Five Problems with Diagnostic Labels
Note to Reader: This article shares the difference between diagnostic and neurodiversity understandings of cognitive differences and explains the unique neuro-trait interaction approach used across ND Perspective to support our community members.
Topic: Neurodiversity, Diagnosis, Cognitive Processing, Emotional Processing, ND Community, Holistic Support, Work-Life-Balance.
We live in a world that understands differences in thinking through the medical understanding of diagnostic labels. This means that psychologists have studied people who are thought to be different, and grouped these differences into categories. For instance:
Autism - Differences with social communication, social interaction and restrictive and repetitive behaviours (including sensory behaviours).
ADHD - Persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning or development.
Dyslexia - Difficulties with accurate or fluent word recognition, spelling, and decoding abilities, despite adequate IQ.
Dyspraxia - Impacted ability to plan and execute motor tasks, leading to difficulties in movement, coordination, and spatial awareness.
Problems with the Current Diagnostic System:
There are many problems with the current diagnostic system, that cause challenges with how diagnostic labels are understood, and how people who are diagnosed are supported.
Problem One - Diagnostic categories were formed many years ago, when the thinking of medical professionals was to "cure" people of their differences. As such, limited research has been done on neuro-trait strengths which as an ND community we know are hugely beneficial to us.
Problem Two - Psychologists who inform what each diagnostic category means, are not often the same people who share these differences themselves. This means that psychologists are interpreting behaviours, interactions and communication from their own neuro-type positionality (as someone who processes the world differently to the people they are observing). This difference in perspective can make understanding neurodivergence a challenge for people who experience the world in "typical" ways because they have no frame of reference by which to understand ND processing. This also means that people who are not neurodivergent may interpret ND behaviours and intentions incorrectly.
Problem Three - The most common supports for children and adults encourage our ND community to conform to neuro-normative behaviours. This approach is still prevalent despite recognising that social conformity can cause mental health challenges, and despite knowing that many neuro-traits have advantages as well as associated challenges.
Problem Four- Diagnostic categories are flawed because they have processing traits that overlap with one category to the next. For instance, executive functioning differences, which include challenges with memory, organisation and systemising are experienced by many different neuro-types. This means that two neurodivergent people may experience the same difference in executive functioning but both have different diagnostic labels to explain this difference. Having an overlap in neuro-traits makes understanding what supports different diagnostic groups require really confusing.
Problem Five - Accessing a diagnosis can be challenging either due to long waiting lists, financial constraints, or because a person’s expression of difference does not align with biased criterion.
Challenges When Sharing a Diagnosis:
Diagnosis is needed in western society, because it is often the way that education, health and work allocate services, resources and supports. However, when you share a diagnosis with someone as a means of asking for support, the presentation attributed to the diagnostic label is so broad that it can be difficult to understand what that diagnosis actually means. As such, when supporting our ND community, adopting a neuro-trait interaction approach provides a much more individualised and holistic understanding of a person’s specific support needs, that values ND strengths, as well as recognises the personal, environmental and social barriers that many in our community experience (Dark, 2023).
Neurodiversity Offers a Different Way of Viewing People's Cognitive Differences:
Neurodiversity is a community informed term popularised by sociologist Judy Singer (1997/2016) and Harvey Blume (1998) that regards neurological variation (such as people diagnosed with dyslexia, dyspraxia, ADHD and autism) as a natural occurring aspect of humanity. To be clear, neurodiversity does not relate to any one diagnostic label, but rather respects the differences in thinking across all people from a non-medicalised perspective.
Whereas the medical understanding groups differences into diagnostic categories (like the ice-cream sundae) and attributes this to a person. For instance "Sally has autism".
Neurodivergence is recognised as being a natural part of who a person is (more like the ice-cream cone). For instance, from a neurodiversity perspective there is no differentiation between where autism ends and ADHD begins but rather an understanding that each person will have a unique mix of differences (colours, and flavours) that are expressed as neuro-traits and interact with different people, and different environments, in different ways.
If Everyone is Unique - How Can We Help People in a Group?
At ND Perspective we support our ND Community to learn about how their mind works, and the supports that they require, from a neuro-trait interaction perspective (Dark, 2023).
This means that we can discuss processing traits such as:
Executive Functions
Attention, Inattention and Inertia
Motor-Coordination & Hypermobility
Maintaining Energy
Verbal and Written Communication
Sensory Processing Differences
In relation to what they mean to the individual person's experience, rather than relying on how they are organised under different diagnostic categories.
Through having an understanding of neuro-trait interaction, our ND community can form a more holistic understanding of how their mind and body work.
By considering neuro-traits rather than broad diagnostic labels, it becomes easier to provide strategies and supports that promote positive work and wellbeing outcomes.
In this article I have shared some of the challenges associated with diagnostic labels, and explained why a neuro-trait interaction approach is necessary for informing supports from a non-medicalised perspective. However, it is important to also recognise that diagnostic labelling is not all bad. For some people a diagnosis is an explanation for a lifetime of struggle, many people assimilate their diagnosis as part of their identity and as mentioned at the start of this article, a diagnosis is often required to access supports, adjustments and services. As such, there must be space for both diagnosis and neurodiversity. However, through the neuro-trait interaction approach I hope that more people will be able to develop a nuanced understanding of their neuro-profile, and access the understanding, supports and adjustments they require to lead happy lives and achieve career success.
Supporting and Celebrating our Neurodivergent Community,
Jess x x