A qualitative study of risk and resilience for positive life outcomes in neurodivergence using the WHO ICF

Resilience is a dynamic process involving the interaction of multi-systemic individual and environmental factors that operate to protect against adversity and promote positive personal outcomes. Resilience is a topic of interest among groups who commonly experience adversity. Yet, it has received limited attention in the context of neurodivergence (e.g., autism and Attention Deficit Hyperactivity Disorder). This study is part of a larger project investigating the bio-psycho-social factors contributing to resilience in neurodivergence using the World Health Organization's International Classification of Functioning (ICF). Interviews and focus groups were conducted with 69 neurodivergent individuals and/or their loved ones to explore the factors they believe influence risk and resilience for positive life outcomes and well-being. A deductive qualitative content analysis was employed to extract meaningful concepts from the interviews, which we then quantified by linking concepts to the ICF. A range of bio-psycho-social factors contributing to risk and resilience were identified, particularly in the ICF's activity, participation, and environmental domains. Key factors included the immediate family, friends, and community members, as well as recreation and leisure, higher-level cognitive functions, and empowerment. Findings, while preliminary, highlight the need to look beyond individual factors alone, emphasizing the variable and context-dependent nature of resilience in neurodivergence.