Drs Chris and Xand van Tulleken are the twin doctors from London who’ve become recognisable faces in the UK over the past fifteen years. My daughter used to enjoy their BBC children’s show Operation Ouch, I found Chris’s Ultra-Processed People an inspirational read, and their BBC Radio 4 show What’s Up Docs? is one of my essential listens. My partner and I even took my daughter to see their live show in London’s West End about ten years ago.
Following a recent holiday, I’ve been catching up this week on shows I missed while I was away, including, I was delighted to discover, the van Tullekens’ episode on neurodivergence: How can we better understand neurodiversity? and its partner, deep-dive episode, in which they explore the evolution of neurodiversity.
Each episode focuses on an aspect of health and wellbeing, featuring a clinical or academic expert in that field. The diversity is tremendous – anything from teeth to Tourette’s to tendonitis. This pair of episodes’ guest was Professor Duncan Astle, professor of neuroinformatics at Cambridge University.
I’m always keen to watch and listen to shows on neurodiversity, particularly listening out for references to dyspraxia. So how was it?
First of all, I was delighted to hear two – yep, two! – references to dyspraxia when listing forms of neurodivergence. I’ve referred many times to how autism, ADHD, and dyslexia tend to ‘triopolise’ discussions about neurodivergent conditions, so it was great to hear DCD’s pair of references. Secondly, I was pleased that the difference between ‘neurodiversity’ and ‘neurodivergence’ was spelled out. I fear they’re too often considered synonyms.
Some other discussion points which grabbed my attention:
Strengths in context: A description of how neurodivergent traits can, in some circumstances, be strengths, such as autistic people’s tendency to hyper-focus on a particular topic.
Prevalence vs diagnosis: Recent years’ rise in diagnoses of some forms of neurodivergence has been spectacular, yet the rise is simply in the direction of the underlying prevalence in the population.
Difference vs disability: Some people with neurodivergent conditions feel that describing their condition as a ‘difference’, not ‘disorder’, pays too little respect to the impact it’s had on their lives, a perspective I’ve written about before when describing the disabling, confidence-shattering, options-narrowing impact dyspraxia has had on me, particularly when I was a lot younger.
Evolutionary origins: A fascinating discussion of neurodivergence’s peculiarly human origin, rooted in the extremely long childhoods and adolescences we experience when compared with our mammalian cousins’ much swifter post-natal brain development.
One topic that particularly chimed with me was Professor Astle’s very helpful, delicately described distinction between the clinical framework of, say, autism, and scales of measurable cognitive and behavioural dimensions. In short, he was saying that two people can be diagnosed with the same form of neurodivergence yet behave and think very differently. This made me think about the phrase I’ve used before: a ‘symptom’s spectrum of severity’. It is common, for example, for dyspraxics to have handwriting struggles, yet an ocean exists between my experience (mild discomfort and fatigue over time) and Rosemary Richings’ description of severe pain from the outset.
I appreciate that the editing of a show like What’s Up Docs? must be tricky. What to cover? What to explore in depth? What to leave out? But, especially given the diagnosis-prevalence discussion, I felt a brief reference to differential diagnosis would have been helpful – specifically, the need to ensure that chaotic and rigid behaviours arising as adaptive responses to adverse childhood experiences (ACEs) are not mistaken for autism or ADHD, which they can behaviourally mimic.
I admit to being biased: the van Tullekens’ work has been a big favourite in my house for a number of years. That said, I thought this was a really good pair of episodes, particularly given the time constraints. I’d love them to do a DCD-specific episode one day. Oh, and if you’re interested in checking out their work, What’s Up Docs? has a sister, mental health-focused show, Complex with Kimberley Wilson, produced by the same team at Loftus Media, which I also recommend.
