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Weight Problems in Dyspraxia

Dyspraxia is a learning disability where body and mind coordination is impaired, making motor movements slow or impossible to make (ie tying shoelaces, playing sports, dancing and other skills). Because of this, most people with dyspraxia are not fit. They are usually overweight and sometimes obese, and this is not good for the dyspraxic person.

Unfortunately being a dyspraxic is a sure risk of becoming overweight or obese. According to the Canadian Medical Association Journal (CMAJ), children with developmental coordination disorder are at greater risk of being overweight or obese.[1]

The study followed 1979 students from 75 schools in Ontario, Canada over a two year period from grade 4 to grade 7. The researchers screened children for coordination difficulties and identified children who may have the disorder. They measured BMI and waist circumference.

“Although DCD has in the past been considered part of the normal continuum of motor proficiency or regarded as merely a “playground disorder” that can be relegated to a secondary position in the universe of children’s health concerns, these results, along with other recent research, suggest that this is no longer acceptable,” writes Dr. John Cairney, Department of Family Medicine, McMaster University, Hamilton, Ontario with coauthors.

The researchers found children with possible developmental coordination disorder were three times more likely to be overweight than typically developing children, and the risk for obesity increased over time. There was no difference between boys and girls in prevalence rates.

The authors conclude “The findings have important implications for intervention. There is a clear need to take a broader, longer-term view of the health consequences of DCD.”

Image courtesy of The Guardian. Dyspraxia can lead to obesity. Not good.

Weight problems in dyspraxic children can turn into obesity or weight gain problems including risk for a lot of diseases like heart attack, stroke, joint problems, atherosclerosis (cholesterol or fat blocking your veins), sleep apnoea and psychological disorders including depression, anxiety, body image disorder and eating disorders (which could make a dyspraxic anorexic or more obese).

What to do in order for dyspraxics to be more fit and not fat?

Diagnosing dyspraxia is very important step in identifying coordination problems. Here, other muscular, motor, or neurological disorders can be ruled out like Duchenne muscular dystrophy (genetic disorder including wasting of the muscles) and cerebral palsy[2] (disorder that affects muscle tone, movement, and motor skills (the ability to move in a coordinated and purposeful way)[3]). By ruling out dyspraxia, fitness management would be easier for the dyspraxic.

After diagnosis, physical and occupational therapies are included in managing dyspraxia. Since generally there is no problem in muscle anatomy, the focus of therapy is for the child to be trained in developing everyday skills needed to thrive in and out of school. This includes such things as learning to use a knife or write legibly.[4]

A physical therapy website has proposed two approaches to managing dyspraxia’s motor deficits[5]:

Two main methods of treatment are generally used with this patient population. The process-oriented approach focuses on the abnormal or immature processes underlying the sensory and motor systems, as frequently occurs in sensory integration therapy.

When treating a child with sensory-based dyspraxia, the initial focus is on providing intensive vestibular and proprioceptive stimulation that is graded and adapted to meet the child’s particular need. This provides the central nervous system with the added sensory input needed for improved muscle tone, coordination and alertness.

Effective treatment gives consideration to activities that provide stimuli in a variety of positions and planes of three dimensional space, that vary in speed from static holding to fast movement, that are linear and angular, and that are transient and sustained.

Activities that provide linear vestibular and proprioceptive input while the child maintains a visual focus are highly effective in improving neck and trunk extension and ocular control while working on anticipatory and projection action sequences.

Activities such as lying prone on a scooter while pushing and pulling a bungee cord provide intensive proprioceptive and vestibular input while developing bilateral coordination, rhythm, timing and visual convergence.

For children with sensory-based dyspraxia, participation in activities that are rich in vestibular and proprioceptive sensory input provide the foundation of improved muscle tone and central nervous system alerting needed for successful participation in of a task-oriented approach, aims to improve and refine specific skills through practice such as skipping, dribbling a ball or riding a bike.[5]

Image courtesy of pediastaff.com. Physical therapy for dyspraxia. (Yes, treadmills can be included).

Activities that can be helpful to address a variety of these areas at the same time are wheelbarrow walking, animal walks, carrying heavy objects, doing handstands against the wall, holding yoga postures, swimming and climbing on the playground or on homemade obstacle courses. Many strengthening activities can be integrated into a child’s daily life: have them help push the full laundry basket to another room, take the gallon of milk from the refrigerator and carry it to the table and carry things up/down stairs.[6]

Image courtesy of baobabtherapyforkids.com.au.

