Essays & Theses

In this thesis, I advocate for access and rhetorical agency for academics with in/visible (dis)abilities. This is also to say that my work is self-advocacy as I negotiate my positionality within academic ableism as a marginalized person with (dis)abilities.  I take an intersectional and interdependent approach to (dis)ability justice and embodied rhetorics, dialoguing with borderland theory, critical race theory, feminist, and decolonial scholarship.  Ultimately, I hope to model an ADHD/neuroqueer form of writing that allows me to discover the rhetorical strengths I and other neuroqueer writers have to offer while reimagining access in discursive sites of power such as the composition classroom, (dis)ability disclosure, and Student Disability Services.

Despite the increased prevalence of autism, there are limited data about how adolescents on the autism spectrum experience autism and, in particular, how they respond to receiving an autism diagnosis from an insider perspective. Adolescence can be a very challenging time for people on the autism spectrum as they enter adulthood where increased socialisation and flexible processing styles are required (Bedard & Hecker, 2020; Sharma & Seshadri, 2020; Westhoff et al., 2020). During adolescence, a person is required to construe increasingly unfamiliar social settings and undergo a range of physiological, emotional, and cognitive changes as they attempt to create a personal and social group identity. Ten adolescents with a formal diagnosis of autism, but no intellectual disability (ID), participated in a semi-structured interview and a modified repertory grid technique (RGT) assessment (Kelly, 1955). The RGT was designed to develop insight into their experiences of receiving and having a diagnosis of autism and their perceptions about its influence on the development of their self. A personal construct theory (PCT) approach was adopted to interpret participants’ experiences using Kelly’s 11 corollaries, which describe the various construct types that people use to construe their own realities. This research also examined the utility of the PCT approach in understanding the participants’ lived experiences. A model is proposed of both vulnerability and protective mechanisms, together with external and internal influences, on the development of the adolescents’ self-identity. Outcomes of the research indicated that whilst the adolescents in this research had high school experiences of bullying, which resulted in isolation, exclusion, and rejection, they also acknowledged that their diagnoses contributed to greater self- awareness and self-acceptance. These findings are significant because the literature revealed that adolescents on the autism spectrum can experience low levels of self- acceptance, a loss of identity, poor mental health outcomes, high rates of suicidality, suicide attempts and death by suicide when compared with their non-ASD same-aged peers (Hirvikoski et al., 2020; Jager‐Hyman et al., 2020; Kirby et al., 2019; Kõlves et al., 2021; White et al., 2017). Most participants recommended increased autism awareness by their peers and teachers, and a need for greater inclusion in the school setting, which suggests that the schools in this research perpetuated a Medical Model of Disability that intensified feelings of difference for these research participants. Despite their self-reported negative experiences of having a diagnosis of autism, participants in this research shared a strong sense of self and perceived their autism to be intrinsically interwoven with their self-identity.

The current state of autism spectrum disorder diagnoses reflects a skew towardmen which is due to a bias in the diagnostic criteria. The diagnostic criteria in the DSM-5 fail to properly assess for alternative-to-male expressions of the disorder; one specific factor that is not adequately addressed is masking. Masking pertains to an individual’s ability to hide and adapt their autistic traits to appear more neuro-typical. Though any autistic person may have the ability to mask their autistic traits, recent research shows that more women than men possess this ability, and to a higher degree. Masking is not exclusive to adults; it is seen in autistic girls from a very young age. The diagnostic criteria need to be amended to account for an expression of autism under the cover of masking. If we do not change the way we diagnose autism, and we keep the insensitive and biased current criteria, we will continue denying diagnosis to so many autistic women who deserve support and acknowledgement. The first step in this process is to gain a better understanding of masking, and the best way to do this is to ask autistic women themselves for their expertise, experience, and guidance. Self-report is necessary in this exploration. I recruited five autistic women through Instagram and then I conducted five semi-structured interviews with each of those women, separately. During the interviews I used an interview guide that consisted of 27 open-ended questions, all of which were aimed at gaining knowledge about the experience of autism and masking for each of these women. I found four themes in common across the interviews: gradual realizations, routine yet forced masking, burnout and comfort-seeking, and advocacy for self.

Pathological Demand Avoidance (PDA) is a proposed Mental Disorder, from Elizabeth Newson, in the United Kingdom. While excluded from the two main diagnostic manuals, PDA has garnered much interest and controversy. While originally viewed as a new type of syndrome, a Pervasive Developmental Coding Disorder. Presently there is much focus on PDA as an Autism Spectrum Disorder (ASD), that ignores broader discussions around how PDA should be clinically viewed. Due to arguments against doing that in favour of diagnosing PDA as an ASD. Charting the history of PDA from Newson’s research, through to how four main divergent schools of thought developed. From PDA being viewed as rebranded autism through to symptoms resulting from the interaction between autism and common co-occurring conditions. Conceptualising PDA as a common mental disorder best conforms to Newson’s opinions and research. Various empirical research supports this outlook. PDA can be diagnosed and researched independently of autism. Such an approach is needed to allow its full nature to become clear through scientific-method research.

