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The Evolutionary-Stress Framework and Neurodiversity: Shifting the Medical Paradigm towards Complex Adaptive Systems

By Lori Hogenkamp
Center for Adaptive Stress

Keywords: Evolutionary-Stress Framework, neurodiversity, complex adaptive systems, medical paradigm, stress, adaptation, resilience, personalized medicine, cognitive profiles, neurotypes.
Abstract

This paper presents the Evolutionary-Stress Framework (ESF), a novel approach that reframes conditions such as autism and ADHD not as disorders but as integral components of human cognitive diversity – a concept grounded in neurodiversity. The ESF perceives these conditions as outcomes of a complex interplay between stress mechanisms, genetic predispositions, and environmental factors. Diverging from traditional pathology-centric perspectives, and even some neurodiversity perspectives, the ESF underscores the adaptive stress responses and evolutionary pressures that contribute to cognitive diversity and ecosystem resilience. It incorporates concepts such as the Adaptive Calibration Model, energy allocation models, and biodynamic interfaces, illuminating the dynamic nature of stress responses and the intricate interactions between biological systems and their environment. The ESF advocates for an integrative, multidisciplinary research approach to further our understanding of these dynamics. It also calls for personalized, systems-focused healthcare models, which acknowledge and cater to the unique needs and potential of neurodiverse individuals, particularly those with complex neurodevelopmental trajectories and associated physiological trade-offs. The transformative potential of the ESF to reshape healthcare practices and enrich the lives of neurodiverse individuals underscores its significance in contemporary medical and scientific discourse

Introduction

Navigating the intricate landscape of health and disease is akin to solving a complex labyrinth, with numerous variables shaping individual health trajectories. The traditional linear medical model, though valuable in understanding rare medical conditions, often fails to capture the dynamic interactions inherent in the human body’s response to challenges. As system dynamics pioneer, John Sterman noted, “Today’s problems often arise as unintended consequences of yesterday’s solutions,” highlighting the limitations of linear thinking for our health and well-being.

In this paper, we introduce the Evolutionary-Stress Framework (ESF), a comprehensive model for understanding health. This framework suggests that individual variations in stress responses, including a concept known as neurodiversity—the range of differences in individual brain function and behavioral traits—are naturally occurring and evolutionarily conserved phenomena. These variations may sometimes exceed adaptive capacities due to a complex interplay of genetic, environmental, and physiological factors.

We propose viewing these variations through the lens of complex adaptive systems and the biopsychosocial-nutritional model, promote a comprehensive understanding of health and behavior. The ESF incorporates concepts such as pluricausality, multifinality, equifinality, and pleiotropy, which facilitate a holistic understanding of personal factors, temporal dynamics, and health pathways.

Drawing on the idea of ‘hidden talents in harsh environments’ (frankenhuis, belskey) the ESF suggests that diverse neurological profiles provide a variety of cognitive tools contributing to collective adaptation and resilience. However, the framework also acknowledges that these evolutionary outcomes can surpass adaptive thresholds when under pressure.

As our understanding of the complex responses to various challenges deepens, the limitations of a one-size-fits-all approach, which often overlooks underlying imbalances and suppresses the inherent complexity and diversity of human systems, become increasingly evident. This oversimplification is particularly problematic in the context of neurodiversity, as it can stifle cognitive diversity and overlook the innovative potential of diverse neurological profiles.
By embracing (the ESF), we underscore the need for personalized, effective, and systems-focused interventions that recognize individual and contextual variability in health. In the forthcoming sections, we will delve deeper into neurodiversity, followed by an examination of the history of stress theory and evolutionary theories.

Neurodiversity: History & Influence

Over recent decades, the concept of neurodiversity has emerged, significantly reshaping our traditional views on human cognition and behavior. Recognizing variations in neurological functioning as inherent aspects of human diversity, this perspective challenges the pathologization of these differences. Instead, it advocates for an appreciation and celebration of unique strengths and abilities (Jaarsma & Welin, 2012; Kapp et al., 2013; Leadbitter et al., 2021; Manallini et al., 2023).

