Professor Emily Jones So, neurodiversity is something that’s used in different ways. So, the broad concept of neurodiversity is this idea that there’s a distribution of different traits across humans, across the human population, and that what we should be really thinking about is individual differences and the different strengths and the different challenges those can bring, rather than assuming that, you know, certain clusters of differences are deficits or disorders, and others aren’t. So, it’s a really important way of recognising that, actually, you know, when we look across people, we can get individual differences in all sorts of different behaviours or ways of thinking, or the ways that our brain work. There’s also the neurodiversity movement, which is an advocacy movement that is helping, or pushing, the – both the research field and the clinical field to really think in this way, to value individual differences, to move away from these, sort of, deficit-based, disorder-based models. And to really show how taking what we call a “neurodiversity-affirmative approach,” so an approach that, you know, recognises people’s strengths and differences, can really help both with, sort of, clinical practice and with our research models and those sorts of things. So, there are different facets in neurodiversity. So, broadly, the neurodiversity concept is that there are traits, sort of, brain traits and cognitive traits, that vary across the whole population, and they’re not bad, and they’re not good, they’re just different. And so, rather than, sort of, viewing particular groups of people who might share particular traits, like autistic people, for example, rather than viewing them as having a disorder or a deficit, we just see those differences as part of the normal spectrum of variation, that brings both strengths and challenges, like everything does. And there’s also the neurodiversity movement, which is an advocacy moment that’s really pushing us, as Clinicians and Researchers, to think in what we call a “neurodiversity-affirmative way.” So, that’s a way that, again, you know, views human differences as bringing strengths and bringing richness to society, and moving away from thinking about, you know, deficits and disorders and the kinds of things that can come with stigma, that, you know, that challenges people’s life outcomes. So, the neurodiversity movement is that, sort of, more advocacy piece, that’s really important in helping us move in the direction of embracing the neurodiversity concept. [Pause] Yeah, so I think, you know, one – the, sort of, traditional biomedical model views things like autism as a disorder. So, the idea that, you know, you have a typical brain and then something goes wrong, and then you have an autistic brain. And neurodiversity really challenges that by saying, “Well, no, there is no, sort of, good and bad. There’s no, kind of, original brain that was then changed into something else. Rather, what we have is this spectrum of different across the population, and one facet of those difference might be autistic people.” And so, part of that is recognising that, yes, people will have challenges that come from limitations that they might have themselves, but also, a lot of the challenges and the disability we experience actually comes from the environment. And so, if there’s stigma towards autistic people, if autistic people aren’t allowed to interact in the way they found comfortable, if they’re not given environments that they find comfortable, then they will experience disability, but that’s not coming from their, sort of, intrinsic traits. It’s coming from the fact that the world is designed for a, sort of, certain type of person, and not everybody fits into that. So, I think it’s really trying to challenge that notion that disability is, sort of, all within you, and you have to be fixed, and rather, saying, actually, we should be thinking about environments that can enable people to flourish, you know, whatever their neurotype [pause]. Yeah, so I think one thing that’s really important for tackling stigma is the language that we use. And so, the neurodiversity framework’s really helped us think about what words we use for different conditions, you know, what labels we use, because labels are really powerful in shaping how people think about differences in children. So, if, for example, we label autism as a disorder, and we use words around deficits and kids having problems with something, or kids failing at something, then that can create this perception that there’s something wrong with the child, which can, of course, contribute to stigma towards that individual, potentially. There’s also a recognition, I think, within the diversity movement, of understanding what differences in children might be perfectly fine for that child, and actually might be helpful. So, stimming’s one really clear example where, you know, a lot of autistic people find stimming really valuable. So, that might be repetitive motions, or it might be fiddling with something, but for a long time, stimming was seen as a negative that had to be stopped or should be prohibited. And so, you know, stigma builds up around it, right? So, you feel like you can’t stim when other people are around, ‘cause they might think badly of you, and then, in turn, you know, if you find stimming helpful and you’re having to inhibit that, that’s going to be stressful, it’s going to produce anxiety. You’re not able to do what’s going to make you feel better. So, having a neurodiversity-affirmative approach, where people around you understand that, actually, stimming is just your way of dealing with stress or anxiety in a particular situation, making it broadly accepted, reduces the stigma associated with stimming, and then means that people can, kind of, express themselves in the way that they want to. So, I think it really helps us think about, you know, where are there things that might have been construed as a deficit that, actually, are just a difference, that are helpful to people, and, you know, if we allow them to express themselves