Wonderings in Neurodivergence

Is Neurodivergence a political smoke screen?

Richard Smith — Wed, 31 Dec 2025 07:01:33 GMT

Reading time approx. 20-30 minutes

4.1 Welcome back!

These posts began as a response to the Mad in the UK articles by John Cromby and Lucy Johnstone, which are critical of the concept of neurodivergence. These can be read here. Out of those criticisms, my aim is to share key insights I’ve gained through my work as a clinical psychologist supporting neurodivergent people.

In earlier posts, I first set out to accurately summarise the authors’ arguments. I then explored how we actually identify autistic people (rather than basing it on one or two common traits). Following this, I discussed robust evidence to establish there are significant neurological differences in neurodivergent people, and then why, despite the author’s claims, neurodivergence can become disabling.

In this fifth (slightly delayed) blog, I talk about the authors claim that neurodivergent diagnoses are unhelpful deflections from the distress caused by worsening political conditions, especially via neoliberalism (an economic philosophy that favours minimal government intervention, free markets, and reduced spending on public services), as well as stopping us from questioning these new norms. This theme comes up a lot in the blogs:

“Competition, deregulation and privatisation, together with longer working hours and increased job mobility, all impact negatively upon community cohesion. Engagement with local groups and voluntary organisations such as churches, youth clubs, community centres and trades unions, which used to ameliorate some of neoliberalism’s adverse effects, is reduced. Some communities have become ghettos of poverty and exclusion where streets are unsafe, amenities run down or absent, and opportunities scarce.”

These are all fair points. Life has become much harder for many people—due to widening inequality, reduced public services, rising profits, and the cost-of-living crisis, to name just a few factors. However, I’m not convinced this means that everyone (or at least an unhelpfully large number of people) is now identifying as neurodivergent, as the authors seem to imply with their focus on hugely increased diagnostic rates. Their concern appears to be that greater ‘awareness’ of neurodivergence allows neoliberalism to get away blameless for people’s suffering.

However, as I’ll show, with further reflection, alternative explanations and deeper understandings can start to emerge. One helpful way to think about this is through the “canary in the mine” metaphor, which some clinical psychologists have introduced to me.

As outlined here (and many other places: https://www.mindmatterstraining.co.uk/autistics-canaries-in-the-coal-mine/ this metaphor describes how ‘the analogy being that we [autistic people] are the first to identify danger and threat, succumb to it, and are a warning sign to others before they too experience it.’. I’ve heard this metaphor used for other persecuted minorities as well.

Image from https://www.helixcentre.co.uk/post/canaries-in-the-coal-mine-neurodiversity-modernity-and-burnout

Neoliberalism produces significant hardship, and autistic people are among the minorities particularly vulnerable to its effects for all the reasons outlined above. In the blogs, the authors discuss several factors that may be harmful to many people but can be especially catastrophic for neurodivergent individuals:

Increased job mobility resulting in constant changes in environments, expectations and social rules, places additional pressure on those with executive functioning differences (e.g. neurodivergent people).
Structured social settings—such as church groups, union meetings, or youth clubs—that typically suit autistic people, who often struggle in unstructured social situations, provide opportunities to connect in environments where they feel safe, valued, and supported. Unfortunately, these spaces are increasingly being reduced.
Fewer social spaces to access that don’t cost money (e.g. ‘third places’) such as parks (where all, but especially hyperactive, people can burn off excess energy), or libraries (where autistic bookworms can gain free access to books to quietly hyperfocus as a way to recharge from the increased stresses of life).
Greater numbers of jobs that require customer interaction (e.g. call centre jobs) may cause autistic people even more distress (especially as telephone calls are often the most stressful and draining of the different forms of communication for neurodivergent people).
Increased use of open plan offices will most affect those people with ‘super’ senses that struggle with auditory filtering, visual sensitivity to artificial lighting and those that can pick up very subtle noises beyond the typical range of human hearing (e.g. hearing electrical transformers in plugs and chargers, or fluorescent tube lights buzzing).

These changing conditions of the societies we live in, which can be extra stressful for neurodivergent people may explain why more neurodivergent people are coming to our services. Extremely few people come for assessment just because they’re curious; they’re almost always suffering in various ways.

The mine is filling with various noxious gases and autistic people are chirping extremely loudly about this (as discussed previously). Similarly, if the world is flooding, very few people are going to flourish or even last long, but the people who struggle to swim are going to drown first (while those with their own mega-yachts are probably going to be ok).

To hammer home this point, using the height metaphor used before, autistic people’s ‘height’ (i.e. the strength of their traits compared to most other people) will be increasingly more problematic in a world where everything is closing in: the metaphorical door frames, cars, clothes are becoming smaller and smaller, causing more and more headaches (both metaphorical and literal).

As the authors outline: “Simultaneously, we have created education systems where children with these characteristics are far more likely to stand out as problems—rather than, say, as quick-thinking, creative individuals who pose interesting if unusual questions.”

Also they note:

“As critic Bruce Cohen puts it:
‘The expansion of ADHD from a rare disorder to a popular disease among young people over the past 35 years can be understood as a result of capitalism’s need to enforce discipline, compliance, and authority on the future workforce at a younger age.’”

Their armchair analysis of neurodivergence is actually just so close to getting it!

We can acknowledge that worsening political and societal conditions, often linked to neoliberalism, create difficulties for most people, and that these challenges can be especially difficult for neurodivergent people to navigate. As psychologists often note, it’s not an either/or—it’s a both/and.

Additionally, I’d agree with the authors about the vast amounts of money being made by private companies stepping in to meet demand the NHS can’t meet. They may not know about the poor quality neurodivergence assessments often reported, lasting possibly only 45 minutes, sometimes conducted by people with very little experience or training, which are also a significant problem. Capitalism does what capitalism does, sadly. A tool being used badly doesn’t make it a bad tool.

4.2 Neurodivergent traits and the exponential stresses of worsening conditions for everyone

Autistic traits can be somewhat fluid in their intensity, and stress levels often intensify or shift them—something that is not always widely discussed. For example, moderate anxiety in social interactions may lead an autistic person to become extremely chatty, speaking at length (often about a passion of theirs) and jumping impulsively from topic to topic. In contrast, increased levels of stress can have the opposite effect, causing the person to shut down, or even become temporarily mute in extreme situations. This pattern was noted a long time ago, but seemingly little known.

This can create a vicious cycle, where stress strengthens an autistic trait, which may create more stress. In the above example, others around the autistic person could lack compassion or even be cruel about their disinhibited talking, or about their inability to talk at that time, creating more stress. There is also the sensory avalanche of stress making autistic people even more sensitive to noise, increasing the stress felt in response to it, forming another vicious cycle, as highlighted in this seminal paper.

More autistic people are struggling to the point of needing support partly because all the extra stress people are experiencing can cause autistic people’s traits to be stronger and potentially more problematic. Small changes in the environment can have a big impact, especially for someone who has emotional regulation and sensory differences; this impact may then be catastrophic for autistic people.

Again, political and social conditions are being included into formulations, not ignored. Either way though, I’m sure we all agree everyone would benefit from better conditions and greater equality.

4.3 Making fuller formulations

“Everything has a label, and the label disqualifies any other explanations.’
“At the same time, we might ask why we are so bad at finding a middle ground”
“pseudo-explanations of ADHD or ASD actually prevent us from identifying the roots of the problem in fragmented social structures and unrealistic demands and expectations”
“The understandable need of employees for the protection offered by a diagnosis is fuelling the apparent increased prevalence in ASD—while individualising challenges to employment conditions that are, in fact, unreasonable for everyone.”

I couldn’t agree more that we need to find a middle ground between understanding everything about someone’s misery through a neurodivergence lens and seeing everything through the lens of the effects of neoliberalism. Fuller formulations containing as many relevant factors as possible will surely be the way forward (e.g. someone’s personal history), rather than criticising one limited explanation and replacing it with another, as the blog writers appear to be doing.

If we’re formulating someone’s distress, knowing they’re autistic or have ADHD adds more areas to investigate, ones that wouldn’t typically be looked at. We can link these to topics discussed in previous blogs about the neuropsychological functioning seen in autistic people, as well as knowing their social and communication style (which can clash with many of the neurotypical majority’s), as I will explain:

Sensory stressors:

I imagine most therapists don’t think to ask how someone’s environment might be triggering their sensory sensitivities to analyse their stress levels. Working in an open-plan office, sitting under the wrong lighting, or trying to socialise in crowded, strong-smelling pubs with loud conversations can create intense distress. Even lighting at home—especially arguments over having “t’ big light” on or off—can cause pain and fatigue. A child might be constantly stressed at school by scratchy clothing labels, harsh classroom lights, or uncomfortable uniforms. And simply leaving the house can become overwhelming when nearby construction or road noise is too much.

Recognising that sensory experiences can be more intense for neurodivergent people highlights why soothing strategies, like fidget toys, weighted blankets, chewing, or rocking chairs, are so important. Many people also don’t realise how tinted lenses or specialised earplugs can, for some people, make public places far more accessible.

Social and communication styles:

Unstructured social situations or conversations can be a struggle for autistic people. This could be due to not knowing what to say (e.g. when engaging in small talk), processing differences may mean fast and changeable conversations (e.g. in group conversations) or non-literal communication (e.g. getting when someone is joking with them, or trying to read other people’s emotions) can be hard to process.

