How shared understanding and empathy can reshape how we define, diagnose, and include disability in Thailand.
Across Asia, the way disability is defined shapes who is seen, who is supported and who remains overlooked. In Thailand, definitions rooted in medical frameworks often leave many neurodivergent and psychosocial experiences out of national data and public understanding. These gaps matter because they determine who is counted and whose needs guide policy decisions.
International organisations such as the United Nations, the World Health Organization and the International Labour Organization each have different working definitions of disability. When national laws and administrative systems do not align with these frameworks, gaps appear in reporting, recognition and access to services.
The Awareness, Diversity, Togetherness (ADT) project, led by the Neurodiversity at Work Research Centre (NWRC), responds to these gaps. The project brings together research, policy and communication to build a clearer and more empathetic understanding of disability in Thailand. Dr Louise, Executive Director of the NWRC, who leads the ADT initiative, shares how the project aims to close the distance between data, diagnosis and lived experience.
Expert insight: Interview with Dr Louise Boyle
Q1. Across different systems, from global organisations to local policies, disability is defined in many ways. How do these differences affect who gets represented in Thailand’s data and who remains invisible?
When different systems define disability in different ways, they’re basically deciding who shows up in the numbers and who remains invisible and that in turn, affects policy, planning, and decision-making for people with disabilities.
Across global, national, and administrative systems, ‘disability‘ is defined differently, creating fragmented understanding of who counts as disabled. International frameworks such as the Convention on the Rights of Persons with Disabilities (CRPD, 2008) and the International Classification of Functioning (ICF, WHO) emphasise a social and rights-based model, where disability results from interactions between impairments and social and environmental barriers.
Thailand’s Persons with Disabilities Empowerment Act (PDEA, 2007) and the Constitution are largely aligned with these global, rights-based definitions of disability, emphasising difficulties in daily life and social participation. In practice though, administrative systems and other frameworks do not fully align and too often rely on narrower, more medical definitions that focus on specific impairment types and severity thresholds.
For example, the national disability survey uses a functioning-based framework with a ‘severe-difficulty’ threshold . A person is only counted as having a disability if they report ‘a lot of difficulty‘ or ‘cannot do at all‘ in at least one of six core areas e.g. seeing, hearing, mobility, memory, communication or self-care. This means people with more moderate, fluctuating or context-dependent difficulties, including many neurodivergent and psychosocial disabilities, often fall below the threshold, disappearing from the headline statistics and, in turn, resourcing and decision-making.
The disability card and benefits system is another example. It relies on medical assessments and a strict documentation process to decide who is officially recognised and eligible for support. In practice, only about 44% of people estimated to have disabilities in Thailand hold a disability card (TDRI, 2022). Many others are rejected because they do not fit narrow categories, or never apply due to stigma, lack of information or practical barriers. Yet, they still face serious barriers in school, work, healthcare and everyday life, but remain statistically invisible and excluded from many social protections.
Several groups are routinely excluded. Neurodivergent people face high stigma, discouraging diagnosis and formal registration (Thai Health, 2025) and many are often undiagnosed due to limited awareness and cultural concerns around ‘saving face‘ (Mallory, 2023). Non-citizens, such as migrants and refugees, are legally excluded from disability card eligibility altogether (UNHCR, 2019). Children outside the education system and people in rural or low-income areas are also overlooked because they lack access to hospitals authorised to issue medical certificates.
This is all to say, when people are missing from the data, they are effectively left out of the decisions, budgets and policies that are supposed to support them. That’s why more inclusive definitions and data practices are so important because they shape whose realities are seen, and whose rights are resourced.
Q2. Neurodivergent and psychosocial conditions are often underreported or misunderstood. How is the ADT Project using communication and research to bring these diverse experiences into the public conversation?
Neurodivergent and psychosocial conditions are significantly underreported in Thailand due to limitations in measurement tools, stigma, and barriers to diagnosis. The ADT Project uses research and communication together to make sure neurodivergent and psychosocial experiences are heard.
We centre lived experience, not just diagnosis, by inviting neurodivergent people and their families to describe their journeys in their own words, highlighting the successes, barriers and challenges they face when navigating healthcare and administrative systems. Lived experience research is critical because it shows how policies and services actually affect PWD and families in real life, and reveals gaps, harms and strengths that rarely appear in official data or clinical notes.
To do this, we run focus groups and interviews in Thai and English, supported by plain-language information sheets and a clear and accessible informed consent process for all participants.
We then turn these stories into visible evidence. By analysing experiences across families and healthcare professionals, the project identifies patterns in who gets help and who is blocked, links these to concrete system issues, and shows where PWD, family and provider perspectives align or diverge. The findings will be translated into briefs, training materials, articles, and case examples for healthcare professionals and policymakers.
In short, ADT takes experiences that are usually hidden or ignored and turns them into a clear evidence base that can shape how Thailand includes, talks about, and plans for neurodivergent and psychosocial disability.
Q3. The ADT Project brings together policymakers, educators and the disability community. What does meaningful collaboration look like to you, and how can empathy guide this work toward more inclusive systems?
For us, meaningful collaboration means bringing together key stakeholders and listening seriously to each group’s expertise. Each stakeholder sees and experiences different parts of the system, so collaboration is about bringing those diverse experiences and perspectives into dialogue, rather than relying on any single viewpoint, and co-creating the systemic change we want to see. This means shifting from a model where decisions flow top-down to one where lived experience, research evidence, and policy expertise inform each other continuously.
In practice, that means creating spaces where neurodivergent people, families and healthcare professionals can respond to our findings, share what feels accurate (or not), and highlight gaps we’ve missed. We share information in accessible formats, invite feedback rather than relying on one-way dissemination, and close the loop by taking what we learn back to the people who contributed.
Empathy is what makes that collaboration meaningful and recognises the personal, cultural and emotional realities that are often invisible in mainstream policy discussions. For ADT, empathy isn’t only about feeling with someone, but using that understanding to push for change. It means asking all stakeholders to reflect on questions like: What does it feel like to move through this system? What would make this process safer, clearer or kinder for you/them?; and creating space for all stakeholders to voice fears, frustrations and pressures without judgement. This means:
- Listening not only for ‘needs,’ but also for the diverse perspectives and lived experiences of stakeholders.
- Recognising the varied contexts of families and communities, including differences in everyday environments and unequal access to services.
- Valuing both community and family-based lived knowledge alongside evidence-based research, giving each an appropriate and balanced role.
- Designing systems that reduce barriers to those accessing disability-related services, especially for groups who currently struggle to obtain assessments, disability ‘status’, or necessary support.
By involving the people that systems actually affect in how problems are described, how evidence is interpreted, and how recommendations are framed, we can help ensure that any changes we propose are grounded in real lives, not just in policy documents.
Dr Louise’s reflections show that redefining disability calls for empathy, precision and coordinated effort. The ADT Project demonstrates that data alone does not advance inclusion. Communication practices and shared understanding influence how people access rights, services and opportunities.
Aligning reporting systems with global frameworks such as the CRPD and the WHO’s ICF is important, and valuing the voices behind the data is equally essential. By promoting barrier-based approaches, accessibility and shared language, ADT supports policymakers, practitioners and communities to understand inclusion and plan for a more equitable future.
Join the ADT Project
The Awareness, Diversity, Togetherness initiative welcomes professionals, educators and people with lived experience of disability to contribute to this work. Sharing your insights helps strengthen inclusive communication and policy frameworks for Thailand.
Join us to close gaps in data, diagnosis and understanding, and contribute to a more inclusive narrative.
Register your interest here.