A potential upside in the increase of diagnoses

When I began private practice, after decades within educational institutions, the concept of neurodiversity was just gaining traction. Initially conceived by the autistic community, the idea that non-normative cognitive expression - neurodivergence -  could (and should) be untethered from value judgements was edgy. The pioneering work of Michael Oliver’s The Politics of Disablement stands out for opening up debate from within-community about who gets to determine value, and whether norms constitute anything other than majority.

One would hope that an increase in awareness, access to assessment and social media’s laudable destigmatisation of all manner of neurodiversities would bring a renaissance in understanding the ways in which our differences express themselves. How ‘normal’ it is to have a varied cognitive profile, what a spectrum of behaviours we, as humans, share. 

Yet some days, it feels like the only substantive change is that we’ve run out of Elvanse.  Market driven diagnostic clinics, reductive online quizzes, smartphone operant conditioning and the legacy of the pandemic’s online tuition have led to a tsunami of diagnosis, self diagnosis and short hand personality traits - ‘Sorry I’m so late, that’s just my ADHD’.

I’m being flippant, but equally, I am wary. What’s the use in increasing awareness of difference if, by virtue of exponential diagnosis, we are actually decreasing systemic support?

A dyslexic pupil shared recently that when she sat her first exams in year 7, there were three pupils in the room. By year 13, one third of her classmates were there. I’ve written before about the timed test - a relic largely irrelevant to GCSE performance - but in light of exam arrangements and their prized 25% extra time, I wonder - how special is a need if we all benefit from it being met

The boundaries we use to demarcate who gets help and who doesn’t have always been porous. They reflect social understanding, governmental agendas and an economic bottom line. The truth is that a substantial increase in diagnoses will challenge even the most robust, well-meaning schools and boroughs; current estimates suggest fully one half of all boroughs would have to declare insolvency were it not for ‘statutory override’ (see link below).

I’d like us to consider these questions:

  • How meaningful are the diagnostic boundaries that unlock adapted educational provision? 

  • Does every child have educational needs that are special?

  • If, conceptually, neurodiversity suggests we are all on a cognitive spectrum, what does this mean for classroom learning and learning support?

  • Is it unrealistic to ask schools to cater to every variation in learning?

There is an American meme doing the rounds — ‘All this ends when enough of us say no’. As the numbers of individuals identifying as neurodivergent increases, there is the chance to move from being a disenfranchised minority to an important collective voice. Using the strength in numbers, neurodivergent people and their allies can challenge the privilege underpinning majority rule which allocates resources. As Oliver argues, we need to influence the ‘policy context within which they occur.’ 

I might need to learn TikTok.

I’m linking an article by the fantastic Francesca Happe, professor of cognitive neuroscience at Kings, around increasing diagnoses, as well as early signposts to the government’s response to the SEN funding crises.


References