This conceptual shift owes its origins to pioneering figures such as Australian sociologist Judy Singer, who introduced the term “neurodiversity” in the late 1990s (Singer, 1998). Autistic advocate Kassiane Asasumasu further expanded on this concept, coining the term “neurodivergent” to denote individuals whose neurological functions diverge from the norm, encompassing conditions like autism, ADHD, and dyslexia (Asasumasu, 2005).

Drawing inspiration from civil rights and disability rights movements, the neurodiversity movement illuminates neurological differences within the human population, asserting the rights of “neurological minorities” for equality and inclusion (Bagatell, 2010). Over time, the narrative has evolved from a deficit-based model to a strengths-based perspective that views neurodivergent traits and behaviors as potential adaptive responses to specific environmental contexts (Del Giudice et al., 2011; Kapp et al., 2013; Ortega, 2009).

Today, the importance of cognitive and behavioral diversity is increasingly recognized across governmental, corporate, and societal realms, leading to the implementation of policies and initiatives promoting inclusion. Multinational corporations like Microsoft, SAP, and IBM have championed neurodiversity in the workplace by instituting dedicated hiring programs for neurodivergent individuals (Austin, 2018). Simultaneously, governments and NGOs are advocating for supportive policies and fostering awareness of neurodiversity at a global level, exemplified by the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD).

These advancements, however, mark only the beginning of a more extensive process of systemic integration of neurodiversity. The real promise lies in integrating neurodiversity into medical paradigms through the Evolutionary Stress Framework (ESF), a move that could offer transformative support to neurodivergent individuals, especially those dealing with health conditions that cause disability.

The principles of the Evolutionary Stress Framework (ESF), informed by the dynamics of Complex Adaptive Systems (CAS), along with a robust understanding of neurodiversity, offer transformative potential to enrich our understanding of the broad spectrum of cognitive and behavioral profiles in society. As we delve deeper into the history of evolution and stress theories in the following sections, we’ll uncover how misconceptions and misunderstandings within these domains have, over time, cultivated biases, stigmas, and inequalities. By re-envisioning these theories within a modern, advanced framework like the ESF, we are offered an opportunity to rectify these long-held misapprehensions.

Such a shift in perspective and understanding could not only act as a catalyst for reducing stigma and bias but also spur the development of more empathetic policies related to education, healthcare, and employment. The ESF encourages healthcare providers, policymakers, and society at large to participate in a profound cultural shift – one that respects and thoughtfully addresses the unique needs of individuals with diverse cognitive and behavioral profiles. This proposed reorientation of understanding represents more than just an academic recalibration; it serves as a roadmap toward a more inclusive and understanding society.

Unraveling the Story: Stress Theories within an Evolutionary-Stress Framework

The concept of stress has a complex and sometimes contentious history in both medicine and public discourse. While widely acknowledged as a factor influencing physical and mental health, stress has often been misunderstood and oversimplified due to its multifaceted nature (Lazarus, 1993; Lupien et al., 2009; McEwen & Gianaros, 2010). This oversimplification has led to the dismissal of patients’ experiences and the neglect of underlying biological, psychological, nutritional, and social factors contributing to health problems (Monroe & Slavich, 2016). Moreover, it has resulted in stigmatization and discrimination, as individuals experiencing stress-related health problems may be blamed or accused of lacking coping skills (Taylor, 2010).

Historically, stress has been perceived as a solely detrimental influence on health, often labeled as the “silent killer” due to its significant impact on well-being and potential association with chronic conditions (Sapolsky, 2004). However, focusing solely on the pathology of stress obscures its critical roles in healing, protection, and adaptation (Naviaux, 2023; Picard, 2019; Ellis & Del Giudice, 2019).

Within the evolutionary-stress framework grounded in complex adaptive systems, stress is understood as a communication network that facilitates balance and fosters growth across biological and environmental levels. This network extends from microscopic cellular structures, such as microbiomes and mitochondria, to macroscopic whole-body systems, social dynamics, and environmental ecosystems. Despite its crucial role in maintaining and regulating these levels, stress has been underappreciated and underutilized in current medical and health models.