It’s important to be aware of other real stressors and pressures on autistic people in these kinds of situations. If someone is reporting high levels of anxiety in social situations, just focusing on the negative cognitions about others perception of them (e.g., in CBT for social anxiety) isn’t going to be effective for anxiety if these extra stressors are not considered. Additionally, and sadly, autistic people may very well get judged if they are struggling to join in or interrupting people by accident.

Before addressing negative thoughts about being judged, it’s important to help the autistic person access social situations that genuinely match their social and communication styles. This might commonly mean activities centred around games, “parallel play” settings, or chatting with one or two people about a topic they care deeply about.

Executive functioning differences:

Autistic people may have “rituals” as they rely on familiarity and sameness to feel calm. These can be mistaken for OCD, but they’re often not driven by the superstitious thoughts often seen in OCD—and treatments like exposure and response prevention can exacerbate distress. Executive-function differences can also show up as forgetting or losing things, living in a disorganised environment, struggling with chores or self-care activities, or finding it hard to focus on tasks for long at work. These challenges can cause significant distress, yet therapists don’t always think to ask how most people are managing day-to-day life.

Offering practical support instead of psychological ones may help an autistic person better in these situations. Someone’s ability to hyperfocus and their logical strengths can be used as coping strategies by encouraging them to spend time on their passions, which may meaningfully lower anxiety levels.

Micro traumas:

The idea that autistic people experience “micro-traumas” is emerging, but already clearly described in the literature, e.g. here and here. These micro-traumas (small, repeated experiences that feel threatening, overwhelming, or invalidating) are important to consider in neurodivergent formulations. Difficulties with seemingly “easy” tasks, unacknowledged sensory differences, and exposure to chaotic or stressful environments can all shape core beliefs about themselves, other people, the world and their future. Over time, these micro-traumas may have cumulative effects comparable to more commonly considered traumatic events, such as assault and abuse of all kinds. Autistic people are also vulnerable to these as well, as noted by the MITUK authors.

Dismissing neurodivergence as a psychologist is self-defeating, as it cutsyourself off from various areas of understanding and extra coping strategies for people you are trying to support. Being aware of neoliberalism’s malign influence in many areas of their lives can help with understanding one of the ultimate drivers of distress, but doesn’t give us much scope for affecting change for the person seeking help in our clinic.

As an important aside, I wonder if it’s been considered how the MITUK blog writers’ discussions will add to neurodivergent people’s distress. I’d suggest they, and others, will sadly and inevitably contribute to the hostile political climate. I would guess the authors completely disagree with Richard Tice’s other political stances and I would be curious as to how they will avoid their opinions being repeated, twisted and weaponised in ongoing attacks on minorities, specifically autistic people. As I’ve said before, while there are many merits in wanting to stop the medicalisation of people’s misery, there is a history of these critiques being co-opted by bad faith actors to remove support from people in need. I would suggest it does actually help to try to ‘be kind’ while also being accurate, curious and open-minded before leaping into criticism of a very important concept for people. Neurodivergence is a concept that can be usefully wielded to inform people how to improve various aspects of their lives.

4.4 Neurodivergent strengths

If neoliberalism is making life more stressful for everyone, making them struggle in various ways and making people think they’re neurodivergent, then how could we see the cognitive strengths seen in neurodivergent people? These strengths can also be used to help with guiding someone around reducing anxiety, or recharging their social battery. On a slight tangent, awareness of these strengths can be helpful when assessing to see if someone’s autistic, when their history could indicate their differences are just related to past trauma.

Will neoliberalism give people their sensory strengths? Their pattern recognition skills? Their increased capacities for certain kinds of long-term memory? Their logical strengths? Their hyperfocus (alongside their distractibility)? These strengths aren’t mentioned in the blogs; maybe the authors are unaware, as it seems many critics of neurodivergence are.

Again, knowledge and experience talking and working with neurodivergent people may have helped highlight these traits and understand these complex issues in more detail and nuance.

4.5 Taking the power back

The authors ask: “Whose power is being reinforced?”

They then follow this up with descriptions of children and adults complaining about and getting changes implemented in their places of education and work e.g. hundreds of neurodivergent people taking their employers to employment tribunals, or children using fidget toys, quiet spaces, extensions on their work and computer software for their writing.

The authors of the blogs complain about people’s diagnoses meaning the fault is seen in the person, but then outline various ways neurodivergent people are then making changes in their environment to help them function! Maybe autistic people are helping lead the way for the changes they’re requesting being normalised for everyone, e.g. flexible working, use of fidget toys, clearer instructions etc, for whoever needs them.

Speaking of neurodivergent people making wider changes…

4.6 A brief aside of neurodivergent people’s contributions to progressive political causes

“As psychotherapist James Davies puts it, when ‘…diagnostic tribes come to replace political tribes… our suffering has been politically defused’.”

The blogs’ authors’ criticisms of neurodivergence distracting from the real societal issues affecting people’s distress and misery made me think of all the neurodivergent people I’d met in clinic who are passionate advocates for progressive causes (that I assume the authors back most, but possibly not all, of), becoming involved in local politics (I’m not denying that autistic people have become involved in extreme right-wing politics too, sometimes with tragic consequences).

Nevertheless, I haven’t noticed Chris Packham stepping away from environmental causes since he was identified as autistic. Greta Thunberg did more before her 16^th birthday to try affect the political climate than the vast majority of us will do in our lifetime. My local MP, Olivia Blake, has spoken about her ADHD in Parliament when advocating for greater SEN provision, not wanting other children to experience the criticism that she did before her “lifechanging” diagnosis. Sarah Hall, another MP, very recently spoke about the importance of supporting neurodivergence in the workplace.

Olivia Blake MP at the launch of the Climate & Nature Crisis Caucus, 29 October 2025- courtesy of www.bylinesupplement.com

I was also surprised to find an analysis highlighting that candidates in the last British election that declared their neurodivergence disproportionally stood for the more left-wing progressive parties:

https://adhduk.co.uk/2024-general-election-neurodiversity-candidate-research/

You could hypothesise many neurodivergent strengths coming in to play. They’ve may be (as well as their own non-neurodivergence-related strengths and traits) using combinations of their hyper focusing abilities, great memories for facts, very strong principles, logical thinking and being less affected by societal expectations to allow them to swim against often overwhelming tides of the right-wing media, as well as general apathy and hopelessness.

I’d suggest the authors and many neurodivergent people are often all on the same side! We don’t need more fuel for this aspect of the culture war dumpster fire. The authors could find some very useful allies amongst the neurodivergent population to rail against the ills of capitalism and neoliberalism.

4.7 Final Take

As I’ve discussed, recognising neurodivergence, deepens our understanding of the political and social roots of people’s distress – rather than distracting from them. Neurodivergent people often feel the impact of inequality and ever-changing environments more intensely. Including neurodivergence in formulations allows for a richer and more compassionate focus whilst still keeping neoliberalism in mind as a key driver of distress. Neurodivergent perspectives highlight where systems are failing and where change is urgently needed, not just for neurodivergent people but for everyone. Criticising the concept of neurodivergence may actually be unintentionally allowing more splitting amongst groups that could be stronger together.

And finally, a happy new year to all! I hope 2026 can bring more unity rather than divisiveness.

Extra Wonderings: Managing The Holiday Season

Richard Smith — Sat, 13 Dec 2025 07:01:34 GMT

X.1 Introduction

I’m taking a brief break from discussing the various anti-neurodivergence narratives around (with the next blog partly touching on the recent political commentary about ‘over-diagnosis’) for an extra blog about helping autistic people navigate the holiday season, using Christmas as an example as this one I know best. For some autistic people, this advice may not be needed at all. However, for many, it may be a particularly difficult time, requiring things to be done differently to what’s often expected at Christmas.

There are tons of these guides around, e.g. here, here and here, so I’m aiming to show the structure behind them as a demonstration of how the concept of Autism is more than a ‘label’, more than an explanation, but a way to formulate why certain situations are more likely to be stressful for autistic people, and, importantly, how to build a plan to make them less stressful.

As discussed before (albeit only with 4 themes), while criticisms have questioned the phrase ‘if you’ve met one autistic person, then you’ve met one autistic person’, taking this phrase too literally to mean all autistic people are so different from each other that there’s no meaning behind the term, actually we see a number of consistent themes of differences in autistic people. While historically we’ve had the triad, I often talk about the ‘pentad’, with differences to the neurotypical majority almost always seen in:

· Social Interaction Style

· Social Communication Style

· Thinking Style

· Sensory Experiences

· Emotional Regulation

The themes are consistent, but the variety between autistic people’s traits exists underneath each of these umbrella themes.

X2 The 5 themes of the Pentad

I’ll briefly introduce each theme, discuss ways in which Christmas might push the stressful buttons within this theme (there will be many generalisations contained within these, that hopefully will seem applicable to a lot of autistic people), then use each theme to construct a person-centred plan for an autistic person to survive Christmas. Some of the ideas may help non-autistic people as well. Also, any changes to Christmas will need to be discussed with those close to the autistic person as some negotiation about changes may be needed.

Similarly, the structure presented can help people formulate (and then find solutions for) why autistic people find other situations extremely stressful and/or exhausting e.g. weddings, working in an office, and various other social situations.

I’m not claiming any single one of these will remove all the stress and distress of Christmas, but hopefully a variety of them put into place can add up to a much easier time.

