Abstract
The concept of neurodiversity has gained rapid scholarly, clinical, and broad community momentum. This includes the inclusion of understanding neurodiversity approaches as a new mandated competency for Australian psychologists to gain and maintain registration to practice. Consensus regarding the core conceptual features and effective application of neurodiversity affirming principles in research is evolving, and the field lacks a standardized tool to guide the interpretation, appraisal, and assessment of neurodiversity affirming mental health research. This includes moving beyond narrow Western ontologies of neurodiversity that often prevail in contemporary scholarship. Moreover, policymakers require guidance on the creation of inclusive policies that are aligned with neurodiversity-affirming best practices, which include trauma-informed care and commitment to cultural responsivity. Above all, it is imperative that neurodivergent people and communities continuously benefit from, shape the priorities of, and remain centralized. This includes ensuring neurodiversity affirming approaches do not reinforce colonial assumptions about independence, productivity, and normative functioning. In this Community Perspective, we draw upon our collective researcher-clinician-lived-experience expertise to synthesize current neurodiversity conceptual evidence and distil key principles for the application to mental health research. The resulting Neurodiversity Appraisal Tool (NeuDAT) is a qualitative instrument to guide clinicians, educators, policymakers, researchers, and other evidence consumers in appraising neurodiversity research.
Lay Abstract
What is already known about the topic?
Neurodiversity affirming approaches are essential in mental health research to address historical research practices that excluded neurodivergent views and experiences. However, there is very little guidance on what a neurodiversity affirming approach is in research. This is a particularly current issue with the 30,000 Australian psychologists now mandated, under new national competency standards, to hold an understanding of neurodiversity approaches.
What this paper adds?
We brought together a multi-disciplinary group of experts including lived and living experience of neurodivergence (including parents, families, carers, and supporters of neurodivergent people), and through a process of exchanging knowledge, including published evidence on neurodiversity affirming approaches and multiple rounds of revisions with the authorship group, we developed a tool to assess neurodiversity affirming mental health research. The NeuDAT provides guiding questions to apply to research to understanding the extent to which neurodiversity affirming approach has been adopted.
Implications for practice, research or policy
The NeuDAT supports aligned, responsive and rigorous appraisal of neurodiversity affirming mental health research. The implications for practice include providing guidance to professionals in their assessment of research and therefore supporting better translation of neurodivergent views and experiences into mental health practice. Researchers can utilise the NeuDAT across the research stages to ensure neurodivergent views and priorities are consistently centred. Policy-makers can utilise the NeuDAT in understanding how to apply appropriate evidence to ensure neurodiversity affirming systems and settings to address inequities for neurodivergent communities.
Background
Grounded in human rights approaches and social models of health and wellbeing, neurodiversity frameworks recognize the rich and expected diversity of human development (1). They accept neurodifferences as natural developmental variations, steering away from deficit-focused and medicalized explanations of human variation (McGrattan, 2025). As a socio-cultural movement, neurodiversity has rapidly become recognized as an essential epistemological shift across health, medical, psychiatry, disability, sociological, human rights, social justice, political, and other research disciplines (McLennan et al., 2025). This has important implications for the practice standards for safe and ethical research, which must continuously evolve in accordance with contemporary societal norms and expectations (Miteu, 2024). Here we refer to neurodiversity as the descriptive arching concept, framework and paradigm, and neurodiversity affirming and neuroaffirming approaches (interchangeably) as the application of neurodiversity as a concept in practice. Neurodifferences relate to neurological variations that differ substantially from the broader population, including thinking, learning, processing, communication, sensory, emotion, behavioral, and other differences.
Neurodivergence includes—but is not limited to—Autism, Attention Deficit Hyperactivity Disorder (ADHD), Specific Learning Disorders including dyslexia, and Obsessive Compulsive Disorder. These diagnostic labels reflect clinical nomenclature that sometimes employs deficit-based and disorder-oriented framings as opposed to neurodiversity affirming approaches, but they are referred to here because they remain the prevailing language within research, clinical practice, and policy contexts (McGinty-Minister, 2026). In contrast to deficit-based frameworks, neurodiversity affirming approaches (also referred to throughout interchangeably as neuroaffirming approaches, reflecting the breadth and diversity of preferred terminology in contemporary scholarship) highlight the significance of social and environmental accommodations, addressing harmful normative standards, and recognizes historical inequities in research, policy, and practice in understanding neurodifferences (Botha & Gillespie-Lynch, 2022). Human-rights principles inform neurodiversity approaches in ensuring equality, mutual respect, power sharing, and accountability for practices that fail to adhere to these principles.
