviour change. The framework is grounded in evidence-based research of the psychology of behaviour change. It is further informed by game analysis and expert design techniques in order to understand how psychological processes map with game design patterns. The Rosetta Wheel has 10 Change Keys, assisting design teams to create game mechanics which foster the psychological processes of change, alongside 19 Key Considerations which support the overall development process. The presentation will cover the research process that led to the development of the framework, along with an overview of the Rosetta Wheel Framework, and will finish off by introducing some implementation ideas of how the framework can be applied in practice.
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This paper offers an account of institutional testimonial justice and describes one way that it breaks down, which we call institutional opacity. An institution is opaque when it becomes resistant to epistemic evaluation and understanding by its agents and users. When one cannot understand the inner workings of an institution, it becomes difficult to know how to comport oneself testimonially. We offer an account of an institutional ethos to explain what it means for an institution to be testimonially just; we then describe how an ethos of institutional testimonial justice can break down when the institution becomes opaque. An opaque institution is especially problematic for individuals and groups already rendered epistemically vulnerable during their interactions with that institution, which we call epistemically vulnerabilised individuals. We articulate the features of an encounter between an epistemically vulnerabilised individual and an opaque institution. We end by tracing ameliorative strategies that could help repair a deteriorated institutional ethos of testimonial justice.
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https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780190622879.001.0001/oxfordhb-9780190622879-e-29
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Attitude of mothers towards their children’s autism may play a role in mothers’ psychological well-being. We investigated the predictive value of how mothers understand autism (as a neurodivergence or a developmental disorder) on their psychological distress. A group of 371 mothers of children on the autism spectrum participated in this study. We found that understanding autism as a neurodivergence was related to lower psychological distress in mothers, even after controlling for the level of autism symptoms. However, when controlling for caregiver burden, their attitude towards autism was no longer significant in explaining their psychological distress. These findings suggest that the way mothers understand autism may be important for their psychological adjustment. However, it also suggests that mothers of children on the autism spectrum may adopt different attitudes towards autism, depending on their child’s level of autism symptoms and the caregiver burden. Lay abstract Mothers of children on the autism spectrum experience high levels of emotional distress. Mothers cope with stress by having their own thoughts and opinions about their children. In this study, we tested whether the way mothers perceive autism may contribute to the level of distress they feel. Some mothers see autism as a developmental disorder that needs to be cured, but some see autism as a type of mind that needs to be accepted. Our findings showed that mothers who see autism more as a type of mind are generally less stressed. But we also showed that it matters how severe are the child’s symptoms, and how heavy was the perceived burden of caring for the child. These results imply that it is worth working on attitudes towards autism to help mothers cope better. But at the same time, we argue that mothers should not be judged for their perceptions of autism, as there is a huge spectrum of a child’s characteristics and family’s life circumstances.
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A central diagnostic and anecdotal feature of autism is difficulty with social communication. Traditionally, these difficulties are regarded as autistic impairments, related to proposed cognitive and social deficits. From this perspective the onus of failures in mutual understanding is placed within the mind/brains of the autistic individuals involved. However, recent research in the social sciences and critical autism studies is beginning to demonstrate that non-autistic people have challenges in understanding autistic people too, and to reframe the communicative difficulties as a two-way double empathy problem. A survey of the literature reveals the need for further empirical investigation of the proposed double empathy problem. This thesis builds on contemporary studies examining intersubjectivity between autistic and non-autistic people, and moves this research into the domain of cognitive linguistics. It explores, theoretically, whether relevance theory (a cognitive account of utterance interpretation) might help make sense of what is happening pragmatically during these breakdowns in mutual understanding. It also examines whether a radical reframing of these breakdowns as akin to intercultural problems might provide any valuable insights. The thesis begins with an interdisciplinary literature review that outlines the central constructs and themes contained within. To begin, the thesis presents an overview of autism research, covering both traditional biomedical theories and more recent phenomenological perspectives informed by the neurodiversity paradigm. Autistic minds are considered as autistically embodied agents navigating a social world comprised of non-autistically shaped norms. Relevance theory is then introduced within the wider context of cognitive pragmatics, and its application to interactions across dispositional borders (i.e. between autistic and non-autistic individuals) technically explored. The second half of the thesis reports on and discusses the results of a small-scale linguistic ethnographic case study. Eight core autistic participants engaged in three naturalistic conversations around the topic of loneliness with; (1) a familiar, chosen conversation partner; (2) a non-autistic stranger and (3) an autistic stranger. Relevance theory is utilized as a frame for the linguistic analysis of the interactions to investigate where mutual understanding is and is not achieved. There is increasing acknowledgement of the importance of autistic stakeholder involvement in autism research. In order to bring my own autistic insights more centrally into this work, I have taken an autoethnographic approach. This method draws on the lived experience of the researcher as a member of the group being studied, and as such offers an emancipatory mechanism for raising up previously marginalized voices.
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Background: We still know little about whether and how the auditory hallucinations associated with serious psychotic disorder shift across cultural boundaries. Aims: To compare auditory hallucinations across three different cultures, by means of an interview-based study. Method: An anthropologist and several psychiatrists interviewed participants from the USA, India and Ghana, each sample comprising 20 persons who heard voices and met the inclusion criteria of schizophrenia, about their experience of voices. Results: Participants in the U.S.A. were more likely to use diagnostic labels and to report violent commands than those in India and Ghana, who were more likely than the Americans to report rich relationships with their voices and less likely to describe the voices as the sign of a violated mind. Conclusions: These observations suggest that the voice-hearing experiences of people with serious psychotic disorder are shaped by local culture. These differences may have clinical implications.
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Recent data -- and personal experience -- suggest that autism can be an advantage in some spheres, including science, says Laurent Mottron.
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In this essay I offer a novel interpretation of the so-called “negative symptoms” of schizophrenia (symptoms characterized by diminishment of overt behavior or expression, including flat affective expression, restricted speech, and apparent apathy), and I consider these symptoms in relation to key aspects of modern culture and consciousness. Contrary to standard assumptions, many “negative-symptom” experiences in schizophrenia actually involve forms of subjectivity characterized by hyperreflexivity and alienation – namely, by exacerbation of various kinds of self-consciousness, often involving disengagement from the grounding frameworks, assumptions, and bodily dispositions that would normally serve as the taken-for-granted background of practical action and experience. Many of these features show a remarkable resemblance to key aspects of modern culture and society – which itself is marked by a “wholesale reflexivity” (Anthony Giddens) and associated detachment from shared, common-sense reality. After discussing these affinities between modernity and madness, I consider various ways in which modern society might actually contribute to, or at least exacerbate, certain characteristics of schizophrenia, and also how it might be especially problematic for persons with this style of being. The person with schizophrenia seems an anomalous yet also an exemplary figure: a person who fails to adopt the social practices or internalize the cultural frameworks essential to normal existence, yet who, in this very failure, typifies some of the most distinctive features of the modern age.
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Aristotle would hardly be the first person one would think of when looking for an enlightened understanding of disability. The ancient Greek world in general did not have what we today would consider a progressive attitude towards disability, of course, but it is likely that Aristotle’s thought set the standard for conceptualizing disability for more than a millennium to follow. He explicitly endorsed, in the Politics,1 the common Greek practice of leaving “deformed” babies to die of exposure and is reputed to have claimed that those “born deaf become senseless and incapable of reason.”2 Given Aristotle’s view of women and “natural slaves,” it hardly comes as a shock that he held a less than estimable view of persons with disabilities.
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Publishing.
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