Being active can be challenging for children with dyspraxia, especially as they get older and sports become more competitive. Sports that can be part of an active lifestyle are worth the extra effort to help the child gain the necessary skills. Swimming, cycling, running, skating and skiing are great activities for children with dyspraxia to participate in with peers or with the family. Being active is critical to maintain health and is also so important for social and emotional well-being. Like the boy riding the bike, many child with dyspraxia may have difficulty learning this skill. However, once they master riding it is an activity they can do for the rest of their lives. It is worth the effort to spend the extra time needed to learn and find help from professionals when necessary to help break down the learning process.[6]

(C) Nintendo. Sports can be difficult for the dyspraxic especially team and ball sports.

Image courtesy of specialolympics.org. Individual sports like swimming are more suitable as exercise and sports activity for dyspraxics.

Physical and occupational therapies can be done patiently until the dyspraxic can acquire and master necessary skills to have the most possible coordinated motor skills (it does not to be as very good as a neurotypical’s motor movements) so that he or she can still enjoy fitness and less likely to have weight problems like overweight and obesity as he or she can be less sedentary.

Reference:

  1. http://www.sciencedaily.com/releases/2010/06/100628124553.htm
  2. http://www.healthexchange.org.uk/information-library/article/condition/developmental-coordination-disorder/diagnosing-dyspraxia/
  3. http://kidshealth.org/parent/medical/brain/cerebral_palsy.html
  4. https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/dyspraxia/understanding-dyspraxia
  5. http://physical-therapy.advanceweb.com/Features/Articles/Deficits-of-Dyspraxia.aspx
  6. http://kidpt.com/2011/03/14/dyspraxia-conquering-the-motor-challenges/
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4

Clumsy Awkwardness (Dyspraxia)

image
(C) Pokemon/Nintendo. All rights reserved.

Maybe you know someone who always trips and bumps into many objects (maybe more that once a day). He or she can’t live a day without spilling food, tripping on the floor, bumping into walls or posts or even other people, or misplacing or dropping things. Or maybe you have watched anime, J-dorama, and K-drama series, even Hollywood films and American TV series, with a lot of clumsy protagonists.

Very funny, right?

image
(C) Pony Canyon/A-1 Pictures/Bridge/Dentsu/Satelight/TV Tokyo. All rights reserved.

Not really. It DOES hurt to the clumsy person. Literally and figuratively hurt. Although clumsy people  are funny, they usually struggle to finish tasks completely, keep balance, and use a skill without much difficulty everyday despite their conscious efforts. This condition is called developmental coordination disorder (DCD) or dyspraxia (also known as motor skills disorder or specific developmental disorder of motor function).

What is dyspraxia?

Dyspraxia is the term used when someone has an inability to carry out and co-ordinate skilled, purposeful movements and gestures with normal accuracy. Someone with dyspraxia has difficulty planning and organising their thought processes (planning what to do and how to do it).[1] Although most people do expreience accidents and mistakes, a person with dyspraxia (dyspraxic) does experience accidents and mistakes more frequently than the neurotypical person. It doesn’t necessarily mean that the dyspraxic is dumb or airheaded as it is portrayed in media.

Dyspraxia is a common disorder affecting fine and/or gross motor coordination in children and adults. It may also affect speech. DCD is a lifelong condition, formally recognised by international organisations including the World Health Organisation.[2] Because it is lifelong, most daily activities become difficult to the dyspraxic person.

But mistakes happen to everyone including me. Maybe dyspraxics should just learn to practice.

Er, yes, but dyspraxics DO experience more dificulty than the rest of us. Here’s why.

Dyspraxia is a chronic neurological disorder beginning in childhood that can affect planning of movements and co-ordination as a result of brain messages not being accurately transmitted to the body.[3] It is like broken electrical wires that cannot deliver electric current properly to the appliance that may cause malfunction.

What causes dyspraxia?

Nothing is known about the exact cause of dyspraxia, but some factors have been hypothesized as causes of dyspraxia. These include immaturity of the nerves at the time of conception. Dyspraxia may be caused by a problem with the nerve cells that send signals from the brain to muscles. Children who were born prematurely, had low birth weights or were exposed to alcohol in the womb may be more likely to have dyspraxia.[4]

Certain neurones in the brain, called motor neurones, do not seem to develop and mature as quickly in someone with dyspraxia. As a result, they are not as effective in transmitting information from the brain telling the muscles to move.[1] Because of this, dyspraxics have weak motor coordination that makes it hard for them to do movements correctly or smoothly.