X2.1 Social Interaction Style

Autistic people tend to struggle in social situations that involve being in a group and also where there is little structure and people are ‘hanging out’, socialising for its own sake. They often report a much smaller ‘social battery’ than non-autistic people may have, and so can only spend so long around other people before they’re exhausted.

So it’s no wonder that the large family gatherings often seen at Christmas will make the day stressful and tiring.

X2.2 Social Communication Style

While more nuanced than this simple explanation, I often see that autistic people’s conversational style is around information exchange (e.g. they can be very good at telling people facts about their favourite topics, or listening to someone else give them interesting facts), rather than the social bonding gained differently through small talk and chit chat.

1:1 or 2:1 conversations are often easier to process than a larger group conversation, where the speed of the conversation, changes of topics and small windows to jump into the conversation will all often be difficult for an autistic person to engage in.

Additionally, honesty may not always be the best policy at Christmas, Christmas cracker jokes may or may not land too. It may also be that talking about a topic the person’s passionate about, e.g. politics, isn’t received well. Non-verbal communication may also be important at times, but often missed by many autistic people.

The larger family gatherings may therefore often have group conversations, probably conversations about what those there have been up to, what other people not there have been up to and general gossip that autistic people may often have much lower interest levels in these kinds of conversations.

X2.3 Thinking Style

For the purposes of this, I would break down and generalise autistic people’s thinking style into two key areas: executive functioning difficulties and logical strengths.

With regards to executive functioning difficulties, there will be a lot of pressure on someone’s ability to organise everything (Presents! Food! Change of routine! Medications! More!), as well as a lot of unknowns (e.g. people’s presents and how to respond to them, or people unexpectedly popping round to say hi). There could be fewer opportunities to hyperfocus on someone’s passions. During the days, there may be switches from one task or activity to another unexpectedly or too quickly. Change is everywhere: routine, decorations all over the place, unfamiliar people visiting.

Autistic people’s logical manner of thinking could also be affected by various arbitrary Christmas traditions that don’t really make much sense, either as a society or within the family.

X2.4 Sensory Experiences

image courtesy of https://nurturing-change.org/

With autistic people’s sensory experiences often more highly detailed than neurotypical people’s, various Christmas sensory inputs could be absolute marmite for each autistic person, e.g. twinkling fairy lights could be something that causes a lot of agitation and annoyance, or could be particularly enjoyable, fascinating or calming. Often typical reactions, but dialled up higher. These could include (focusing on just 6 of the senses):

· Auditory: Repetitive Christmas songs, children playing (having fun),

· Visual: Christmas lights, cluttered environments, fairy lights,

· Touch: Having to hug family members, wearing smarter clothes for Xmas dinner, the texture of different foods,

· Smell: Lots of food being cooked, people’s new perfumes,

· Taste: Flavour of different foods,

· Motion/gravity: Long car journeys to see family.

X2.5 Emotional Dysregulation

Everything can seem heightened at Christmas; for everyone but especially for autistic people. This could be a positive experience, e.g. the extra excitement that some autistic people may feel about Christmas, or the empathic joy from seeing others happy.

However, disappointments may be harder to hide. Loneliness may feel stronger. The overwhelm from everything can come out as anger. Christmas may be a reminder of people who have died. An empty social battery can lead to exhaustion, meltdowns and shutdowns.

Many autistic people experience self-critical thoughts (e.g. why can’t I do things like everyone else? Because I’m a…), which may be exacerbated by others’ verbalised criticisms as well. Extreme emotions may lead to extreme coping strategies: alcohol, drugs, self-harm etc.

X3 Building a plan

Now we can see how to use knowledge of the 5 areas (1. social, 2. communication, 3. thinking style, 4. sensory processing and 5. emotional dysregulation) to understand the structure behind the various plans out there, or to make more individualised plans for Christmas.

These aren’t all the possible suggestions, but hopefully people can pick and choose which ones apply to them to construct their individualised plan, as well as use them to prompt further ideas. Some of the suggestions may tick more than one of the 5 ‘pentad’ boxes at the same time too

Also, importantly, some of these suggestions came from a few autistic people in a post-diagnostic group I helped facilitate many years ago, so thank you to them.

X3.1 Suitable Social Interaction

Autistic people may benefit from:

· Choosing to spend it alone,

· Spending some time with other autistic people,

· Spending Christmas with just one or two people,

· Giving yourself regular, possibly hourly, breaks from being around other people,

· Avoiding unstructured group time,

· Being able to leave the dinner table early,

· Focusing on spending time with people with structured activities (e.g. board or video games),

· Focusing on spending time alongside others, with ‘parallel’ activities such as going for a walk, watching favourite films/TV, or doing crafts alongside others. Sitting quietly while others are chatting may also be tolerable.

image from theguardian.com

X3.2 Autistically Friendly Conversation

Factors to think about in this area:

· Having only one or two others around, as above, to avoid group conversations,

· Spending time with people who like to talk about similar topics,

· Thinking if cracker jokes needed?

· Deciding if presents have to be opened in front of everyone. Honest reactions can then be had behind closed doors.

X3.3 Thinking Style

Autistic people may benefit from support with their executive functions and/or reducing change:

· Having support to organise presents (or essentials like medications) beforehand,

· Making small pre-agreed changes to the lay out of the house, e.g. adding decorations bit by bit, day by day,

· Not having any decorations and keeping their environment the same,

· Sticking to a pre-agreed timetable, as much as is possible,

· Only being in a familiar environment,

· Only being with familiar people,

· Treating Christmas day as just another day and sticking to a typical schedule.

Their logical and visuo-spatial strengths may come into play as well:

· Spending a lot of time with a favoured activity e.g. buying a new video game especially or getting stuck into crafting,

· Some autistic people have told me of their strength with wrapping presents efficiently,

· Others may really enjoy making their own Christmas decorations.

X3.4 Sensory Experiences

People could consider:

· Shopping online, or ensuring you go to shops at quiet times (especially with the extended hours) might be best,

· Eating their favourite food rather than a traditional Christmas dinner,

· Wearing Loop earplugs/noise cancelling headphones or similar throughout the day,

· Not being obliged to hug family members to say hi/bye.

· Walking instead of driving around as this may be particularly calming,

· Having a quiet place/room to go to when needed, possibly full of suitable sensory activities.

X3.5 Emotional Regulation

With this, it will be important to be aware of:

· Practising self-compassion (easier said than done!) being kind to yourself about not doing things the way people may expect you to do. Understanding why this is the case (e.g. many of the reasons in the previous section), as well as reading about other autistic people’s struggles at Christmas, may help this.

· Again, having a quiet place to go to when needed, full of sensory soothing activities,

· Being aware of drinking too much and magnifying emotions,

· Ensuring any helpful coping strategies for difficult emotions are taken if spending Christmas elsewhere,

· Leaving the room if the atmosphere becomes intense or heated.

Quickly generalising these tips to other situations

To re-iterate, through using the 5 areas (1. social, 2. communication, 3. thinking style, 4. sensory processing and 5. emotional dysregulation) to understand the broad range of autistic people’s strengths, differences and difficulties, we can start to understand why various other situations are especially stressful for autistic people and then use the structure to form plans for those situations:

· Working in an office (1 example from each area):

Stresses from: 1. constantly having people around, 2. people making small talk, 3. often being interrupted, 4. fluorescent tube lighting and 5. general stress being magnified.
Solutions will often include extra time working from home to suit: 1. the person’s greater need for isolation, 2. free from idle chit chat, 3. free from interruptions, 4. where they can set the sensory environment to their need and 5. private space to go calm down if matters become overwhelming.

· Going to a wedding:

Stresses from: 1. being around people for a long time, 2. people making small talk, 3. being in a very new place with new people, 4. loud conversations all around and 5. possibly absorbing a lot of heightened emotion from around them.
Solutions: 1. Being able to take breaks to go recharge their ‘social battery’, 2. being sat with people who share similar interests, 3. scouting out the venue beforehand and having a set timetable for the day beforehand, 4. using Loop earplugs or similar, 5. having a set place to go relax when needed.

Conclusion

I hope, if nothing else, that the writings here help give autistic people, and those around them, permission to do things their way at such a significant time of year. Once the structure behind the advice is understood, people can then generalise the advice to various other difficult situations. The ‘label’ of Autism can then become much more: a formulation and a guide.

Please comment below if you have any other tips to share with others!

Why neurodivergence becomes disabling

Richard Smith — Mon, 27 Oct 2025 20:00:34 GMT

Reading time 22-35 minutes

3.1 Why neurodivergence becomes disabling: why neurodivergent people aren’t ‘just a bit quirky’

In recent blogs I explored the key points of John Cromby and Lucy Johnstone’s arguments on neurodivergence and summarised their points in a way as valid and helpful as possible. I also explored how we actually identify autistic people - rather than basing it on one or two common traits. Then I discussed how we can be confident there are significant neurological differences in neurodivergent people.

Here, I focus on a central claim: the idea that being neurodivergent isn’t a credible or severe enough disability. This claim has various sub-themes related to it:

Diagnoses are going up so this means they’re not credible or valid
You don’t need to be disabled to get a diagnosis.
Originally, only people with a Learning/Intellectual Disability were diagnosed as having Autism.
It’s not as bad as a physical disability

One word of warning: this may be a difficult read, especially for neurodivergent people.

