Neurodiversity beyond the West

Summary

Nearly everything this wiki describes, the neurodiversity paradigm, the social model, the double empathy problem, the epistemic justice framework, the vocabulary of masking and burnout and meltdown, was developed in English, by researchers and advocates based in the United Kingdom, the United States, Australia, and northern Europe. The diagnostic instruments that define autism (ADOS-2, ADI-R) were validated on Western populations. The self-advocacy movement that challenged the deficit model grew in Anglophone online spaces. The philosophical traditions that underpin the neurodiversity paradigm (Fricker, Nussbaum, Merleau-Ponty) are European.

This does not make these frameworks wrong. It makes them partial. The question this page asks is what happens to our understanding of neurodivergence when we look beyond the contexts in which that understanding was produced.

The research gap

The scale of the problem is quantifiable. Fewer than 20% of the global population lives in high-income Western countries, yet the overwhelming majority of autism research originates there (Koh et al., 2023). Abubakar et al. (2016) found only 53 peer-reviewed studies on autism from nine of the 46 countries in sub-Saharan Africa, a region where 40% of the population is under 15. For most of the world’s children, there are no prevalence data, no validated screening instruments, and no service infrastructure.

This is not just a resource problem. It is an epistemic one. When a field’s entire evidence base comes from WEIRD (Western, Educated, Industrialised, Rich, Democratic) populations, the knowledge it produces reflects WEIRD norms. What counts as atypical social behaviour, what counts as a communication deficit, what counts as a repetitive or restricted interest: all of these judgements are made against a cultural baseline that is treated as universal but is not.

When the instruments don’t travel

Autism diagnostic instruments were designed and validated in Western clinical settings. The ADOS-2 relies on observation of social-communicative behaviour against implicit norms: eye contact, conversational reciprocity, gestural communication, imaginative play. These norms vary across cultures in ways that are clinically significant.

Leeuw et al. (2020) developed a conceptual framework for understanding cultural and contextual factors in autism and documented specific misalignments. In many East Asian cultures, reduced eye contact with authority figures is a sign of respect, not a social deficit. In collectivist societies, the boundary between “typical” social compliance and masking may be drawn differently, because social conformity is a cultural expectation for everyone, not just for autistic people. Atherton et al. (2023) found that autistic traits understood as deficits in Western contexts (preference for solitude, intense focused interests, discomfort with social ambiguity) were weighted differently in Japanese cultural settings.

The consequence is not just that autism might be missed in non-Western populations. It is that the thing being measured may not map cleanly onto the construct as it was defined. A diagnostic instrument calibrated against British or American social norms does not become culturally neutral by being translated into another language. The norms travel with it.

Southeast Asian research confirms this. A 2024 review in Frontiers in Child and Adolescent Psychiatry found that existing screening tools (M-CHAT, SCQ) missed culturally specific presentations and called for instruments developed within, not merely adapted for, non-Western populations.

Disability frameworks that predate the Western debate

The medical model vs social model debate that structures so much of Western disability thinking is itself culturally specific. Other traditions have understood neurological and cognitive difference through frameworks that do not map onto this binary.

In many African cultures, disability is understood relationally and communally rather than individually. The concept of ubuntu (“I am because we are”) frames personhood as constituted by relationships, not by individual capacity. A person with a disability is still fully a person because personhood is not contingent on cognitive or physical independence. Grummt (2024) argued that ubuntu philosophy already contained something structurally similar to the neurodiversity paradigm’s insistence on the value of all minds, but arrived at it through communal ethics rather than individual rights.

In Indigenous knowledge systems, cognitive difference has sometimes been understood as spiritually significant rather than pathological. Bruno et al. (2025), in a landmark paper on global Indigenous perspectives on autism, documented frameworks in which what Western medicine labels as autism was understood as a form of spiritual giftedness or as evidence of a particular relationship with the non-human world. The Plains Cree concept of acahk pimatsiwin was offered as one example. The authors are careful not to romanticise these frameworks or to suggest they are uniformly positive: spiritual interpretations of disability can also lead to stigma, neglect, or the denial of practical support. The point is that they represent different epistemologies, not just different attitudes toward the same phenomenon.

Religious frameworks add further complexity. In some South Asian and Middle Eastern contexts, disability has been understood through lenses of karma, divine testing, or spiritual purification. These frameworks can produce both acceptance (the person’s difference has meaning and purpose) and harm (the person’s difference is their or their family’s fault). They are not reducible to either the medical or the social model, and the neurodiversity paradigm’s insistence on “natural human biodiversity” may not resonate in cultural contexts where “natural” and “spiritual” are not separable categories.

The neurodiversity movement’s cultural specificity

Nair, Farah, and Boveda (2024) asked directly: is neurodiversity a Global Northern White paradigm? Their analysis identified several ways in which the movement reflects its cultural origins.

The movement’s infrastructure is English-language and internet-dependent. Online autistic communities, where much of the neurodiversity vocabulary was developed, require literacy, internet access, and English fluency. Autistic people in the Global South who lack these resources are excluded not just from the movement but from the conceptual tools it has produced.

The movement’s philosophical foundations are European. Fricker is British. Nussbaum is American. Merleau-Ponty is French. The social model emerged from the UK disability rights movement. The neurodiversity paradigm was coined by an Australian. None of this makes the ideas parochial, but it does mean they carry assumptions about individualism, rights, identity, and selfhood that are culturally specific.

