It Takes All Kinds of Minds

from IMS Magazine Summer 2023

Combatting Health Inequities

By Iciar Iturmendi-Sabater

Like a Scottish kilt, every person is differently woven. Based on the tartan yarn colours and patterning, the final designs may perpetually vary. Just as every kilt is unique, no person is 100 per cent neurotypical. Instead, neurodiversity means no one stands exactly at the population mean point of every psychological trait, let that be concentration ability, social skills, restrictiveness of interests or repetitiveness of behaviors (to mention a few). People are rather woven like a kilt — with unique and complementary sets of traits.

Traveling to Scotland in March was my first chance to attend an in-person conference: It Takes all Kinds of Minds (ITAKOM). As Professor Nick Walker put it, its purpose was that attendees could ‘undergo some neuroqueering’, that is, to acknowledge the richness in the differences between us.

It’s been said that neurodiversity-focused research is currently in crisis.1 To put it simply (perhaps, too simply), the field appears split between two apparently competing perspectives. On one end are those who consider neurodivergent conditions such as autism, attentiondeficit/hyperactivity or learning disorders (amongst others) as medical conditions characterised by inherent difficulties which should be supported. For instance, a teenager with a tic disorder may seek behavioral or pharmacological help to alleviate their tics, which get in the way of daily tasks.

On the other end are those who look at neurodivergent conditions from a more social lens—differences are not uniquely inherent to a person but also stem from social expectations. For example, the social difficulties typically attributed to autistic children may instead be the product of an interaction between persons with differing neurotypes and social schemas. The difficulties arise in the interaction, rather than from empathic deficits within the autistic child (this is a myth!). Understandings rooted in the social perspective were held by the majority ITAKOM.

Available literature tells us that information transfer is similarly efficient in both autistic and neurotypical groups whereas communication efficiency is reduced in neurodiverse groups.2 But cooperation between neurotypes is not necessarily negative: A poster presented at ITAKOM showed preliminary evidence that indeed, when only autistic, only neurotypical, and mixed neurodiverse pairs were asked to build towers out of spaghetti and modeling clay, the towers built by mixed pairs were ranked as most innovative.3

My takeaway from ITAKOM is that the medical vs. social debate in neurodiversity research is partly flawed since the social model does also emphasise the need for support. As speaker Holly Sutherland suggested, neurodivergent people’s ‘capacity jug’ (which represents one’s capacity to cope with stress) fills up quicker due to prevailing neurotypical expectations in society, calling for support. The social model promoted at ITAKOM suggests that we must first investigate whether the environment could be changed to free up ‘capacity jug’ space, rather than directly focusing on remediation of individual characteristics. For example, if a child’s school performance drops due to being distracted, one should remove external distractors in the test-taking environment.

Kilts find it easier to thrive in gloomy Scotland but if worn in a wedding in Madrid (like my Scottish uncle did when marrying my Spanish aunt), guests may need a quick primer on Scottish traditions beforehand. As a neurotypical researcher, ITAKOM was the ultimate neuroqueering experience!

References

Raw Talk is a graduate student-run podcast at the University of Toronto about medical science, and the people who make it happen. We focus on the journeys, perspectives, and expertise of health researchers, professionals, students, patients, and community members at the University of Toronto and beyond.