The impact of stress on an individual is influenced by various factors, including personal characteristics, neurotypes, and the context in which stress occurs. Additionally, the relationship between stress and programming, along with subsequent environmental matches for inflammatory and energy regulation patterns, further shapes an individual’s stress response (McEwen & Stellar, 1993).

Experts such as John Sterman and Dave Snowden caution against oversimplification when dealing with health and stress responses within complex systems. Sterman, known for his work on system dynamics, argues that mistakes are made when the rules of complex systems are not considered (Sterman, 2006). Similarly, Snowden, through his Cynefin Framework, emphasizes understanding complexity and context-dependence before developing interventions (Snowden, 2002). Approaches to stress and health should account for the complexity, dynamism, and context-dependence of these phenomena.

However, our current medical infrastructure is not adequately equipped to address the complexity of stress (McEwen, 1998). Therefore, prioritizing funding, education, and research initiatives to support the development of a comprehensive framework for understanding stress should become a top priority for policymakers, healthcare professionals, and researchers alike.

This understanding of stress as an integral, multi-level component of our complex biological and social systems underscores the need for an equally complex and multifaceted framework for addressing stress-related health issues. Just as stress transcends simplistic categorizations of beneficial versus harmful, our approach to health and wellness must also move beyond linear interpretations. The evolutionary-stress framework provides such a lens, as it acknowledges the diverse origins and implications of our biological systems. By recognizing stress as an integral, multi-level component of our complex biological and social systems, we can develop more nuanced and personalized approaches to addressing stress-related health issues. This framework emphasizes the importance of context, complexity, and individual differences in shaping stress responses and health outcomes, paving the way for a comprehensive understanding of stress within the context of chronic conditions, health, and evolution.

Tracing Back: Evolutionary Theory

Examining the rich and, at times, controversial history of evolutionary theory is essential to understanding its implications for medical practice. This history has furnished invaluable insights into human health and disease, while also giving rise to misuse and misinterpretation, leading to detrimental practices (Gould, 1981; Kevles, 1985; Nesse & Williams, 1994). The lessons from these triumphs and failures are crucial as we aim to incorporate evolutionary perspectives into the medical field more effectively.

Historically, a linear interpretation of evolutionary theory introduced concepts like “survival of the fittest” and natural selection into medicine, underlining the role of genetic fitness in health outcomes (Nesse & Williams, 1994). However, these principles’ misinterpretation birthed harmful ideologies like eugenics and social Darwinism, which have disproportionately harmed marginalized communities (Gould, 1981; Kevles, 1985).

Eugenics, an ideology originated by Galton (1883), aimed at enhancing the genetic quality of the human population by promoting reproduction among those deemed “fit” and discouraging those labeled “unfit.” This ideology led to forced sterilization and reproductive control, primarily targeting people with disabilities and people of color (Kevles, 1985; Lombardo, 2008). This concept was later used to rationalize forced sterilization, immigration limitations, and even genocide (Kevles, 1985; Lombardo, 2008).

Social Darwinism, another distorted interpretation of evolutionary principles, proposed that the “fittest” individuals and groups would naturally ascend to the top of societal structures (Hofstadter, 1944). This ideology was misused to legitimize racial and ethnic hierarchies, white colonization, and the subjugation of indigenous populations (Gould, 1981; Stocking, 1968). Such misapplications overshadowed the potential benefits of integrating evolutionary perspectives into medical practice.

In contrast, the Evolutionary Stress Framework aims to offer a more fruitful lens to evolutionary theory, advocating for a dynamic view of health that deviates from harmful and reductionist ideologies. By viewing health through the lens of evolutionary processes, we can better understand the interplay of genetic, environmental, and physiological factors that shape human health (Barrett et al., 2016). This understanding reveals that individual differences in health outcomes and stress responses are not mere aberrations, but result from adaptive processes that have enabled our species to flourish in diverse environments (Ellis et al., 2017;? ).

