Toward an Emergent Paradigm for Neurodiversity and Health

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Hogenkamp, L., Sanghavi, D., & Natri, H. (2026). Toward an Emergent Paradigm for Neurodiversity and Health. Autism in Adulthood. https://doi.org/10.1177/25739581261433443

Publication date: 24 Mar 2026 Added to AutiHub: 15 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
3
Publication authors identified as autistic
2 / 3 (66.7%)
  1. Lori Hogenkamp *
  2. Dhwani Sanghavi
  3. Heini Natri *

Abstract

Autism research has developed through multiple paradigms. Medical models locate difficulty within individual neurology, while social and neurodiversity models emphasize environmental barriers and the legitimacy of cognitive variation. Biopsychosocial and hybrid approaches integrate these perspectives, recognizing that biological, psychological, and social factors all matter. Yet these frameworks remain largely descriptive and offer limited accounts of how these domains dynamically interact across development to produce the wide heterogeneity observed in autistic experience and adult outcomes. This paper introduces the Evolutionary Stress Framework (ESF), a complexity-based model that reframes neurodevelopmental variation as the emergent outcome of stress–energy regulation and predictive processing over time. Drawing on stress physiology, adaptive calibration theory, predictive processing, and disability scholarship, we review traditional medical, social, biopsychosocial, and hybrid models; examine the contributions and limits of the neurodiversity paradigm; and articulate ESF’s core constructs: emergent neurotypes, stress incoherence, and emergent allostasis. Within ESF, autistic traits function as coherent, context-dependent stress–energy strategies rather than separable strengths and deficits. ESF conceptualizes pathology not as deviation from a normative baseline but as stress incoherence—states in which long-standing calibrations become unsustainable under current environmental conditions. This framework helps explain heterogeneity, developmental change, the clustering of physical and mental health conditions, and the disproportionate burden of burnout and health disparities observed in autistic adulthood. ESF shifts intervention targets from trait suppression to environmental design, co-regulation, and individualized support organized around bio-neurotype–specific regulatory needs. We outline implications for research, clinical practice, and policy and identify directions for empirically operationalizing ESF constructs.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 15 Sep 2026 14:56.

Cited references
71
With a DOI
61
Without a DOI, from raw bibliography text
10
22 / 71 (31.0%) cited references include at least one author identified as autistic.
References with data to complete
4 / 71 (5.6%)
References with detected author names
67 / 71 (94.4%)
Without detected author names
4
Without a structured title
4
Without a stable identifier
10
References with raw author names still to review
4
References with external metadata lookup issues
1
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
271
From DOI or external metadata
271
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
5
94 / 271 (34.7%) names are linked to an author already present in AutiHub. 177 / 271 (65.3%) names are not yet linked.
Names linked to a person identified as autistic
37 / 271 (13.7%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 37 / 94 (39.4%). Distinct people identified as autistic: 26 / 247 (10.5%).
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