Can the neurodiversity approach apply to ADHD? Exploring the lived experience of ADHD as neurodivergence
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Introduction: Contrary to medical and social constructionist approaches, in the neurodiversity approach, ADHD is considered a value-neutral neurodivergence, rather than a deficit to-be-cured or a societal problem affecting identity, fostering stigma and overmedicalization. This paper explores, guided by lived-experiences, the applicability of the neurodiversity approach to ADHD in comparison to the other approaches.Methods: We examine key claims of the medical and social constructionist approaches to ADHD, using an “inside-out” perspective, based on studies documenting first-person perspectives of ADHD adolescents and adults with experiencing ADHD, disability, getting or having a diagnosis and with medication. Results: In these lived experiences (1) ADHD characteristics are generally not experienced as universal deficits (2) disability primarily stems from a highly invalidating mismatch between the ADHD person and their neuronormative environment (3) the ADHD diagnostic label brings both beneficial and disadvantageous consequences (4) medication is often a balancing act between costs on people’s bodies and identity and benefits as medication is necessary to meet important life-goals and for navigating unaccommodating environments.Discussion: Considering ADHD a difference with disability mainly occurring in mismatch with environment and not a unified deficit, nor a purely social problem, reflects people's lived experiences, makes an ADHD diagnosis easier to reconcile with oneself and can make the balancing act of medication easier. The neurodiversity approach may be a promising and less stigmatizing alternative to current approaches. It empowers people by valuing lived experience as expert evidence and provides a clinical, societal and research framework of ADHD that integrates both individual and environmental aspects of disability.