A significant body of clinical research has demonstrated that neurodivergent individuals are more likely than neurotypical individuals to have transgender and/or gender expansive identities (Janssen et al., 2016; Strang et al., 2014; Warrier et al., 2020).  Within this body of research, neurodivergence and transgender identities are commonly mutually pathologized. Existent medico-psychiatric literature has been found to describe neurodivergence and transgender identities as “co-morbidities” and hypothesizes neurodivergence as a “cause” of transgender identity (Shapira & Granek, 2019, p. 506).  A small but growing body of clinical, sociological, and theoretical scholarship has demonstrated the importance of non-pathologizing approaches to mental and physical healthcare for this population, the complexity of neurodivergent and transgender identity construction, and the importance of intra-community solidarity (Egner, 2019; Oswald et al., 2021; Strang et al., 2020).  However, little is known about individuals’ internal experience of this phenomenon. iv  The present study utilizes hermeneutic and queer phenomenology to explore transgender and neurodivergent individuals’ experiences and understandings of gender identity and neurodivergence, connections drawn between gender identity and neurodivergence, experiences within broader LGBTQ+ community, and experiences accessing gender-affirming, medical, and mental healthcare.  Participants who identify as both transgender and neurodivergent were recruited via social media and 13 individuals took part in the hour-long semi-structured interview process.  Five essential themes emerged from the data:  (1) fluid and expansive identities,  (2) relationality and identity development,  (3) connections between gender and neurodivergence,  (4) diverse experiences within LGBTQ+ community, and  (5) experiences within the healthcare system. Participant gender and neurodivergent identities were found to be fluid, and identity development and expression were found to be informed by relationships and social dynamics.  All participants drew at least some connections between their gender identities and neurodivergence.  Participant experiences within the broader LGBTQ community included both those of inclusion and exclusion.  Finally, participants did not report ableist discrimination in gender-affirming care settings.  However, all participants reported experiencing transphobia in healthcare settings.  Implications for social work education and practice are presented as well as directions for future research

The purpose of this transcendental phenomenological study was to examine the perceptions of self-efficacy among neurodiverse students in STEM programs at four-year universities. Albert Bandara’s social cognitive theory (SCT) guided this study as it relates to the influence of environment, social interaction, and communication on learning development and academic mastery. Improving academic self-efficacy among neurodiverse students in STEM programs in higher education begins with understanding how these students encounter the academic world.  SCT provided the framework for this study to answer the central research question and sub-questions: (1) What are the self-efficacy experiences of neurodiverse students currently enrolled in a STEM program at four-year institutions in the United States?  (2) How do autistic students in STEM-related fields of study experience the social campus environment? (3) How do autistic students in STEM-related fields of study perceive the academic support and accommodations they receive?  This study reviewed the background of diversity and inclusion in higher education, research related to the experience of autistic and other neurodiverse students, and the need for a pedagogical approach in STEM programs that accommodates the varied needs of neurodiverse students.  The study involved eleven autistic students currently enrolled in STEM-related majors who have completed at least one year of higher education. The research took place at two four-year institutions in the United States: Greenwood University (pseudonym), a state-sponsored institution in the Northeast, and Hightower University (pseudonym), a private research institution in the South. Additional participants were identified through snowball sampling. Data were collected by individual interviews, anecdote discussions, and a focus group. Data analysis followed Moustaka’s modification of Van Kaam’s method of phenomenological analysis.

The use of behavior modification (BM) based treatment, the best-known example being Applied Behavior Analysis (ABA), is established as an evidence-based practice for promoting communication and other outcomes for Autistic individuals. As such, many Speech Language Pathologists (SLPs) use it in their practice to target various forms of communication. Among many autistic advocacy groups, however, ABA and other BM informed therapies are often described as a detriment to mental and emotional health. Organizations such as the Autistic Self Advocacy Network (ASAN) have come out against the practices and recommend finding different approaches to teaching communication skills. Much research is needed to understand this disconnect between the scientific and clinical community’s understanding of BM based therapy as an effective, evidence-based therapy model, and the experience of autistic advocates as traumatic. As a small, early step in the large amount of research needed, this study takes a qualitative, phenomenological based approach, using semi-structured interviews to gain insight into the lived experiences of autistic individuals who were recipients of BM based intervention. The results of this study have the potential to illuminate future research directions, help therapists develop a more comprehensive understanding about the effects of BM on the lives of autistic individuals, and begin the work of building common priorities between the clinical and autistic communities.

