Summary
How we think about disability determines how we treat disabled people — what we research, what we fund, what we build, and what we expect. There is no single “correct” model of disability, but some models serve autistic and neurodivergent people better than others. This page surveys the major frameworks, from the medical model that still dominates clinical practice to the neurodiversity paradigm that increasingly shapes self-advocacy and research. Each model is assessed for what it does well, where it falls short, and how it specifically relates to autism and neurodivergence.
Understanding these models matters for anyone working in the field of sensory processing and autism — because the model you operate from determines whether you see a person in distress as someone who is broken, someone who is oppressed, or someone who is navigating a mismatch between their needs and their environment.
The medical model
The medical model locates disability within the individual. It frames disability as a consequence of biological impairment — something wrong with the person’s body or brain that requires diagnosis, treatment, and where possible, cure. Under this model, the primary response to disability is clinical: identify the pathology, classify it, and intervene to bring the person closer to “normal” functioning.
Origins and influence
The medical model has no single originator; it reflects the broader medicalisation of human variation that accelerated during the 19th and 20th centuries. Within autism specifically, the medical model has shaped everything from the diagnostic criteria in the DSM and ICD to the dominance of deficit-focused research and behavioural interventions designed to reduce visible autistic traits.
What it does well
The medical model has real practical value. Diagnosis under a medical framework is the gateway to services, funding, and legal protections in most countries. It enables the identification of co-occurring conditions (epilepsy, gastrointestinal difficulties, mental health challenges) that require medical attention. For some autistic people, particularly those with high support needs, medical understanding of their specific neurological profile is essential to their care.
Where it falls short
The medical model’s central weakness is that it frames the person as the problem. When autism is understood solely as a disorder — a collection of deficits to be remediated — the logical response is to make autistic people less autistic. This has produced a long history of interventions focused on normalisation: suppressing stimming, forcing eye contact, training “appropriate” social behaviour. The costs of such approaches, including the mental health toll of masking (see: masking-and-camouflaging), are now well documented.
The model also tends to homogenise. By focusing on shared diagnostic criteria, it can obscure the enormous heterogeneity within autism. A framework that treats all autistic people as having the same “disorder” struggles to account for why some autistic people thrive in environments designed for them while struggling in environments that are not.
Relationship to autism and neurodivergence
The medical model remains the dominant framework in most clinical and educational settings globally. It is not wrong to note that autism has a neurobiological basis — it does. The problem is the inferential step from “neurobiologically different” to “disordered and in need of correction.” Critics within both the disability rights movement and the neurodiversity community argue that this step reflects social values about what counts as “normal,” not objective scientific conclusions (Chapman, 2021; Dwyer, 2022).
The social model
The social model of disability draws a sharp distinction between impairment (a characteristic of the person’s body or mind) and disability (the disadvantage caused by a society that fails to accommodate that impairment). Under this model, a wheelchair user is not disabled by their legs — they are disabled by the absence of ramps, lifts, and accessible design. Disability is not a personal tragedy; it is a political issue.
Origins
The social model emerged from the UK disability rights movement. Its intellectual foundations were laid by the Union of the Physically Impaired Against Segregation (UPIAS), whose Fundamental Principles of Disability document (1976) argued that “it is society which disables physically impaired people” through “unnecessary isolation and exclusion from full participation in society.” The term “social model of disability” was coined by Mike Oliver in 1983, drawing directly on the UPIAS framework. Oliver, a disabled sociologist, developed the model as a practical tool for understanding disabled people’s oppression and for redirecting attention from individual impairment to structural barriers (Oliver, 1990; Barnes, 2019).
Key figures in the development of the social model include Paul Hunt, Vic Finkelstein, and Maggie and Ken Davis, all disabled activists who drew on their own experiences of segregation and institutionalisation.
Writing thirty years later, Oliver (2013) reflected that the social model “took on a life of its own” beyond what he intended. He never suggested the individual model should be abandoned, nor that the social model explained everything. What frustrated him was the academic cottage industry of critiquing and revising the model, which he argued depoliticised it without offering alternatives that could improve disabled people’s lives. His position remained pragmatic: the social model was a tool for identifying and removing barriers, not a comprehensive theory of disability. The critiques, however valid intellectually, had not produced better outcomes for the people the model was designed to serve.
