Neurodiversity Affirmative Practice

An effective psychotherapeutic relationship is built on the foundation of adaptability and genuine empathy towards individuals and their unique needs. This requires therapists to approach their clients with respect and curiosity towards their backgrounds, cultures, experiences, communication styles, and attachment patterns. However, some traditional therapies, such as social skills training, may diverge from this fundamental principle of psychotherapy. Instead of focusing on the individual’s personal experiences and needs, these therapies may prioritize teaching a set of predetermined skills or behaviors, which may not necessarily be relevant or effective for everyone. This can result in a lack of personalized and meaningful therapy, which can hinder the client’s progress and growth.

NEURODIVERSITY-AFFIRMATIVE PRACTICES ARE:

• Person-centred, Strength based

• Motivational (people only change for which they believe in)

• Trying to understand from their point of view

• Holistic approach, psycho-social-emotional

• Environmental (e.g., occupational, sensory experiences)

• Development across lifespan

Holistic Assessments

• Get to really know the person

• Willingness to work with all areas impacting the client (family, school, community)

Up to date with the latest research and sometimes the “newest trends”

• What’s happening in the neurodivergent community?

• What’s the up to date research?

• Listen to autistic researchers and individuals with lived experiences as autistics

Familiarity with but unlimited to understanding:

• Neurological basis of Neurodiversity

• Brain areas and functioning (e.g., pre-frontal cortex, amygdala, and their interactions with other brain regions)

• Theories gathered via authentic autistic experiences (e.g., Intense world theory, Persistant Drive of Autonomy/ Pathological Demand Avoidance, Double Empathy Problem)

• Trauma, Developmental trauma

• Famous autistic people, learning case studies

• Social Model of Disability vs Medical Model of Disability

SOCIAL MODEL OF DISABILITY

A disclaimer on my diagnostic reports:

“The medical model of disability…describes individual differences in communication styles, responses to the environment, and behaviour as deficits in comparison to the typically developing population (Neurotypicals). However, under the social model of disability, disability is due to socially constructed barriers within the individual’s environments that prevent them from fully integrating. Treatment providers are advised to provide individualized support affirmingly and respectfully when working with neurodivergent individuals.”

What are some basics of a Neurodiversity Affirmative Practice?

Respect the neurodivergent community’s preference to use identity-first language. Hence, an individual presenting with autistic traits who meets the diagnostic criteria for autism spectrum disorder (DSM-5-TR), are referred to as autistic, and not 1) individuals with autism, 2) individuals with an autism spectrum disorder (ASD).

Embracing neurodiversity is about accepting, including, celebrating and supporting neurodivergent children. Their differences are part of natural variation and don’t need to be treated or changed – Yael Clarke, Educational & Developmental Psychologist. (https://raisingchildren.net.au/guides/a-z-health-reference/neurodiversity-neurodivergence-guide-for-families)

Embracing neurodiversity involves:

• acknowledging that neurodivergent children might do things differently from neurotypical children

• adjusting tasks and activities so that neurodivergent children can fully participate

• making the most of neurodivergent children’s skills, especially the skills they’re proud of

• helping neurodivergent children develop ways of managing everyday tasks and activities that feel natural to them

• not expecting neurodivergent children to change behaviour like stimming, which doesn’t interfere with their everyday activities

Underlying elements of the Neurodiversity Affirmative Paradigm:

1. Understand, accept, respect, listen, and accomodate

2. Changes in language used

   1. Deficit → Differences

   2. Difficulties → Preferences

   3. Atypical → Characteristics

   4. Abnormality → Experiences)

3. Assessment methods and Reports

   1. Recognizing limitations of all assessment tools, neurotypical norm, neurotypical language and expectations

   2. Adjusting use of language such as deficit based to strength based

4. Intervention and Support

   1. Shifting from neurotypical goals to honouring individuals’ preferences and needs

   2. Shifting from “within individual changes” (e.g., behaviour modification, reducing stimming) to Environmental changes, Expectation changes

5. Provide education to families, schools, workplaces and community

Removing barriers for neurodivergent people