Three issues guided this review. First, factors that increase the incidence of gender dysphoria among DHRC is examined. Second, the change in the generational view of gender identity will be reviewed and contrasted. Finally, school and community-based programs will be reviewed. Issues related to gender dysphoria among the population diagnosed with ASD is a specific focus. By identifying and defining Gender Identity, educators will be more equipped to support all students and create a gender inclusive classroom.

Intervention and education programs for autistic individuals have been greatly informed by the medical model of disease/disability. Under this model, autism is seen as something to be fixed or remediated, and interventions have often focused on reducing autistic traits in an effort to get the autistic person to appear more “typical.” Autistic advocates have denounced this, and there is still much debate on what kind of interventions are best for autistic individuals. A viable alternative to the medical model is the neurodiversity approach, where neurological differences such as autism are seen as a valuable contribution to human diversity and should be accepted. Though it has been argued that early intervention can in fact be compatible with the neurodiversity approach, the field still has much work to truly become neurodiversity-affirming. This dissertation discusses three ways to ensure interventions move toward being more neurodiversity-affirming: considering intervention social validity (i.e., acceptability) from the autistic perspective, gathering feedback on interventions from autistic adults, and assessing professionals’ attitudes toward neurodiversity. The first paper herein is a systematic review of social validity assessment in Pivotal Response Treatment research, with an emphasis on assessment of the autistic point of view. The second is a qualitative investigation of 214 autistic adults’ feedback on common intervention goals for young autistic children. The third paper presents the development and validation of an instrument designed to measure professionals’ attitudes toward neurodiversity. Findings from the first two studies suggest that autistic perspectives need to be included much more frequently when designing and implementing interventions, and that professionals need to consider the importance of developing autistic identity, autonomy, and self-advocacy skills. Finally, the neurodiversity attitudes questionnaire (NDAQ) presents a valid way of measuring professionals’ attitudes such that neurodiversity training needs can be assessed, which will hopefully ultimately lead to more neurodiversity-friendly interventions.

In this paper, I argue, in alignment with Autistic scholars such as Remi Yergeau and Nick Walker, that neurodivergent experience is frequently neuroqueer and thereby promotes a readiness to challenge normative social standards through neuroqueer concepts of gender.  This analysis provides person-centered accounts of recent statistics which have found that neurodivergent individuals are more likely to be gender non- conforming than their neurotypical counterparts.  This paper focuses on two key claims.  First, it aligns politically with the neurodivergent movement by asserting that the neurodivergent community is a distinct and valid community united by shared experiences of systemic violence and compulsory neuronormativity.  Second, it argues that membership in this community implies an understanding of the neurodiversity paradigm and a readiness to challenge normative social standards through neuroqueer concepts of gender.  This challenge to neuronormative structures may predispose neurodivergent individuals to deconstruct heteronormative expectations, potentially explaining higher rates of queerness among neurodivergents as a socio-cognitive rather than solely biological phenomenon.  These claims are explored through four main themes:  (1) performance and passing,  (2) transgressing and moving against social norms,  (3) belonging and identity within community, and  (4) a dissociative perspective on gender.

In recent years, there has been a growing and high-profile movement for ‘global mental health’. This has been framed in ‘psych system’ terms and had a particular focus on what has come to be called the ‘Global South’ or ‘low and middle-income countries’. However, an emerging ‘Mad Studies’ new social movement has also developed as a key challenge to such globalising pressures. This development, however, has itself both being impeded by some of the disempowering foundations of a global mental health approach, as well as coming in for criticism for itself perpetuating some of the same problems as the latter. At the same time, we are also beginning to see it and related concepts like the UNCRPD being given new life and meaning by Global South activists as well as Global North activists. Given such contradictions and complexities, the aim of this paper is to offer an analysis and explore ways forward consistent with decolonizing global mental health and addressing madness and distress more helpfully globally, through a Mad Studies lens.

This project is the culmination of the author’s efforts to put into words, images, and videos, among other things, his attention-deficit hyperactive disorder (ADHD), which was diagnosed during his time at graduate school. This diagnosis afforded the author a new perspective on his education so far. It prompted him to research further into how neurodiverse thinkers adapt to life in the university, and how the university adapts to their presence, in a word: poorly. There are too few accounts from scholars with ADHD or autism spectrum disorder (ASD) just to name a couple of neurodivergent identities. It is the author’s hope that by reimagining the way a text may look in the field of Rhetoric and Writing Studies, we can begin to move the needle on how we think about thinking in the classroom. While this document does its best to simulate the original project, you will get the best experience by viewing this document in its original, hypertextual format, which will be linked to in the Appendix.