What it does well
The social model is politically powerful. It reframes disability from a personal problem into a collective one, and it demands environmental and structural change rather than individual remediation. It has been enormously influential in disability rights legislation, including the UK’s Equality Act and international frameworks like the UN Convention on the Rights of Persons with Disabilities (CRPD).
For autistic people, the social model offers a crucial insight: much of the difficulty autistic people experience is created by environments designed exclusively for neurotypical people — open-plan offices with harsh fluorescent lighting, schools that demand hours of stillness, social norms that penalise directness and reward performance.
Where it falls short
The social model was developed primarily by and for people with physical disabilities, and its strict separation of impairment from disability has been criticised — not least by disabled people themselves. Tom Shakespeare and others have argued that the model can become an “inflexible ideology” that underplays the reality of embodied difficulty (Shakespeare & Watson, 2001).
For autistic people, this limitation is acutely felt in the domain of sensory processing. Sensory distress — the pain of a fire alarm, the overwhelm of a crowded space — is not straightforwardly “caused by society.” While environmental design can reduce sensory overload, the underlying sensory processing difference is real and can cause genuine suffering regardless of how accommodating the environment is. Some autistic people, particularly those with intellectual disability and high support needs, experience difficulties that would persist even in a perfectly accommodating world. A model that locates all disability in social barriers can inadvertently minimise these experiences.
Relationship to autism and neurodivergence
The social model has been deeply influential in autistic self-advocacy. Many autistic people find it liberating to understand their difficulties as products of a hostile environment rather than personal failings. However, the model works better as a political tool than as a complete description of autistic experience. As Judy Singer (1998) noted in the thesis that introduced the concept of neurodiversity, “neither social constructivism nor biological determinism” was adequate for autistic people. The neurodiversity paradigm can be understood in part as an attempt to move beyond this binary.
The biopsychosocial model
The biopsychosocial model, as expressed in the World Health Organisation’s International Classification of Functioning, Disability and Health (ICF, 2001), attempts to integrate the medical and social models. It frames disability as the result of interactions between biological factors (the person’s body and health condition), psychological factors (their cognition, emotions, and coping), and social/environmental factors (the structures, attitudes, and environments around them).
What it does well
The ICF framework is widely used in clinical and rehabilitation settings. Its emphasis on functioning rather than diagnosis alone can be useful: two people with the same autism diagnosis may have very different functional profiles depending on their environments, supports, and co-occurring conditions. The model’s recognition that context matters — that the same person may function very differently in different settings — aligns well with autistic experience.
Where it falls short
In practice, the biopsychosocial model is often criticised as “the medical model with social garnish.” When clinicians are trained primarily in biomedical frameworks, the “bio” tends to dominate, and the “psycho” and “social” components become afterthoughts. The model can also be used to justify locating the problem back in the individual under the guise of considering “all factors” — particularly when psychological factors are framed as deficits in coping rather than rational responses to hostile environments.
Relationship to autism and neurodivergence
The biopsychosocial model is the stated framework of many autism services, but its application is uneven. At its best, it encourages practitioners to consider the whole person in context. At its worst, it provides a veneer of holism over what remains a deficit-focused, individually-directed approach. Neurodiversity advocates have generally regarded it as an improvement on the pure medical model but insufficient on its own.
The neurodiversity paradigm
The neurodiversity paradigm is not, strictly speaking, a model of disability. It is a framework for understanding neurological variation as a natural and expected part of human biodiversity — analogous to biodiversity in ecosystems. Under this paradigm, conditions like autism, ADHD, dyslexia, and others are understood as neurological differences, not pathologies. The paradigm does not deny that these differences can be disabling, but it argues that the framing of “disorder” is neither scientifically necessary nor socially neutral.
Origins
The term “neurodiversity” was coined by Judy Singer, an autistic Australian sociologist, in her 1998 Honours thesis. Singer was influenced by the social model of disability but found it insufficient for autism, arguing that neurodiversity demanded its own framework — one that could acknowledge both the social barriers autistic people face and the reality of neurological difference without pathologising it.
