Background: Attention deficit hyperactivity disorder (ADHD) is more commonly missed in females than males, partly because the diagnostic criteria may not fully capture the female presentation. This study aimed to qualitatively identify difficulties experienced by females with ADHD, especially those beyond the current diagnostic criteria, from the perspective of parents/carers and professionals. Method: Seven focus groups were conducted in the UK in 2023: three with parents/carers, two with healthcare professionals, and two with educational professionals, involving a total of 35 individuals. Participants were asked to describe their experiences of supporting girls with ADHD. Data were analysed using the framework method. Results: Four themes were identified: (1) attention regulation difficulties and their social impact, (2) hyperactivity and impulsivity manifest more verbally and subtly, (3) prominent difficulties with emotional impulsivity and regulation and (4) difficulties are more obvious at home than at school. Conclusion: Female ADHD might be missed as difficulties are less externally disruptive and more emotional than the current ADHD diagnostic criteria. Additionally, females may engage in masking behaviours. Improving current ADHD diagnostic assessments and criteria to reflect this presentation would benefit diagnostic inequalities and access to care for females with ADHD.
Fetal Alcohol Spectrum Disorder (FASD), a lifelong neuro-disability, is more prevalent than many other neurodivergent identities. Yet, it is often not even mentioned in texts, reports or social media posts when discussing the overarching neurodiversity paradigm. Prevalence rates for FASD in the criminal legal system are as high as 36% of incarcerated populations, and the impact of ignoring this neuro-disability is catastrophic for people living with FASD whom interact with criminal justice agencies and processes. FASD is the neurodivergent elephant in the room, because the disability is often missed and left out of mainstream discussion of neurodiversity. This article explores this major oversight by identifying reasons why FASD might be left out of the neurodiversity conversation and how people with FASD are immersed and overrepresented in all experiences of criminal legal system surveillance – from child welfare to policing, to youth justice involvement, to imprisonment and forensic in-patient experiences. The neurodivergent elephant is indeed rather large, but the elephant has a voice and needs to be seen and heard - to that end this article will both challenge the exclusion of FASD and ensure that living experience voices arguing for its inclusion and recognition are centered.
This paper introduces an autistic-led and developed narrative-based assessment protocol addressing the paradigmatic and systematic underdiagnosis of autism in adult females. Traditional diagnostic instruments, validated primarily on male cohorts, fail to capture the Female Autism Phenotype characterized by sophisticated masking, internalized traits, and distinct cognitive styles. Through analysis of 988 written narratives from autistic women worldwide, eight thematic domains emerged: observational detachment, social navigation challenges, masking/identity fragmentation, sensory-perceptual differences, relational patterns, distinctive cognitive styles, characteristic developmental trajectories, and ethical rigidity. In opposition to an often-accepted paradigm of autism, where the subject is a male child, often with accompanying intellectual disability, 70.7% of this study's participants held college degrees, challenging deficit-based stereotypes. The narrative methodology circumvents masking behaviors triggered by face-to-face assessments, with 76% of participants expressing experiences in writing they couldn’t verbalize. Drawing on Critical Autism Studies and Husserlian phenomenology, bridging the gap between Social/Behavioral Sciences and the Arts and Humanities, the Wilderwood Reflective Assessment and Diagnostic Indicator of Autistic and Neurodivergent Cognitive Expression (WRADIANCE) shifts diagnostic power from clinician observation to client self-report, honoring autistic women's capacity for self-knowledge. This neurodivergent-affirming approach represents a fundamental paradigm shift in autism assessment, offering a pathway to identification that validates rather than pathologizes female autistic experience.
