Commentary: A spectrum for all? A response to Green et al. (2023), neurodiversity, autism and health care.

This article discusses the challenge of balancing the growing understanding of autism as a spectrum with neurodiversity principles. The author supports a new framework that could help healthcare providers better serve autistic children by finding middle ground between viewing autism too broadly (which can create barriers) and ignoring neurodiversity perspectives (which can also harm children's rights).

This commentary responds to Green et al.'s framework for reconciling the expanding autism spectrum with neurodiversity principles in healthcare. The author argues that without evidence-based frameworks, the field risks losing definition entirely. While the broadening clinical definition of autism has paralleled growth in neurodiversity movements, both an 'endless spectrum' and denial of neurodiversity principles can create barriers to meeting autistic children's human rights. The commentary endorses Green's framework for its grounding in basic and clinical evidence and potential real-world healthcare applications, emphasizing that successful implementation requires collaboration across all communities.

The commentary suggests that healthcare providers need evidence-based frameworks to navigate the tension between spectrum definitions and neurodiversity principles. Implementation of such frameworks may improve service delivery to autistic individuals, but requires collaborative effort across communities and empirical testing.

As a commentary piece, this provides opinion and theoretical discussion rather than empirical data. The effectiveness of the discussed framework has not been tested through implementation studies.

The broadening of the clinical definition of autism over time-the so-called, autism spectrum-has run in parallel with the growth of a neurodiversity movement that has reframed the concept of autism entirely. Without a coherent and evidence-based framework through which both of these advances can be situated, the field is at risk of losing definition altogether. In his commentary, Green describes such a framework, which has appeal because of its grounding in basic and clinical evidence, and its ability to guide its users through its real-world application in health care. An endless spectrum creates barriers to autistic children having their human rights met, but a denial of neurodiversity principles has the same effect.

Green's framework holds great promise in coherently framing this sentiment. The real test of the framework is in its implementation, and all communities should walk that path together.