Historical perspectives on neurodevelopmental disorders: The merging of us and them

Abstract

Attitudes towards neurodevelopmental disorders (NDDs) have transformed and teetered throughout history, often reflecting the societal culture of the time. Although individuals with NDDs are presently more valued than they have ever been, there are historic and current perspectives and events which have propelled the study of NDDs in both positive and negative directions. The notion of disability originated in Antiquity, where infants with “physical deformities” were deemed unworthy of societal membership. Despite later community inclusion in the Middle Ages, disability was perceived to result from demonic possession or punishment. Subsequently, individuals with NDDs were placed in institutions designed for physical and social isolation. The Enlightenment marked the first positive shift in attitudes and treatment towards those with disabilities, as proponents advocated for the removal of inhumane institutional conditions. The humane movement, moreover, contrasted the long-held belief that individuals with disabilities were “inferior” and “dumb” by illustrating that children with NDDs were capable of learning and worthy of education. The Industrial Revolution reversed these progressive ideas by associating disability with inefficiency. Further, during WWII, the eugenics movement propagated the belief that NDDs blemished a strong nation, which inculcated widespread support for the forced sterilization and mass murder of individuals with NDDs. Global legislation was instated postwar to protect the rights of those with NDDs. These progressive ideas, originating from the humane movement, fostered the many educational methodologies and opportunities now available for children with NDDs. Though current perspectives towards NDDs have vastly improved, there is greater confusion regarding the moral implications of advancing research in biotechnology for genetic engineering and testing. While benefits exist, there is potential for the emergence of a modern eugenics in the 21^st century. The obscurity of this dilemma poses serious moral questions that must be considered within the historical context of perspectives on NDDs.