Objectives Evolving understanding of adult attention deficit hyperactivity disorder (ADHD) suggests that current diagnostic approaches may miss key features of adult presentation, including hyperfocus. This study explored hyperfocus in ADHD adults and its conceptual relatedness to ‘flow’. Methods Seven U.K.-based ADHD adults participated in semi-structured interviews, analysed thematically. Hyperfocus triggers, contexts, and consequences were examined. Results Hyperfocus was typically triggered by task interest, often under time constraint. Participants recognised patterns in hyperfocus but reported minimal control over its onset or cessation. The intensity and duration of hyperfocus episodes varied, with longer periods leading to significant physical, psychological, and social repercussions necessitating recovery. Conclusions Hyperfocus in ADHD adults is complex, variable, and distinct from flow, having both adaptive and maladaptive aspects, depending on duration and intensity. We propose that future research should consider a new operationalisation of hyperfocus in ADHD that recognises these elements. These findings, particularly when considered within the context of monotropism, aid ADHD adults in understanding their own functioning and underscore the need to incorporate hyperfocus into clinical ADHD frameworks.
Adulthood is characterized by demands and expectations, including increased independence and responsibility, career and personal growth, and relationship stability. For adults with extreme demand avoidance (EDA) traits, characterized by an anxiety-driven need for autonomy and a pervasive resistance to everyday demands, these expectations can evoke an overwhelming anxiety, where avoidance functions as a form of self-preservation rather than disinterest or amotivation. This phenomenological qualitative study explored the lived experiences of Australian adults with EDA traits and the ways they navigate adulthood. Fifty-three participants completed an online survey that included the EDA Questionnaire-Adult version to determine the presence of EDA traits and study eligibility. Fourteen adults aged 21–50 years with suspected EDA then went on to complete open-ended questions exploring everyday demands and coping strategies. Their responses were analyzed using thematic analysis, and five themes were observed, which we called: 24/7 Turmoil, A Tug-of-War Within, Hell is Other People, Misunderstanding and Stigma, and I Will Survive. Collectively, the findings depict adulthood as a demand-saturated environment marked by chronic overwhelm, exhaustion, and guilt. This study addresses an important gap in the literature, emphasizing the need for autonomy-supportive, compassion-focused, and neurodiversity-affirming approaches across clinical, workplace, and social contexts. Lay Abstract Adulthood often involves many demands, such as working, managing daily tasks, maintaining relationships, and taking on more responsibility. For adults with extreme demand avoidance (EDA), these everyday expectations can feel overwhelming. EDA is linked to high anxiety and a strong need for autonomy. Avoiding demands is not about laziness or lack of motivation, but instead works as a way to protect oneself from intense anxiety. This study explored the experiences of Australian adults with EDA and how they manage the demands of adulthood. Fifty-three adults took part in an online study and completed a questionnaire to identify EDA traits. Fourteen people aged between 21 and 50 went on to answer open-ended questions about daily demands and coping strategies. We analyzed their responses to identify common patterns and experiences. Five key themes were identified: 24/7 Turmoil , A Tug-of-War Within , Hell is Other People , Misunderstanding and Stigma , and I Will Survive (also see Infographic in supplementary material). Together, these themes show that adulthood can feel like a constant source of pressure, leading to ongoing overwhelm, exhaustion, guilt, and self-doubt. At the same time, participants described resilience, creativity, and ways of adapting their lives to protect their well-being. This study highlights the need for greater understanding of EDA in adulthood and supports approaches that are flexible, autonomy-supportive, compassionate, and affirm neurodiversity in clinical, workplace, and social settings.
This paper examines the effectiveness and impacts of fraud protection guidance on the public, focusing on neurodivergent people. It seeks to identify and understand the gap between current protection efforts and the needs of those most at risk of misunderstanding such messages and, consequently, experiencing disproportionate harm through fraud victimhood. Drawing on a survey of 2,023 people conducted in 2025, this research explores differences between neurotypical and neurodivergent respondents in terms of fraud exposure, confidence in fraud detection and the psychological, financial, and health impacts of victimisation. The findings reveal that neurodivergent people are both more confident in their ability to identify fraud and more likely to experience it, suggesting a misalignment between self-perceived and actual protective capacity. These people also report more severe emotional, financial and health consequences following fraud victimisation. The paper concludes with evidence-based recommendations for improving the design and delivery of public-facing fraud protection information to ensure inclusivity, accessibility and accuracy, and to reduce barriers to understanding and reporting.