Historical exclusionary practices are particularly evident throughout research focused on neurodivergent groups (D'Mello et al., 2022). Many of the past efforts to address challenges experienced in the context of neurodivergence have targeted adjustments to the individual (e.g., teaching neuronormative social skills to neurodivergent people), rather than removing or reducing social and physical environmental barriers (e.g., fostering neurodiversity affirming environments); in other words, there has been a historical attempt to “normalize” neurodivergent individuals in line with neuronormative expectations (McLennan et al., 2025). Where individual agency, preferences, and capacities to adopt neuronormative behaviors are not considered, intervention success tends to be attributed to unwillingness or incapacity within the individual, rather than recognized as context-dependent and relational outcomes.
Despite being well-intentioned (if not misinformed), this has placed a disproportionate burden on neurodivergent individuals and the broader neurodivergent population to adapt to misalignments between individual needs and socio-environmental demands (Aguirre Mtanous et al., 2026; Cleary et al., 2023). For example, Milton et al. (2022) highlighted the injustice of holding the autistic community as solely responsible for adapting to meet normative standards (i.e., exemplified in the “double empathy problem”) (Milton et al., 2022). By emphasizing an inherent asymmetry in expectations, they bring to attention the observed effect of autistic-to-autistic communication, whereby social communication difficulties are often reduced. Navigating communication discrepancies is a societal, community, and whole-of-population responsibility, not solely autistic people. Such historically individualizing approaches contribute to placing disproportionate burden on neurodivergent people and contribute to poorer mental health outcomes observed among neurodivergent communities (Cleary et al., 2023).
Inequitable mental health outcomes are reported for neurodivergent people across the mental health continuum (Choi et al., 2022; Cleary et al., 2023; French et al., 2024; Hossain et al., 2020). This includes tragic estimates that autistic adults experience a 25-fold increased risk of suicidality compared to non-autistic adults (Conner et al., 2023). Neuroaffirming reform therefore has direct relevance throughout psychiatry, tertiary mental health settings, psychopharmacological settings, and other settings providing treatment of severe mental ill health and suicidal distress response. Neurodivergent lived experiences support this reform. Despite high utilization of such services, a consistently reported barrier among neurodivergent people and their families, carers, and supporters includes low levels of understanding among service and professional understanding of neuroaffirming practice, which contributes to exacerbated distress, poorer outcomes, and adversely impact further help-seeking due to risks of re-traumatization (Hotez et al., 2024; Mazurek et al., 2023; O’Connor et al., 2024).
Evidence-based practice is gold standard for ensuring rigorous and high-quality mental healthcare. Therefore, inadequate representation of community priorities in research continues to impact mental health inequities for neurodivergent people (Hotez et al., 2024). Individuals assigned female at birth, for example, are more likely to experience delayed ADHD diagnosis, owing to historically underexplored unique expressions and experiences in research, resulting in diagnostic criteria that inadequately respond to unique expressions (D'Mello et al., 2022). Delayed diagnosis increases risk of anxiety, depression, and maladaptive coping (Attoe & Climie, 2023). Challenges with executive functioning (e.g., task initiation, planning, and emotional regulation), as a core feature of ADHD, can impact relationship formation, academic engagement, work, and other life domains. Delayed diagnosis, therefore can increase vulnerability for individuals assigned female at birth across multiple life domains (Attoe & Climie, 2023). Recognizing and addressing such historical inadequacies of the research evidence to date is essential to avoid perpetuating inequitable mental health and other poorer outcomes. This includes reconsidering dominant health frameworks that are consistently adopted throughout research and practice, but largely conceptualize health as it relates to Western paradigms of health and well-being (Dudgeon et al., 2022; Limenih et al., 2024; Rhodes, 2019). As such, it is essential that contemporary neurodiversity approaches must further seek to understand and center the experiences of those experiencing intersectional disadvantage, and ensure genuine commitment to challenging dominant discourse.