The paradigm has been significantly elaborated by the autistic scholar and advocate Nick Walker, who distinguishes between neurodiversity (the biological fact of neurological variation in the human species), the neurodiversity paradigm (a framework for understanding that variation), and the neurodiversity movement (a social justice movement). The philosopher Robert Chapman has further developed the theoretical foundations, arguing for an “ecological” model of disability that understands functioning in terms of person-environment fit rather than individual deficit (Chapman, 2021).
What it does well
The neurodiversity paradigm reframes the conversation fundamentally. Instead of asking “what is wrong with this person?” it asks “what does this person need to thrive?” It honours the lived experience of autistic people who do not experience their autism as a disease. It demands that research consider strengths alongside challenges, and that interventions be evaluated by whether they improve quality of life, not by whether they make someone appear less autistic.
The paradigm has been particularly important in challenging the dominance of normalisation-focused interventions and in centering autistic voices in research and policy.
Where it falls short
The neurodiversity paradigm has been criticised — sometimes fairly, sometimes through misunderstanding — for appearing to minimise the very real difficulties some autistic people experience. Parents and caregivers of autistic people with high support needs have expressed concern that a “difference not disorder” framing could undermine access to services and support.
Some of this criticism rests on a misreading of the paradigm. Most neurodiversity advocates, including Walker and Chapman, are explicit that autism can be disabling and that autistic people need and deserve support. The paradigm’s position is that disability arises from the interaction between the person and their environment — not that it doesn’t exist. However, the paradigm has at times been represented by voices at one end of the autism spectrum, and the experiences of autistic people with intellectual disability and very high support needs have not always been adequately centred.
There is also an unresolved internal tension about whether autism is a disability at all. Some autistic people identify strongly as disabled; others do not. The neurodiversity paradigm does not require a single answer, but the ambiguity can be confusing in policy and clinical contexts.
Relationship to autism and neurodivergence
The neurodiversity paradigm is now influential in autism research (Pellicano & den Houting, 2022), in clinical guidelines (including the ICD-11’s acknowledgement of masking), and in self-advocacy globally. A large community survey (Dwyer et al., 2023, published in Autism) found that support for the neurodiversity movement was associated with endorsing environmental change and opposing normalisation-focused interventions, while still supporting the teaching of adaptive skills — suggesting more nuance among advocates than critics sometimes assume.
The human rights model
The human rights model of disability is grounded in the UN Convention on the Rights of Persons with Disabilities (CRPD, 2006). It frames disability as a human rights issue: disabled people have the right to full participation in society, to reasonable accommodation, and to be free from discrimination. Unlike the social model, which focuses on removing barriers, the human rights model asserts positive obligations on states and institutions to ensure inclusion and participation.
Lawson and Beckett (2021) argue against the common view that the human rights model simply improves upon the social model. Their “complementarity thesis” holds that the two models have different subjects and different functions. The social model identifies the structures that disable; the human rights model establishes the legal obligations to change them. Drawing on Foucault’s technologies of power, they show that each model operates at a different level of analysis: one reveals the mechanism of oppression, the other provides the legal and institutional tools to contest it. In the human rights context, they are complementary rather than competing.
Relationship to autism and neurodivergence
The CRPD is particularly relevant to autistic people with intellectual disability, for whom questions of legal capacity, consent, and self-determination are acute. Article 12 of the CRPD, which affirms that disabled people have legal capacity on an equal basis with others, has implications for guardianship practices, supported decision-making, and the rights of autistic people to make choices about their own lives. The human rights model also supports the right to communication, including non-verbal communication, and the right to accessible environments.
The affirmative model
The affirmative model of disability, articulated by Swain and French (2000), reframes disability as a positive identity. Where the social model sought to remove barriers and the medical model sought to fix impairments, the affirmative model celebrates disability as part of human diversity and as a source of identity, community, and pride.
Relationship to autism and neurodivergence
The affirmative model finds its neurodivergent counterpart in the growing culture of autistic pride and neurodivergent identity. For many autistic people, autism is not something they have but something they are — a core part of their identity that they would not wish to change. The affirmative model provides a framework for this experience and for the communities, cultures, and forms of solidarity that have emerged from it.
