Neurodiversity and Neurominorities: From a Medical to a Social Model

Introduction

Neurodiversity is the concept that every brain is unique. Indeed, all of them are different. For centuries, people have explored talents, IQ, and personality. Initially, it was thought that mental illness stemmed from humors, the heart, or the loss of the soul. However, as early as the fifth century BCE, some recognized the brain as the source of thought. Even Hippocrates, with his theory of the four humors, wasn't entirely wrong if one considers chemical humors as neurotransmitters. The major flaw of the medical model is its belief that those who deviate from the norm and face challenges need to be "fixed." Admittedly, my ADHD can be frustrating. I dislike the ADHD tax and wish I had better object permanence and wasn't so time-blind. Yet, I also appreciate how creative my brain is and how quickly it identifies opportunities others might overlook. The truth is, I don't want to change my brain because it would mean losing my unique strengths. This is where the social model becomes relevant. Below, you'll find an explanation of why both the medical and social models are necessary, what the social model entails, and what investing in both could do for the individuals and society.

Understanding Neurodiversity and Neurominorities

Neurodiversity refers to the natural variability in brain functioning, as each brain is unique. Some people excel in specific skills like motor abilities or languages. While all brains vary, those significantly different from the average are considered neurodivergent. This group is diverse in information processing and behavior, leading to various diagnoses. However since a diagnosis is usually part of the medical model, in 2020 Nancy Doyle coined a term I will use from now on; neurominorities. A neurominority is a population that shares common elements of neurodivergence shown by a specific symptom cluster and is, therefore, subject to similar challenges and discrimination in facing the neurotypical society. Below you see an image of the classification of neurominorities, which includes both neurological and social factors to be considered.

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  Image from "Unraveling Neurodiversity: Insights from Neuroscientific Perspectives" by Hagar Goldberg

  Neurodivergence is expressed both due to the inherent neurological differences in neurodivergent brains and because our societies lack the inclusivity needed for these brains to thrive. Emma Strachan recently offered a compelling analogy to explain this concept. She compared it to people who wear glasses. Before glasses became widely available, poor eyesight was considered a disorder, making it difficult to navigate daily life and increasing the risk of injury. Today, glasses and contact lenses help compensate for poor eyesight, allowing those who need them to participate fully in most aspects of society. We no longer pity them, despite the fact that they may never achieve perfect 20/20 vision. Moreover, because eyesight is so crucial, individuals with poor vision have the option to correct it permanently through surgery, within the limits of medical science. We continue to research ways to improve the lives of those significantly affected by vision impairments. What if we took a similar approach to neurodivergence?

  
  

  The Medical Model of Disability

  The classic medical model approached disabilities as impairments and dysfunction of the person. Basically, if you are sick, you need to be fixed. However, we could be making a distinction between disorder and disability, which are now used interchangeably. The autism researcher Baron-Cohen suggested updating medical terms to consider neurodiversity and a more precise differentiation between disorder and disability, According to Baron-Cohen, a disorder is maladaptive functioning in organic and behavioral levels which happens always, independent of context. Disability is a disruption of behavioral ability due to internal or external barriers (or their combination) leading to a compromised performance in specific functions and specific environments. So, for a disability changing the context would mean changing the performance. Just as we see with glasses for people with bad eyesight.

  Medical terminology about neurodiversity and neurominorities is not just about words, as it calls for different actions by policymakers and systemic solutions. Baron-Cohen suggests that while a disorder requires a cure or treatment, disability requires societal adjustments and support.

  
  

Transition to the Social Model of Disability

So what if we started to take away as many barriers as we could? What if, we started to include the people it concerns in designing solutions for their issues? What if, we started to value the differences for what they can bring us? I think that's the fundamental goal of transitioning to a social model of disabilities. Diagnoses like dyslexia, ADHD, Schizophrenia, Mood Disorders, ASD and OCD have a high heritability rate and have always been around. This challenges the idea that they merely reflect an error in production and dysfunction that should essentially be fixed by modern science. If it has not given us a competitive evolutionary advantage, it would have been filtered out.

According to this view, neurodiversity can be seen as a form of biological altruism. Certain genetic traits that may cause challenges for individuals can also provide advantages for society as a whole. For instance, people with ADHD often have genes that make them more likely to seek new experiences and take risks. While this can put them at a higher risk for physical harm, social difficulties, and mental health issues, these same traits can also help society by increasing diversity, adaptability, and the ability to evolve. In summary, while individuals may face personal challenges, the overall benefits of neurodiversity can help the entire community. But if we follow the social model, the community would benefit without the suffering for the individual.

And for those for whom their different brain is no a disability but a disorder, we can continue to invest in medical science to see if this can be cured. Because, I do not want anyone to suffer.

Closing Statement

So in my opinion the medical model and the social model should co-exist. Basically, I want the world to offer glasses, or white canes for people with bad eyesight or blindness. However, I also want to world to see if blindness or bad eyesight can be fixed for those who want that. Just so they don't have to rely on tools anymore. That they have access to all jobs that are up until now still unavailable to some, such as being a pilot, surgeon, photographer or professional athlete. This means that the social model is there, advocating for systemic and contextual solutions to remove the barriers that create disability for neurominorities. The medical model designed to ease, or even better, remove the suffering of those with disordered brains who want this permanent solution.

Citation: Goldberg, H. Unraveling

Neurodiversity: Insights from

Neuroscientific Perspectives.

Encyclopedia 2023, 3, 972–980.

https://doi.org/10.3390/

encyclopedia3030070