Incorporating evolutionary theory into medical practice can help identify the adaptive functions and trade-offs underlying various health conditions, leading to personalized healthcare interventions (Nesse & Williams, 1994). This approach advocates for an equitable healthcare system that ensures the health and well-being of all individuals, regardless of their genetic fitness or other characteristics. It is through this lens of evolutionary theory, complemented by a sophisticated understanding of stress as a complex adaptive system, that we can truly address the nuanced health challenges of the 21st century.

Integrating Medical Models with Neurodiversity

The traditional medical model has undoubtedly made significant strides in disease management and improving life expectancy. However, its limitations become apparent when we consider the rich diversity of human cognitive and behavioral traits and the multi-dimensional nature of health. By overlooking the adaptive nature of these traits and pathologizing them without acknowledging individual trade-offs between health maintenance and environmental stressors, the medical model falls short in capturing the complexities of human well-being. In our complex world, a singular approach to health and wellness is no longer sufficient. To effectively address the intricate connections between stress, health, and diverse cognitive traits, it is crucial to move beyond traditional boundaries and integrate insights from the medical model, the neurodiversity movement, Complex Adaptive Systems theory, and the Evolutionary-Stress Framework.

The current paradigm of health, firmly rooted in linear cause-effect relationships and categorical classifications, is challenged when it comes to understanding the complex interplay between stress and health. While traditional medical models have been successful in unraveling rare medical conditions, they struggle to address the spectrum of chronic conditions, mental health disorders, and developmental issues we face today. The need for a paradigm shift—a move towards an integrative, individualized approach to understanding stress and its impact on health—is becoming increasingly evident (Holman, 2020; Picard, 2021).

Dr. Robert Naviaux’s groundbreaking research offers a captivating view of our body’s cellular landscape, illuminating the active participation of mitochondria in detecting and responding to threats, akin to the proverbial “canaries in the coal mine” (Naviaux, 2023). This portrayal of an active, adaptive cellular response aligns seamlessly with the core principles of the Evolutionary-Stress Framework (ESF).

The neurodiversity movement provides a strength-based perspective on cognitive and neurological differences. While this perspective has been invaluable, it has also faced criticism for its potential reductionism and for overlooking the complex needs of individuals grappling with severe medical conditions intertwined with their neurodivergence. It is evident that a more comprehensive understanding is needed, one that recognizes the interconnectedness of neurodiversity and health complications—a gap that complexity models can help bridge. The Evolutionary-Stress Framework (ESF) aims to move beyond the binary choice of exclusively focusing on individual deficits or environmental influences. This framework explores the trade-offs arising from diverse neurological profiles and how these profiles contribute to individual resilience, adaptation, and long-term well-being.

To illustrate this comprehensive understanding, let us examine how these ideas apply to a particular case: Autism Spectrum Disorders. By exploring the intricate interplay between stress, health, and neurodiversity within the ESF, we can gain valuable insights into the complex dynamics that shape the experiences of individuals with Autism Spectrum Disorders.

Autism Spectrum Disorders: Are They Really Disorders?

Research into autism has wide-reaching implications for understanding neurodiversity, potentially informing the development of personalized intervention and support strategies for individuals with diverse cognitive and behavioral profiles (Chevallier et al., 2012; Marco et al., 2011). By connecting autism research with the broader notion of neurodivergence, we can enrich our understanding of cognitive and behavioral variation in human populations.

By integrating complexity concepts into our understanding of autism, we can rethink the balance between function and dysfunction. Complexity suggests that the traits we associate with autism might be adaptations necessary for regulating stress and energy rather than signs of a dysfunctional system. However, these adaptations can become inefficient when they’re stretched to the extreme, appearing as disorders when they disrupt the balance of functionality.

These traits are often misinterpreted as vulnerabilities rather than strengths, owing to their role in energy-regulating trade-offs. For instance, just as a racehorse’s long legs provide an advantage in speed but also an increased risk of injury, autistic traits are adaptive mechanisms with trade-offs. These traits, although seeming like vulnerabilities, also embody strengths contributing to the individual’s functioning and resilience.