The model has limitations similar to those of the neurodiversity paradigm: it works well for people who experience their autism positively but may not resonate with those who experience significant suffering. It is, however, an important corrective to the relentless negativity of deficit-focused research and media representation.
The Foucauldian critique: disability, power, and normalisation
The models above ask what disability is and what should be done about it. A Foucauldian analysis asks a different kind of question: how did we come to think about disability this way in the first place? What systems of power produce the categories of “normal” and “abnormal,” and whose interests do those categories serve?
Michel Foucault’s concept of biopower describes how modern states manage populations through norms: statistical averages that define what is typical, with deviations from the norm classified as pathological and targeted for correction. Diagnostic systems, clinical categories, and intervention programmes are, in this reading, technologies of normalisation. They do not simply describe reality; they produce it. The DSM does not discover that autism is a disorder; it constitutes autism as a disorder through an act of classification that carries institutional force.
Anders (2013) traces this logic from Foucault’s technologies of normalisation to contemporary societies of control, arguing that the management of deviance has shifted from overt institutional discipline (the asylum, the special school) to distributed systems of monitoring and intervention that operate through diagnosis, medication, and behavioural management in everyday settings. The ABA therapist in the family home, the SENCO tracking behavioural targets, the diagnostic pathway with its standardised instruments: these are all, in Foucauldian terms, sites where normalising power operates.
Nguyen (2015) extends this analysis to global governance, showing how the World Health Organisation’s Global Burden of Disease framework constructs disability as a measurable cost to be reduced, embedding a medical-economic logic that treats disabled lives as inherently less valuable. The politics of “inclusion” in international development frameworks can function as a more sophisticated form of normalisation: bringing disabled people into systems designed around non-disabled norms rather than transforming those systems.
This perspective is uncomfortable but illuminating when applied to neurodiversity. The diagnostic pathway described in Diagnostic pathways is simultaneously a route to self-understanding and support and a technology of classification that sorts people into categories carrying institutional consequences. The neuro-affirming practice movement (see NAIT’s 2024 guidance on diagnostic reports) can be read as an attempt to use the diagnostic apparatus while resisting its normalising logic, writing reports that validate rather than pathologise. Whether this resistance can succeed within the diagnostic system, or whether the system’s structure always reasserts itself, is an open question.
The Foucauldian critique does not replace other models. It adds a layer of analysis that helps explain why, despite decades of advocacy, the medical model persists; why “inclusion” can coexist with exclusion; and why diagnostic categories carry such weight even when the biology they claim to describe is heterogeneous and contested (see Genetic heterogeneity in autism).
The capabilities approach
The capabilities approach, developed by the economist Amartya Sen and the philosopher Martha Nussbaum, asks not “what is wrong with this person?” or even “what barriers does society impose?” but “what is this person able to do and to be?” It focuses on the capabilities — the real freedoms and opportunities — available to a person, and argues that justice requires ensuring a minimum threshold of capabilities for everyone.
Nussbaum (2006, Frontiers of Justice) specifically addresses disability, including cognitive disability, arguing that traditional theories of justice have failed to account for disabled people. Her list of ten central capabilities — including life, bodily health, bodily integrity, senses/imagination/thought, emotions, practical reason, affiliation, play, and control over one’s environment — provides a framework for evaluating whether a person is able to live a flourishing life.
Relationship to autism and neurodivergence
The capabilities approach is particularly useful for autism because it focuses on expanding options rather than normalising the person. Pellicano et al. (2022, Nature Reviews Psychology) applied Nussbaum’s capabilities framework to research on autistic adulthood, arguing that it offers a way to identify where autistic adults thrive and where they struggle without reducing autism to a list of deficits. The approach asks: can this person form relationships? Can they engage in meaningful activity? Do they have control over their environment? These questions are directly relevant to sensory processing — because a person whose sensory environment causes constant pain or overwhelm has diminished capabilities, regardless of whether the “problem” is located in them or in the environment.
The capabilities approach also aligns well with the concept of a prikkelprofiel (stimulus profile): the point is not to fix the person but to understand what they need to function well.
