There is consensus regarding some neurodevelopmental conditions being classed as neurominorities, with a ‘spiky profile’ of executive functions difficulties juxtaposed against neurocognitive strengths as a defining characteristic.

Neurodiversity at work: a biopsychosocial model and the impact on working adults | British Medical Bulletin | Oxford Academic

A definition has emerged for psychologists and educators which positions neurodiversity ‘within-individuals’ as opposed to ‘between-individuals’. To elucidate: the psychological definition refers to the diversity within an individual’s cognitive ability, wherein there are large, statistically-significant disparities between peaks and troughs of the profile (known as a ‘spiky profile’, see Fig. 1). A ‘neurotypical’ is thus someone whose cognitive scores fall within one or two standard deviations of each other, forming a relatively ‘flat’ profile, be those scores average, above or below. Neurotypical is numerically distinct from those whose abilities and skills cross two or more standard deviations within the normal distribution.

Most humans are average in all functional skills and intellectual assessment, some excel at all, some struggle in all and some have a spiky profile, excelling/average/struggling. The spiky profile may well emerge as the definitive expression of neurominority, within which there are symptom clusters that we currently call autism, ADHD, dyslexia and DCD; some primary research supports this notion. In the future, these may shift according to our educational and occupational norms such as social demands, sedentary lifestyles, literacy dependency and automation of gadgets. To elucidate, although there are clear biological markers for those with a spiky profile which lead to observable, measurable psychological differences, there is nothing innately disabling about those differences when we consider a traditional, tribe-based community of humans. Within the biopsychosocial model of neurodiversity, understanding work-related intervention and treatment becomes more about adjusting the fit between the person and their environment than about treating a disorder. Critical review of the extant biopsychosocial research supports the social model proposition that the individual is not disabled, but the environment is disabling.

Neurodiversity at work: a biopsychosocial model and the impact on working adults | British Medical Bulletin | Oxford Academic

neurominority is a population of neurodivergent people about whom all of the following are true:

1.) They all share a similar form of neurodivergence.

2.) The form of neurodivergence they share is one of those forms that is largely innate and that is inseparable from who they are, constituting an intrinsic and pervasive factor in their psyches, personalities, and fundamental ways of relating to the world.

3.) The form of neurodivergence they share is one to which the neurotypical majority tends to respond with some degree of prejudice, misunderstanding, discrimination, and/or oppression (generally facilitated by classifying that form of neurodivergence as a medical pathology).

Examples of neurominority groups include Autistic people, dyslexic people, and people with Down Syndrome.

It’s also possible to be neurodivergent without being a member of a neurominority group. Examples include people with acquired traumatic brain injuries, and people who have altered their own neurocognitive functioning through extensive use of psychedelic drugs.

The word neurominority can function as either a noun (as in, “Autistics are a neurominority”) or an adjective (as in, “Autistics are a neurominority group”).


Differences in sensory perception have been reported as a hallmark of neurominority internal experience, which may affect pain management, sleep patterns and increase routine-change difficulties during in-patient care.

Neurodiversity at work: a biopsychosocial model and the impact on working adults | British Medical Bulletin | Oxford Academic

Understanding the importance of nomenclature, sensory sensitivity and the lasting psychological effects of intersectional social exclusion is key for physicians wanting to interact confidently and positively with neurominorities. The proposed biopsychosocial model allows us to provide therapeutic intervention (medical model) and recommend structural accommodation (legislative obligation) without pathologization (social model). In other words, we can deal pragmatically with the individuals who approach us and strive for the best outcomes, given their profile and environment.

Neurodiversity at work: a biopsychosocial model and the impact on working adults | British Medical Bulletin | Oxford Academic

Peripheral Minds

We’re the kinky outliers, the peripheral minds. We’ve always been here, living and working the edges, creating dynamism and surprise, “bringing value to cooperative goals”.

Throughout our history, we have always had communities and villages with a core majority group of stabilizing, social, community-oriented individuals, and we always had the periphery minds, the outliers, those who needed to take in more information from their environments. The hyper-aware and vigilant; the innovators, the explorers, the protectors, the athletes, the hunters, the scientists, the geeks, the artists and the creative.