What are the symptoms of dyspraxia?
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(C) Kyoto Animation. All rights reserved.
Oops! You really don’t know whether this girl is stupid or is dyspraxic.

Symptoms vary per person and also its severity. But here is the list of general symptoms of dyspraxia:

Gross Motor Symptoms – the general whole body movement like running and dancing is difficult to execute by the dyspraxic[3]:

-Poor timing[5]
-Poor balance[5][6] (sometimes even falling over in mid-step). Tripping over one’s own feet is also common.
-Difficulty combining movements into a controlled sequence.
-Difficulty remembering the next movement in a sequence.
-Problems with spatial awareness,[6][7] or proprioception.
-Some people with developmental coordination disorder have trouble picking up and holding onto simple objects such as pencils, owing to poor muscle tone and/or proprioception.
-This disorder can cause an individual to be clumsy to the point of knocking things over and bumping into people accidentally.
-Some people with developmental coordination disorder have difficulty in determining left from right.
-Cross-laterality, ambidexterity, and a shift in the preferred hand are also common in people with developmental coordination disorder.
-Problems with chewing foods.

Fine Motor Symptoms – movements of only body parts (arm, hand) that do small work like sewing, using knife and fork, combing hair, and applying cosmetics – these are also difficult to the dyspraxic.[3] Handwriting also is not coordinated. Problems associated with this area may include[3]:

-Learning basic movement patterns.[8]
-Developing a desired writing speed.[9]
-Establishing the correct pencil grip[9]
-The acquisition of graphemes – e.g. the letters of the Latin alphabet, as well as numbers.

image

Image courtesy of wikipedia.org

Example of fine motor skill deficit in dyspraxia shown in this girl completing a globe puzzle.

Developmental Verbal Dyspraxia or Childhood Apraxia of Speech:

This symptom involves dificulty in language expression not as a result of muscle weakness, paralysis, or deafness, but of the brain having difficulty coordonating the muscle movements to say sounds, syllables, and words.[10]

Key problems include[3]:

-Difficulties controlling the speech organs.
-Difficulties making speech sounds
-Difficulty sequencing sounds
-Within a word
-Forming words into sentences
-Difficulty controlling breathing, suppressing salivation and phonation when talking or singing with lyrics.
-Slow language development

These are general symptoms. Here are the signs of dyspraxia per age range[4]:

Waring Signs in a Toddler:

Is a messy eater, preferring to eat with fingers rather than a fork or spoon
Is unable to ride a tricycle or play ball
Is delayed at becoming toilet trained
Avoids playing with construction toys and puzzles
Doesn’t talk as well as kids the same age and might not say single words until age 3

Warning Signs in Preschool or Early Elementary School:

Often bumps into people and things
Has trouble learning to jump and skip
Is slow to develop left- or right-hand dominance
Often drops objects or has difficulty holding them
Has trouble grasping pencils and writing or drawing
Has difficulty working buttons, snaps and zippers
Speaks slowly or doesn’t enunciate words
Has trouble speaking at the right speed, volume and pitch
Struggles to play and interact with other kids

Warning Signs in Grade School or Middle School:

Tries to avoid sports or gym class
Takes a long time to write, due to difficulty gripping pencil and forming letters
Has trouble moving objects from one place to another, such as pieces on a game board
Struggles with games and activities that require hand-eye coordination
Has trouble following instructions and remembering them
Finds it difficult to stand for a long time as a result of weak muscle tone

Warning Signs in High School:

Has trouble with sports that involve jumping and cycling
Tends to fall and trip; bumps into things and people
May talk continuously and repeat things
May forget and lose things
Has trouble picking up on nonverbal signals (gestures, body language, figures of speech) from others

How is dysraxia diagnosed?

