Neurodiversity-affirming assessments

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Nick’s Article on The Neurodiversity Paradigm

Nick Walker is a queer autistic professor of psychology, a cofounder of the worker-owned publishing house Autonomous Press, a longtime participant in autistic culture whose ideas have influenced the emergent fields of neurodiversity studies and critical autism theory, and a transdisciplinary scholar whose work explores the intersections of neurodiversity, embodiment, queer theory, and transformative practice. 

Nick suggests ; 

Neurodiversity, simply put, is the diversity among human minds. For 15 years or so after the term was coined, it was common for people to speak of neurodiversity as “diversity among brains.” There still are plenty of people who talk about it that way. I think this is a mistake; it''s an overly reductionist and essentialist definition that's decades behind present-day understandings of how human bodyminds4 work.

Mind is an embodied phenomenon.

The mind is encoded in the brain as ever-changing webs of neural connectivity. The brain is part of the body, interconnected with the rest of the body by a vast network of nerves. The activity of the mind and body creates changes in the brain; changes in the brain affect both mind and embodiment. Mind, brain, and embodiment are intricately entwined in a single complex system. We're not minds riding around in bodies, we're bodyminds.4

A lot of people hear neuro and they think, brain. But the prefix neuro doesn't mean brain, it means nerve. The neuro in neurodiversity is most usefully understood as a convenient shorthand for the functionality of the whole bodymind and the way the nervous system weaves together cognition and embodiment. So neurodiversity refers to the diversity among minds, or among bodyminds.

In terms of scholarship, discourse, and praxis, there are two basic ways to approach the biopsychosocial phenomenon of neurodiversity. Sometime around 2010, I started referring to these two approaches as the pathology paradigm and the neurodiversity paradigm.2

The pathology paradigm starts from the assumption that significant divergences from dominant sociocultural norms of cognition and embodiment represent some form of deficit, defect, or pathology. In other words, the pathology paradigm divides the spectrum of human cognitive/embodied performance into “normal” and “other than normal,” with “normal” implicitly privileged as the superior and desirable state.

The neurodiversity paradigm starts from the understanding that neurodiversity is an axis of human diversity, like ethnic diversity or diversity of gender and sexual orientation, and is subject to the same sorts of social dynamics as those other forms of diversity—including the dynamics of social power inequalities, privilege, and oppression. From this perspective, the pathologization of neurominorities can be recognized as simply another form of systemic oppression which functions similarly to the oppression of other types of minority groups.

RMC Approach :
Rainbow Mandala Clinic (RMC) offers neurodiversity-affirming ADHD assessments that respect each person’s identity, communication style and lived experience. 

Our approach recognises individual strengths alongside the challenges that may lead someone to seek assessment and support.

We allow up to three hours for an assessment of previously undiagnosed ADHD, with appointments typically lasting approximately two and a half hours. This provides time for a relaxed, structured conversation in which you can share your experiences, reflect on your history and ask questions.

We recognise that people communicate, process information and express themselves in different ways. You are welcome to move, change position or take a comfort break during your assessment. We encourage you to discuss any adjustments that would help you feel more comfortable and supported.

Space to be yourself

Some people have spent years masking or camouflaging their differences to meet social expectations. At RMC, we aim to create an environment in which you feel comfortable expressing yourself naturally, at your own pace.

There is no expectation that you must be able to identify or immediately let go of masking. Our clinicians are interested in understanding your internal experience, including the effort involved in managing everyday demands, even when those difficulties are not apparent to others.

Understanding masking and camouflaging

The Camouflaging Autistic Traits Questionnaire (CAT-Q) is a self-report questionnaire that explores strategies used to compensate for, mask or adapt autistic characteristics in social situations. It was developed and evaluated with autistic and non-autistic adults. It can help inform a conversation about camouflaging, but it does not diagnose autism or ADHD. (link.springer.com)

If you would like to explore this further, the Embrace Autism CAT-Q webpage provides information and an online questionnaire with an automatically calculated total score. A high score does not, by itself, establish that someone is autistic; results need to be understood alongside developmental history and broader clinical assessment. (embrace-autism.com)

An individual approach to assessment and care

Our assessment approach considers the whole person, including attention, executive functioning, emotional regulation, sensory experiences, relationships and everyday functioning. Where autism or other neurodevelopmental differences may be relevant, we explore these within the assessment and discuss whether further assessment or support would be helpful.

We recognise that each person’s needs and responses to treatment are individual. Where medication is appropriate, decisions are collaborative, with attention to benefits, side effects and the person’s priorities.

What neurodiversity-affirming means to us

At RMC, we recognise neurological diversity as part of human variation. We respect different ways of thinking, learning, communicating and experiencing the world, while acknowledging that neurodevelopmental conditions can involve substantial difficulties and disability.

Our approach includes recognising strengths, respecting identity, adapting communication and reducing barriers to participation. This is compatible with careful diagnostic assessment, evidence-based treatment and practical support.

We draw on the social model of disability to consider how environments, expectations and attitudes can create barriers. Alongside this, we recognise each person’s clinical needs and right to access care.

Our goal is to help you understand your experiences and access support that improves your wellbeing and everyday life, while respecting who you are.