The Evolutionary-Stress Framework postulates that stress and constraints shape neurodiversity, an idea that can be elucidated through the principle of entropy. Entropy provides insights into the equilibrium between order and disorder in cognitive systems, such as those observed in neurodiverse conditions including autism. It’s essential to note that ‘disorder,’ as indicated by entropy, isn’t inherently detrimental. It’s a natural aspect of system behavior and crucial to its functionality.

Biological systems, like the human body, are highly ordered and labor continuously to preserve this order. This involves counteracting entropy to establish and uphold structures and systems that are highly organized. The physiological process of homeostasis serves as a prime example of the body’s active management of entropy, endeavoring to maintain a stable, consistent state against the inherent tendency towards disorder.

In the context of neurodiversity, maintaining lower entropy equates to preserving the smooth and predictable functioning of the body’s systems. However, a certain degree of ‘disorder’ or variation from the norm, can be a source of strength. For instance, in autism, entropy can offer insights into the emergence of both strengths, such as exceptional attention to detail, and challenges, such as sensory overload, associated with autistic traits. These variations contribute to the rich diversity of human cognitive experiences and capabilities

However, these challenges do not inherently signify dysfunction or disorder. They often surface when the environment’s demands exceed the efficiency of the adaptive strategies. Thus, what we perceive as ‘disorder’ or ‘dysfunction’ may often be an adaptive response pushed to its limits. We could think of these as “adapted neurotype with trade-offs”, as the amplification of traits are subject to energy budgeting or allocating resources to certain priorities as a stressed environment would signify greater needs and attention to whatever that person prioritizes and their subsequent trade-offs. This is described by “Hidden Talents in Harsh Environments” (Ellis et al., 2022)

This perspective highlights the need for environments that accommodate neurodivergent individuals, reducing undue stress, and allowing for optimal expression of their unique traits. It encourages us to shift our view of ‘disorder’ from a deficit-focused perspective to one that appreciates the complex interplay of biology, environment, stress, and adaptation in human neurodiversity. Yet, despite these insights, we lack a unified theoretical framework that holistically incorporates these facets and guides us in understanding and supporting neurodivergent individuals. The time is right for the development of new perspectives, ones that acknowledge and integrate these complexities. .

The Evolutionary-Stress Framework

The Evolutionary-Stress Framework (ESF) is a novel conceptual framework that I am introducing, born out of my own unique journey and personal exploration across diverse fields of study. Informed by my lived experiences and intellectual curiosity, it represents an effort to synthesize and integrate a multitude of perspectives, creating a new lens through which to view and understand our complex world. It represents an attempt to bridge the insights of evolutionary biology, stress research, and neurodiversity, aiming to illuminate the intricate interplay between genetic, environmental, and adaptive factors that sculpt human cognition, behavior, and health.

The ESF, instead of looking for a single cause or toxic exposures causing damage, places a spotlight on the role of stress, evolution, timing of impacts and energy regulation in catalyzing the development of diverse conditions, disorders, and traits, while simultaneously recognizing individual differences, contextual nuances, and the inevitable trade-offs inherent in adaptive processes.

In blending past and contemporary models, theories, and cutting-edge technologies, the ESF aspires to a comprehensive understanding of overall well-being. While it takes autism as a case study, its ambition is to enrich our current medical model and expand our understanding of health as a product of stress as an evolutionary force.
Stress—arising from environmental factors we respond to—is traditionally seen as something we aim to eliminate or cope with. However, viewing stress within the Evolutionary-Stress Framework suggests a delicate balance between internal and external factors contributing to our evolution, health, and allostasis (McEwen, 1998). This perspective, which respects the individual’s unique needs, environmental influences, and the intricate interactions shaping their lived experiences, embodies the notions of complexity and nonlinearity. It holds promise for a deeper comprehension of evolution and our role within it.