A diagnosis of dyspraxia can be made by a clinical psychologist, an educational psychologist, a pediatrician, or an occupational therapist. Any parent who suspects their child may have dyspraxia should see their GP (general practitioner, primary care physician), or a special needs coordinator first.[11]

Assessment for dyspraxia includes developmemtal history, intellectual abilities, and gross and fine motor skill testing.[11] There, the assessor will test specific skills including hand grip, balance, and touch sensitivity. This will be compared to the developmental milestones of the typical child. Comparing children to normal rates of development may help to establish areas of significant difficulty.[3]

However, dysraxia is very hard to diagnosed becauuse it does not present symptoms obviously like ADHD (being hyperactive) or autism (being aloof). It is also difficult because the dysraxia/DCD is not recognized yet in most parts of the world except in English-speaking countries and some parts of Europe (in Scandinavia, dyspraxia is called deficits in attention, motor control and perception (DAMP)[12]). Especially when the health care peovider is not completely aware of the disorder, the diagnosis may not be made clearly and dyspraxia may be missed.

How is dyspraxia treated?

There is no cure for dyspraxia, but there are a lot of mamagement techniques needed to cope with dyspraxia. The earlier the detection, the better the outcome of dyspraxia management. Therapies include occupational therapy, speech and language therapy, and physical therapy. Other strategies include educational modification like one-on-one coaching[13] so it will be easier fof the dyspraxic to acquire skills and knowledge.

For adults, structure and routine at work stations can help a dyspraxic employee get the work done. Office technology like ergonomic office furniture and electronic gadgets and word processors can also help. Breaking own their work into manageable chunks and to use different coloured folders for different tasks to help with organisation. Allowing regular breaks can improve productivity.[14]

If the diagnosis is made during late childhood to adulthood, the dyspraxic has already acquired anxiety, depression, or emotional disturbances due to repetitive failure at school or work, social isolation, and discrimination made be colleagues, schoolmates, and teachers. Usually, dyspraxics have low sense of self-esteem, thus, psychological counselling is also recommended. Medications like antidepressants can also help.

What happens if dyspraxia is not diagnosed?

If dyspraxia has not given intervention, life will be hard for the dyspraxic. He or she will continually struggle at school especially with skills like art, music, physical education or gym, and crafting. Because dyspraxics cannot read nonverbal communication, they are often struggling in making and keeping friends and romantic relationships, which in turn may leave the dyspraxic isolated and depressed. By the time the dyspraxic reaches adulthood, he or she has the high risk of unemployment, underachievement, and divorce or having unstable relationships.

Awareness of dyspraxia

Interest in studying dyspraxia started in the 1960s[15], although the term dyspraxia is not yet coined. In 1972, A. Jean Ayres called dyspraxia disorder of sensory integration.[3][16][17] Dr Sasson Gubbay called it the ‘clumsy child syndrome’ in 1975.[3][18][19][20] Dyspraxia is only coined
by the American Psychiatric Association (APA) in 1987[21], though Samuel Orton first coined developmental dyspraxia in 1937.[22]

Since dyspraxia is only a recent diagnosis, still most people are not yet aware of the condition, which may conclude that there are people with undiagnosed dyspraxia and may be struggling in their everyday lives. More awareness is needed to recognize dyspraxia especially in most parts of the world.

How common is dyspraxia?

According to Dyspraxia Foundation USA, 1 out of 10 people have dyspraxia[23]. It is 4 times more common in males than in females, and it is hereditary.[3]

Can a dyspraxic be successful?

Yes with early detection and mamagement. Dyspraxics can also have strengths like in literature, music, acting, math, and science, and computer studies too. Below are some people with diagnosed or suspected dyspraxia[24]:

Sir Isaac Newton
Pablo Picasso
George Orwell
Ernest Hemingway
Emily Bronte
G. K. Chesterton
Jack Kerouac
Richard Branson
David Bailey
Daniel Radcliffe
Albert Einstein
Robin Williams
Samuel Taylor Coleridge
Bill Gates
Marilyn Monroe
Stephen Fry
Florence Welch of Florence + The Machines

If that’s so, can I also count Jennifer Lawrence? She is clumsy particularly at the Oscars.

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Image courtesy of dailymail.co.uk

Well, I guess so…

Who knows? Maybe your clumsy best friend might actually write the sweetest romance novel ever or be an award-winning actor or become a Nobel laureate in medicine.

How about Mr. Bean?