3.2 Reasons for increased Neurodivergence identification

Diagnoses have hugely increased in the time I’ve been qualified. This is mostly a good thing. This has been discussed extensively elsewhere (e.g. especially in this excellent article), reflecting several key themes: vastly increased recognition; broader and more inclusive, criteria from originally very stringent and limited ones; more screening; services getting better at recognising autistic people in under-represented groups; the internet helping autistic people find a community and a shared understanding; and possibly that autistic people are getting into relationships with each other much more.

One other angle to add, from personal experience: I previously worked in a national tertiary service that accepted referrals from most of Yorkshire, parts of Lancashire and Lincolnshire - but bizarrely not originally commissioned to work with people from Sheffield, where it was based!

Accessibility was a challenge due to travel distances. Thankfully, things have significantly improved now. I would estimate that well over 10 more localised services now provide assessments for these areas. Accessibility to assessments has increased significantly in recent times, including the introduction of online assessments. For autistic people who struggle to leave their house, this is often an ideal option.

3.2.1 Understanding the 2% prevalence rate

When I started into the Sheffield service, covering that large geographical area, less than 15 years ago, assessment rates were significantly lower. In 2011–2012, referral rates were approximately 7 or 8 per week. If an estimated 2% of the UK population is autistic, that’s potentially around 1.4 million people who may need assessments. So, while referral rates have certainly increased, this tells us relatively little when they were starting from such a low baseline.

We could understand this using statistical models applied to the distributions of traits/abilities like sensory differences, social communication, or executive functioning etc. Statistically, within any given trait/ability, approximately 2% of people fall at least two standard deviations above or below the mean (e.g. 2% of people are 6’4” or above, in reference to my previous ‘tall-istic’ metaphor). It’s important to consider that autism isn’t defined by being at one end of just a single distribution (rather there are many co-occurring differences), however this kind of modelling may help to explain why a 2% prevalence rate is probably reasonable—it reflects how neurodivergent traits may be distributed. These quantitative differences then can lead to qualitatively different experiences - which I discussed in Blog 2.

The next blog will explore the “Canary in the Mine” metaphor. This can help explain the social factors which are driving the increase of neurodivergent people seeking assessment. Social circumstances can make interaction between their environment and their neurodivergence to be more disabling and/or clearer.

3.3 How Environments Disable Autistic People and the Double-Edged Swords of Neurodivergence

Neurodivergence encompasses many differences. I’ll be brief here - although it is worth much more space. Many of the differences can become disabling, when the traits interact with the environment e.g, finding it very hard and/exhausting to make small talk or to participate in group conversations when surrounded by neurotypical adults, who often engage in small talk or chat in groups.

Many others are double-edged swords like heightened senses leading to sensory abilities and fascinations alongside hypersensitivities, or dysregulated attention that can cause inattentiveness but also the ability to hyperfocus.

Some may be best described as just inherent differences (e.g. short-term memory difficulties, or motor coordination difficulties) without a clear strength. Nevertheless, the consequences of being autistic on the person are often significantly impactful, as discussed in the next section.

It is important to recognise that some neurodivergent individuals may view these traits as a disability, whereas others may see them as differences. This depends on a variety of factors such as: circumstances, life experiences and the environment which all play a role in how well someone can function.

Also, these double-edged swords may appear like contradictions to the outside, to inexperienced, or possibly incurious, eyes, but I aim to approach these in more detail when discussing the blog authors’ theme of ‘It’s all contradictory’.

3.4 The common impacts of being neurodivergent

One of the blog authors claims that people are given a diagnosis of ADHD or autism, yet there is no “identifiable bodily impairment” (?? no, me neither). They also reference a quote from a single writer, Robert Chapman (I’m not sure he’s the singular authority on neurodivergence, despite their repeated references to him), that “Aspergers Syndrome (hereafter, autism) is an example of neurodivergent functioning with no inherent clinical suffering or disablement”.

They expressed concerns with the growing number of people without any ‘obvious’ signs of neurodevelopmental problems (e.g. intellectual impairment, epilepsy, delayed milestones such as late expressive language). These claims mirror stereotypical portrayals by the media (or even healthcare professionals) that neurodivergent people are “just a bit quirky”, “eccentric” or only experience “inconveniences”.

3.4.1 How the MITUK blog authors seem to envision autistic people’s lives

No one should be being identified as autistic without there being a significant impact on their lives stemming from their autistic traits, although these may not correspond with ‘bodily impairment’ (whatever the MITUK authors meant by this). Apparently, “Many of the adults who are currently being diagnosed are objectively successful, often with their own families and careers.’

It’s interesting that the blogs rail against neoliberalism elsewhere, but then judge people’s success seemingly solely by their careers and families. It seems unlikely they genuinely believe that simply having a job and/or a family are the only keys to a good life. They show no exploration of the quality of that job or family life.

For instance, I recall one client who successfully held down a job, was married and had children. She was so exhausted by her office job that she had to recover in bed, alone, in the dark, for most of the evening. This impacted on her family, as well as her own quality of life. Another person I saw had to make things up for every Monday morning when asked what they’d been up to all weekend. The true answer was mostly sleeping off his exhaustion from the previous week’s work.

We can look at the definition of a disability under the UK’s Equality Act (2010): ‘You’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities.’ This definition doesn’t seem to reduce matters to simply not having a job and/or not having a family.

It’s pretty easy to think of many other aspects of wellbeing to consider as important. For autistic people, there are a huge number of stats indicating life is often incredibly difficult for them, with the impact of their differences being broad. Here are just a few:

Emotional wellbeing:

While researchers often use psychiatric diagnoses (which have their own validity issues), the rates are extremely high of various forms of anxiety (twice the number of autistic people reporting difficulties with anxiety than non-autistic people)

In my clinical experience, it is rare to meet an autistic adult whose levels of anxiety don’t have a significant impact on their life. This can stem from various reasons, such as from being around other people (without necessarily having socially anxious thoughts), being around common sensory inputs, to having to experience too much unpredictability, as well as the more commonly known psychiatric descriptions and categories of anxiety (e.g. panic, OCD, social anxiety, GAD etc).

Research further indicates that autistic people are:

4 times more likely to suffer from depression in their lifetime

Suffer increased suicidal thoughts, planning and actions, with over double the number of autistic people reporting these than neurotypical people. (I was recently struck by Sami Timimi’s [an ally/collaborator of the authors and website] comments in an article questioning whether being autistic isn’t just ‘liveable through’)

Higher rates of the use of self harm (as reported in the previous paper)

Also the harder autistic people try to mask, the worse their mental health can become, as reported here and here.

Physical wellbeing:

I wonder if this is the frequent result of years of chronically poor emotional wellbeing for autistic people:

· Autistic people experience higher rates of chronic fatigue, chronic pain, IBS

· Research indicates more premature deaths on average in autistic people without an Intellectual Disability:

Work and Quality of life:

· Just 3 in 10 autistic adults are in work, compared to 5 in 10 for all disabled people and 8 in 10 for non-disabled people (apologies for comparing these groups; I present them so autistic people’s difficulties are taken seriously, rather than trying to claim matters are more difficult for them than for other minority groups).

· Poorer quality of life is often reported: In this paper general outcomes for half of autistic people was reported as being in the range of poor or very poor. “Poor” was defined as an individual who was unable to lead an independent life, but where there was “some potential for social progress”; and “very poor” was defined as an individual unable to lead “any kind of independent existence”

· In a large study looking at young people’s (with Special Educational Needs) social lives, many of the 600+ autistic people in the study reported never seeing friends (39% of participants), never being called by friends (47%), and never being invited to activities (48%). 28% were categorised as socially isolated, i.e. all 3 of the previous conditions being met.

Self esteem:

Lower self-esteem has been reported (albeit in this small study), although having a positive Autism social identity appeared to offer a protective mechanism.

Something is clearly going on here, with various factors adding up to make autistic lives qualitatively different, often for the worse, to the majority of the population. It is a shame the authors of the blogs don’t know, didn’t ask about, or have ignored statistics such as these.

But they’re celebrities so they must be successful…

Equally the celebrities cited illustrate the point that external success can mask personal struggles. Melanie Sykes may have excelled in her career but faced alopecia, domestic violence and heart issues. Courtney Love struggled with heroin addiction, Stephen Fry with severe mental health diffiulties and Anthony Hopkins with childhood loneliness. Also: Elon Musk, is he ok?

We cannot formulate precisely what is exactly behind these difficulties or be sure how much of the person’s neurodivergence contributed to their less apparent difficulties. Still, there is the clear running theme of neurodivergence. It might be worth asking the celebrities themselves their thoughts on “How then, to give them a diagnosis of a significant impairment, when they do not appear to be impaired?”

3.5 Missing the Learning/Intellectual Disability (ID)

The authors of the MITUK blogs outline: “In the words of a father with two non-verbal sons who require 24-hour care: ‘Neurodiversity advocates ignore the harsh realities of severe autism, and want to forget about my sons and others like them…. For them, autism is a life-altering, cruel disability, and I’d do anything to help them feel good and give them a better quality of life’.”

It’s easy and appropriate to feel a lot of empathy and compassion for these people’s situation. I took an educated guess that the two sons would be considered as having an Intellectual Disability (another concept that is hard to exactly define, but a category often used in services and society), which is probably much more impactful in their lives than their also being autistic. It then turned out the article the authors link to in their blog actually mentions the sons have “intellectual disabilities”. I would guess the authors of the blogs have at least some experience of working with people with an Intellectual Disability and may have thought this was relevant.

