Neurodivergence: meaning, types, and how diagnosis is made

“The history of the term neurodivergence begins in the 1990s, within advocacy movements related to autism spectrum rights. The central idea was to value the diversity of human neurological functioning rather than treat it as a disorder.

Over the years, the use of the term has expanded, and today neurodivergence refers to different modes of brain functioning that diverge from ‘typical’ functioning (the most common pattern) in how people:

• interact,
• relate to others,
• perceive,
• reason,
• learn,” explains Dr. Tobia.

Neurodivergence is therefore not a pathology. It represents a shift in perspective: from the concept of abnormality to that of inclusion, valuing differences, and supporting everyday well-being for those with this type of functioning.

Neurodivergence is not a diagnosis (it does not correspond to a diagnostic category), but it may describe the neuropsychological functioning of individuals characterized by conditions such as:

• Autism spectrum disorder (ASD): difficulties of varying degrees in social communication and interaction, restricted interests, and repetitive behaviors;
• ADHD (Attention Deficit Hyperactivity Disorder): marked by impulsivity, inattention, and hyperactivity;
• Specific learning disorders (SLD): including dyslexia (reading difficulties), dyscalculia (difficulty with calculations), dysorthography, and dysgraphia (writing difficulties);
• Giftedness (high intellectual potential): cognitive abilities above the population average;
• Tourette’s syndrome: primarily involuntary motor and vocal tics;
• Dyspraxia: difficulties in planning and executing actions and movements.

“The signs of neurodivergent development, which deviates from typical developmental trajectories, differ depending on whether the person is in preschool age (3–6 years), school age (6–18 years), or adulthood,” explains Dr. Tobia.

In young children, attention should be paid to communication and language development and how they interact with others, both verbally and non-verbally. For example, some children may:

• not seek relationships;
• avoid eye contact;
• not speak;
• engage in atypical social behaviors (e.g., rejecting or being distressed by physical contact, or conversely, intruding excessively into others’ personal space);
• play in unusual or developmentally inappropriate ways.

The first to notice signs suggesting atypical development are often parents, who discuss them with the pediatrician, or early childhood educators, who can recognize subtle differences through comparison with other children.

“As children enter primary school, with its increasing cognitive and attentional demands, difficulties with learning or attention may become evident.

In adolescence, peer relationships often highlight neurodivergence: teenagers may be excluded because their social behavior is perceived as odd or inappropriate compared to the ‘norm’.

In adulthood, challenges may include highly restricted interests or difficulties in social interactions, impacting work or career choices. Here, the individual’s personal history becomes central: reconstructing developmental milestones from childhood helps identify early signs of neurodivergence. Atypical functioning is constitutional and lifelong, it is not confined to a single phase of development,” says Dr. Tobia.

For children, an evaluation pathway is often initiated by the pediatrician, based on parental concerns or observed behaviors.

“The process begins with a multidisciplinary assessment involving child neuropsychiatrists, psychologists, and speech-language pathologists,” explains Dr. Tobia.

Once a diagnosis confirming neurodivergent functioning is established, a therapeutic plan is developed, tailored to the individual’s difficulties and condition, as well as the resources and educational services available. Diagnosis, as the specialist emphasizes, is an important tool but must be used judiciously.

“A certification should only be issued if neurodivergent traits align with one or more neurodevelopmental disorders and if they significantly interfere with daily life, causing distress or impairment,” notes Dr. Tobia.

Diagnosis can be useful for obtaining support. For example, special education teachers, school aides, or the drafting of an IEP (Individualized Education Plan) or PDP (Personalized Didactic Plan) to promote inclusion for students with special educational needs.

“In other cases, particularly in adults, completing an evaluation and simply gaining an explanation of one’s cognitive profile can itself provide psychological benefit,” she adds.

Does neurodivergence predispose individuals to conditions such as depression, obsessive-compulsive disorder (OCD) or anxiety disorders?

“There is indeed a higher prevalence of psychiatric or psychological comorbidities in individuals with atypical neurological functioning compared to the neurotypical population.

For example, data on students with SLD show that the incidence of psychopathology (anxiety, depression, etc.) is much higher in those diagnosed during adolescence or adulthood, compared to those diagnosed in preschool or school age.

Children diagnosed earlier often develop effective coping strategies and have better long-term psychological outcomes. Those diagnosed later, however, may go through prolonged periods of distress, questioning the reasons behind their difficulties and developing feelings of inadequacy,” Dr. Tobia explains.

Neurodivergence and learning are closely intertwined, requiring awareness, flexibility, and personalized strategies.

“Neurodivergent children often learn differently and face specific challenges: social communication difficulties impacting oral skills, reading and writing disorders (dyslexia, dysgraphia), or limited sustained attention (ADHD),” explains Dr. Tobia.

To address these needs, proper teacher training is essential, enabling educators to adapt both teaching methods and assessment tools to each child’s characteristics.

Among the most effective inclusive methodologies are:

• Cooperative learning: small group activities that promote communication, problem-solving, and collaboration skills;
• Peer tutoring: students at different competence levels support each other’s learning;
• Flipped classroom: students study materials independently at home, while classroom time is used for discussion and collaborative work.

“All these approaches, widely used today, create collaborative, stimulating, and inclusive learning environments. But education is not just about academic instruction: classroom relationships are a pillar of learning. Feeling accepted by teachers and peers reinforces self-esteem and enhances learning outcomes,” Dr. Tobia emphasizes.

How can cognitive and emotional differences be leveraged as strengths rather than obstacles in social contexts?

“Especially in learning contexts, both within and beyond schools, there are multiple areas for action:

• In classrooms, exposure and awareness are key. Classes that include children with autism, disabilities, or other forms of neurodivergence offer growth opportunities for all students, who learn to naturally accept diversity.
• In assessments, professionals describing a child’s neuropsychological functioning should emphasize strengths. Teachers and educators can build on these to design learning strategies. Even in severe cases, it is crucial to identify and apply these strengths in daily life. Helping neurodivergent individuals feel proud of their characteristics is of fundamental importance,” concludes Dr. Tobia.