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Image courtesy of buzzfeed.com

Er?…

Reference:
1. http://www.patient.co.uk/health/Dyspraxia.htm
2. http://www.dyspraxiafoundation.org.uk/about-dyspraxia/
3. http://en.m.wikipedia.org/wiki/Developmental_coordination_disorder
4. https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/dyspraxia/understanding-dyspraxia#item2
5. Missiuna C, Gaines R, Soucie H, McLean J (October 2006). “Parental questions about developmental coordination disorder: A synopsis of current evidence”. Paediatr Child Health 11 (8): 507–12. PMC 2528644. PMID 19030319.
6. Geuze RH (2005). “Postural control in children with developmental coordination disorder”. Neural Plast. 12 (2–3): 183–96; discussion 263–72. doi:10.1155/NP.2005.183. PMC 2565450. PMID 16097486
7. Wilson PH, McKenzie BE (September 1998). “Information processing deficits associated with developmental coordination disorder: a meta-analysis of research findings”. J Child Psychol Psychiatry 39 (6): 829–40. doi:10.1017/s0021963098002765. PMID 9758192.
8. Lacquaniti F (August 1989). “Central representations of human limb movement as revealed by studies of drawing and handwriting”. Trends Neurosci. 12 (8): 287–91. doi:10.1016/0166-2236(89)90008-8. PMID 2475946.
9. Polatajko HJ, Cantin N (December 2005). “Developmental coodination disorder (dyspraxia): an overview of the state of the art”. Semin Pediatr Neurol 12 (4): 250–8. doi:10.1016/j.spen.2005.12.007. PMID 16780296.
10. http://en.m.wikipedia.org/wiki/Developmental_verbal_dyspraxia
11. http://www.medicalnewstoday.com/articles/151951.php
12. Hellgren L, Gillberg C, Gillberg IC, Enerskog I (October 1993). “Children with deficits in attention, motor control and perception (DAMP) almost grown up: general health at 16 years.” Dev Med Child Neurol 35 (10):881-92. doi:10.1111/j.1469-8749.1993. PMID 8405717
13. http://www.webmd.boots.com/children/guide/dyspraxia?page=2
14. http://www.dyspraxiafoundation.org.uk/dyspraxia-adults/workplace-employers/
15. http://www.dyspraxia.ie/aboutus_history
16. Ayres AJ (1972). “Types of sensory integrative dysfunction among disabled learners”. Am J Occup Ther 26 (1): 13–8. PMID 5008164.
17. Willoughby C, Polatajko HJ (September 1995). “Motor problems in children with developmental coordination disorder: review of the literature”. Am J Occup Ther 49 (8): 787–94. doi:10.5014/ajot.49.8.787. PMID 8526224.
18. Gibbs J, Appleton J, Appleton R (June 2007). “Dyspraxia or developmental coordination disorder? Unravelling the enigma”. Arch. Dis. Child. 92 (6): 534–9. doi:10.1136/adc.2005.088054. PMC 2066137. PMID 17515623.
19. Gillberg C, Kadesjö B (2003). “Why bother about clumsiness? The implications of having developmental coordination disorder (DCD)”. Neural Plast. 10 (1–2): 59–68. doi:10.1155/NP.2003.59. PMC 2565425. PMID 14640308.
20. Gubbay SS (October 1978). “The management of developmental apraxia”. Dev Med Child Neurol 20 (5): 643–6. PMID 729912.
21. Addy L, Dixon G (2013). “Making Inclusion Work for Children with Dyspraxia: Practical Strategies for Teachers.” Routledge. ISBN 1134378033.
22. Davis AS (2010). “Handbook of Pediatric Neuropsychology.” Springer Publishing Company. ISBN 0826157378.
23. http://www.dyspraxiausa.org/
24. http://www.aucklanddyspraxia.org.nz/drupal/Article%20-%20Famous%20Dyspraxics

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Wired Differently

I’m back. Last time, I introduced you what will I blog in this page. Now, I will define my topic. We sometimes encounter people who are weird in some ways and think and behave in a manner which deviates from normal. We usually refer to them as ‘wired differently’ or simply abnormal or ‘special.’ In the medical community, they are diagnosed with ‘learning disabilities.’ But not all of them agree with this concept. Instead, they advocate neurodiversity.

What? What’s that word again?

Neurodiversity. According to the definition in Wikipedia, neurodiversity is an approach to learning and disability that suggests that diverse neurological conditions appear as a result of normal variations in the human genome.[1] This term was coined in the late 1990s as a challenge to prevailing views of neurological diversity as inherently pathological, and it asserts that neurological differences should be recognized and respected as a social category on a par with gender, ethnicity, sexual orientation, or disability status.[2] To make this definition a little less complicated, let’s just compare this to biodiversity. Like in ecosystems where there are diverse species of life forms from plants to animals, the same goes for humans who have brains wired differntly resulting in multiple intelligences and differing in the way of thinking.

