An integrative approach between neurodiversity perspectives and quality of life models for autistic people across the spectrum of support needs

Introduction: Autism is increasingly understood not through deficit-based frameworks but through approaches that emphasize rights, inclusion, and well-being for autistic people across the spectrum of support needs, including non-speaking individuals, those with intellectual disability, and those experiencing mental health challenges. Two perspectives have been central to this shift: Quality of Life (QoL) models, rooted in applied disability research, and the neurodiversity paradigm, arising from autistic self-advocacy and social justice movements. Aim: This mini review examines the convergences and tensions between these perspectives, generating a set of integrative principles to guide support providers, researchers, and policymakers. Evidence is synthesized across three thematic perspectives: socio-political and paradigmatic debates, particularly language, identity, and representation; applied and clinical practice, including the aims, role, and risks of supports and interventions; and research, with attention to participatory approaches, lived-experience priorities, and the representation of autistic people with extensive support needs. Discussion: Six principles emerge: (i) well-being depends on both self-acceptance and the quality of supports; (ii) language should balance contextual function with individual preference; (iii) identity has transformative value, requiring diagnostic practices that are inclusive, participatory, and non-deficit oriented; (iv) supports are essential mechanisms for participation, not threats to identity; (v) interventions should promote autonomy, belonging, and growth without enforcing normalization; and (vi) research must ensure autistic participation across all stages, with accessible processes and priorities aligned with autistic preferences. Together, these principles offer a framework for integrating QoL and neurodiversity approaches in ways that advance rights, inclusion, and well-being.