Introduction

Neurodiversity, loosely meaning 'all kinds of minds', is a term that was coined in around 1997 by Australian sociologist Judy Singer, herself on the autistic spectrum, and first put into print by journalist Harvey Blume, but without attributing Singer, in The Atlantic in 1998. 

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The general concept is simply that all humans vary in terms of neurocognitive abilities. GeniusWithin puts it well: "Everyone has talents and things they struggle with. However, for some people the variation between those strengths and weaknesses is more pronounced, which can bring talent but can also be disabling."

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As Simon Baron-Cohen says "it challenges the default assumption that autism [or any other disability] itself is a disease or disorder that needs to be eradicated, prevented, treated or cured."

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As in most areas recently, terminology is disputed and regularly causes more heat than light. To be precise:

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• Disorder: symptoms causing dysfunction where the cause is unknown

• Disease: symptoms causing dysfunction where the cause is known

• Disability: where someone is significantly below average on a standardised measure of function

• Difference:  variation in a trait, such as eye colour

• Divergence: where a difference between two things begins

• Diversity: being composed of differing elements or qualities.

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Classification

The alternative 'medical' model produces lists of 'authorised' diseases and crosses over fearlessly into disorders. The two best-known classifications are DSM and ICD. 

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• DSM is the Diagnostic and Statistical Manual of Mental Disorders. DSM-IV was published by the American Psychiatric Association in 1994. 

•  ICD is the International Statistical Classification of Diseases. ICD-10 was published in 1992 by the World Health Organisation.

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This is a simplified look at ICD-10. 

• Chapter VI covers Diseases of the Nervous System. This is where we find meningitis, Parkinson’s Disease, multiple sclerosis and epilepsy. These are disorders of the BRAIN not the MIND (although that may be the most controversial distinction ever made).

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• Chapter V. covers the Mental and Behavioural Disorders:

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1. Schizophrenias

2. Depressions

3. Phobias

4. Eating disorders

5. Personality disorders

6. Organic disorders, eg dementias    (but shouldn't this be in Chapter VI?)

7. Retardation

8. Substance use disorders

9. Early onset emotional disorders, eg ADHD

10. Developmental disorders

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• The final section, Developmental disorders, looks like this:

1. Specific developmental disorders of speech and language

2. Specific developmental disorders of scholastic skills

        (i)        Spelling                 (ie Dysgraphia)

        (ii)      Arithmetic            (ie Dyscalculia)

        (iii)     Reading                 (ie DYSLEXIA)

3. Specific developmental disorder of motor function (ie Dyspraxia)

4. Mixed specific developmental disorder

5. Pervasive developmental disorders (“PDD”, including Autism).

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These classifications are used for diagnosis, intervention, and, increasingly, litigation. That is because all recognised disabilities are powerfully protected by legislation. 

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Disability Discrimination

The Disability Discrimination Act  became law in 1995. It makes it illegal to treat disabled  people less favourably. It seems simple … but is very complex in practice and has since been strengthened by SENDA 2001 and the Equality Act 2010. Someone discriminates if they:

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Treat a disabled person less favourably

            AND

Cannot justify the treatment 

             OR

Fail to make reasonable adjustments

 

What counts as a reasonable adjustment is not defined, sensibly because every situation is slightly different and what might be reasonable in one circumstance might not be in another.

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What counts as a disability IS defined, but not by reference to DSM or ICD. It is a "physical or mental impairment which has

   (a) substantial and long-term adverse effect

 on the (b) ability to carry out normal day-to-day activities."

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This, of course, is fodder for greedy lawyers.

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Disability Positivism

The publication in 1994 of Ron Davis's The Gift of Dyslexia marks the start of a concerted, and eventually successful, campaign to reclaim learning differences as advantageous. Or at least potentially advantageous, given how much difficulty dyslexics continued to face in the text-dominated GCSE state education model.

 

Since then there has been an increasingly silly attempt to reclassify greats from the past as having specific learning difficulties: dyslexia for Leonardo da Vinci, Albert Einstein, George Washington, Hans Christian Andersen, autism for Michelangelo, Charles Darwin, Albert Einstein, Thomas Jefferson, Hans Christian Andersen!

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A lot of this is nonsense, but fairly harmless. What is less clear is the eventual impact of the current craze for big corporations to show off their new Heads of Neurodiversity or Neurodiversity-at-work initiatives (eg BBC, Direct Line, JP Morgan, Amazon, Ford). Raising awareness is important, of course, and so is appointing people with the right skills to the right jobs. But there are two strong dangers: firstly that a few alterations to the lighting or noise levels is significantly enabling, rather than slick furniture-company merchandising; secondly that horizons may be being narrowed rather than widened. For example EY say:  

"Functions such as IT, legal and compliance are usually prime candidates for employing neurodiverse talent. Leaders in these departments might consider starting a discussion about neurodiversity with relevant HR representatives and functional inclusion and diversity leaders."

That doesn't look like much of a stretch to me!

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Much more interesting is the work that GCHQ have been doing to attract dyslexic applicants:

 “We’re looking for people who can see something that’s out of place in a bigger picture, who have good visual awareness and can spot anomalies,”

said Jo Cavan, director of stratagy. GCHQ put out a video podcast on the strengths that dyslexics can bring to spying. For example, Charlotte says: 

“I’m often looking through a lot of data and I find that my dyslexia helps me to see the bigger picture and spot patterns that aren’t always obvious to everyone else around me. I also find that my approach to finding solutions is very different.”

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The Numbers

The most common conditions under the neurodiversity umbrella are:

• Attention Deficit Hyperactivity Disorder (or ADHD): inattention, distractability and impulsivity; about 4% of children and 3% of adults.

• Autism Spectrum Disorder (or ASD) degrees of difficulty in communicating with others and sensory overload; about 1% of the global population is estimated to be on the spectrum.

• Dyslexia: difficulties with reading and spelling; prevalence estimates range from 3% to 20% (with 10-15% commonly cited).

• Dyspraxia: challenges with coordinating physical movements; about 2% of the population are severely affected, with 6-10% estimated to be affected to some degree.

• Dyscalculia: challenges with numbers; affects up to 10% of the population, with 3-6% commonly cited.

 

However the reality is that these are only a small subset of the difficulties which children may present with in school. The most straightforward way to classify these is to use the 4-fold distinctions in the Education and Health Care Plans (EHCP). Fortunately these distinctions exactly match our own educational model (Head, Heart, Hands and Humanitas). The figures are for numbers of EHCPs in Gloucestershire in 2019.

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1. Cognition and Learning Difficulties    36%

2. Emotional Difficulties                              20%

3. Physical Needs                                              9%

4. Communication Difficulties                  36%

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Within the first category by far the largest category is Moderate Learning Difficulties (MLD) with 28% of all EHCPs. MLD is a catch-all category defined as "attainments well below expected levels in all or most areas of the curriculum, despite appropriate interventions". The number of specific learning difficulties (ie dyslexia, dyspraxia, dyscalculia) is very low at 2%.

 

This must mean that the vast majority of dyslexics are not considered by the local authority to have sufficient impairment to need an EHCP. Total school age population is roughly 100,000 of whom 10,000 could be considered to be on the dyslexic spectrum of difficulties. A maximum of 80 have EHCPs.

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However the second biggest category of any is Autism Spectrum Disorder (ASD) which is a subset of Communication Difficulties: 20% of all EHCPs. Actual numbers are shown below.

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