But how is that? Of course people think differently. Each person is unique.

Err, what shall I say? Yes, each individual thinks differently, but what I mean is the way the brain develops from childhood to adulthood. Let me explain further.

Neurodiversity encompasses all people whose brains develop differently from the normal people. The development can be either delayed or advanced or deficient. People under neurodiversity are called neurodovergent. Neurodiversity include dyslexia (difficulty in reading letters), attention deficit hyperactivity disorder (ADHD) (short attention span, hyperactivity, and impulsiveness), autism spectrum disorder (ASD) (hyperfocus to detail, deficient in social skills), Tourette syndrome (involuntary body movement), developmental coordination disorder (DCD) or dyspraxia (difficulty in planning and coordinating movement), and dyscalculia (difficulty in reading numbers, or ‘dyslexia of numbers.’) These conditions are also collectively known as learning disabilities. On the other hand, people whose brains develop without these conditions stated above are called neurotypical.[3]

This concept has attracted controversy because it attacks the traditional notion that ADHD, ASD, and the like are disabilities that are needed to be fixed or cured, but rather, respect the differences in thinking as part of the normal human genome variation, just like the variations in human sexual orientation or variations in human physical appearances.

Neurodiversity is a concept akin to biodiversity or cultural diversity that recognizes neurological disorders as a natural human variation. Rather than looking for cures, neurodiversity advocates work to promote social support systems and spotlight the value of neurological differences, in the same vein as variations in learning styles or social tendencies like introversion and extroversion.[4]

In short, people under neurodiversity are just normal variations of the human specie, not an abnormality of some sort.

To illustrate this, the diagram of neurodiversity[7] by the late Mary Colley, author of Living With Dypraxia, is shown below:
image

That’s the presentation with the difficulties associated with those conditions. The following diagram[8] below shows the strength with each condition:
image

They’re really overlapping. Okay, I think you are somewhat getting the point, but who started and how did neurodiversity begin?

An autism advocate and an autist herself, Judy Singer, coined the term in 1990s as part of the autism advocacy campaign.[2] Another autism advocate, Jim Sinclair, wrote in his 1993 article “Don’t Mourn For Us” told parents that the autism itself cannot be separated from the person who is born with it, but rather part of the person itself.[5] The term neurodiversity appeared on Harvey Blume’s 1998 The Atlantic article where he said, “Neurodiversity may be every bit as crucial for the human race as biodiversity is for life in general. Who can say what form of wiring will prove best at any given moment? Cybernetics and computer culture, for example, may favor a somewhat autistic cast of mind.”[6]

Since then, hundreds of people with otherwise neurotypical development have advocated neurodiversity as the way of being the way sub-Saharan Africans in the United States and LGBT communities have advocated their rights before. A lot of neurodiverse people have contributed to society whether be in art, science, politics, and so forth. However, people with neurodiverse conditions are still continued to be bullied, ridiculed, and abused in all walks of life from infancy to old age. That’s why they are prone to suffer from anxiety and depression. Nevertheless, neurodiversity campaign remains strong, and more neurotypical people are beginning to accept neurodiverse people as who they are, particularly in the Western World.

It’s a long way to go. They’re really wired differently, but the same members of the modern human specie Homo sapiens like us.

Next time, I will post about the different conditions under neurodiversity one by one, their presentation, diagnosis, treatment, prognosis, advocacy, and some samples of people who have these conditions.

References:

[1] Jaarsma P, Welin S (February 2011). “Autism as a Natural Human Variation: Reflections on the Claims of the Neurodiversity Movement” (PDF). Health Care Anal 20 (1): 20–30.
[2] http://en.m.wikipedia.org/wiki/Neurodiversity.
[3] Sinclair, Jim (1998). “A note about language and abbreviations”. Archived from the original on 2008-06-06.
[4] http://www.pbs.org/pov/neurotypical.
[5] Autism Network International newsletter, Our Voice, Volume 1, Number 3, 1993.
[6] Blume, Harvey (September 30, 1998). “Neurodiversity”. The Atlantic. Retrieved November 7, 2007.
[7] http://joelgethinlewis.com/2013/05/23/self-storm-troopers-strongbox-neurodiversity-and-snowfall/
[8] http://www.geniuswithin.co.uk/infographics/neuro-diversity-venn-diagram/