Neurodiversity-Affirming Rehabilitation: A Narrative Review of a Paradigm in Transition

Abstract

The neurodiversity movement has prompted a fundamental re-examination of how rehabilitation professionals conceptualise and support autistic, attention-different, dyslexic and other neurodivergent people. Departing from a deficit or pathology model that prioritises normalisation, neurodiversity-affirming practice reframes neurological difference as a natural form of human variation to be accommodated and valued rather than corrected. This narrative review traces the origins and core tenets of the neurodiversity paradigm and synthesises recent scholarship on its translation into rehabilitation, with particular reference to occupational therapy and allied disciplines. It contrasts affirming and non-affirming approaches, examines the ethical critique of normalisation-focused intervention, and sets out emerging principles including environmental adaptation, strengths-based goal-setting, the valuing of interdependence over enforced independence, the fostering of a coherent identity, and the meaningful inclusion of neurodivergent voices and professionals. Barriers to authentic paradigm change — among them entrenched medical-model assumptions and superficial or rhetorical adoption — are discussed. The review concludes that a genuine shift requires reflexivity, structural change and sustained collaboration with neurodivergent communities