in their own way, they’re going to flourish [pause]? So, the idea of neurodivergent, or certainly where the concept is talked about the most, I think at the moment, is in autism, is coming from autistic people. And autism, you know, in the clinic, would be defined as differences in social communication, with perhaps differences in the flexibility of interests and in sensory reactivity. I think autistic people would often describe those sensory differences as a, sort of, primary factor. So, maybe finding light levels more impactful than other people would, or smells being much stronger or hearing sounds differently. So, that just whole difference on a sensory experience of the world is something that a lot of autistic people talk about. And actually, that idea of social interaction, and so many interesting ideas recently coming from Damian Milton and others, called the “double empathy problem,” which is the idea that actually what – so-called neurotypical people, so non-autistic people, find it just as hard to read or interpret autistic people as autistic people do neurotypical people. So, this idea that it’s really a, sort of, cultural barrier, rather than a deficit that is experienced by one group. But I think, more broadly, increasingly, the, sort of, neurodivergence, or neurodiversity movement, has been extended to lots of other conditions, too. So, ADHD is another example, where people might have differences in attention style, or concentration, but again, that will also often come with lots of strengths, creativity often, other things like that. And I think it’s really important that we don’t, you know, create new barriers, so we don’t say, “Well, autism and ADHD are neurodiversity, and so, they’re okay, but there are these other conditions that we should still see in the deficit model, ‘cause they’re bad.” So, I think it’s really important that we have the, sort of, you know, the rising tide raise, or boats, that the neurodiversity movement is actually about recognising the value of everybody, regardless of their level of ability or disability, or what particular difference they’re experiencing. And it’s not about saying – you know, pulling autism or ADHD out and separating those off, it’s about, you know, improving outcomes for everybody [pause]. Yeah, so I think that the biggest misconception is that neurodiversity only applies to people who don’t have support needs or medical needs. So, this idea that it’s all about embracing strengths, and, you know, recognising people with extraordinary talents, and it’s about saying then, “Well, people don’t then need any help, so, you know, we can take that away,” and it’s really not about that. It’s about valuing differences, you know, regardless of your – what needs you might have. And so, you know, the neurodiversity, sort of, concept embraces the fact that lots of people do have support needs, and are going to need significant adaptations, or potentially, interventions, or supports, or treatments, for example. So, you may well need treatment for anxiety, or for associated conditions of autism or – you know, all sorts of things, and neurodiversity doesn’t exclude embracing the medical model in those areas. But it’s broadly saying that we shouldn’t be seeing things that are differences in people’s, sort of, psychological traits as wrong or bad, and we should be trying to reduce stigma around mental health conditions and around neurodevelopmental conditions, and, you know, supporting everyone’s right to flourish, rather than be held back. So, I think that’s probably one of the biggest misconceptions and I think, sometimes, it gets almost deliberately misinterpreted as an excuse to, you know, not provide people with the support that they need, from the, sort of, argument that, “Well, you know, if this is just a difference, then we don’t need to provide anything.” But a lot of, actually, the neurodiversity movement is about how do you provide neurodiversity-affirmative care? So, you know, how do we provide good medical care for autistic people that suits their needs? And so, I think that’s probably one of the most important things to tackle [pause]. Yeah, so I think one thing that’s really important in our field, in our research field, is looking at how we interpret our research findings. So, historically, there’s been a tendency to compare, for example, autistic people and neurotypical people, and whenever you see a difference between those groups, to interpret that as a deficit in the autistic group. So, regardless of what you’re looking at, you know, reaction time or accuracy, or motor differences, there was a tendency in the literature for a long time to interpret that as a deficit, and of course, it’s not. All we’re seeing is a difference. And so, challenging that thinking in the first place, to shift towards accurately reflecting what the data’s showing, which is just that you’ve got a group difference, is important. And then, really considering the function of that difference. So, are we seeing something that’s adaptive for the person? So, you know, stimming, for example, might be something that’s very adaptative for an autistic person. So, yes, they might be doing more of it than somebody else, but it’s helping with stress and anxiety, and therefore, it’s contributing to positive outcomes for them. Or where are we seeing things that might be maladaptive for the person? Which means something that they’re maybe doing to try to cope with an environment, that nonetheless, is going to have negative consequences for them. And therefore, what we might want to do is figure out what we can change in the environment, so they don’t have to react in that way. So, for example, masking is something that a lot of autistic women talk about, and that’s trying to hide your autistic traits so that you can fit in better. But the consequence of that, or at least that’s described by a lot of autistic people is that it increases stress, right, and anxiety and burnout, and feeling like you’re not being your true self. And so, if we can reduce stigma, and do the kinds of things