Shifting Paradigms
The below information was developed with creative and intellectual contributions from Laurel York, Registered Psychologist located in Calgary, AB [www.yorkpsychology.org]
The medical model and social disability model of autism are two different perspectives on understanding and framing autism. Each model has distinct approaches to how autism is perceived, treated, and supported. These models can also be extended to other neurotypes, including ADHD.
Medical Model of Autism
The Medical Model of Autism primarily views autism as a disorder or medical condition that needs to be treated, managed, or cured. It focuses on the individual, considering autism a pathology or illness that can be diagnosed, categorized, and potentially treated through medical or therapeutic interventions.
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Focus: The medical model emphasizes the neurodevelopmental differences seen in people with autism, viewing these as deficits or impairments in areas such as communication, social interaction, and behavior. These differences are often seen as symptoms of a disorder that should be addressed.
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Treatment: The goal is often to identify the areas of difficulty and implement therapies or interventions to reduce these issues. This might include behavioral therapies, medication, and other forms of intervention aimed at promoting functioning within a neurotypical societal framework.
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Perspective: The medical model sees autism as a condition that needs to be "fixed" or treated, often focusing on normalizing behavior to fit societal expectations.
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Criticism: One major criticism is that the medical model pathologizes autism, treating it as something inherently wrong with the individual. It does not always consider the positive aspects or strengths that may come with neurodiversity, such as attention to detail or deep focus in certain areas. Critics also argue that it overlooks the importance of societal accommodations and support systems (Pisciotta, 2024).
Social Model of Disability
The social model of disability presents a very different perspective; it sees autism as a natural variation in human development. According to this model, the "disability" associated with autism is not intrinsic to the individual but is a result of society’s inability to accommodate neurodiversity.
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Focus: This model emphasizes the barriers that society places in the path of those with autism. It suggests that disability arises when societal structures fail to accommodate diverse ways of thinking, behaving, and communicating.
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Perspective: The social disability model does not view autism as a disorder or deficit but as part of the spectrum of human neurodiversity. The challenge for individuals with autism is not their neurodevelopmental differences but the way society fails to support and include them.
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Social Inclusion: The goal of this model is to promote understanding, acceptance, and inclusion. It calls for societal changes such as improved accessibility, better education, inclusive work environments, and greater awareness of neurodiversity.
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Criticism: Some argue that the social model may downplay the very real challenges faced by individuals with autism, such as sensory overload, difficulties with communication, or co-occurring conditions like anxiety. While it focuses on societal barriers, it may not always address the need for individual support in some cases (Inclusion London, 2025).
Key Differences between the Medical and Social Disability Models
The Rise of Neurodiversity
In recent years, the neurodiversity movement has gained momentum, aligning closely with the social disability model. The movement views neurological differences, including autism, as natural variations rather than pathologies, advocating for acceptance, accommodations, and celebrating diverse ways of thinking and being. Neurodiversity emphasizes the idea that society should be more inclusive and adaptable, rather than requiring individuals to change.
Examining the medical model and the social model of disability can help us better understand how autism has been framed historically (medical model) and the new pathway forward to understanding autism as a neurological difference, in which autistic folks experience both a lack of societal accommodations and very real challenges (e.g., sensory differences). The shifting paradigm to the social model of disability highlights how people with autism can be supported in a way that maximizes their potential and quality of life.
A recent Canadian report, from the Canadian Academy of Health Sciences (CAHS) – aimed to inform a National Autism Strategy from a social model of disability (CAHS, 2022).
"Recognition of the neurodiversity paradigm and the social model of disability is fundamental to ensuring a positive transformation of society towards acceptance and true inclusion for all. It is also necessary so that we can modulate the types of supports and services available to focus on the expressed needs of Autistic people." (CAHS, 2022, p. 9).
The committee included Autistic researchers, clinician-researchers, Indigenous advisors, and advisors with lived experience of Autism. This is an important step towards the social model; a national report funded by the Public Health Agency of Canada.
Intersectionality & Diversity Key Areas (CAHS, 2022)
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Need to consider cultural locations and intersectionality, including
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Rural and remote locales
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Ethnicity and race (including newcomers and language minorities)
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Socioeconomic status
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Gender, gender identity, and sexual orientation
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Complexity of support needs
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Diversity of family structures
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2. Intersectionality is critically relevant for all Autism-related issues
3. Indigenous led, culturally relevant, and localized approaches are essential
Social Inclusion Identified Key Areas (CAHS, 2022)
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How do we develop the elements of inclusive communities including accessibility and inclusion in public spaces
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Addressing stigma, ensuring human rights, and promoting acceptance
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Promoting physical and emotional safety
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Social inclusion through technology
Autistic Self-Advocacy Network's (ASAN) state that ethical pitfalls for intervention aren't specific to single services or interventions and that the goal(s) should not be to make autistic person appear neurotypical or to cast autistic traits as negative.
ASAN share their First Principles and Ethical Core Statements
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Ensure input from autistic folks who have experienced the intervention
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Autistic people are people first, inclusive of co-occurring disabilities, such as intellectual disability
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Autistic traits are not targets for interventions
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Autistic people have the same right to give and revoke informed consent and assent
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Therapies and services must focus on improving the autistic person's quality of life by increasing opportunities for and access to self-determination, communication, self-advocacy, and other goals important to the autistic person in question
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Supports don't need to be autism-specific to help autistic people
They include "Always Acceptable" Interventions & Practices to Promote
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Trauma-informed approaches
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Cultural competency & cultural humility
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Prioritize effective and robust communication systems first
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Provide space/time for processing and offer breaks
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Encourage the client to communicate their goals for the intervention
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Presume competence
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Minimize physical contact & always ask for consent
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Target supports and services toward specific skills that benefit the client
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Reject functioning labels
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Acknowledge, celebrate, & encourage what a person is good at
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Incorporate special interests
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Use developmental approaches to supports and services
References
Autistic Self Advocacy Network. (n.d.). For whose benefit? Evidence, ethics, and effectiveness of autism interventions. Autistic Self Advocacy Network. https://autisticadvocacy.org/policy/briefs/intervention-ethics/
Canadian Academy of Health Sciences. (2022). Autism in Canada: Considerations for future public policy development - Weaving together evidence and lived experience. The Oversight Panel on the Assessment on Autism, CAHS. https://cahs-acss.ca/autism-assessment/
Inclusion London. (2025). The Social Model of Disability. Author. https://www.inclusionlondon.org.uk/about-us/disability-in-london/social-model/the-social-model-of-disability-and-the-cultural-model-of-deafness/
Pisciotta, A. (2024). Shifting paradigms: Rethinking autism beyond the medical model. Retinking Autism, Voices in Bioethics, 10, https://doi.org/10.52214/vib.v10i.12503