Neurodivergence: Are inclusive organizations limited by the pervasiveness of the medical model? Lessons from a Critical Interpretive Synthesis

Abstract

The inclusion of neurodivergent people remains limited in organizations, even if policies or structures are put in place to this end. What then might explain the low inclusion of neurodivergent individuals in the workplace? This article sets out to answer this question with a critical interpretive synthesis (CIS) of the literature. CISs adopt the methods of systematic reviews, but attempt to overcome their limitations by starting with a broad question that is able to incorporate the “context” of the chosen questioning, and by striving to incorporate the results of potentially diverse studies and disciplines into a single, coherent framework. The present CIS proposes an understanding of the dynamics that limit the inclusion of neurodivergent people. Our findings bring to light the synthesizing argument that, even within inclusive organizations, inclusive practices remain characterized by the pervasiveness of the medical model, which is reflected in three uses of medical diagnosis. First, diagnosis strictly categorizes individuals without taking into account the variability of symptoms, the role of the context, and the specificities of the individual. Second, diagnosis is also considered indispensable for obtaining organizational adaptations. Third, medical diagnosis continues to guide the inclusion processes developed by organizations, in particular by amalgamating symptoms and needs. A discussion of the systemic dynamics existing between these three uses of medical diagnosis opens up new avenues for developing inclusive organizations, in particular by proposing to anchor the uses of medical diagnosis in the social model of disability.