Our brains are vast, diverse, and complicated– and some work differently than others. That is neurodiversity. Neurodiversity is the difference of the range of thought between everyone’s brains, and it can often be diagnosable. But in some cases, these cognitive differences can go unnoticed, and it can harm the individual to a great extent. Ideally, proper diagnosis at an early age is necessary, but can sometimes be difficult, because of gaps and biases present in research regarding neurodiversity. When researching neurodiversity, it is important to have participants that are equally represented in order to avoid bias.
In many, certain symptoms are overlooked when it comes to a proper diagnosis. Most of this is due to a lack of research or biases in the research done. For example, males are four times more likely to be diagnosed with autism. This is a direct result of the fact that a lot of the research done on autism is done on males, in which female participants are either underrepresented or completely excluded. Participants are chosen to be part of the study through a screening system called ADOS, which assesses an individual's behaviors and gives them a numerical score ranging from 15-60 (30 or above is considered autistic) which helps researchers decide who should be part of the study. Females are 2.5 times more likely to be excluded by this system than males are. This is a problem because males and females present autism in different ways. Because females are unequally represented in autism studies, symptoms of autism are often overlooked in females, which delays the process of diagnosis.
The same bias is seen in diagnoses of ADHD. Women and girls often get diagnosed later in comparison to males. Girls typically present inattentively (short attention span, forgetfulness, difficulty to stay focused), which is typically overlooked in the process of diagnosis. Boys present hyperactivity (trouble sitting still, acting without thinking, fidgeting, talking a lot). Symptoms are more likely to be overlooked by medical professionals because inattentive ADHD has more internalized symptoms, such as depression, or anxiety. Females also tend to get less referrals to professionals regarding their undiagnosed ADHD. People typically view ADHD as being disruptive and talkative, and when students don’t fit that image, it can be difficult for them to notice symptoms of ADHD and make a proper referral. A study in 2009 had teachers and guardians read brief descriptions of patients with ADHD, the only difference being gender. Both teachers and parents were less likely to refer a female patient to a professional. Most symptoms of ADHD in women are passed off for other conditions. In fact, a national survey showed that 14% of women with ADHD were treated with antidepressants before being properly treated.
These biases can delay diagnosis for individuals who have these conditions, and this can negatively impact their social and emotional; health because leaving these disorders undiagnosed can delay the treatment and adjustment to their condition. And sometimes, those illnesses can worsen, making it even harder for an individual to cope. To add on to that, many of those left undiagnosed with such disorders can also lead to individuals stressing unnecessarily or ignoring their physical health, which can be very harmful to them in the future. To prevent these unnecessary complications, biases that are prevalent in research should try to be minimized, so that the research done can help everyone. In addition to that, an attention to detail in therapists, teachers, and parents and guardians can ensure that any child who needs help can get it.
There are more biases in research and treatment of mental illnesses than just gender, as discussed in this post, but one thing they all have in common is the fact that none of them should exist. Biases like these result in partially complete research or diagnosis, which can greatly affect the lives of patients and other undiagnosed individuals. Sometimes, a change in mindset and procedure is all it takes to make a change in our system for the better.
Written by : Manasvi Kattekola
Edited by : Manav Desai
Citations
Moskal, Emily. "What Does It Mean to Be Neurodiverse in Medicine?" Stanford Medicine, 3 May 2023, scopeblog.stanford.edu/2023/05/03/what-does-it-mean-to-be-neurodiverse-in-medicine/#:~:text=Neurodiversity%20includes%20people%20with%20attention,best%20support%20such%20patients'%20needs.
D'Mello, A. M., Frosch, I. R., Li, C. E., Cardinaux, A. L., & Gabrieli, J. D. E. (2022). Exclusion of females in autism research: Empirical evidence for a “leaky” recruitment-to-research pipeline. Autism Research, 15(10), 1929–1940. https://doi.org/10.1002/aur.2795
Trafton, Anne. "Studies of Autism Tend to Exclude Women, Researchers Find." MIT, 8 Sep. 2022, news.mit.edu/2022/studies-autism-women-bias-0908.
Park, Hyung Seo et al. “Comparison of the Autism Diagnostic Observation Schedule and Childhood Autism Rating Scale in the Diagnosis of Autism Spectrum Disorder: A Preliminary Study.” Soa--ch'ongsonyon chongsin uihak = Journal of child & adolescent psychiatry vol. 29,4 (2018): 172-177. doi:10.5765/jkacap.180015
Quinn, Patricia O, and Manisha Madhoo. “A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis.” The primary care companion for CNS disorders vol. 16,3 (2014): PCC.13r01596. doi:10.4088/PCC.13r01596
"The Dangers of Untreated Mental Illness." High Focus Treatment Centers, 22 May 2018, www.highfocuscenters.com/dangers-untreated-mental-illness/.
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