Theory of Peripheral Minds of Autism – Peripheral Minds of Autism

This theory proposes that throughout history we evolved working together in villages and communities. The core majority were a group of similar-minded individuals that could get along easily and keep the peace. They evolved to process and prioritize information for sociability. They were adept at imitation, following the crowd and working with others. Because we know from the work of Dr. Fisher and Dr. Michael Lesser that these personalities were dispersed in such a way as the periphery were the more rare personality types. More interested in things and tinkering, exploring, telling stories and taking up causes. These different groups, or personalities, processed information uniquely and had different priorities and motivations. They were innovators, explorers, protectors, leaders, scientists, geeks, artists and creatives (Lesser and Kapklein, 2003). These neurodiverse outliers processed and experienced the world very differently than the more sociable core. However, because of both the core and the diverse Peripheral Minds we thrived with each unique personality bringing value to cooperative goals (Bergmüller et al., 2010; Smaldino et al., 2013).

Is Autism a Stress Adaptation? – Peripheral Minds of Autism

Given the extent of overlap between the conditions, the under-diagnosis of females who instead present with anxiety, depression or eating disorders, and the estimated prevalence of each condition, a reasonable estimate of all neurominorities within the population is around 15-20%, i.e. a significant minority. Research supports a genetic component to most conditions which, when considered with combined prevalence rates, suggests an evolutionary critique of the medical model: if neurodivergence is essentially disablement, why do we keep replicating the gene pool? The less extensive, yet persistent, body of work indicating specialist strengths within neurodiversity, supports the hypothesis that the evolutionary purpose of divergence is ‘specialist thinking skills’ to balance ‘generalist’ thinking skills (as per the ‘spiky profile’). The evolutionary perspective is congruent with the Neurodiversity movement and essential to understanding the occupational talent management perspective that is currently in vogue.

The psychomedical histories outlined in Table 2 speak to the evolutionary critique for two reasons. Firstly, they demonstrate the consistency of the ‘specific’ rather than ‘general’ nature of impairment (the spiky profile) across all four conditions over time, irrespective of the changing nature of causal theories. The conditions are named and identified according to their most prominent deficits, which are themselves contextualized within our normative educational social history. Dyslexia is discovered around the same time as literacy becomes mainstream through education; ADHD becomes more prevalent with the increasing sedentary lifestyles from the industrial revolution; autism increases in line with modern frequency of social communication and sensory stimulation and DCD as our day-to-day need for motor control of complex tools and machinery becomes embedded. The evolutionary critique of neurodevelopmental disorders is that their perceived pathology is related to what we consider normal in modern times, as opposed to what is normal development within the human species. 3,7,53–55 Secondly of interest from the timeline in Table 2 is the final column, wherein we see that, despite consistent observation of similar neurobiological differences, we lack a single unifying theory for any condition.

Neurodiversity at work: a biopsychosocial model and the impact on working adults | British Medical Bulletin | Oxford Academic

Minority Stress

Under a minority model of disability, HFA and AS represent a distinct socio-political experience as neurominorities with wide ranging diversity (Altman 2001; Jaarsma and Welin 2012). ‘Neurominority’ is a relatively new term coined to describe those who fall under the neurodiverse model (Walker 2012). This study will examine how stress related to social stigma (e.g., Frost 2011) contributes to heightened rates of mental health problems experienced by the autistic community. We highlight the utility of social stress models (Meyer 2003; Meyer, Schwartz, & Frost, 2008) in understanding mental health and wellbeing in autism.

The stigma afforded to autistic individuals likely explains why multiple studies have found a high risk of victimisation in the HFA/AS community; including physical, verbal, and sexual victimisation across the life-span from childhood (Little 2002), to adulthood (Rosenblatt and National Autistic Society 2008). Similarly, autistic individuals are more likely to face workplace discrimination in terms of unfair dismissal, workplace harassment, underemployment, and unemployment (Baldwin, Costley, and Warren 2014; Barnard et al. 2001; National Autistic Society 2012). Social rejection can also be internalized and self-perpetuating. For example, as a result of experiences of rejection, neurominorities may become embroiled in a negative self-concept, built upon the foundation of social rejection (Link et al. 1989). While the previously discussed research into victimisation and discrimination documents high rates of exposure among autistic populations, researchers have yet to focus on the impact of victimisation on the wellbeing of autistic individuals.

The primary aim of the minority stress model is to explain disparities in health between majority and stigmatized minority groups (Meyer 2003). Social stress theory hinges on the idea that social disadvantage can translate into health disparities (Schwartz and Meyer 2010). Researchers hypothesize that decreased social standing leads to stigmatized minority groups being exposed to more stressful life situations, with simultaneously fewer resources to cope with these events. Social structure facilitates this process through acts of discrimination and social exclusion, which are added stress burdens that socially advantaged groups are not equally exposed to.

(PDF) Extending the Minority Stress Model to Understand Mental Health Problems Experienced by the Autistic Population

Further reading,