Neurodivergent individuals also experience disproportionate exposure to interpersonal violence, victimization, and coercive control across the lifespan, making trauma-informed approaches foundational to neuroaffirming practice (Fox, 2025; Fox et al., 2025). Critically, these patterns are often framed as reflecting individual vulnerability associated with neurodivergence. This obscures the relational, organizational, and systemic conditions that produce risk, limit protection, and constrain access to appropriate support. Reframing trauma exposure as a product of social exclusion, power imbalances, and inadequate systems of care shifts attention toward the responsibility of institutions and services to respond in ways that are safe, inclusive, and trauma-informed and to mitigate retraumatization (Health & Services, 2014). Trauma-informed care approaches therefore also provide a critical framework for recognizing cumulative harm, mitigating re-traumatization, and promoting safety, trust, and empowerment within services and institutions engaging neurodivergent individuals.
Unsurprisingly, there have been rapid and scaled efforts to adopt neurodiversity affirming approaches in research and practice to address these gaps. This includes an average year-on-year increase of 40% in scholarly outputs including “neurodiversity” as a term between 2000 and 2022 (Shah & Holmes, 2023). A recent scoping review found the most consistent feature of neurodiversity approaches (other than that the concept is best described as evolving) was acceptance of neurodifferences as a result of natural human variation, and alignment of neurodiversity with social justice, disability- and human-rights movements (McLennan et al., 2025). Further components were neurodivergence as inseparable from identity, strengths-based acceptance of difference, and environmental supports for neurodivergent differences (McLennan et al., 2025). The significance in terminology for neurodiversity approaches (e.g., identity-first terminology as preference) was highlighted, including the variations of preference and diversity of neurodivergent views and priorities (McLennan et al., 2025), mirroring broader acknowledgment of the influential role of historical language and terminology in perpetuating systemic inequity and reinforcing marginalization (McGinty-Minister, 2026).
Recent reform in Australian psychological practice has centered neuroaffirming approaches as core practice. As of December 2025, Australian Registered Psychologists are mandated by the Psychology Board of Australia to “Understand neurodiversity … approaches to supporting people with developmental disability” and must demonstrate the “ability to adapt psychological practice and make reasonable adjustments” (Psychology Board of Australia, Professional Competencies for Psychologists, Competency 7.9). This represents the first-time neurodiversity has been articulated as a mandated core competency for Australian psychologists. The expected impact extends far beyond psychological practice, noting the broader influence from the psychology discipline on education, health, and workplace settings that are informed by psychological sciences. Neurodiversity affirming mental health approaches have been associated with improved mental health outcomes for neurodivergent people, whereas inadequate affirmation has been associated with greater symptom severity and poorer support experiences (Kroll et al., 2024). Practitioners report low confidence, knowledge and competency in supporting neurodivergent clients in clinical settings (Morris et al., 2023). Indeed, an umbrella review of mental health interventions for autistic adults found little evidence that approaches were responsive to neurodivergent experiences, preferences, and neurodiversity affirming principles (Curnow et al., 2023). Practitioners are now faced with the difficult reality (and ethical challenge) that neurodivergence is not only common among client and general populations, but that historical approaches to psychological practice are inadequate.