The movement’s political priorities reflect Global North concerns. Workplace accommodations, diagnostic access, inclusive education, anti-stigma campaigns: these presuppose institutional structures (formal employment, universal schooling, clinical diagnostic services) that do not exist in much of the world. For a family in rural sub-Saharan Africa whose autistic child has no access to any kind of educational or healthcare system, the neurodiversity movement’s debates about diagnostic language may be irrelevant to their immediate situation.

Hirota, Cheon, and Lai (2024) explored how neurodiversity concepts are received in East Asian contexts and found a more nuanced picture. Some elements translate well: the rejection of deficit framing resonates in cultures that already value cognitive diversity within their own philosophical traditions. Other elements sit uneasily: the emphasis on individual identity and self-advocacy may conflict with collectivist values that prioritise family harmony and social cohesion over individual self-expression.

What this means for the wiki

This wiki is, transparently, a product of the tradition it is now examining. Its primary author is European. Its AI research assistant was trained predominantly on English-language text. Its philosophical framework draws on Anglophone and European thinkers. Its sensory processing content originated in a Dutch research programme. It would be dishonest to pretend otherwise.

The acknowledgement does not invalidate the work. It contextualises it. The frameworks described across this wiki (the neurodiversity paradigm, the social model, the capabilities approach, the epistemic justice framework) are powerful analytical tools. They have produced genuine improvements in how neurodivergent people are understood and treated. They are also partial, and their partiality matters most for the people they were not built to describe: neurodivergent people in the Global South, in Indigenous communities, in cultures where the Western medical-social binary is not the starting point for thinking about human difference.

A truly global understanding of neurodivergence will require not just translating Western frameworks into other languages but engaging with the epistemic traditions that already exist elsewhere, traditions that may have been asking their own versions of the Socratic question (see Socratic inquiry and neurodivergent knowledge) long before Western autism research began.

Open questions

Can the neurodiversity paradigm be decolonised, or does the attempt to make a Western framework “include” non-Western perspectives reproduce the dynamic it claims to challenge? The alternative might be to let non-Western frameworks speak on their own terms rather than assimilating them into a paradigm designed elsewhere.

What would autism research look like if it were led by researchers in the Global South, using instruments developed for their own populations, asking questions that matter in their own contexts? The current model (Western researchers adapting Western tools for use in non-Western settings) is better than nothing. It is not the same as locally generated knowledge.

How should this wiki handle its own cultural specificity? The honest answer is: transparently, as a limitation rather than a universal claim. The frameworks here are useful. They are not the only frameworks, and the people they serve least well are often those with the least power to build alternatives.

Key sources

• Abubakar, A., Ssewanyana, D., de Vries, P.J. and Newton, C.R. (2016). Autism spectrum disorders in sub-Saharan Africa. The Lancet Psychiatry, 3(9), 800-802. doi: 10.1016/S2215-0366(16)30138-9
• Atherton, G., Morimoto, Y., Nakashima, S. and Cross, L. (2023). Does the study of culture enrich our understanding of autism? A cross-cultural exploration of life on the spectrum in Japan and the West. Journal of Cross-Cultural Psychology, 54(5), 524-546. doi: 10.1177/00220221231169945
• Bruno, G., Lindblom, A., Masternes, J.-A., Tupou, J., Waisman, T.C., Toby, S., Vining, C. and Magiati, I. (2025). Global Indigenous perspectives on autism and autism research: colonialism, cultural insights and ways forward. Autism. doi: 10.1177/13623613251318399
• Grummt, M. (2024). Sociocultural perspectives on neurodiversity: an analysis, interpretation and synthesis of the basic terms, discourses and theoretical positions. Sociology Compass, 18(5), e13249. doi: 10.1111/soc4.13249
• Hirota, T., Cheon, K.-A. and Lai, M.-C. (2024). Neurodiversity paradigms and their development across cultures: some reflections in East Asian contexts. Autism. doi: 10.1177/13623613241285678
• Koh, Y.J., Kim, Y.S., Park, J. and Lim, E.C. (2023). Shifting the centre of gravity: towards a truly global representation in autism research. Frontiers in Psychiatry, 14, 1258625. doi: 10.3389/fpsyt.2023.1258625
• Leeuw, R.R., de Boer, A.A. and Minnaert, A.E.M.G. (2020). A conceptual framework for understanding the cultural and contextual factors on autism across the globe. Autism Research, 13(7), 1029-1050. doi: 10.1002/aur.2276
• Nair, V.K.K., Farah, W. and Boveda, M. (2024). Is neurodiversity a Global Northern White paradigm? Autism. doi: 10.1177/13623613241280835
• Pillay, S., Duncan, M. and de Vries, P.J. (2021). Autism in the Western Cape province of South Africa: rates, socio-demographics, disability and educational characteristics in one million school children. Autism, 25(4), 1076-1089. doi: 10.1177/1362361320978042

Related pages

• Neurodiversity as political philosophy
• Epistemic justice and neurodivergence
• Models of disability
• The neurodiversity paradigm
• Critical Autism Studies
• Socratic inquiry and neurodivergent knowledge
• Philosophy of neurodivergent experience
• Diagnostic pathways
• Autism screening, surveillance, and genetic testing