Embracing Neurodiversity in Brazil: Current State, Challenges, and Pathways Toward Affirming Care

Objective: Examine the current state of autism and ADHD assessment in Brazil through the neurodiversity paradigm, identify cultural challenges, and propose pathways toward neurodiversity-affirming mental health care. Methods: We conducted a narrative review of neurodiversity literature and analyzed de-identified, aggregate data from a large-scale Brazilian online mental-health self-screening platform. The platform hosts 45 published self-report instruments spanning multiple conditions; 9 autism- and ADHD-specific instruments are the focus of this analysis. Between December 2020 and November 2025, the platform recorded 2,897,676 total submissions, corresponding to approximately 1.41 million unique devices. The autism/ADHD subset accounted for 1,478,215 submissions, or approximately 815,000 unique devices. Results: Neurodiversity discourse remains limited in Brazilian mental health despite massive demand for accessible assessment. Platform data revealed a predominance of women in the demographic subset (64.8%; N=138,756), late help-seeking age (mean 27.7 years, median 25.0, SD=12.1), concentration in the Southeast among IP-geolocated respondents (51.2%), explosive growth during the COVID-19 and post-lockdown period peaking in 2022, and the finding that 95.6% of respondents reported no prior autism diagnosis. Conclusions: Brazil has an opportunity to build neurodiversity-affirming care through cultural adaptation, digital innovation, and centering neurodivergent voices.