People with learning disabilities and/or who are autistic/neurodivergent are more likely to experience sexual violence. When they report, they are less likely to be believed or to receive appropriate support. There is limited research that considers the impact of the environment where victims of crime give evidence on victim testimony. Specific issues include the location and layout of interview rooms, background noise, harsh lighting and other sensory stressors. This study focuses on the views, experiences and recommendations of victim-survivors of sexual violence. The research team worked with 10 co-researchers with learning disabilities and/or who are autistic/neurodivergent to understand how police interview spaces affect how people feel and communicate. We held three online workshops, and a participatory walk through of a police space. The study found that sensory overload from the physical environment can make it harder for people to understand the information provided and the questions asked during the interview and to formulate a response. It shows the importance of flexibility in interview room design and presents practical recommendations. Working with co-researchers with lived experience, it calls for inclusive, trauma-informed and person-centred responses in the criminal justice system. Lay Abstract People with learning disabilities and/or who are autistic/neurodivergent are more likely to experience sexual violence. When they report, they are less likely to be believed or to receive appropriate support. There is limited research that talk about the experiences and recommendations of those affected by the spatial environment of police interview spaces. Specific issues include the location and layout of interview rooms, background noise, harsh lighting and other sensory stressors. This study worked with 10 co-researchers with learning disabilities and/or who are autistic/neurodivergent to understand how police interview spaces affect how people feel and communicate. We held three online workshops, and a participatory walk through of a police space. The study found how sensory overload from the physical environment can make it harder for people to understand and speak. It shows the importance of police spaces being flexible based on different needs. It presents practical recommendations for spaces to make people feel more comfortable, informing changes in a local police force and beyond. By showcasing the voices of co-researchers with learning disabilities and/or who are autistic/neurodivergent, it calls for inclusive, trauma-informed and person-centred responses in the criminal justice system.
According to estimates, the prevalence of various forms of neurodivergence is much higher among musicians than in the general population. Despite this fact, we know very little about the lived experiences of neurodivergent (ND) musicians in professional settings, such as educational institutions and places of employment. The lack of information leads to a lack of understanding, appropriate support, and inclusion of ND personnel in these spaces; therefore, it is crucial to gather accurate information directly from the population. A Participatory Action Research (PAR) study was planned and organised by ND musicians, which consisted of an in-person event and online follow-up conversations, where members of the community (ND musicians, music educators, music researchers, and neurotypical allies) were invited to discuss various aspects of their vocational education and professional lives. In alignment with the guiding principles of PAR, all participants were invited to contribute to the outputs to ensure their autonomy and utilise their unique expertise to the fullest. Given the quantity and richness of the data and the limited space, detailed discussions about the findings will be published separately. Here, we opted to focus on the methodological approach and procedure to provide a template for using PAR with adult ND communities.
This study presents a multilevel investigation of neurodivergence in relation to psychological safety, relationship quality, and team identification. Moreover, it examines the influence of awareness and social acceptance of neurodiversity on these relations. Utilizing a sample of 70 teams, we disentangle within-group and between-group effects and discuss the differences. Our findings indicate that neurodivergent individuals report lower perceived psychological safety, leading to diminished team identification and relationship quality. However, teams with a high proportion of neurodivergent members report higher psychological safety at the group level, suggesting that neurodiverse teams, on average, experience higher psychological safety, relationship quality, and team identification.
Neurodivergent people (e.g., dyslexic people) do not always agree with the terms commonly used by others (e.g., professionals) to describe their neurodivergence. Our mixed methods study aimed to investigate terminology preferences for different categories of developmental neurodivergence (e.g., autism, dyspraxia) among people from those communities. Participants ( n = 902) completed an online survey, ranking the likeability and offensiveness of a range of person-first and identify-first terms for their diagnoses. We invited them to tell us reasons for their preferences via open text response, which we analysed using thematic analysis. Paired samples on identity vs. person first preferences showed identity first language was significantly more likeable, and significantly less offensive for most categories, but not all (stuttering and Tourette syndrome). For the thematic analysis, we developed two key themes, (1) ‘How they talk about us’, which focussed on the inadequacy of existing terminology, and the stigma associated with particular labels, and (2) ‘How we talk about us’, which focussed on viscerality of certain terms, agency to express personal preferences, debates around identity vs. person first terms, and identification with the concept of ‘disability’. Our findings have implications for how neurodivergent people are described, especially by those in professional services.