Where this wiki stands
This wiki draws primarily on the neurodiversity paradigm and the social model, while incorporating insights from the capabilities approach and the human rights model. It takes the position that:
- Sensory processing differences are genuine neurological differences, not deficits.
- Distress arises primarily from mismatch between the person and their environment, not from the person being “broken.”
- Some autistic people, particularly those with intellectual disability and high support needs, experience difficulties that cannot be fully explained by environmental barriers alone. “Difference not deficit” does not mean “no difficulty.”
- The goal of understanding sensory processing is to expand what a person can do and be — to support their capabilities, their comfort, and their participation in a life that is meaningful to them.
- Autistic people are the primary experts on their own experience. Research, practice, and policy should be shaped by their voices.
This is a stance, not a dogma. The wiki acknowledges that reasonable people disagree about these frameworks, and that the landscape is still evolving.
Open questions
- How can the neurodiversity paradigm better centre the experiences of autistic people with intellectual disability and very high support needs?
- What would a truly integrative model look like — one that takes seriously both the embodied reality of sensory difference and the social construction of disability?
- How do models of disability translate across cultures? The UPIAS-derived social model is a product of the UK disability movement; its applicability in other contexts (including the Netherlands) is not automatic.
- How should clinical services navigate the tension between the medical model (which provides access to diagnosis and support) and the neurodiversity paradigm (which challenges the framing of autism as disorder)?
Key sources
- UPIAS (1976). Fundamental Principles of Disability. London: Union of the Physically Impaired Against Segregation.
- Oliver, M. (1990). The Politics of Disablement. Basingstoke: Macmillan.
- Oliver, M. (2013). The social model of disability: thirty years on. Disability & Society, 28(7), 1024–1026. doi: 10.1080/09687599.2013.818773
- Shakespeare, T. & Watson, N. (2001). The social model of disability: an outdated ideology? In Exploring Theories and Expanding Methodologies: Research in Social Science and Disability, Vol. 2, pp. 9–28.
- Singer, J. (1999). Why can’t you be normal for once in your life? From a problem with no name to the emergence of a new category of difference. In M. Corker & S. French (Eds.), Disability Discourse. Buckingham: Open University Press.
- Walker, N. (2021). Neuroqueer Heresies: Notes on the Neurodiversity Paradigm, Autistic Empowerment, and Postnormal Possibilities. Fort Worth: Autonomous Press.
- Chapman, R. (2021). Empire of Normality: Neurodiversity and Capitalism. London: Pluto Press.
- Dwyer, P. (2022). The neurodiversity approach(es): what are they and what do they mean for researchers? Human Development, 66(2), 73–92. doi: 10.1159/000523723
- Dwyer, P. et al. (2023). Community views of neurodiversity, models of disability and autism intervention: mixed methods reveal shared goals and key tensions. Autism. doi: 10.1177/13623613231205629
- Nussbaum, M. (2006). Frontiers of Justice: Disability, Nationality, Species Membership. Cambridge, MA: Harvard University Press.
- Pellicano, E. et al. (2022). A capabilities approach to understanding and supporting autistic adulthood. Nature Reviews Psychology, 1, 624–639. doi: 10.1038/s44159-022-00099-z
- Swain, J. & French, S. (2000). Towards an affirmation model of disability. Disability & Society, 15(4), 569–582.
- United Nations (2006). Convention on the Rights of Persons with Disabilities.
- World Health Organisation (2001). International Classification of Functioning, Disability and Health (ICF). Geneva: WHO.
- Livingston, L.A. & Happé, F. (2017). Conceptualising compensation in neurodevelopmental disorders: reflections from autism spectrum disorder. Neuroscience & Biobehavioral Reviews, 80, 729–742. doi: 10.1016/j.neubiorev.2017.06.005
- Lawson, A. & Beckett, A.E. (2021). The social and human rights models of disability: towards a complementarity thesis. The International Journal of Human Rights, 25(2), 348–379.
- Anders, A.D. (2013). Foucault and ‘the right to life’: from technologies of normalization to societies of control. Foucault Studies.
- Nguyen, X-T. (2015). Genealogies of disability in global governance: a Foucauldian critique of disability and development. Foucault Studies, 19, 67–83.