A mounting body of research suggests that neurodiversity, exemplified by autism, constitutes a natural variation within human populations, fostering adaptability and resilience (Baron-Cohen, 2009; Geschwind & State, 2015). This evidence incorporates genetic influences (Geschwind & State, 2015), evolutionary advantages Baron-Cohen, 2009; Maille & Schraeden, 2017), cognitive trade-offs ((Happé & Frith, 2020), environmental factors, gene-environment interactions (Keil & Lein, 2016), and cross-species examples of neurodiversity within biodiversity (Morris & Palmer, 2023; Shpigler et al., 2017). Traits associated with autism and other neurodiverse conditions can be viewed as trade-offs, appearing disordered, overly programmed, mismatched or becoming problematic under certain circumstances or in the presence of overwhelming stress or stress loads (Happé & Frith, 2020; McEwen, 2017).

The Evolutionary-Stress Framework, as an emerging model, provides a potential new lens for understanding neurodiversity and autistic individuals in particular, drawing upon various models and theories (Arora et al., 2020; Barrett, 2017; Del Giudice et al., 2011; Nederhoff & Schmidt 2012; Taylor et al., 2022; Taylor & 2023; Shonkoff, 2010; Shonkoff et al., 2022). It could allow for a more nuanced comprehension and guide the creation of interventions that enhance the life quality of autistic and neurodivergent individuals (Del Giudice et al., 2011). By examining autism through the ESF, we can delve into the complex interplay between genetic, environmental, and adaptive factors shaping cognitive and behavioral profiles, thus guiding the development of innovative diagnostic and treatment strategies (singletary?, Prizant?, )

With insights from autism research and its broader implications for understanding neurodevelopmental disabilities (NDs), we can begin to explore the potential of the ESF in providing a more comprehensive understanding of cognitive and behavioral variation. By examining the role of stress and related processes, like the Free Energy Principle, predictive coding, and energy allocation, we can develop a deeper understanding of the complex interplay of factors contributing to the diverse cognitive and behavioral profiles present in human populations.

Redefining Neurodiversity: An Integrative Approach Based on Evolutionary-Stress Framework

Throughout my exploration of mental health and NDs, the works of Michael Lesser, Helen Fisher, Bruce J. Ellis, and Lisa Feldman Barrett have deeply influenced my thinking. Lesser’s concept of a spectrum of character types highlights the fact that variation in traits outside of the average does not necessarily imply pathology, but can represent distress and programming in those particular “amplified” traits (Hogenkamp, 2009). This perspective extends beyond personalities and encompasses the gamut of cognitive and behavioral traits we encounter. Importantly, stress does not “cause” any specific outcome in a straightforward manner. Instead, akin to weather and chaos patterns, the outcomes stress produces depend on the unique interplay of the individual, the timing, and the context of stressors and impacts.

Fisher’s research into the biological foundations of personality and temperament has reinforced my appreciation of the inherent biological diversity and drivers of human cognition and behavior. Concurrently, the Adaptive Calibration Model (ACM) by Ellis, Shirtcliff, and DelGiudice provides a convincing account of the variability and trade-offs in stress reactivity and regulation, emphasizing how these variations might serve as adaptive responses to environmental conditions.

In my earlier work, I posited the idea that autism could be seen as a stress adaptation in neurotypes. This viewpoint has since significantly influenced my understanding of neurodiversity and our medical model (Hogenkamp, 2018). I’ve come to perceive neurodevelopmental disabilities (NDs) as a complex ensemble of traits that have been sculpted by a multitude of interacting variables. I now perceive NDs as a dynamic interplay—a symphony with one’s environment that achieves a delicate equilibrium between threats and resources. This perspective uncovers NDs not as a deviation from a norm but as a dynamic ballet of adaptive responses. It celebrates each individual’s unique cadence within the grand ensemble of human diversity.

Adopting such a perspective opens up a rich tapestry of new inquiries into the emergence, manifestations, and modulation of conditions such as depression. Rather than viewing depression as a monolithic condition, it may represent a collection of adaptive responses, akin to distinct weather patterns within specific climates. Each neurotype, shaped by its unique blend of genetic, epigenetic, and environmental influences, may interact with stressors differently and exhibit diverse expressions of depressive symptoms.