To add to these challenges, there remains an evolving consensus and disagreement in what constitutes a neurodiversity affirming approach. For example, concerns have been raised that advocacy for strengths-based approaches may be insufficient if applied too rigidly and may be misunderstood as devaluing clinical or medical support, disproportionately and adversely impacting people and families with high support needs (Srinivasan, 2025). Despite recent progress, including a Delphi-consensus defining neurodiversity affirming practice in the context of Australian psychologists working with autistic adults (Flower et al., 2025), there is no standardized scope of competency for neuroaffirming approaches in psychological practice. Srinivasan (2025) also highlights cultural limitations in neurodiversity discourse, which can reflect dominant Western societal values, such as equating autonomy with functioning without assistance (Srinivasan, 2025). Indeed, the recent Psychology Board of Australia competency reform also mandates the competency of culturally-responsive practice, including the ability to reflect on and learn from Aboriginal and Torres Strait Islander cultures and Aboriginal knowledges (Competency 8.5). Clinicians, therefore, must be equipped with an understanding of neurodiversity affirming approaches in the context of broader sociocultural contextual factors, such as mental health being relational, cultural, and structural. The critical need to address intersectional experiences of neurodiversity, including through trauma-informed care, decolonial frameworks and Global Majority epistemologies, is essential (Nair et al., 2026). There remains a critical gap in fully accounting for Indigenous epistemologies, particularly those of Aboriginal and Torres Strait Islander Peoples. Neurodiversity discourse, like many contemporary health frameworks, risks reproducing Western individualized constructs of identity, autonomy, and functioning (Nair et al., 2026). First Nations perspectives position wellbeing as inherently relational—embedded within kinship systems, Country, community, and collective responsibility (Dudgeon et al., 2025; Gee et al., 2014). Without this grounding, neurodiversity frameworks may inadvertently reinforce colonial assumptions about independence, productivity, and normative functioning.
Distilling such conceptual complexities, respecting diverse views, and translating to a guidance framework to appraise mental health research given recent reform, is an ambitious task. There are also practical, ethical, and contextual considerations in applying standards to research through an appraisal process when research can often be resource-limited, discipline-specific and where full implementation of principles may not be feasible. At the same time, there remain substantial risks in the current state, including a lack of guidance on neurodiversity affirming mental health research, reporting standards, or translational frameworks for applying neurodiversity research to psychological practice. Rapid uptake of recognition and interest in neurodiversity has led to researchers identifying—presumably without ill intent—as conducting neurodiversity affirming research with little justification as to how such an approach has been adopted. Low regard to underlying conceptual complexities poses many risks, including ongoing failure to center and meaningfully engage lived experience (e.g., terminology used in research in which authors identify adopting a neuroaffirming approach, can be inconsistent with community preferences).
The need for guidance on appraisal for neurodiversity affirming approaches in mental health research is urgent, with the >30,000 psychologists in Australia who are, as of December 2025, mandated to ensure understanding of neurodiversity approaches in psychological practice. The recently launched Australian National Autism Strategy 2025–2031 and the Australian National Roadmap to Improve the Health and Mental Health of Autistic People 2025–2035, developed through co-design with lived experience and insights from autistic people, families, carers, advocates, researchers, and other stakeholders, seeks to ensure strengths-based and autism-affirming care as standard clinical practice. Comparable momentum is also evident in the United Kingdom. For example, in England, the National Strategy for Autistic Children, Young People, and Adults 2021–2026 has formalized cross-sector commitments to improving autistic people's lives, while updated (2023) Health and Care Professions Council standards for practitioner psychologists require bias reflection and the ability to make (and support) reasonable adjustments in practice.
In the context of such significant international reform and uptake, and with acceptance that no single framework can evaluate all types of mental health research, it is essential that guidance be provided to address historical harms, strengthen alignment across research, policy, and practice, and, above all, to ensure that the priorities of neurodivergent people and communities remain centered. The aim of this Community Perspective, building upon the literature summarized in this background, our collective clinician-lived experience-research expertise, and pre-existing practice-based guidelines that guide ethical neurodiversity affirming research conduct (e.g., Horton et al.; Nicolaidis et al., 2019) was to synthesize current neurodiversity conceptual evidence and distil key principles for the application to mental health research. Guided by existing appraisal tools and review findings we sought to (a) develop key questions based on the literature and (b) propose an initial appraisal tool to guide neurodiversity affirming mental health research and research practices.