The co-occurring ID is often missed in the media as well when talking about people who are ‘severely autistic’ e.g. here or here; I’d suggest that what is often meant seems to be someone has a moderate to severe Intellectual Disability and is also autistic with it. This therefore makes comparisons of some early descriptions (Kanner’s, not Asperger’s) of autistic people to modern day understandings of being autistic not as relevant as the authors make out.

It is true about needing to hear much more and from many more voices of people with a Intellectual Disability; recently I was impressed by a talk of someone discussing their research doing just this. I hope it is one of many examples of this.

3.6 The blog authors’ comparisons of disabilities

Comparing people’s situations and traits as more or less disabling than other people’s is unhelpful. Rather than helping to lead to compassion and understanding they contribute to infighting amongst minorities. I’m sure this is not something the authors would want. There should be enough support to go around and a sufficient supply of empathy. Compassion isn’t a zero-sum game.

Instead, they do compare disabilities:

“Should awkwardness in social situations or difficulty prioritising daily tasks, for example, count as ‘disability’ in the same sense as using a wheelchair, recovering from a stroke, or perhaps having extreme mood swings?”

Again we can see a couple of swallows (i.e. traits they minimise) making a neurodivergent summer in their eyes, rather than understanding the depth and breadth of areas that neurodivergence encompasses. Their inclusion of ‘extreme mood swings’ as a comparison does indicate they’ve not met many neurodivergent people. Emotional dysregulation is a very common neurodivergent trait (with the stats above showing they often use self-harm and have thoughts of suicide as escapes from these extreme emotions).

Comparisons are too complex to make anyway, as autistic people, as with other people with disabilities/difficulties/differences that impair their functioning, are very affected by the environment they’re in (as discussed above). We could ask if an autistic person is in the woods, and there’s no one around to stress them out, then are they disabled? Unfortunately, life doesn’t allow that and autistic people are surrounded by many many aspects of life that push on their difficulties and cause them a lot of pain and misery.

Picture courtesy of https://silvotherapy.co.uk/articles/autism-and-nature-connection

3.7 Final Take

So in summary, I hope the authors of the blogs, and those reading them, can keep in mind:

There are a lot of reasons why many more people are being identified as neurodivergent, more than enough to explain matters rather than simply seeing the increase as a fashionable trend of meaningless labels being thrown around.
There’s a lot of complex interactions between neurodivergent differences and the environment that impairs neurodivergent people’s lives.
The impacts of these interactions often make autistic people’s lives really difficult and cause a lot of misery for them.
Comparing autistic people’s differences and difficulties to autistic people who have an Intellectual Disability (with or without realising) or people with other disabilities isn’t really helpful, as if compassion is a limited resource.

I hope you’ll join me next time briefly discussing why the concept of neurodivergence shouldn’t deflect from societal issues affecting most people.

And once again, thank you to Amy Longworth, aspiring Clinical Psychologist for her efforts to trim and tame my wonderings.

3.8 Appendix: Summary and example quotations of theme 3: Being Neurodivergent isn’t a Credible Enough Disability

Theme 3. It’s not a credible or severe enough disability, successful people are diagnosed, diagnostic rates are rocketing. It’s not as bad as a physical disability.

Autism originally only occurred in people with an Intellectual Disability

Part 1 of this blog series described how the original, much narrower DSM criteria for autism applied only to people with severe, lifelong intellectual impairments. This presentation does seem to fit the description of a neurodevelopmental disorder of some kind (although confirmatory medical tests are currently lacking).
This dilemma becomes particularly apparent in relation to those people with severe and/or profound intellectual disabilities who are also described as having autism. This group is disabled by any accepted standard.
Rather, we are concerned with the growing numbers of people without any obvious signs of neurodevelopmental problems (e.g. intellectual impairment, epilepsy, delayed milestones such as late expressive language) who nevertheless report more subtle difficulties in communication and socialising, perhaps along with a narrow range of intense interests, and difficulties reading social cues or coping with change.
Over time, the diagnostic criteria for both ADHD and ASD have widened, both officially and unofficially, and now include many who previously would not have been given a diagnosis. This was deliberate, and took place after lobbying by advocates in the USA, who see a lifelong diagnosis as the key to healthcare and disability legal protections. Many more who didn’t have disabilities were diagnosed.
In the words of a father with two non-verbal sons who require 24-hour care: ‘Neurodiversity advocates ignore the harsh realities of severe autism, and want to forget about my sons and others like them…. For them, autism is a life-altering, cruel disability, and I’d do anything to help them feel good and give them a better quality of life’.
The expansion of neurodivergence has, paradoxically, led to alienation and anger amongst parents and carers of those children identified as having autism according to earlier, much narrower DSM criteria. These children typically have severe deficits and impairments that do seem to fit the description of a neurodevelopmental disorder of some kind (although medical tests are currently lacking).

People with no problems are identified as autistic

’What used to be called Asperger’s Syndrome (hereafter, autism) [is] an example of neurodivergent functioning [with] no inherent… clinical suffering or disablement’.
The problem is further illustrated by the growing number of celebrities with outwardly successful lives who now describe themselves as ‘autistic’ or as having ADHD; in the UK this includes Chris Packham, Anthony Hopkins, Melanie Sykes, Gary Numan, Rory Bremner, Stephen Fry, Ant McPartlin, Sheridan Smith, Sue Perkins, Jamie Oliver, Johnny Vegas and Heston Blumenthal, and in the USA Dan Ackroyd, Jerry Seinfield, Elon Musk, Courtney Love, Darryl Hannah, James Taylor, John Denver, and a growing number of others.
Rather, we are concerned with the growing numbers of people without any obvious signs of neurodevelopmental problems (e.g. intellectual impairment, epilepsy, delayed milestones such as late expressive language) who nevertheless report more subtle difficulties in communication and socialising, perhaps along with a narrow range of intense interests, and difficulties reading social cues or coping with change.
The neuro-story is seductive. It offers a simple explanation that appears to solve all of a person’s problems. Do you think you’re not as successful as you’d like to be? Is life too hard? It’s not your fault, it’s because you’re different and the world wasn’t designed for you.
Many of the adults who are currently being diagnosed are objectively successful, often with their own families and careers. How then, to give them a diagnosis of a significant impairment, when they do not appear to be impaired? The solution, again, is masking. The person says that they feel that life is harder for them than other people, and that they have to work harder than everyone else to hide their authentic autistic selves—and the neuro-affirmative professionals, it appears, accept this as a significant impairment. Thus, highly qualified and successful adults can qualify for a diagnosis that was originally intended for those with serious and enduring difficulties in functioning. It’s a form of diagnostic appropriation.
Running alongside these developments is the argument that those who are diagnosed as, or who identify with, ASD, ADHD or AuDHD are disabled, even if not disordered or diseased, and have a right to appropriate supports and adjustments.

Comparison with other forms of disability

In addition, some describe themselves as ‘disabled’ in a sense that seems to go beyond the disability movement’s meaning of the term. This leads to debates about the equivalence of different types of ‘disability’—awkwardness in social situations, for example, versus using a wheelchair or recovering from a stroke.
Nevertheless, it does seem that there are ways in which neurodiversity may differ from many other categories of disability. Should awkwardness in social situations or difficulty prioritising daily tasks, for example, count as ‘disability’ in the same sense as using a wheelchair, recovering from a stroke, or perhaps having extreme mood swings?
But for the great majority of instances of neurodivergence – notably, people given diagnoses of ASD or ADHD – there is no identifiable bodily impairment. Rather, diagnosis largely focuses upon self-reports, so can only be based on social norms.

What’s neurological about neurodivergence?

Richard Smith — Thu, 02 Oct 2025 06:00:32 GMT

Reading time: 14-22 minutes

2.1 A recap on the debate of Neurodivergence

Critics often argue that the absence of any blood tests or brain scans to test for Autism or ADHD leads to some questions about whether they are truly neurological. This blog builds on previous discussions about the “What is Neurodiversity?” blogs from Mad In the UK, co-edited by Clinical Psychologists John Cromby and Lucy Johnstone. If you haven’t seen them yet, their series can be read here. A (hopefully!) useful summary of their major themes can be found in my first blog, while discussion about their repeated point of ‘One neurodivergent swallow equals a summer’ i.e. people are identified as neurodivergent from only one or a few mild traits that are common in the population, can be found in my second blog.

Now we can focus the discussion on how we can approach the “neuro” aspect of neurodivergence. This aspect is repeatedly dismissed, both in the blogs, but also in other media by critics such as their ally, Dr Sami Timimi, (e.g. a podcast with a 90s catchphrase-based comedian called I’m ADHD! No You’re Not which can be found here or here). Sami, a child psychiatrist, has also published many books, such as the Myth of Autism and has written many times for Mad In the UK.

2.2 But there is no biological marker…

The critics (as seen in the table of quotations at the bottom of this blog) raise a fair point: there has been “a failure to find any specific and/or characteristic biological abnormality’ to confirm the validity of the term ‘ADHD’.” The same point is often made about Autism.

As Sami often says, there is no blood test or brain scan that can test for whether someone is neurodivergent, which is true (despite many claims over the years). However, is this really the ‘gotcha!’ he presents it as?

