I broadly agree, although I think one underlying problem is the term “neurodiversity” itself. It groups autism, ADHD, Tourette’s, bipolar disorder and a collection of largely unrelated conditions beneath one increasingly capacious umbrella. It is rather like the demographic category “18 to 34”. An 18-year-old woman and a 34-year-old man may be convenient inhabitants of the same spreadsheet, but that does not mean they have much else in common.
“Neurodiversity” may be useful as a political coalition or a general argument for tolerance. It is far less useful clinically. It tells us almost nothing about a person’s particular condition, impairment or support needs.
The diagnostic threshold also needs tightening significantly. Existing criteria supposedly require symptoms to have been present since childhood, to occur across different areas of life and to cause substantial functional impairment. Yet ordinary distractibility, procrastination, boredom and disorganisation are increasingly treated as sufficient evidence of ADHD.
Curiously, it is nearly always ADHD. I rarely encounter people casually announcing that they have self-diagnosed autism, but I am increasingly told by apparently ordinary, functional people that they “have ADHD” because they lose their keys, dislike boring work or struggle to concentrate while carrying a permanently connected distraction machine in their pocket.
Self-recognition can be a legitimate beginning. Many people, including me, were diagnosed late because something genuine had been missed. But self-recognition cannot also be the conclusion. The conditions have not become lifestyle choices, but adopting the labels sometimes has.
The NHS is then placed in an impossible position. It cannot simply dismiss people requesting an assessment, because some will genuinely need a diagnosis and support. Yet demand is overwhelming a system without the capacity or effective mechanisms to distinguish probable clinical need from much looser self-identification.
[Today’s Guardian report](https://www.theguardian.com/society/2026/aug/28/adhd-autism-costs-england-running-out-of-control-nhs-alliance) describes spending increasing tenfold in some areas, adult ADHD expenditure rising from £11 million to a projected £51 million, and individual areas receiving invoices from dozens of providers charging between £300 and £3,000 for ostensibly similar services. Whatever proportion of applicants ultimately receive a diagnosis, the machinery created to process this demand is becoming financially and clinically incoherent.
The final irony is that this harms people with serious neurodevelopmental disabilities. As someone with diagnosed autism and ADHD whose conditions have had substantial lifelong consequences, I am thoroughly tired of being told that “everyone has a bit of it”. As the language becomes ubiquitous, the public begins to conclude that everyone is claiming ADHD and that everyone claiming it is probably exaggerating.
A movement intended to legitimise neurological disability risks trivialising it. Once almost anyone can claim to be neurodivergent, the word ceases to distinguish those who are genuinely and seriously disabled from those experiencing the ordinary difficulties of being human in a distracting and increasingly dysfunctional world.
Very well said. I couldn’t agree more. It is no wonder there is such cynicism around when we are asked to believe that all of these people have at the same time suddenly become ‘neurodiverse’. I wrote this piece partly as a corrective to my book in which I am much more critical of the identity-activists. I wanted to acknowledge here what could have been, and might still be, an advance for people who genuinely struggle and can advocate for each other. But that’s politics. Not medicine.
Yes, it’s politics not medicine. I and my colleague John Cromby were among the first to critique the ND phenomenon/ideology and our blog series has been widely read. Here is the first one, in case you haven’t come across it.
I think you are right about where the neurodiversity movement has led us. Your account shows how Singer’s vocabulary helped a relatively small group form a collective identity, how that identity developed into a social movement, and how the movement subsequently expanded far beyond its original constituency.
Where I may differ is in locating the source of the problem. You seem to regard neurodiversity as an initially humane and useful idea whose contradictions emerged through its later expansion. I wonder whether the category error was present in the term from its birth.
First, “neuro” implicitly ties cognition to the nervous system. It encourages us to speak of different “brains,” “wiring” or “kinds of minds,” as though cognition originates in a nervous system that can be abstracted from the rest of the organism. But cognition is embodied. The nervous system develops and functions in continuous interaction with immune, endocrine, metabolic, autonomic and sensorimotor processes, all within a relational and cultural environment. What, then, is specifically *neuro* about the differences being described?
Second, “diversity” slips from a population-level description of variation into a positive evaluation of particular individual outcomes. Yet diversity is not synonymous with benignity. Biodiversity is famously “red in tooth and claw”: it includes predation, parasitism, suffering and extinction as well as cooperation and resilience. Immunological diversity protects populations against pathogens, but the mechanisms that generate it also carry collateral risks, including autoimmune conditions such as type 1 diabetes. Something may contribute to variation or resilience at population level while being profoundly harmful to an individual.
The term *neurodiversity* therefore appears to do two things simultaneously: it reifies emerging developmental patterns as distinct neurological kinds, and then valorises those kinds through the morally positive language of diversity. From the uncontroversial observation that human beings vary, we move to the existence of a “neurodivergent” category of person, then to an identity, a political constituency and an entitlement to support. Those are different language games, but the same vocabulary allows us to move between them without spelling out or justifying the transitions.
None of this diminishes the equal human worth of people experiencing these difficulties. Respecting the person does not require us to celebrate every biological or developmental outcome that the person experiences.