The authorship team included research, clinician, and lived experience (i.e., neurodivergent authors, lived and living experience of mental ill health, family, carers, and supporters of neurodivergent people) expertise. The authorship expertise further spanned neurodiversity, public health, population health, First Nations leaders, Indigenous knowledge systems, social, emotional, and cultural wellbeing, education, psychiatry, health promotion, community-based mental health prevention and early intervention, suicide prevention, implementation scientists, human-rights, disability, and lived and living experience research leadership. Further, our authorship team included practicing mental health professionals (i.e., psychologists) across a range of endorsement areas (i.e., clinical, educational, performance, developmental, and community). All authors commit to upholding neurodiversity affirming practice and research. We recognize it is unlikely a single framework or tool will entirely capture all nuances of neurodiversity affirming approaches, but that guidance can mitigate harm perpetuated through misintended adoption of the approach. The authorship team reviewed and agreed to the underlying concepts and principles that informed this work and considered biases inherent in individual approaches to knowledge exchange. The authorship group recognize and commits to the ongoing advocacy for neurodivergent people and communities in recognizing historical harms in research practices and in ensuring self-determination for neurodivergent people. Our authorship team includes First Nations and non-Indigenous people, and together we commit to upholding Indigenous Data Sovereignty. We recognize First Nations people as owners, controllers, and stewards of data and knowledge that concerns First Nations people, their cultures, knowledges, and resources.
Method
Informed by previous methods for research tool development (Maeda et al., 2023; Whiting et al., 2017), Cochrane Rapid Reviews Methods Guidance (Klerings et al., 2023), and deductive methods (Fife & Gossner, 2024) based on conceptual features of neurodiversity affirming approaches summarized in the background section, we conducted a rapid review of current neurodiversity conceptual evidence. Given the rapid and recent progress in conceptualizing features of neurodiversity and underpinning complexities, reviews were eligible if they were published in the last 5 years, from 2022 onward. We ensured a specific search and synthesis of literature (i.e., of any research design) focused specifically on intersectional First Nations and neurodiversity perspectives as a commitment to accountability towards Indigenous epistemologies. Key neurodiversity components and principles from literature sources were thematically analyzed (Braun & Clarke, 2006) and distilled into guiding questions informed by existing appraisal tools and research guidance frameworks (e.g., Dark, 2024; Harfield et al., 2020). These findings were shared for review and feedback among the authorship group, who collectively determined the items that were proposed in the final tool. Principles and resultant items in the tool relating to Indigenous knowledges were accessed, controlled and determined by First Nations team members, in accordance with Indigenous Data Sovereignty.
Guiding principles identified from the review were translated into appraisal items through an iterative, deductive process following previous methods for research appraisal tool development (Ahmed et al., 2025; Fife & Gossner, 2024; Maeda et al., 2023). Each principle was operationalized into observable features of research practice, informed by existing appraisal frameworks and participatory research guidance. Draft items were developed and refined through collective knowledge exchange within the authorship group, with attention to validity, clarity, applicability across research contexts, and alignment with neurodiversity affirming, and human-rights approaches. Consensus was reached through iterative review, resulting in the final set of NeuDAT items. Consistent with early-stage tool development (Maeda et al., 2023; Munn et al., 2014), the NeuDAT has not yet undergone formal evaluation or usability testing, and is intended as a preliminary framework to guide appraisal.
Findings
The findings of the rapid review indicated six interconnecting guiding principles (Table 1). These principles informed the development of corresponding appraisal items, operationalized within the NeuDAT (Table 2). It is noted that this summary of evidence and subsequent principles are by no means comprehensive and should not be interpreted as exhaustive. A commentary of the guiding principles are as follows, and the principles, the evidence supporting their extraction, and the application to research appraisal based on existing tools, are reported in Table 1.
Guiding Principles, Underpinning Evidence, and Items Used to Develop the Neurodiversity Appraisal Tool (NeuDAT).
Neurodiversity Affirming Approaches Acknowledge the Broad and Expected Variations of Humans, and Focuses on Environmental Adjustments and Accommodations
A key defining feature of neurodiversity throughout the review evidence was the recognition of the broad and varied neurodifferences spanning social, communication, emotional, behavioral, and other characteristics that are normal and expected variations of the human population. Further, the evidence recognized harmful impact of historical approaches to mental health research and practice, which viewed neurodifferences as deficits, which universally required corrective intervention. This does not necessarily indicate that intervention is not warranted, but individuals, families and carers require genuine agency and choice in intervention. As such, the identified reviews described that neurodiversity affirming approaches identify the essential role of environmental targets for addressing difficulties and challenges, as well as the importance of environmental-individual fit, and genuine agency and choice. Environmental factors must be understood not only as immediate social or physical contexts, but as shaped by ongoing colonial structures, including racism, dispossession, child removal, and over-incarceration. These structural determinants profoundly shape neurodivergent experiences and mental health outcomes for First Nations Peoples.