This variance may extend to the individual’s response to treatments and interventions, underscoring the need for personalized approaches. Some individuals may lean more towards the physiological expressions of depression, such as chronic fatigue and sleep disturbances, while others may grapple more with cognitive-emotional aspects such as ruminative thoughts and emotional dysregulation. By recognizing the unique pathways to the manifestation of symptoms within each neurotype, we can develop tailored interventions that address the specific needs and strengths of each individual.

This perspective highlights the importance of understanding the complex and dynamic nature of mental health conditions and the role of neurodiversity in shaping their manifestation and treatment. By embracing this perspective, we can move towards a more personalized and inclusive approach to mental health that celebrates the diversity of human experience.
Incorporating neurodiversity into our medical models could indeed offer profound insights into these complex, inflammatory-regulated medical conditions. This reframed understanding calls for a departure from the ‘one-size-fits-all’ approach and instead advocates for a more nuanced, individualized strategy. By embracing the complexity of our biopsychosocial dynamics, we can craft more effective and compassionate interventions that consider the unique strengths, challenges, and needs of each individual within their specific environmental contexts.

The Neurotypical World

We often hear autistic people stating that their struggles stem from living in a world designed for the Neurotypical. With insights from Adaptive Calibration Model (ACM) and the Dandelion, Orchid and Tulip hypothesis (cite), let’s delve further into these speculations. The term ‘neurotypical’ would refer to individuals who primarily exhibit dandelion-like characteristics—excellent social motivation and resilience to stress. Mathematically speaking this group would be considered the ‘norm’ or the average. Their resilience mirrors the robust, adaptable nature of dandelions. They comprise a homogeneous group, accounting for approximately 30-40% of the population.

Neurodivergent individuals, often associated with neurotypes such as autism, ADHD, dyslexia, and dyscalculia, represent a broader spectrum of stress sensitivities and adaptive responses. Resembling a mix of orchids and tulips in terms of sensitivity and adaptability, their traits emerge from a complex interplay of inherent neurological differences, adaptive trade-offs, and environmental factors. Although they are numerically more common, neurodivergent individuals constitute minority subgroups within the spectrum of stress variability.

Such categorization could aids in developing a nuanced understanding of the misconstrued notion of ‘normal’ or ‘average’ in medical models as synonymous with ‘healthy.’ It would be essential to recognize that these labels are not merely products of societal bias or convenience but are rooted in evolutionary and ecosystem logic. ‘Average’ or ‘normal’ individuals would register as healthiest, yet this is not an ideal state; instead, it represents a particular subset of human variability in stress response and adaptability.

While dandelions are undoubtedly resilient, would we want a garden composed solely of dandelions? We’d miss the unique beauty and charm of roses, sunflowers, or orchids. Sterman keenly observed that our past mistakes breed our current problems, and one of these mistakes is the ‘one-size-fits-all’ mentality. Instead of fostering a ‘garden’ suitable only for ‘dandelions,’ we should aim for a garden that celebrates and nurtures all types of ‘flowers’.

New World, New Words
Building on these insights and aiming to infuse complexity dynamics and neurodiversity concepts into our evolving medical model, we could play with new terms to describe more complexity in neurodevelopmental disabilities and neurodivergence such as “stratified fuzzy clustering” and “overlapping neurotype continua”.

“Stratified fuzzy clustering” refers to the idea that neurodivergent traits are not confined to rigid categories but can coexist and intertwine in complex ways. This concept acknowledges that individuals may display varying degrees of different traits that can overlap and interact in intricate patterns, giving rise to a ‘cluster’ of traits rather than a single, isolated one.

The term ‘fuzzy’ recognizes that the boundaries between these clusters are fluid and dynamic, reflecting the intricate, adaptive nature of neurodiversity. The term ‘stratified’ acknowledges that these clusters can exist at different levels or ‘strata,’ reflecting the influence of multiple interacting factors like genetics, environment, and personal experiences.
“Overlapping neurotype continua” refers to the idea that neurodivergent traits exist along a continuum, rather than in distinct categories. Each individual’s neurotype represents a unique point on this continuum, influenced by their specific combination of genetic, environmental, and experiential factors. The term ‘overlapping’ emphasizes that these continua are not distinct, but intersect in myriad ways, creating a multidimensional landscape of neurodiversity.