Might the movement’s later expansion therefore be less a corruption of Singer’s original idea than the unfolding of conceptual assumptions already contained within the word *neurodiversity*?
Sorry, I’ve started using the language Singer et al use. AC means Autistics and Cousins - the latter being the geeks and nerds who were starting to congregate in the early chatrooms. So, already she was describing a community of outsiders rather than just high-functioning Autistics. Really appreciate the opportunity to discuss, Kevin.
Thank you, Dave. “Autistics and Cousins” is especially revealing, because it helps us identify the different language games being played.
In the social and historical language game, ACs describes a genuine community: heterogeneous people who recognised affinities in one another and found that the internet offered a more congenial environment for communication. I can readily understand why that was valuable.
But the discussion then seems to slide into a biological language game in which the shared phenotype is treated as evidence of a genetically determined neurological type. That transition cannot simply be assumed.
GWAS does not reveal a discrete “autistic genome” corresponding to a coherent Homo autisticus. The diagnosed phenotype is profoundly heterogeneous, and its associated polygenic architecture is heterogeneous too. Heritability within a population does not mean that the phenotype is genetically predetermined in an individual, nor does genetic association establish a bounded natural kind.
This leads me towards what I find a more compelling explanation: emergent determinism and degrees of constraint. Developmental outcomes emerge through continuing interaction among genetic variation, immune, endocrine, metabolic, autonomic and sensorimotor processes, lived experience and the surrounding relational environment. As these interactions accumulate, some developmental pathways become more constrained and therefore increasingly likely—but they were not fully specified at conception.
The early internet may therefore have been a “prosthetic” not for a pre-existing human subtype, but for heterogeneous people whose difficulties became less constraining—and whose capabilities became more visible—within a different communicative environment.
The community was real. The shared experiences were real. But neither, by itself, establishes the existence of a discrete neurological kind. I am thoroughly enjoying this discussion too.
I don’t disagree with any of that. I take the term as given here but in my book I have a little more to say about its political character. It is a species of identity politics - Singer just substituted ‘neuro-‘ for the celebration of ethnic diversity etc and, more recently, with notions that we are all on some kind of gender spectrum too. These movements are themselves, as much as they valorise fragmentation, a consequence of the ideological collapse of the old post-war politics. The new social movements of the 70s and 80s, etc, and the rise of ‘woke’ social theory in the universities. But still there was something going on in the 1990s, with the emergence of the internet as a ‘prosthetic’ for these ACs, that I really like.
I broadly agree, although I think one underlying problem is the term “neurodiversity” itself. It groups autism, ADHD, Tourette’s, bipolar disorder and a collection of largely unrelated conditions beneath one increasingly capacious umbrella. It is rather like the demographic category “18 to 34”. An 18-year-old woman and a 34-year-old man may be convenient inhabitants of the same spreadsheet, but that does not mean they have much else in common.
“Neurodiversity” may be useful as a political coalition or a general argument for tolerance. It is far less useful clinically. It tells us almost nothing about a person’s particular condition, impairment or support needs.
The diagnostic threshold also needs tightening significantly. Existing criteria supposedly require symptoms to have been present since childhood, to occur across different areas of life and to cause substantial functional impairment. Yet ordinary distractibility, procrastination, boredom and disorganisation are increasingly treated as sufficient evidence of ADHD.
Curiously, it is nearly always ADHD. I rarely encounter people casually announcing that they have self-diagnosed autism, but I am increasingly told by apparently ordinary, functional people that they “have ADHD” because they lose their keys, dislike boring work or struggle to concentrate while carrying a permanently connected distraction machine in their pocket.
Self-recognition can be a legitimate beginning. Many people, including me, were diagnosed late because something genuine had been missed. But self-recognition cannot also be the conclusion. The conditions have not become lifestyle choices, but adopting the labels sometimes has.
The NHS is then placed in an impossible position. It cannot simply dismiss people requesting an assessment, because some will genuinely need a diagnosis and support. Yet demand is overwhelming a system without the capacity or effective mechanisms to distinguish probable clinical need from much looser self-identification.
[Today’s Guardian report](https://www.theguardian.com/society/2026/aug/28/adhd-autism-costs-england-running-out-of-control-nhs-alliance) describes spending increasing tenfold in some areas, adult ADHD expenditure rising from £11 million to a projected £51 million, and individual areas receiving invoices from dozens of providers charging between £300 and £3,000 for ostensibly similar services. Whatever proportion of applicants ultimately receive a diagnosis, the machinery created to process this demand is becoming financially and clinically incoherent.
The final irony is that this harms people with serious neurodevelopmental disabilities. As someone with diagnosed autism and ADHD whose conditions have had substantial lifelong consequences, I am thoroughly tired of being told that “everyone has a bit of it”. As the language becomes ubiquitous, the public begins to conclude that everyone is claiming ADHD and that everyone claiming it is probably exaggerating.
A movement intended to legitimise neurological disability risks trivialising it. Once almost anyone can claim to be neurodivergent, the word ceases to distinguish those who are genuinely and seriously disabled from those experiencing the ordinary difficulties of being human in a distracting and increasingly dysfunctional world.