Diversity in Perceived Conceptual Features of Neurodiversity Is Evident
There is considerable variation in how neurodiversity is conceptualized within the literature. Reviews examining neurodiversity consistently identify that the most appropriate descriptor for the field is evolving. For example, the term neurodivergent has often been used in the context of ADHD and autism, representing the set of developmental differences that substantially vary from typical human development. However, there is consideration as to whether all neurocognitive differences—for example, including those acquired through injury—are considered neurodivergent. Recognition of the diverse views and neurodiversity as an evolving concept was regularly discussed through the identified reviews, and acknowledgment of diverse views and preferences was a consistent emerging feature. This was further exemplified through the recognition that a single approach or framework was unlikely achievable given the breadth, application, and diversity of views in the field. A highlighted limitation was the tendency of neurodiversity conceptual research to remain positioning in the dominant Western discourse of health and wellbeing, focusing on individual autonomy, without integration of relational, collective informed concepts that comprise health and wellbeing. Diversity of conceptual features was an essential component, alongside the recognition that accountability to diverse epistemologies is also essential.
Strengths-Based, Trauma-Informed Approaches Are Accepted as Essential
The reviewed literature indicated that neurodiversity affirming approaches are underpinned by the assumption that individual diversity should be valued and respected, and that being neurodivergent is not inherently adverse; rather, it is associated with a greater likelihood of adverse experiences, including low community awareness and exposure to stigma, abuse and discrimination that shapes outcomes. The reviewed literature recognized that neurodivergent community views have historically been excluded from research and practice and that health and mental health services (which are ultimately informed by such research) have been inadequate in implementing affirming practices. This further necessitates the need for trauma-informed approaches, given that many neurodivergent people may have experienced poorly equipped health, community, research and other settings and services, and such approaches inherently acknowledge the need for physical and emotional safety alongside respect, acceptance, and empowerment. Grounded in a strengths-based and neurodiversity-affirming perspective, trauma-informed care foregrounds the importance of understanding how past and ongoing adverse experiences shape engagement with services, research, and institutions. It emphasizes the creation of physically and emotionally safe environments, alongside practices that promote respect, acceptance, agency, and empowerment.
Self-Determination for Neurodivergent People Is Upheld
The reviewed literature recognized imbalanced power relationships that have characterized neurodivergent people and their engagement with research, mental health, and other services, ultimately negatively impacting autonomy and opportunities to contribute to decision-making related to the factors that impact functioning. The literature discussed medical terminology (e.g., deficit, disorder, and restricted) designed to describe different types of neurodivergence as contributing to stigma towards neurodivergent people. The significance of terminology for neurodiversity affirming approaches (e.g., identity-first terminology as a preference for the majority and noting diversity of preferences) was highlighted as an essential mechanism for upholding sovereignty and self-determination for neurodivergent people. Priority groups were recognized, referring to the unique experiences of individuals who face multiple intersecting identities. Self-determination within neurodiversity research must extend beyond individual autonomy to encompass collective, cultural, and relational dimensions of decision-making. For First Nations Peoples, self-determination is inseparable from sovereignty, kinship obligations, and responsibilities to community and Country. This challenges dominant Western framings that prioritize independence as a marker of wellbeing, instead recognizing interdependence, reciprocity, and relational accountability as central to human flourishing.
Community Priorities, Views, and Experiences Are Embedded Across All Research Stages
The reviewed literature aligned with broader human-rights frameworks and the need for prioritizing participatory research methods and shared decision making where appropriate. Neurodiversity affirming research practices included shared power, genuine collaboration and input for neurodivergent priorities, including priority setting for research aims, co-design and other collaborative methodologies, and translation of research findings that ensure impact and improved outcomes for neurodivergent populations.
Neurodiversity Research Must be Accountable to Indigenous Sovereignty, Relationality, and Country
This includes recognizing that research occurs on unceded lands, is shaped by colonial histories, and must be accountable to First Nations governance structures. Research must move beyond inclusion towards Indigenous leadership, data sovereignty, and community-defined benefit. This requires embedding Indigenous methodologies, privileging local knowledges, and ensuring that research processes and outcomes do not reproduce harm.
