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Hope and Health

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Hope & Health
Articles and Updates from WVU Medicine Children's

04/2/2024 | Kelli Kuzniar, DSW, LICSW, ITDS

Autism Spectrum Disorder: How About Neurodiversity Affirming Instead of Disorder?

Temple Grandin, the guru of autism, says, “You meet one person with autism, you’ve met ONE person with autism.”

Most people still think of autism in stereotypes or extremes. The characteristic of autism is unique in each person diagnosed, and it is marked by differences in communication and social skills and the presence of focused special interests. These differences manifest in unique ways and levels for children and adults diagnosed with it.

So, why the label of a disorder? In this blog, we will review the general epidemiology and diagnostic criteria related to autism. Additionally, we will review the concept of neurodiversity affirming language and what this looks like in today’s world.

Brief History of Autism

First, let’s start with a brief history of the diagnosis of autism spectrum disorder. The diagnosis of autism was viewed as a form of childhood schizophrenia caused by the “refrigerator mother” or a cold and uncaring mother. Blame the mom, right?

Then, autism was neuro-biological in etiology along with a set of related developmental disorders. Currently, autism is a spectrum condition with wide-ranging degrees of abilities.


A brief review of the epidemiology of autism purports that 1 in every 36 children are diagnosed with autism, according to the National Institute of Mental Health (NIHM). This represents an increase in children diagnosed with autism from the previous estimate in 2018 of 1 in every 59 children.

Males are four times as likely as females to be identified as having autism. However, females are missed or misdiagnosed related to the diagnosis of autism. Girls are often able to blend in, mask, or hide their traits of autism.

The prevalence of the diagnosis of autism is higher in white children, with 7 percent greater than Black children, and 22 percent greater than Hispanic children, according to the NIHM. The differences have persisted but narrowed over time.

Socioeconomic (SES) differences exist as well. The prevalence of the diagnosis is higher among those with a higher SES, and within the same SES stratum, the racial differences persisted.

Diagnostic Criteria

The “Diagnostic Statistical Manual” (DSM), the guide for diagnosing mental health disorders, uses the language of deficits, such as deficits in social communication and social interaction and restricted, repetitive patterns of behavior, interests, or activities. These patterns are present in the early developmental period and create a clinically significant impairment in social, occupational, or other critical areas of functioning.

The DSM outlines certain specifiers of the “severity” level of the diagnosis, which include:

  • Level 1: requiring support
  • Level 2: requiring substantial support
  • Level 3: requiring very substantial support

Most often, children present to mental health professionals because of severe behavioral issues. These behavioral issues include irritability, aggression, self-injurious behavior, hyperactivity and inattention, and instability of mood. Associated behavioral symptoms that may also occur are disturbed language developmental and usage, intellectual disability, precocious skills (atypical social and communication behavior or movements, and special interests), and insomnia.

Neurodiversity and Neurodiversity Affirming

Neurodiversity is the idea that neurological differences, such as autism, are natural and expected variations of the brain. Neurodiversity affirming means accepting and embracing neurodivergent brains as equal, valid, and not broken or in need of repair. Neurodiversity uses a strength-based, rather than a deficit-based, approach (not broken or in need of repair). Children may need communication and social skills training or speech and language therapy to help them engage more fully in the neurotypical world. With so many children diagnosed with autism, is it necessary to hold on to the old stereotypes where autism is seen as negative? Or should we embrace the idea that differences are honored and celebrated?

Instead of whispering, “He has autism” like it’s something to hide, we should celebrate this unique way of seeing the world and aid the family in validating and encouraging the journey of the child diagnosed with autism and explaining to the him that his brain functions differently and is not broken.

We can help parents/caregivers to understand the world of autism and how they can help their child live a full and happy life. Recently, the phrase “Autism Awareness” has changed to “Autism Acceptance.” Accepting the differences in others and not judging. Wouldn’t that make the world a better place?

About the Author

Kelli Kuzniar, DSW, LICSW, ITDS, is a clinical social worker and clinical assistant professor of social work at WVU Behavioral Medicine and Psychiatry. Dr. Kuzniar has worked with children and their families for the past 25 years. She is an ardent advocate for children and strives to ensure that children have access to mental health services, including school-based therapy services. Dr. Kuzniar provides evidence-based interventions for children and families experiencing a variety of mental health challenges. She also has a clinical interest in autism and reactive attachment disorder. Dr. Kuzniar specializes in evidence-based therapies for children and families who have experienced traumatic stressors and is nationally certified in Trauma Focused Cognitive Behavioral Therapy. Dr. Kuzniar’s research interests include reactive attachment disorder, autism spectrum disorder, and trauma related disorders.

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