This approach emphasizes that neurodivergence isn’t a static characteristic but can evolve over time in response to various stressors and life experiences. Recognizing this can guide us in our treatment and support of neurodivergent individuals, allowing us to perceive neurodivergence as a fluid spectrum of cognitive and behavioral variation.
While these proposed redefinitions and the Evolutionary-Stress Framework provide a more nuanced understanding of neurodiversity, they are grounded in personal experiences and self-guided research and further investigation is needed for their validation and refinement. Incorporating these concepts, however, may pave the way for a more comprehensive appreciation of individual differences and the development of personalized interventions and context-dependent supports.

Integrating the Evolutionary-Stress Framework and Neurodiversity for Personalized Approaches

The Evolutionary-Stress Framework (ESF) and the concept of neurodiversity offer valuable insights for reimagining medical models from a complex adaptive systems perspective (Sterling, 2012; Ellis & Del Giudice, 2019). By integrating these concepts, we can develop more personalized and nuanced approaches that account for individual variability in stress reactivity, cognitive profiles, and adaptive strategies (Del Giudice, 2018; Crespi, 2016).

Understanding the evolutionary context and adaptive functions of neurodiverse traits can help clinicians appreciate different cognitive profiles and their potential interactions with environmental stressors (Kapp 2013; Pellicano & den Houting 2021; Singletary, 2015; Yu & Zhu 2018). This can inform the development of context-sensitive interventions that promote resilience and well-being, rather than merely attempting to “fix” perceived deficits or abnormalities (Armstrong, 2011: Ellis & Del Giudice, 2019; Kapp 2013).

Recognizing the role of stress and adaptation in shaping neurodiversity can inspire new research directions that explore the complex interplay between genetic, environmental, and developmental factors, as well as their contributions to individual differences in cognition and behavior (Del Giudice, 2018; Nesse, 1990). Recent studies have provided evidence for the potential use of stress biomarkers in early autism identification and intervention (Fatemi et al., 2012; Lai et al, 2016). This complexity-based, stress-informed approach to autism identification and intervention has the potential to revolutionize our understanding of neurodiversity and promote the well-being of neurodivergent people.

Historically, we have viewed energy-saving strategies as weaknesses, driven by the paradigm of survival of the fittest and competitiveness. This perception has led to targeting any behaviors deviating from what was considered “normal.” However, recognizing neurodiversity as a natural facet of the human experience leads us to a more inclusive perspective. It underscores the unique contributions of individuals with diverse cognitive and behavioral profiles, rather than marginalizing them due to misconceptions about “abnormality.” In this context, traits often viewed as neurodivergent—such as energy-saving strategies—might indeed be adaptations shaped by evolutionary pressures, offering benefits in specific environments. Therefore, the focus shifts from eliminating perceived weaknesses to fostering a society that appreciates and supports cognitive and behavioral diversity.

Conclusion

In conclusion, this paper advocates for a paradigm shift toward personalized interventions by incorporating the Evolutionary-Stress Framework and neurodiversity concepts into medical models. By reframing disorders as dynamic interplays of genetic, environmental, and developmental factors, we can gain a more nuanced understanding of human health. However, to fully realize this goal, considerable barriers in research, clinical practice, and societal attitudes must be addressed.

Fostering a comprehensive understanding of neurodiversity is essential for navigating the complexities of health, as neglecting this perspective can have profound health implications. Adopting this approach may facilitate individuals and communities in managing their unique health circumstances optimally. This endeavor not only has the potential to revolutionize healthcare, but it also underscores the importance of acknowledging and appreciating the broad spectrum of human cognitive and behavioral diversity in our quest for health and well-being. By embracing this perspective, I hope we can move towards a more inclusive and supportive society that values and celebrates the diversity of human experience.