From diagnosis to dynamic profiling – how digital tools can drive equity

Professor Amanda Kirby, CEO of Do-IT Solutions., Campaigner for Neurodiversity, Medic, Knowledge Translator, researcher.

Originally published as part of The Neurodiversity 101 LinkedIn Newsletter.

For decades, we’ve organised neurodevelopmental differences into categories — autism, ADHD, dyslexia, developmental coordination disorder, and others — as though each existed in isolation. Yet, as decades of research now show, human development doesn’t work like that. Co-occurrence is the norm, not the exception. Boundaries blur, needs change, and people grow and adapt across time and context.

Why the categorical model no longer works

Systems like DSM and ICD were designed to create consistency, not complexity. But they’ve struggled to keep up with what we now know:

• Shared genetic, cognitive and neurobiological factors link many neurodevelopmental conditions.
• Profiles often shift with age, environment, and life events.
• Threshold-based diagnoses can exclude those who fall just outside criteria but still experience significant barriers.
• Traditional tools often ignore social determinants — poverty, trauma, exclusion, language and cultural background — that shape presentation and access to support.

As Astle and Bathelt (2019) observed, the “one label per person” model is straining at its limits.

From diagnosis to understanding

A needs-led, biopsychosocial model reframes assessment as a process of understanding the whole person — their strengths, challenges, environment and goals — rather than of allocating a label. It draws on Engel’s (1977, 1980) principle that health and functioning emerge from the interaction of biological, psychological and social systems. In neurodevelopmental contexts, this means asking not only what traits are present but how they interact with the world around the individual.

Such an approach encourages shared decision-making, reduces stigma, and promotes early, context-specific intervention — rather than waiting for diagnostic certainty before offering help.

The case for dynamic assessment

Static assessments capture a single moment. They can’t reflect how needs change over time or across environments. Dynamic assessment, by contrast, recognises that learning and adaptation are continuous. It:

• Tracks growth and change, not just baseline ability.
• Integrates multiple perspectives — individual, family, school, clinician.
• Embeds contextual and environmental data.
• Enables iterative feedback and recalibration, aligning with real-world complexity.

This mirrors what Michelini et al. (2024) describe as the neurodevelopmental spectrum — overlapping dimensions of attention, communication, learning, motor and emotional regulation that vary across the population.

When we understand individuals dimensionally rather than categorically, we can better tailor support and reduce inequities in who receives help, and when.

What this means for services

Adopting dynamic, biopsychosocial frameworks requires:

• Integrated systems that share information across education, health, and community settings.
• Iterative assessment, updating understanding as circumstances change.
• Inclusive data that represent diverse populations, ensuring fair norms.
• Training and culture change, so practitioners value ongoing profiling as much as diagnostic precision.

The outcome is not simply efficiency — it’s equity. People receive earlier, more relevant support, reducing the escalation of need and improving wellbeing while waiting.

In summary

Neurodiversity reminds us that difference is part of being human. Our challenge is not to narrow definitions further, but to build systems that are flexible enough to respond to change. Dynamic, needs-led and biopsychosocial models offer a pathway toward that goal — one grounded in science, ethics and lived experience.

Selected references

• Astle, D. E., & Bathelt, J. (2019). Remapping the cognitive and neural profiles of children who struggle at school. Developmental Science, 22(1).
• Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136.
• Fusar-Poli, P., et al. (2019). Transdiagnostic psychiatry: A systematic review. World Psychiatry, 18(2), 192–207.
• Michelini, G., et al. (2024). Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? World Psychiatry, 23(3), 333–357.
• Fabiano, F., & Haslam, N. (2020). Diagnostic inflation in the DSM. Clinical Psychology Review, 80.
• Gillberg, C. (2010). The ESSENCE in child psychiatry. Research in Developmental Disabilities, 31(6), 1543–1551.

Blog Author

I am Amanda Kirby, CEO of Do-IT Solutions a tech-for-good company that delivers thought provoking consultancy and neuroinclusive guidance and training. We have developed cutting edge web-based screening tools that have helped 10s of 1000s of people. We strive to deliver person-centered solutions relating to neurodiversity and wellbeing.

I am a mixed bag of experiences and skills, an odd ball… and have 25+ years of working in the field of neurodiversity.

I am a medical doctor, Professor, and have a Ph.D. in the field of neurodiversity; parent and grandparent to neurodivergent wonderful kids and am neurodivergent myself.

Theo Smith and I wrote the UK award-winning book Neurodiversity at Work Drive Innovation, Performance, and Productivity with a Neurodiverse Workforce. My 10th book came out called Neurodiversity and Education in March this year. Excitingly, Theo and I have another book coming out next year!