In Aotearoa New Zealand, Young Adult Courts provide an adapted court process for people aged 18–25, built on a commitment to procedural fairness and a vision of an enlightened world where all those seeking access to justice experience being seen, heard, and understood. The well-documented over-representation of ‘neurodivergent’ presentations, which impact information processing, comprehension, decision making, communication, and emotion regulation, are an inherent barrier to this aim, unless addressed directly. This paper describes how a multi-profession group grappled with challenges including diagnostic, conceptual, and ethical issues, cultural safety, resource limitations, and the pragmatic utility of recommendations. It outlines how these were resolved through the development of a ‘functional neurodiversity’ model that pays attention to the primary strains of court participation, and a strengths-based ‘Court Participation Tool’ that evaluates those strains and provides tailored recommendations to enable participation. Pilot outcomes from a trial of this screening process are described.
Increasing research attention has been drawn to the lived experiences and needs of neurodivergent people in prison. However, this research has typically focussed on the experiences of prisoners, whilst the lived experiences and needs of neurodivergent prison staff remain overlooked. Therefore, this study aimed to address gaps in existing knowledge by qualitatively exploring how neurodivergent people experience working in a prison environment. Semi-structured interviews were conducted with eight neurodivergent prison staff working in prisoner-facing roles. Interviews explored staff's career journeys from initial recruitment and induction processes to their daily interactions with prisoners, other staff, and the prison environment. An interpretative phenomenological analysis of the data identified three group experiential themes. Broadly, themes captured the ways in which participants reconciled their professional and personal identities as neurodivergent people in the prison, issues related to navigating the prison social world and workplace culture, and practical challenges associated with working in a custodial environment. Findings contribute to a richer understanding of how prisons can better accommodate neurodivergent staff, promote inclusivity, and enhance workforce wellbeing. The paper concludes with implications for policy, staff training, and organisational support structures to enable neurodivergent employees to flourish.
Multi-sensory environments (MSEs), or sensory rooms, are widely used in schools to support pupils with additional learning needs. While commonly accessed by autistic pupils, no research has directly explored their perspectives. Focussing on the impact of MSEs on wellbeing, we investigated autistic pupils’ self-reported experiences of MSE use. Thirteen autistic pupils (11–15 years) from mainstream schools participated. They completed semi-structured interviews with an autistic interviewer about their experiences, as well as a five-minute self-directed MSE session, which was video recorded. Reflexive thematic analysis of the interviews, conducted by one autistic and one non-autistic researcher, found that autistic pupils believed self-directed MSE use supported their mental wellbeing, learning, and ability to manage sensory overwhelm. Participants valued the flexibility to adapt the space according to their individual and context-dependent needs. While sensory equipment was frequently used, pupils also described engaging in a broader range of activities. Analysis of behaviours observed in the videoed session identified three themes: Turning Off and Relaxing; Sensory Seeking and Defence; and Stimming. Overall, findings suggest that autistic pupils experience MSEs as beneficial for both wellbeing and learning. The findings highlight the importance of self-directed, individualised approaches to sensory support and the value of creating autistic-informed spaces in schools.
