Neurodiversity and Intellectual Disability: Opportunities and Challenges for Functioning and Participation Across the Life Course

There is increasing recognition that intellectual developmental disabilities are best understood through strengths, everyday functioning, and participation rather than through deficits or predicted limitations. The "F-Words" framework (ie, Function, Family, Fitness, Fun, Friends, Future) translates the World Health Organization's International Classification of Functioning, Disability and Health into language that is meaningful for clinicians and families. Using three common pediatric scenarios (eg, Down syndrome, fetal alcohol spectrum disorder, prematurity), this review shows how early counseling and interdisciplinary support can shift care from prediction to enablement-focused participation. These early global developmental delay conditions are commonly accompanied by uncertainty and deficit-based prognostic framing. A function- and participation-focused approach supports clinically useful goal setting, reduces diagnostic overshadowing and stigma, and improves alignment with family priorities. We propose practical, clinically applicable principles for enablement counseling and collaboration across health, education, and community systems to support belonging and quality of life across the life course.