From disorder to neurotype? Exploring a neurodiversity-affirming take on the autism diagnostic label.

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Abstract

Autism is increasingly claimed to be a neurotype, an expression of human neurodiversity, rather than a disorder. In this Community Perspective, I explore the implications of this paradigm shift for autism as a clinical diagnosis. Can a non-pathologising, yet clinically meaningful alternative to the current diagnostic label be envisioned?To ground this exploration empirically, I synthesise qualitative findings of how autistic individuals and their relatives experience the current diagnostic label in practice. Drawing on the disease–illness–sickness triad, I evaluate these experiences from clinical, personal, and societal perspectives, highlighting the current label’s multifunctional but ambivalent nature.I then introduce and critically assess three alternatives to the current label: elimination, clinical case formulation, and self-identification. Each addresses certain shortcomings of the existing label, but none preserves the full range of its functional value.Finally, I outline a proposal for a revised, neurodiversity-affirming diagnostic label. Two core reforms are advanced: [1] a co-produced reformulation of diagnostic criteria, integrating first-person perspectives and reducing deficit-based language; and [2] the replacement of the impairment criterion with a contextualised assessment of person–environment mismatch.I hope this Community Perspective can help to stimulate further discussion on the future of the autism diagnostic label.

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