Many neurological differences don’t appear on a brain scan. Consider migraines - they can be very debilitating but as far as I understand don’t show up on brain scans. Would Sami deny the real pain experienced by patients with migraines or suggest the pain comes from elsewhere? Would they require other experiences to be validated by brain scans, like reliving traumatic memories? Hearing distressing voices? I doubt it.

2.3 Can brain scans even show subtle enough differences?

Courtesy of https://medcell.org/systems_cell_biology/nervous_system_lab.php

When we talk about the brain, it’s important to remember brains are full of billions of tiny cells called neurones, along with extremely thin connections between them, axons. These are measured in nano- and micro- metres. MRI brain scans offer about 1-2mm-sized voxels. Would we expect to see differences in the actual circuitry on these blunt scans, as opposed to what does show up on these scans following trauma to the brain, such as strokes or after severe head injuries? I wouldn’t think so. Even with this, multiple studies on the differences in the tracts of white matter in autistic brains (i.e. bundles of axons) are discussed in a recent book ‘The Lost Girls of Autism’ by Gina Rippon (which is also generally a really helpful book, discussing why autistic women have been missed for so long, but I think these discussions about their experiences help us get closer to the heart of what being autistic actually entails).

2.4 Beyond brain scans: the importance of psychometrics

Differences in brain functioning can be demonstrated without resorting to brain scans. Neuro-psychometric testing can provide valuable insight. These also allow us to specify multiple aspects of what neurodivergence involves, particularly in two significant areas: sensory processing and executive functioning.

In my previous blog, I shared some research about how many neurodivergent adults report differences in their sensory processing experiences - sensory fascinations, sensory discrimination abilities and sensory sensitivities. These appear to relate to the greater definition/detail in how they seem to experience the world, across multiple sensory domains. These experiences most likely stem from the way their brain process information as opposed to the differences stemming from the sensory organs themselves.

A commonly reported difference across many neurodivergent diagnoses - especially in autistic people and those with ADHD - is executive functioning (EF). The frontal lobes, especially the pre-frontal cortex, are thought to be key areas for the networks that carry out EFs. The diagnostic criteria for ADHD reads to me as a list of 18 executive functioning tasks. Coming from the other direction, lists of executive function difficulties resemble a description of people with ADHD, as seen in this commonly-used EF questionnaire, These include emotional dysregulation, which isn’t included in the ADHD criteria, despite being a very common feature for neurodivergent people. Neuro-psychometric testing with autistic people often shows some strengths (e.g. planning and decision making, albeit with more concrete/logical problems), as well as many difficulties with other EFs (e.g. cognitive flexibility, working memory).

That said, while I’m no expert in this specific area, I’m not always sure the tests are useful or time efficient for diagnostic assessments when assessing individuals, as opposed to their application in large groups like in the review cited. I wonder if this is largely due to the heterogeneity in the tests and the people being assessed.

In my experience (which I wouldn’t say is extensive!) of using these tests, we often assess in situations that aren’t very ecologically valid. Assessments typically take place in rooms with minimal distractions, no other competing demands and while the tester is trying to be a calming presence. People have often been very motivated to do their best in clinical settings. However, I know neurodivergent people’s motivation, energy and emotional levels fluctuate hugely in day-to-day life. Most likely as result of their executive functioning difficulties – the ones we are trying to assess!

Nevertheless, difficulties with executive functioning would link with what is often reported and discussed by neurodivergent people, or what I have observed on home visits – especially people’s organisation - in my work with autistic people. Additionally, when unpicking and getting under the surface of autistic people’s difficulties in certain areas, they report what could be interpreted as EF difficulties.

For example, when interrupted while ‘hyperfocused’, they speak about severe task switching difficulties, that it is extremely stressful to switch from focusing on the activity they’re passionate about (e.g. being in ‘reading mode’) to then quickly get into ‘talking mode’. They report the other person then talking to them, but it is very hard to listen as their brain is still thinking about the first task (even if they’ve stopped the task, e.g. they’ve put the book down). Switching back to the first activity is then sometimes very difficult.

In a similar way, when you unpick why unexpected changes to plans are so stressful for autistic people, they often report feeling frozen in making all these new unexpected decisions of what to do in the new unexpected situation. A common coping strategy for autistic needing a lot of notice for plans so they can spend long periods of time planning (hours, days or weeks!) for many of the possible eventualities in what could happen, or what might be said in conversation. When people with ADHD are asked about blurting things out in conversations, they report a mix of both finding it hard to control their urge to speak (impulsivity)and also a need to say it there and then before they forget it (working memory difficulties).

2.5 Towards a clearer understanding of Neurodivergence

Through this discussion, we can begin to try build a clearer explanation for neurodiversity, particularly across these two significant dimensions: sensory processing and executive functioning. While there will be other curves/dimensions to include in a fuller model, we could initially imagine two bell-shaped curves representing people’s functioning in these areas (although this is probably a simplified version of what’s going on), with neurodivergent people sitting in both tails of these at the same time. Other ability curves could be added too – such as empathy strengths and difficulties, or logical strengths - especially as our knowledge of neurodivergence expands.

The authors of the Mad In the UK blogs understandably highlight the vagueness often present in describing neurodivergent people. For example, Kassiane Asasumasu’s original statement described them as those “whose neurocognitive functioning diverges from dominant societal norms in multiple ways” or other statements saying they have brains that think differently. With more specificity around what can be meant by neurodiversity and neurodivergence, we can better answer criticisms of neurodivergence. More importantly, this can help neurodivergent people better understand themselves and access more specific support.

2.6 From Circular Arguments to Linear Thinking

Additionally, building a model of neurodivergence helps to move beyond the circular thinking Sami Timimi often talks about. We want to avoid this, e.g. someone being told ‘You must have ADHD because you forget things’ and then the person saying ‘I forget things because of my ADHD’.

Instead, as an example, it could be said:

1. My neurodivergent brain includes a frontal lobe system that has not developed typically/is not functioning as well as it often does for other people.

2. This gives me executive functioning difficulties - including working memory difficulties,

3. My brain easily forgets auditory information when distracted.

4. I need support from others, or other ways to remember information (such as instructions written down on paper, put into relevant apps etc) given to me.

Similarly, rather than ‘I can’t bear loud noises due to my autism’, a more complex but valid explanation can come from:

1. I have a neurodivergent brain that processes certain sensory domains in a lot more detail than other people.

2. This makes certain sensory inputs a lot more intense for me than they are for others.

3. With certain noises this makes them extremely intolerable, e.g. high-pitched noises. Additionally, this intensity makes other sounds much more pleasurable, e.g. if I listen to my favourite music.

4. This gives me my auditory sensitivity.

5. I need to accept I should avoid loud places where possible and/or wear specialised ear plugs to dampen the sounds.

These examples demonstrate a linear process: a predictive model, an explanation that links to neurodivergent people’s real life experiences and a justification for what specific support is needed, rather than a circular argument. I’m not presenting this as necessarily the right model, but it’s more an example of an attempt to step away from the previous circular reasoning. I’d also want to avoid just presenting Autism and ADHD as simply a list of symptoms/traits (as the psychiatric model does).

Finally, as we can show that there are significant sensory and executive functioning differences and difficulties in neurodivergent people, I would ask the authors of the blogs, where are these abilities located in the human body? Maybe it’s the kidney – should we call autistic people ‘nephro-divergent’? No, I think we’re safe that neuro- is a valid prefix to use for neurodivergence.

2.7 Final Take

I hope that’s been helpful to discuss how we can put the ‘neuro’ in neurodivergence, as well as some implications for it. While the blog authors outline that there are no brain scans to assess for neurodivergence, this seems unrealistic with the resolution of current technology and the tiny size of differences we’d theorise are there. Instead, we can see differences in brain functioning through different tests and neurodivergent people’s lived experiences, e.g. around sensory abilities and executive functioning. This can then inform supports and adjustments that neurodivergent people need.

Stay tuned for the next blog when I’ll discuss their position that neurodivergence isn’t credible or severe enough to be seen as a disability.

Thanks again to aspiring Clinical Psychologist, Amy Longworth, for her support with editing this.

2.8 Appendix: Select Quotations from this theme

2. Neurodivergence isn’t neurological.

There are no bio-markers/ tests/scans so neurodivergence doesn’t exist or the differences don’t exist.

“We simply can’t ask why, because there is already (apparently) an answer. Fidgeting in class is because a child has ADHD; getting upset if a friend ghosts you is attributed to ‘Rejection Sensitive Dysphoria’; feeling anxious about leaving the house is ‘Pathological Demand Avoidance’; and so on. Everything has a label, and the label disqualifies any other explanations. Parents who ask me about their children’s behaviour will often have a long list of possible diagnoses they are considering—could it be autism, ADHD, autistic burnout, conduct disorder or even BPD?”

“This leaves us with the circular argument common to all psychiatric diagnoses (with a few exceptions such as dementia):

‘Why is my child so fidgety and restless?’, ‘Because he has ADHD’; ‘How do you know he has ADHD?’, ‘Because he is so fidgety and restless’.”

“In a detailed overview, Sami Timimi concludes that, although there certainly are children (and adults) who are unsettled, restless, impulsive and easily distracted (traits which may affect their relationships, education or employment) there has been ‘a failure to find any specific and/or characteristic biological abnormality’ to confirm the validity of the term ‘ADHD’.”