that allow people to unmask, that might, in turn, then have positive consequences for them. So, I think it’s about thinking about, yeah, looking at differences and interpreting them correctly as differences, and then, thinking about what function they have for the person and how they react with the environment [pause]. So, I think there’s a number of different things. I mean, firstly, recognising what differences in children are actually helpful for them. So, you know, we talked about stimming, and that’s something that a lot of autistic children find beneficial. And so, you know, provided it’s not something that’s, sort of, self-injury, or, you know, that’s clearly going to have a negative impact for them, allowing children to do that is probably going to support their development. And then, there’s also things around recognising what environments might be enabling or challenging for children. And so, a lot of autistic children will have sensory differences, so things like flickering lights can be an issue, you know, lots of sound, changing sounds in schools, that’s often a real challenge. So, for example, allowing things like noise-cancelling headphones, that allow children to hear the Teacher, but that block out some of the external noise can be really helpful. You know, thinking about textures, so, you know, if a child’s showing what you might call challenging behaviour, often, what’s happening is they’re trying to communicate to you that they’re overwhelmed by something. And so, if you can work with their family or with them to work out what it is that’s overwhelming them, then, again, you know, you can change the environment around them to try to support their ability to, kind of, engage and interact with other children. And then, I think it’s also important to think not just about, you know, what can you do to help that individual child, but then what can you do for the children around that child to reduce stigma, and to help other children in the class, you know, recognise and champion neurodiversity? And often, children, you know, are really open and don’t have the same kinds of preconceptions as maybe adults do. And so, they’re often very receptive to this kind of thing, but they do, you know – they can react differently to children who are different, and so, working with whole classroom, kind of, approaches, to help children support the inclusion of kids who might be neurodivergent is also really important [pause]. So, I think one thing that’s been really exciting in the autism field is the focus on sensory differences. So, autistic people have talked about that for a long time, that, you know, often, the sensory – the differences in the way of experiencing the sensory world is the primary thing that they experience. And when we’ve looked back at our infant data, now, actually, we do see that differences in sensory processing are some of the earliest things that we see emerge in development. And so, that, I think, illustrates how, you know, listening to people, having a more experiential perspective on what autism is, or how people experience things differently, can help us then go and ask new questions in our research data and, actually, identify things that do look like robust early differences. So, actually, what we find is that some of the social differences do seem to at least be detectable later in development than some of these very early sensory changes. And so, I think that, you know, shift in focus, from the, sort of, older tradition of research that primarily focused on social functioning and social interaction, towards focusing on sensory differences and the environment, has been something that’s very much been influenced by autistic people, and the, sort of, neurodiversity movement [pause]. I think there’s a big debate within the autism field at the moment about this idea that, does neurodiversity exclude people with more significant support needs? And so, although the neurodiversity movement is really designed to, kind of – or trying to support optimal outcomes for everybody, and to champion the needs of everybody regardless of your disability level, I think there can be this misreading of it in some areas that almost, kind of, use it as an excuse to say, “Well, we don’t – you know, therefore, people don’t have support needs and we cannot worry about that.” And so, there have been Researchers or Clinicians arguing that we need to make sure that we are using language that allows us to recognise people who have high support needs, because, you know, if we can’t talk about certain ways of thinking about people who might have more significant issues, then maybe that means we can’t advocate for their needs, and maybe that means we can’t attain as many resources. Whereas, I think the neurodiversity, sort of, advocates would say that, “Actually, you know, listening to people’s internal perspectives is important for understanding individuals who have high support needs, too.” So, for example, autistic people who can’t communicate, there’s a debate over who should speak for them. So, you know, should Clinicians be speaking for them, or should it be other autistic people who might be able to better understand, you know, some of the things they’re experiencing, even if those people can’t communicate themselves? So, there is a controversary at the moment over the best approach to that. And I think both – not both sides, but, you know, both sets of people have the same goal, which is to improve outcomes for people, particularly who have high support needs, who can’t communicate their own needs as well as others, who, you know, might have very significant medical and social challenges. But I think they disagree about the way that we get there, and I think there’s been a encouraging move towards having more open conversations about, well, how do we, sort of, embrace the best bits of both these approaches? And how do we make sure we can start advocating for people who do need lots of resources, whilst also not viewing them in a, sort of, deficit-based way, and, you know, seeing their value to society, too?