Potential Applications
The NeuDAT is proposed as a complementary instrument to guide the appraisal of neurodiversity affirming mental health research and to augment clinicians’, policy-makers’, and researchers’ knowledge of principles in research practice. The foundations for this tool development were in the recent revisions to Australian psychologist competency standards, which mandate an understanding of neurodiversity approaches to maintain registration to practice. As such, it has been prepared with a specific focus on mental health-related research, and with the specific target audience of psychologists and mental healthcare professionals in their adherence to the scientist-practitioner model. Given broader reform in mental health and healthcare including the principle of person-centered care, alongside broader progress including inclusive education systems, organizational policies to ensure diversity, inclusion and equity in the workplace, and contemporary understandings of human-rights informed ethical research practices, this tool may have great reach and application across-sectors in throughout research, policy, and practice. It may be used as a complementary tool in systematic reviews alongside other standardized quality appraisal tools. Researchers may seek to integrate the items in their research design processes and incorporate justification within research publications relative to their consideration, as has been the case of other efforts to address historical exclusionary practices in research. It is our hope that the NeuDAT will further stimulate conceptual and theoretical discussion regarding the application to research practice, and translation to neurodiversity affirming approaches in mental health and psychological practice. An adapted tool is envisaged for nonresearch, nonscientific settings and communities, such as for community members seeking to critically appraise the quality of information available in other public settings, such as media, social media, and science communication content. We anticipate critical evaluation of our proposed principles, to which we remain unwaveringly responsive to revise and improve the NeuDAT.
Limitations
This Community Perspective sought to provide a rapid (i.e., not comprehensive) review of evidence, and apply our collective researcher-clinician-lived experience expertise to develop a guidance tool to support (not replace) understanding of neuroaffirming mental health research appraisal. The NeuDAT represents a preliminary appraisal framework and has not yet undergone formal validation. We acknowledge that a single framework is unlikely to apply to all neurodiversity research, and that high-quality, neuroaffirming research can take many forms. As an example, and as per Srinivan's description of the socio-cultural limitations in the current neurodiversity discourse (Srinivasan, 2025), there are risks in assuming strengths-based approaches exclude the use of deficit, medically focused terminology and interventions which can be clinically necessary in some contexts. We recognize the need to better understand how these principles can be applied across disciplines and settings, particularly those that do not closely align with social models of health, and within settings that may be constrained by resources or methodological requirements. These considerations will form the focus of future work, which will further explore the practical, ethical, and other considerations in applying the NeuDAT, including piloting through multi-stakeholder groups across diverse research contexts to understand utility, and with the intention to revise and review the tool pending such insights.
Conclusion
In this Community Perspective, we sought to respond to rapid community, scholarly, and clinician uptake of neurodiversity affirming approaches through providing a high-level summary of conceptual features and proposing a tool to guide the rigorous appraisal of neurodiversity affirming mental health research. The authorship group comprises a broad range of research-clinical-lived experience expertise, First Nations and non-Indigenous knowledge holders, which collectively has enriched this Community Perspective. However, given the limitations of the rapid review methods and potential failure to incorporate exhaustive literature, rigorous piloting of the NeuDAT is required, and further revisions and refinements are expected. The NeuDAT is intended to provide broad considerations and ultimately support the design and use of research, clinical practice, and inclusive policies that benefit neurodivergent people. We have positioned this tool as a complementary asset to augment broader developments in the field and to ensure responsiveness to emerging research. There has been a rapid advancement in strengthening and ensuring that the rights and sovereignty in the context of neurodiversity are upheld. It is essential that the research, health, and other professional communities continue to reflect on and engage with research and ensure genuine commitment to practices that enhance and ensure benefits for neurodivergent people and communities. Without embedding Indigenous sovereignty, relationality, and accountability, neurodiversity risks becoming another framework that names difference while leaving underlying structures of colonial harm intact. We propose the NeuDAT to support the facilitation of these processes.
Footnotes
Ethical Approval and Informed Consent Statements
Not applicable.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Movember Foundation, and CMB receive funding from Suicide Prevention Australia.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
Not applicable.