“Or, putting this in plain English, no ADHD biomarkers have so far been found. There is no known biological basis for ADHD, no evidence that some people have ‘ADHD brains that crave dopamine and struggle with attention regulation’, and no objective evidence of a ‘neurodevelopmental disorder’ that causes the difficulties which can attract this diagnosis—troubling though they may be.”

“despite long lists of criteria, psychiatric diagnoses such as ASD and ADHD are ultimately based on subjective judgements (by the clinician) about subjective experiences (of the client), rather than on biomarkers – because there are none.”

One Neurodivergent Swallow Equals a Summer?

Richard Smith — Sat, 20 Sep 2025 20:59:34 GMT

Estimated reading time 15-24 minutes.

1.3 Theme 1: One Neurodivergent Swallow Equals a Summer

“Everyone’s a little bit neurodivergent” - a statement that is often heard, in conversation, in blogs and in the media, often to the immense frustration of neurodivergent people. In this blog I will explore the first of the themes that come up in the Mad In The UK blogs in more detail (archived here). Additionally, I will focus on the complexity and nuance involved in neurodivergent assessment and why reducing neurodivergent traits to something simplistic is unhelpful and inaccurate.

I will explore what I, and other psychologists I know, look for when assessing to see if someone is neurodivergent. In the Mad In The UK blog, the authors may sometimes appear to be talking about people they’ve seen on Twitter who talk about their own neurodivergence. These are people I can’t speak for.

Summary of Theme 1: One Neurodivergent Swallow Equals a Summer

The authors present a black and white idea of neurodivergence, suggesting that having one trait equals someone being seen as autistic/ADHD/ neurodivergent. (The language used around autism does give this impression at times, e.g. when discussing people ‘having’ an autism spectrum disorder). The authors can then point out single traits and dismiss or minimise them as everyone has them. This implies that everyone is neurodivergent, which then suggests, no one can be neurodivergent.

Relevant Quotations:

“The ever-expanding range of neurodivergent experiences circulated on social media also includes: reading too much, collecting information about birds, cars, trains or planes, high pain tolerance, not responding promptly to texts, feeling exhausted after a long office day, speaking the truth, feeling tired all the time, wearing bright colours, disliking fluorescent lights, enjoying being alone, fidgeting, biting your fingernails, staying up too late, being concerned about social justice, disliking wearing socks, losing your car keys, being constantly late, impulsivity, scrolling through your phone when you should be doing something else, and waving your hands when talking; and may even explain, according to one anxious enquirer, ‘difficulty getting hold of a plumber.’”

“In practice, possession of a single ‘neurodivergent’ trait seems to be enough to qualify for self-diagnosis into the category.”

“In fact, learning to comply with social norms and manage our own behaviour and responses is a universal developmental task. To an extent, we all play roles in social situations. More importantly, use of the term ‘masking’ as if it was something unique to the neurodivergent context obscures the fact that under neoliberalism everyone is encouraged to mask—often to an extreme degree.”

“Masking is something we all do. We learn how to refrain from acting on our impulses and how to act appropriately in social situations, even when it doesn’t come naturally. That is part of growing up.”

“In practice, possession of a single ‘neurodivergent’ trait seems to be enough to qualify for self-diagnosis into the category.”. This indicates that people are identified as neurodivergent by exhibiting one or two traits. Using this argument, it can be pointed out that everyone does that from time to time. This suggests either everyone is neurodivergent (and it’s meaningless) or no one is neurodivergent as they’re just the same as everyone else. ‘Masking’ is a particular target, reducing the experience of autistic (or ADHD) masking to just acting socially appropriately.

While they initially discuss this in relation to self-diagnosis, they use it to cover all talk of neurodivergence. This shows at best, they haven’t seen a diagnostic assessment. At worst – they are being disingenuous.

It is easy to explain how, in practice, assessment of neurodivergence differs from this simplistic description of it. I’m going to focus on:

· The breadth of traits I suggest are needed to be identified as neurodivergent,

· The strength/severity of traits needed to be identified as neurodivergent,

· Significant impact of these traits needed to be identified as neurodivergent.

1.4 Frequency and breadth of traits needed

For simplicity I’ll just focus on autism assessments; a similar process is followed in ADHD assessments. Alongside someone’s relevant history, I’m looking for differences in this specific range of areas:

· Social Style

· Communication Style

· Thinking style (often linked to executive functioning difficulties, but also to certain cognitive strengths)

· Sensory experiences

So, while every profile of autistic experiences is unique, we would tend to see multiple differences within all four of these themes. The variety exists underneath the themes, but the presence of these themes is very consistent (as we’ll discuss later in theme 5).

The DSM 5 has criteria for what to be looked for, but essentially, they can be boiled down to these areas (The DSM criteria and how mixed up they are, is a blog for another day). We’ll return to these 4 key areas later in answering some of the other questions posed by the blogs.

So straight away it’s clear we’re looking at four areas of difference in autistic people. Then within those areas, we’re looking for a number of differences from what could be perceived as typical.

Within the area of autistic thinking style, I’d often see people exhibiting (among other traits):

· Ability to hyperfocus on their passions,
· task switching difficulties,
· difficulties with short notice plans and changes (at the very least).
· (slightly less commonly) a drive for large collections and certain aspects of their environment to stay untouched.

In sensory processing, I’d typically see someone experiencing significant aversive sensory experiences in at least 3 of the key sensory domains:

· Sight
· smell,
· taste,
· touch and
· sound

These often exist with sensory fascinations on the aversions’ flip sides, alongside some differences in perceptions of pain, temperature, gravity, body sensations, space and time.

I could similarly list many areas of social and communication differences commonly seen in autistic people as well.

Looking at isolated individual traits can make it easy to dismiss them (e.g. as they do with short term memory difficulties), but ironically with the somewhat unfair stereotype of autistic people, it misses the bigger picture. It is like looking at the magnificence of a tiger and dismissing it while commenting “Well, loads of things have stripes, it’s no different to a zebra or a ring-tailed lemur.” Pretty absurd stuff.

A bit of probability theory

Even if having a trait ‘A’ is common, it’s quickly evident that it wouldn’t be that common to have multiple ones. If each trait outlined is present in 50% of the population and are assumed to be independent events (one for the probability theory fans). The chances of simply having trait ‘A’ and “B, C, D, E and G” together, just seven traits, is 0.78%. In neurodivergent assessments we’re looking for many more traits than that! So, we can see that a group of common-ish traits - while I’d argue the traits we’re looking at aren’t that common- has a very low probability of all co-occurring.

1.5 The strength/severity of the traits present

So we’ve covered that the breadth of traits seen in neurodivergent people is far wider than the authors of the blog suggest, but the strength of the traits is far greater than they describe too. Speaking to autistic people, you quickly see just how much their differences stand them out from the crowd.

Again, it’s somewhat easier for the points to work with the more concrete differences seen in autistic people’s thinking style and their sensory processing.

Let’s consider the example ‘reading too much’. An autistic person who loves reading can hyper-focus to such an extent that time disappears for 8, 9, 10 hours, often more. The sun may go down without them noticing. They could often go without food or drink, or don’t use the toilet in that time. People trying to get their attention may struggle to, without going up to the person and prodding them; calling their name may be a waste of breath. These are common stories from autistic people I assess (although substitute reading for whatever their particular passion is). It is one part of their experiences that I’m jealous of: I wish I could focus for that long and gain that much pleasure from the extended ‘flow state’ autistic people report. I’m going to guess this isn’t the typical experience for most people.

If we pick out the ‘disliking fluorescent lights’ example the authors use. I’ve met many autistic people who struggle to do much more than squint under the fluorescent tube lighting common in lecture halls, supermarkets, offices and hospitals. Some get headaches after 20 minutes, others become very tired or sleepy within that time instead. If this is the ‘typical’ reaction of people to fluorescent lights, I wonder if the authors could explain why they’re being used at all? This example can be easily adapted to a specific sensory difference e.g., reactions to sounds or certain food textures.

The world would be very different if most people experienced the severe sensory differences that autistic people often report. The world wouldn’t contain fluorescent lighting, xenon headlights, computer and phone screens that can’t be dimmed even further. There would be no motorbikes, road works or crowded places. We wouldn’t have onions and mushrooms, clothes not made of cotton, air fresheners, or moderately spicy food; we’d have food that is either bland or mouth-meltingly spicy, as preferred by other neurodivergent people.

In recent times, the enhanced sensory discrimination abilities reported by autistic people have been measured as well e.g. with orientation discrimination of oblique lines (https://pubmed.ncbi.nlm.nih.gov/24870402/) or the work by Anna Remington et al. on auditory processing capacity in autistic people: (https://crae.ioe.ac.uk/portfolio/attention-and-perception/).

These quantitative differences can also be seen in questionnaires used as adjuncts to diagnostic assessments. The RAADS-R one I feel is the best of a bad bunch (see also the AQ). Even so, the stats for it outline that autistic people score on average over 130. While people that haven’t been identified as autistic score between 20 and 30 (also not zero, showing autistic traits aren’t individually unique to autistic people). The different scores of masking using the CAT-Q between autistic and neurotypical people can be seen here: https://embrace-autism.com/cat-q/#Average_scores divided by gender. With autistic women scoring on average 124 out of 175, while neurotypical women scoring about 90.

