Dismantling ‘human kind’ categories: reconfiguring neurodivergent identities in contemporary diagnostic services

Classification has long been recognised as a fundamental aspect of human society with significant social, moral and political consequences (Bowker & Star, 2000). Within medicine, diagnostic classifications and categories have a vital role in structuring care, but many have also now become powerful – yet controversial - social identity categories (Brinkmann, 2016). This is particularly the case for neurodevelopmental diagnoses such as attention deficit hyperactivity disorder (ADHD) and autism. The power of these diagnoses is arguably tied to categorical essentialism which establishes them as stable, objective and meaningful ways of distinguishing between different types of human (Haslam, 2000). However, dramatic shifts in diagnostic knowledge and practice have the potential to undermine this essentialism, as some neurodevelopmental services rethink the role of categorical diagnosis in service provision, potentially shifting towards dimensional approaches to assessing neurodevelopmental diversity and need. Yet the consequences of these shifts remain unknown. By tracing the reconfiguration of these two diagnostic categories at a pivotal historical moment, this project aims to produce novel insights into a) the (usually hidden) ideological forces and practices shaping the transformation of diagnostic categories, and b) the social, personal and moral consequences of diagnostic transformation and de-essentialism.