The History of Diagnosis for Neurodiversity: A Systematic Review

Introduction

The history of neurodiversity has largely been attributed to one woman: Judy Singer, an Australian sociologist. However, recent findings suggest that in reality, she was one of many that developed the term “neurodivergent” and was not the first to study it (Botha et al., 2024). The concept itself was largely formed by groups of autistic activists who wished to challenge the harmful label, “disabled” (Botha et al., 2024). The Cleveland Clinic describes the term neurodivergent as variations in cognitive function that differ from societal norm (Neurodivergent: What It Is, Symptoms & Types), but a key point to notice is that there is no such thing as a normal brain. Everyone’s brain works differently, but neurodivergent describes someone whose brain affects their lives negatively. Neurodiverse people have faced inequalities presented to them by society such as diagnosis disproportion, educational fallbacks, and solutions to enact positive change. 

Diagnosis Based on Gender

There is a significant gender disparity in the diagnosis process, with women largely being diagnosed later in life. Even if women display symptoms in adolescence, those symptoms largely go ignored (Quintal, 2022). This causes a deficit in learning due to boys being diagnosed and treated early in life, making their academic careers more manageable. Estimates found that boys are four times more likely to receive an autism diagnosis than those assigned female at birth, and new research found that about 80% of females until age 18 are undiagnosed (UCLA Health, 2023). One of the reasons for this is simply that the world is designed for men. Scientific research was largely based on male subjects for years, and studies done on neurodivergent conditions were no different. Since autism was traditionally considered a male condition, most of the research was done on males instead of both genders, causing females struggling with the condition to be unable to receive support (UCLA Health, 2023). Similarly, women typically get diagnosed with ADHD in their 30s to 40s (Sachdev et al., 2024). This major deficit in diagnosis based on gender has allowed for some women to fall through the cracks in our system, not allowing them to receive the proper care that they deserve. This is a colossal issue in the world of neurodiverse people, but it could be solved by an increase in research done on women with neurodivergent conditions such as ADHD and autism. 

Neurodiversity in Education

Due to the different ways in which neurodiverse brains work, neurodiverse people sometimes have difficulties in the current educational system. This can be further exemplified when looking at the research done before on differences in diagnosis on gender, causing some females to be unable to receive needed help. The education system is similarly set up for one type of person: someone who excels at standardized tests. Not only does this inadvertently harm those with neurodiverse brains, but it harms others who simply like to learn in different ways. The rigid structure of the education system not only leaves behind those with learning disabilities, but also those that excel in areas other than stressful tests not designed for neurodivergent abilities (Tenorio et al., 2014). There is simply nothing wrong with those who learn differently; the problem comes from society forcing those to conform to a ‘normal’ structure. Alternate testing structures could include extended time, differing testing structures, and studies centered on strength based learning. Additionally, the importance society places on the curing or normalization of those with learning disabilities can be frustrating to those who rightly believe there’s nothing wrong with them because every brain adapts differently. This can be even more relatable for women struggling to obtain a neurodivergent diagnosis. Women with a neurodivergent condition are often labeled incorrectly, due to educators not understanding that they have a learning disability and may need additional help. No matter the gender, those with a neurodivergent condition may struggle with the specific testing structure our educational system has set up. Due to this, it has become necessary for educational institutes to expand their testing systems to adapt to each individual learner, or else the system courts the risk of young students falling through the cracks. 

Solutions and Conclusion

It is unnecessary for so many people in our world to struggle in society due to a strict social structure that is unaccommodating for those with a neurodivergent condition. Solutions to the issues presented would be to change the standardized testing structure, as what we have now only favors a select group of students. This could include alternate testing formats, testing real world skills, and strength based learning. A large part of the solution would similarly be to increase sex disaggregated research and to increase knowledge on how to aid neurodivergent conditions. Addressing these disparities requires a substantial shift in how society interacts with neurodivergent individuals. Implementing inclusive educational policies and improving research on gender differences in neurodivergence will aid in the creation of a world in which all individuals have the ability to reach their full potential.

References

Botha, M., Chapman, R., Walker, N., Giwa Onaiwu, M., Kapp, S. K., & Stannard Ashley, A. (2024, March 12). The neurodiversity concept was developed collectively: An overdue correction on the origins of neurodiversity theory. National Autistic Society, 28(6). Sage Journals. https://doi.org/10.1177/13623613241237871

Neurodivergent: What It Is, Symptoms & Types. (n.d.). Cleveland Clinic. Retrieved March 3, 2025, from https://my.clevelandclinic.org/health/symptoms/23154-neurodivergent

Quintal, A. (2022, August 18). Why neurodivergent women are diagnosed with ADHD and autism later in life, and what this means for their careers. The Brain Charity. Retrieved March 8, 2025, from https://www.thebraincharity.org.uk/neurodivergent-women-adhd-autism-adults/

Sachdev, P., Sreenivas, S., & Booth, S. (2024, May 21). Attention Deficit Hyperactivity Disorder in Women. WebMD. Retrieved March 8, 2025, from https://www.webmd.com/add-adhd/adhd-in-women

Tenorio, M., Campos, R., & Karmiloff-Smith, A. (2014, July 25). What standardized tests ignore when assessing individuals with neurodevelopmental disorders. PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC4712353/

UCLA Health. (2023, October 12). Understanding undiagnosed autism in adult females. UCLA Health. Retrieved March 8, 2025, from https://www.uclahealth.org/news/article/understanding-undiagnosed-autism-adult-females