Very well said. I couldn’t agree more. It is no wonder there is such cynicism around when we are asked to believe that all of these people have at the same time suddenly become ‘neurodiverse’. I wrote this piece partly as a corrective to my book in which I am much more critical of the identity-activists. I wanted to acknowledge here what could have been, and might still be, an advance for people who genuinely struggle and can advocate for each other. But that’s politics. Not medicine.
Yes, it’s politics not medicine. I and my colleague John Cromby were among the first to critique the ND phenomenon/ideology and our blog series has been widely read. Here is the first one, in case you haven’t come across it.
https://www.madintheuk.com/2024/12/part-1-neurodiversity-what-exactly-does-it-mean/
Thanks Lucy, I’ll take a look!
I think you are right about where the neurodiversity movement has led us. Your account shows how Singer’s vocabulary helped a relatively small group form a collective identity, how that identity developed into a social movement, and how the movement subsequently expanded far beyond its original constituency.
Where I may differ is in locating the source of the problem. You seem to regard neurodiversity as an initially humane and useful idea whose contradictions emerged through its later expansion. I wonder whether the category error was present in the term from its birth.
First, “neuro” implicitly ties cognition to the nervous system. It encourages us to speak of different “brains,” “wiring” or “kinds of minds,” as though cognition originates in a nervous system that can be abstracted from the rest of the organism. But cognition is embodied. The nervous system develops and functions in continuous interaction with immune, endocrine, metabolic, autonomic and sensorimotor processes, all within a relational and cultural environment. What, then, is specifically *neuro* about the differences being described?
Second, “diversity” slips from a population-level description of variation into a positive evaluation of particular individual outcomes. Yet diversity is not synonymous with benignity. Biodiversity is famously “red in tooth and claw”: it includes predation, parasitism, suffering and extinction as well as cooperation and resilience. Immunological diversity protects populations against pathogens, but the mechanisms that generate it also carry collateral risks, including autoimmune conditions such as type 1 diabetes. Something may contribute to variation or resilience at population level while being profoundly harmful to an individual.
The term *neurodiversity* therefore appears to do two things simultaneously: it reifies emerging developmental patterns as distinct neurological kinds, and then valorises those kinds through the morally positive language of diversity. From the uncontroversial observation that human beings vary, we move to the existence of a “neurodivergent” category of person, then to an identity, a political constituency and an entitlement to support. Those are different language games, but the same vocabulary allows us to move between them without spelling out or justifying the transitions.
None of this diminishes the equal human worth of people experiencing these difficulties. Respecting the person does not require us to celebrate every biological or developmental outcome that the person experiences.
Might the movement’s later expansion therefore be less a corruption of Singer’s original idea than the unfolding of conceptual assumptions already contained within the word *neurodiversity*?
Sorry, I’ve started using the language Singer et al use. AC means Autistics and Cousins - the latter being the geeks and nerds who were starting to congregate in the early chatrooms. So, already she was describing a community of outsiders rather than just high-functioning Autistics. Really appreciate the opportunity to discuss, Kevin.
Thank you, Dave. “Autistics and Cousins” is especially revealing, because it helps us identify the different language games being played.
In the social and historical language game, ACs describes a genuine community: heterogeneous people who recognised affinities in one another and found that the internet offered a more congenial environment for communication. I can readily understand why that was valuable.
But the discussion then seems to slide into a biological language game in which the shared phenotype is treated as evidence of a genetically determined neurological type. That transition cannot simply be assumed.
GWAS does not reveal a discrete “autistic genome” corresponding to a coherent Homo autisticus. The diagnosed phenotype is profoundly heterogeneous, and its associated polygenic architecture is heterogeneous too. Heritability within a population does not mean that the phenotype is genetically predetermined in an individual, nor does genetic association establish a bounded natural kind.
This leads me towards what I find a more compelling explanation: emergent determinism and degrees of constraint. Developmental outcomes emerge through continuing interaction among genetic variation, immune, endocrine, metabolic, autonomic and sensorimotor processes, lived experience and the surrounding relational environment. As these interactions accumulate, some developmental pathways become more constrained and therefore increasingly likely—but they were not fully specified at conception.
The early internet may therefore have been a “prosthetic” not for a pre-existing human subtype, but for heterogeneous people whose difficulties became less constraining—and whose capabilities became more visible—within a different communicative environment.
The community was real. The shared experiences were real. But neither, by itself, establishes the existence of a discrete neurological kind. I am thoroughly enjoying this discussion too.
I don’t disagree with any of that. I take the term as given here but in my book I have a little more to say about its political character. It is a species of identity politics - Singer just substituted ‘neuro-‘ for the celebration of ethnic diversity etc and, more recently, with notions that we are all on some kind of gender spectrum too. These movements are themselves, as much as they valorise fragmentation, a consequence of the ideological collapse of the old post-war politics. The new social movements of the 70s and 80s, etc, and the rise of ‘woke’ social theory in the universities. But still there was something going on in the 1990s, with the emergence of the internet as a ‘prosthetic’ for these ACs, that I really like.
Thanks for engaging Dave. I am not a psychologist so I am often short in understanding. What are AC's?