Children who have experienced adverse childhood experiences (ACEs) often present with emotional and behavioral characteristics that overlap with attention-deficit/hyperactivity disorder (ADHD), yet it remains unclear which trauma-related needs uniquely distinguish children with and without ACEs. Using data from 10,869 children receiving services in a statewide public mental health system, we compared children with ADHD and ACEs (ADHD + ACE) ( n = 6,024) to those without ACEs (ADHD-only) ( n = 4,845) on trauma-related emotional, behavioral, and risk behavior domains from the Child and Adolescent Needs and Strengths (CANS) assessment. Attachment difficulties, traumatic grief/separation, depression, oppositional behavior, self-mutilation, danger to others, poor judgment, and sexually reactive behavior independently predicted greater odds of ADHD + ACE classification. In contrast, attention/concentration difficulties and behavioral regressions were negatively associated with ADHD + ACE status, suggesting that when trauma-related emotional and risk behavior needs are jointly considered, ADHD-only profiles may be characterized by narrower attentional and behavioral regression concerns. Older age was also associated with higher likelihood of ADHD + ACE classification. Findings highlight a trauma-related dysregulation phenotype among children with ADHD + ACE and underscore the importance of trauma-responsive, developmentally informed, and dimensional assessment in mental health systems, rather than relying solely on attention when conceptualizing ADHD.
In vitro fertilization (IVF) treatment often involves significant psychological distress, yet many current support models are limited in taking a preventative lens and one which considers neurodiversity. This paper discusses the literature regarding fertility and IVF treatment for Autistic and Attention-Deficit-Hyperactivity Disorder (ADHD) individuals and highlights Bancroft's Hope Affirm Thrive framework, a universal psychological support model integrating trauma-informed care and systematic neurodiversity screening and support for IVF populations. Hope Affirm Thrive employs a three-tiered model delivering psychoeducation, emotional regulation skills from Dialectical Behavior Therapy, trauma processing through Eye Movement Desensitisation and Reprocessing, and Schema Therapy interventions. Universal screening for Autism and ADHD traits enables proactive accommodation without requiring diagnosis. The framework was specifically adapted for Australian healthcare contexts and IVF treatment timelines and addresses identified gaps by providing preventive rather than reactive support. This framework provides a replicable template for neurodiversity-affirming, trauma-informed psychological support adaptable to other high-stress medical contexts beyond IVF.
This article is a neurodivergent reading of the peripheral character of Mi Heng 禰衡 within Chinese historical novel Romance of the Three Kingdoms 三國演義 (sanguo yanyi) by Luo Guanzhong 羅貫中 (1280–1360). In a close reading, I discuss Mi Heng as a neurodivergent figure who subverts the normative behavioural codes of the court, in addition to his embodyminded difference of superior cognitive ability. Following this, I consider how insights from Mad Studies can enrichen the discussion, creating a maddened neurodivergent reading approach. In this maddening, I address how Mi Heng is ultimately persecuted as a result of his neurotypology. I then conclude with reflections on the future possibilities of this model. This paper proactively engages with non-Western literature to disrupt the Eurocentric nature of Early Modern Neurodiversity Studies and learns from Critical Neurodiversity Studies in its drawing on Mad Studies theorising. Lay Abstract This article focuses on the minor character of Mi Heng禰衡 as he is depicted in the Chinese novel Romance of the Three Kingdoms 三國演義 ( sanguo yanyi ) by Luo Guanzhong 羅貫中 (1280 – 1360). I read the text in detail and first consider how Mi Heng is a neurodivergent character who goes against the accepted behaviour in the court. I also consider his internal differences, namely his superior cognition. After this, I draw on ideas from Mad Studies to make the discussion richer. By doing this, I create a ‘maddened neurodivergent reading approach’. When I apply ideas from mad studies to the conversation, I discuss how Mi Heng is persecuted because of his neurodivergence. I then finish by thinking more about the future ways this model can be applied. This paper proactively engages with non-Western literature, which is important due to the focus on European and Western literature within the field of Early Modern Neurodiversity Studies. The paper also learns from Critical Neurodiversity Studies which reminds us of the importance of drawing on Mad Studies ideas.
