How We Think About Disability Matters

A paradigm describes how we think about and understand something. Paradigms are important because they impact our actions and attitudes. There are 3 main disability paradigms that people draw from today and they each influence us to think differently about disability. They each command different emotions from us, ranging from pity to celebration. They each direct us to respond and act differently in relation to disability. How we think about disability matters because it influences how we feel and act towards ourselves, our disabled loved ones, and our disabled clients.

Since the beginning of the 1900s, neurological disabilities (neurodivergences) have been conceived through a medical disability paradigm. In this paradigm, neurodivergences (autism, dyslexia, ADHD, etc.) are understood as a problem. They are seen as inherently negative experiences that are inferior to other ways of thinking, sensing, and understanding the world. The problem of disability is inside our brains and bodies, it is a problem with us. In other words, the problem of disability is individualized.

Through the medical disability paradigm, the compassionate response to disability, like any problem, is to try to fix it. Throughout the past century, medical professionals have worked diligently trying to identify, diagnose and fix neurodivergence. They ask questions like: how can we identify communication disabilities? How can we treat autism so that it goes away and stops bothering the people it impacts? What actions can we take so that people with these problems, that is autism, dyslexia, inability to speak, etc., look to us to no longer be impacted by these awful problems? The compassionate response is to find a cure or a way to remediate the problem because problems are bad!

[Image description: An infographic comparing the medical model and the social model of disability. In the top half there is a drawing of a person with arrows all around and pointing to them labeled “problem.” In the bottom half the same person with arrows pointing away from him labeled “barriers.”]

In the 1960s disability advocates, many of who were physically disabled began questioning the individualized understanding of disability. They conceived of the social disability paradigm (often known as the social model). They asserted that the problem is in society not within individual bodies or brains. They noticed that disabled people were seen as only their disability rather than as people. This gave rise to person-first language. They advocated for the personhood of someone to be acknowledged first and then their disability. For example, “Amber is a person with autism” or “Hawa is a person with dyslexia.”

Advocates for the social paradigm of disability demanded societal changes so that people with disabilities could participate in society just like anyone else. They asserted that if every building had a ramp and elevator, people who use wheelchairs would not be disabled. Similarly, they advocated that supports and accommodations are required by neurodivergent people so that they can also participate in society, education, and community.

Advocates for the social paradigm of disability have made incredible gains for the disability community. They helped establish rights and laws that are in place today to ensure that everyone, regardless of disability, has a right to participate in society. Rather it is society’s responsibility to ensure we have what we need to participate. We see these gains in new building codes, individualized education plans, and accessible learning centers.

[Image description: An infographic titled “How we think about disability matters.” Below there are three vertical rectangles. On the left is a red one labeled “medical paradigm” and reads, “Disability is a problem. We need to fix it! Identify, diagnose and eliminate.” The center rectangle is blue labeled “social paradigm” and reads, “Society is the problem not people with disabilities. We need to support and accommodate.” The right rectangle has a rainbow background labeled “neurodiversity paradigm” and reads, “Neurodiversity is the norm. Affirm neurodivergent people. Let’s support wellness defined by them!”]

Within the past two decades, autistic activists and writers have begun advocating for a neurodiversity paradigm of disability. The neurodiversity paradigm argues that the binary between disabled and neurologically normal is created and maintained by our cultures and societal structures and practices. It works to dismantle this binary and believes that neurodiversity, the diverse range of sensory, emotional, and cognitive processing styles present in human beings is itself the norm. Advocates for the neurodiversity paradigm do not believe that neurodivergence is inherently pathological, negative, tragic, or unhealthy. Rather, the neurodiversity paradigm takes an affirmative approach to neurodivergence, believing that it can be valuable, lead to creative potential, and perhaps support the survival of human beings. For this reason, neurodiversity advocates encourage neurodivergent people to take up their disabled identity as a political action to show that there is nothing wrong with their identity, this is called identity-first language. For example, “Hawa is autistic” or “I’m dyslexic.”

The neurodiversity paradigm argues that neuronormative standards and stigma about neurodivergent people are what cause the most harm. It does not believe in standards but rather seeks to find ways to ensure everyone has well-being in our communities. The neurodiversity paradigm believes we need to listen to neurodivergent people to understand what well-being looks like for them. From there we can determine what societal adjustments and changes along with services, accommodations, medications, etc. are desired by each neurodivergent individual. More than anything, the neurodiversity paradigm seeks to center neurominority people and discover innovative ways to support their wellbeing defined by them, not standards or norms.

Neurodiversity encompasses everyone—neurotypical and neurodivergent. Some people mistakenly refer to disabled people as neurodiverse. Everyone fits into the category of neurodiverse though so this doesn’t make sense to say. This can lead to reproducing the harmful binary that the neurodiversity paradigm questions and seeks to dismantle. If you want to talk about someone who has a neurological processing style that is viewed as different from the majority or is seen as disabled in our society, use the word neurodivergent.

So, how we think about disability matters. The paradigm we use to understand disability impacts who we listen to, the actions we take, and the goals we work towards— all of these choices have significant impacts on many members of our society, families, and maybe even ourselves. What one does your work, school, or community use to guide their choices? What fits for you? No one can tell you which is the right or wrong one to believe in. Each neurodivergent person should be able to choose the one that fits best for them and have that choice respected by their families and professionals.

Monica is a dyslexic, queer, community organizer, activist, S2C Practitioner, MSW student, RDI® Consultant, home renovator, canoer, and gardener.