First, do no harm: Cautionary reflections on the assessment and diagnosis of neurodevelopmental disorders

It is generally assumed that the assessment process for neurodevelopmental disorders (NDDs) and ultimately receiving a NDD diagnosis is helpful for understanding, anticipatory guidance, and intervention. However, many potential harms are embedded in this process. This chapter will begin by defining neurodevelopmental disorders (NDDs) and reviewing conceptual models proposed for these conditions. We will then describe how the assessment process is undertaken for NDDs and the various diagnostic approaches used, including the benefits and weaknesses of these approaches in clinical, intervention, and research settings. Potential harms that might arise from both the assessment process and the diagnostic description itself will then be considered. Finally, using the lens of neuroethics, we will explore ways to mitigate or prevent potential harms. Engaging researchers, clinicians, educators, policy makers, and people with lived experience in reflection and dialog regarding these concerns will be critical. There has been little written about the harms of assessment and diagnosis for NDDs in either the scientific literature or public discourse. It is our hope that this chapter will encourage all stakeholders to anticipate these potential harms, prevent or mitigate their effects, and ultimately build a better future for individuals with NDDs.