Within ADHD scholarship, clinical discussion and lay discourse, there exists a conceptual and ideological conflict between the two dominant theoretical paradigms aimed at understanding ADHD. The paradigm adhered to by an individual, whether it be a biomedical model or a social/neurodiversity paradigm, presents important practical implications with regard to all aspects of their work and its intended audience. For researchers, their chosen ADHD paradigm informs the chosen methodology, theoretical perspective, applicability of findings and readership. For clinicians, their paradigm has direct implications on patient care, advice and intervention use. This paper details the justifications and benefits of each paradigm, alongside the primary criticisms directed from its opposition. The paper concludes with a nascent conceptual heuristic for developing your own theoretical perspective of ADHD to aid in the strengths and implications of your position. This heuristic assists those writing and discussing ADHD to acknowledge and respond to the likely criticisms of their conceptual position.
Spoken interaction plays a central role in everyday social and institutional life. This article examines how interactional disfluency becomes vulnerable to misinterpretation as suspicious or risky within fraud-prevention and identity-verification contexts. While existing literature has examined the medical and psychological impacts of stammering, there is limited criminological insight into how communicative difference is operationalised within fraud-prevention practice. Using a critical documentary and conceptual analytic approach, this article synthesises literature on stammering, disability, neurodiversity, and social harm to explore how normative assumptions about fluent, rapid, uninterrupted speech are typically embedded within institutional procedures and expectations of credibility. It identifies procedural, structural, social, and linguistic barriers experienced by people who stammer (PWS) that generate communicative friction and expose them to heightened security scrutiny during verification processes. Spoken interaction is frequently operationalised as a behavioural indicator of credibility or risk, creating significant challenges for PWS. The article argues that communicative fluency operates as a hidden indicator of trust, rendering stammered speech structurally vulnerable to misclassification. Framed criminologically, these harms arise from routine organisational design rather than individual communicative deficit, situating speech-dependent verification as a key site where disability, risk, and legitimacy intersect.
Community-based early detection and intervention for NDDs has increasingly received prominence in public health research. Despite diagnostic opportunities, limited awareness of child development, social support and standardised care pathways delays diagnoses and access to services. Engaging lived experiences builds trust, improves quality and access to care. However, there is limited synthesised knowledge on involving lived experiences, especially those of autistic individuals and their caregivers, in conceptualising community awareness to promote service utilisation. This scoping review reports on community-engaged research methodologies employed within community-based programs to build awareness to promote early identification and intervention . Studies after 1980 were included to follow the advocacy movement following deinstitutionalisation. Fifteen thousand and six hundred and seventy-three abstracts were screened, of which 66 were selected for full-text review and 16 met eligibility criteria. Studies were from the United States of America, the United Kingdom, Canada, Australia and Bangladesh. Caregivers supported identifying knowledge gaps and information preferences, while autistic voices amplified authentic experiences. Most studies used community-based participatory research and half utilised collaborative partnerships. Interviewing was used in six studies. Cultural adaptation for marginalised or underrepresented communities.was a key focus. With engagement occurring across disciplines, the nomenclature varies. Standardising community-engaged practices across community-based programmes may ensure appropriate representation across a range of cultural contexts.
Background Primary school classrooms are busy multi-sensory environments where children engage in important formal learning. Evidence suggests that sensory features of classrooms can negatively impact engagement and learning. This may be particularly important for neurodivergent children with sensory differences, especially autistic children. Some sensory features of the classroom are under teachers’ control, that is, displays. Aims To systematically investigate the impact of sensory classroom features (classroom displays and classroom noise) on engagement by testing the impact on task engagement for autistic and neurotypical children. Sample There were 25 autistic (8–11 years) and 22 neurotypical children (6–11 years). Methods An experiment in which two groups of children (autistic and neurotypical) completed classroom tasks (self-directed reading comprehension) under four experimental sensory conditions (baseline, visual [displays present], audio [classroom noise], and visual and audio) in a ‘mini-classroom’. Task behaviour was video-recorded and coded for analysis. Results Experimental evidence showed that displays can have a detrimental impact on engagement, leading to more off-task behaviour, especially for autistic children. Evidence of the negative impact from classroom noise was not found here, but is discussed in relation to the experimental context. Conclusions This evidence has significant implications for optimising learning for all children, but especially for autistic and neurodivergent children with sensory differences.