Why would these scores differ so much, if, as the authors make out, there is no group that we can identify as autistic and their differences are actually common?

I could explore many other differences in neurodivergent people - their ‘social batteries’, their conversational preferences or difficulties with change - but hopefully this is enough.

1.6 The significance of the impact of these differences

‘We’re all a little bit autistic’, a conclusion that can feel invalidating for many autistic people and which I want to avoid. We can see that these quantitative differences we have explored can produce qualitatively different experiences.

The Tall-istic Analogy

A metaphor I use often, is that identifying someone as autistic is akin to making a diagnosis of ‘Height Disorder’ - or seeing them as a ‘Tall-istic’ person. Autistic traits are present in everyone to some degree. Yet for some people the amount and impact they have, means we make a black and white “diagnosis” when someone is at the far end of a continuum (generally around the top 1.5%). Obviously, we’re looking at far more than one dimension when completing an assessment, but hopefully the point is clear.

Using this quantitative difference of something we all have, i.e. some degree of height, we can start to think how different life would be to be as a ‘Tall-istic’ person. As people may know, the person in the photo is Andre the Giant, a French professional wrestler. He was known as ‘The Eight Wonder of the World’ as a wrestler, and billed as being over 7 feet tall. He would have made huge amounts of money in his professional career, while also being cheered (or sometimes booed) by thousands of people in arenas. He was known to drink over a hundred beers in one sitting. However, he also experienced tremendous amounts of pain, social barriers and limitations because of his height.

So while we all ‘have’ height, extremely few of us have anything approaching his height. He lived a life that is hard to imagine for us more averaged-sized people. Equally, while it is hard to specify exactly the boundary when someone becomes ‘Tall-istic’, in practice most of us would be able to offer a ‘diagnostic’ opinion on it. Human beings categorise all kinds of spectra. A quantitative difference gives a qualitatively different experience.

Masking: the hidden cost

It is clear, in autistic people that their quantitative differences often lead to qualitatively different experiences. As the authors acknowledge, “we all play roles in social situations.’, which is true to an extent. Yet they don’t acknowledge, or possibly know about, the huge impact masking has on autistic people. This is worthy of a whole blog in itself.

A client of mine stated he must consciously monitor how he presents himself, when interacting with people or just generally going about his day being around others. A 3-hour trip out of the house would take up to 6 hours of his day, as he had to factor in significant rest time. I only hope that the authors do not experience this level of exhaustion just from being around other people.

The impact of the mental gymnastics that autistic people report that they’re experiencing are much more than people’s typical experiences of just thinking of how to be polite to people, as the authors indicate.

The significant levels of exhaustion commonly reported by autistic people highlight how their experiences aren’t in the typical range. Additionally, we can consider their rates of very poor emotional wellbeing, employment rates, physical health, self-harm and suicidality (these will be discussed in more detail in a later blog). These all add up to make the overall neurodivergent experience noticeably different - while being unique in each neurodivergent individual’s case - from what many others are experiencing.

1.7 Final thoughts…

So, I hope I have fairly summarised the points made in the Mad In The UK blogs, by authors I highly respect. The points made usefully highlight some holes in thinking about and explanations of neurodivergence, alongside a number of misunderstandings or misrepresentations.

Firstly, when discussing how they perceive people talking about neurodivergence, they give a picture of people seeing a single common experience and saying that this means they are autistic, have ADHD or are neurodivergent. However, in clinical practice, clinicians will be looking for a very broad range of experiences, under 4 consistent themes for autistic people (social interaction style, social communication style, thinking style and sensory experiences). This broad range of experiences are then assessed for the depth, severity and strength of them, before looking at the significant impact these differences cause for the person.

I hope that’s been helpful to have these aspects of understanding neurodivergence and assessment of neurodivergence, i.e. demonstrating the ‘divergence’ aspect. Stay tuned for the next blog, where I will discuss how we can put the ‘neuro’ in neurodivergence.

Finally, many thanks again to Amy Longworth for her help with editing this blog and her ideas on shaping it.

What is Neurodiversity?

Richard Smith — Sat, 20 Sep 2025 17:26:01 GMT

Reading time approx 6-9 minutes

1.1 Neurodiversity—What Exactly Does It Mean?’.

This is a key question I have been thinking about for many years. Yet some answers I have come across recently, imply my work over the last 14 years -which I feel has helped thousands, might have been pointless.

Lucy Johnstone, a prominent and much-respected figure in the anti-diagnosis and anti-psychiatry movement shared a blog from the team at Mad In the UK in July 2024 on the UK Clinical Psychology Facebook group. The article was part of a four part series on “Mad in the UK” website, which you can read here: https://www.madinamerica.com/neurodiversity-series/). Their answer to this key question quickly becomes clear: neurodiversity is meaningless.

The blogs sparked a lot of initial discussion. The first blog received 148 comments on the Clinical Psychology Facebook group (a good few from myself!). The following 3 gained 60 odd in total. On Twitter (never X) comments were fewer, but the first blog was retweeted approximately 100 times – especially from the Mad In the UK Twitter account. Since then, I have seen the ideas from the blogs repeated in online talks and conferences put on by A Disorder 4 Everyone, as well as interviews given by Dr. Sami Timimi, a child and adolescent psychiatrist, relating to his book ‘Searching for Normal’.

I attended a conference “De-medicalising misery” in 2010 or 2011, when a third-year trainee clinical psychologist. It was recommended by my course mates Verity and Emma and it shifted my perception. I was sold on how the disease model of human suffering was actively unhelpful. I was officially ‘anti-diagnosis’. It seemed bizarre to me – and cruel at times – how we could turn people’s emotions into diagnosable conditions to be cured, mostly by medication. (Please see the Power Threat Meaning Framework, which is essential reading and extremely useful clinically: https://www.bps.org.uk/member-networks/division-clinical-psychology/power-threat-meaning-framework).

Then, after qualifying, I applied this anti-diagnosis enlightenment (somewhat ironically) by becoming a diagnostician. But not of people’s mental health, but of Autism.

Over the years this contradiction has raised many questions for me: Why do I believe we shouldn’t categorise people’s emotions – that we should instead focus on understanding and supporting people. Yet most of my work has focused on categorising people’s possible neurodivergence? How can I marry the two opposing positions?

Within the four blogs and in the author’s previous writings and videos, I noticed some of the same points being made repeatedly. These included recurring misconceptions, misreporting and misunderstandings, alongside some genuinely useful highlighting of gaps and inconsistencies of how neurodiversity is spoken about. As a clinical psychologist specialising in the area, these are issues I come across often.

They also came at an interesting time as Autism appeared to be a new front line in the culture wars and a way to try remove our empathy for yet another minority (e.g. here or here [behind a paywall]).

Over the last year, I have considered how responding to the critiques of neurodiversity, from the perspective of a clinician working with neurodivergent adults, could help us to understand autistic people and those with ADHD better. More importantly it could help them to better understand themselves. More clarity in the area is needed. I believe it can help people with their clinical work, whether in identifying autistic/neurodivergent people, or helping them therapeutically. It may also give some directions for future research and how research is conducted. I am open about having much less experience working with children and welcome perspectives from those working with neurodivergent children (or perspectives from anyone really!). I don’t claim to know all the answers; we’re dealing with a complex aspect of human experience.

Additionally, I hope that the series of blogs I aim to write in the response to the original blogs can also initiate more meaningful dialogue between the various parties involved. A back-and-forth of ‘Neurodivergence exists! ‘Oh no it doesn’t’ gets us nowhere. However, discussions about the opposing positions could lead us in more helpful directions in the future – ones that are both compassionate and constructive. So, this is also an invitation: let’s talk!

1.2 Thematically Analysing the Blogs

Before that can happen though, let’s talk about the blogs themselves. To help with this, I - with a little help from some Clinical Psychologist friends - did what a good doctoral-trained Clinical Psychologist might do: conduct a thematic analysis of the blogs (please, stick with me here!) The following table identifies 10 themes. I’ll look at each theme individually in this and subsequent blogs, providing illustrative quotations and descriptions to discuss how the main point in each theme can be answered.

Themes:

1. One Neurodivergent Swallow Equals a Summer
2. Neurodivergence isn’t neurological.
3. Neurodivergence isn’t credible or severe enough to be seen as a disability.
4. Labels ignore societal issues.
5. It’s all contradictory
6. Diagnoses lead to disadvantages.
7. There’s no definition of Autism, or what exactly is neurodivergence.
8. The movement splits people up.
9. The writers misunderstand/misrepresent assessments
10. Neurodivergent voices are ignored, invalidated or mocked.

Additionally, I’ve seen many of these themes become generalised to ideas shared by the authors in other media I’ve read, watched or listened to. This includes podcasts (e.g. I’m ADHD! No you’re not), books (e.g., Searching For Normal by Sami Timimi), newspaper articles (e.g., the Telegraph, as above) or online talks and conferences (e.g., AD4E).

It’s important for discussions to remain respectful, constructive and curious. Alongside these themes, unfortunately there are multiple stories in the blogs of clinicians or researchers being excluded or criticised harshly, because of the authors’ beliefs – these are incidents I can’t comment on specifically.

Stay tuned as in the next blog, I’ll begin by looking at their first theme: “One Neurodivergent Swallow Equals a Summer.”

Finally, a huge thank you to Amy Longworth for her help with editing this blog and her ideas on shaping it.