What is neurodiversity-affirming practice?
“Neurodiversity” is a term for the different ways that brains develop and process the world around them. “Neurodiversity affirming” means that we recognise brain differences (such as ADHD or Austim) are not deficits.
It is essential for speech pathologists to work in ways that value, respect, and support each person’s unique personality, passions, and preferences in life (Trembath et al., 2022).
Speech Pathology Australia, which is the peak body representing speech pathologists states that therapy should not seek to reduce or ‘cure’ neurodiversity, but rather, to work with individuals, those around them, and/or the environments in which they live, learn, and work, to promote individual rights and choices.
How is this different from previous ways of practicing?
In the past, therapy has often focused on trying to teach neurodiverse people to adopt neurotypical communication styles. A neurotypical person is an individual who thinks, perceives, and behaves in ways that are considered the norm by the general population.
As neurodiversity-affirming clinicians, our aim is to understand and support a range of communication styles to support neurodiverse and neurotypical people to communicate as effectively as possible.
Our therapists may adapt resources used in therapy to ensure they are used in a neurodiversity-affirming way.
What does this look like in practice?
At Box Hill Speech Pathology, we plan therapy to help each client achieve meaningful goals that supports communication in day-to-day life. This could include:
- Getting to know our clients, their families, and communities, so we understand
where and how they prefer to communicate.
- Asking lots of questions about what our clients want to work on and how they learn.
- Giving communication partners (people who regularly communicate with the client) strategies to engage with their neurodiverse family members or interpret their communication attempts.
- Providing strategies to communicate wants, needs, and thoughts, through spoken or nonverbal language.
- Reflection on how different communication styles or language choices affect connections or relationships.
How is neurodiversity-affirming practice consistent with evidence-based practice?
Evidence-based practice is an approach to health care that must consider the best available research evidence. However, not all studies or therapy programs take into consideration the personal experience of neurodiverse people.
As clinicians at Box Hill Speech Pathology, we feel that it is important to think about client values and preferences when we are choosing a therapy approach for our clients.
Speech Pathology Australia acknowledges that speech pathologists may employ a range of evidence-based supports when providing services to neurodiverse people and their families.
We understand the importance of continually monitoring and re-assessing each individual’s progress towards their goals to make sure they are benefiting from therapy and no harm is being caused.
What about assessment for Autism and formalised assessment tools?
Paediatricians and psychologists use criteria listed in the Diagnostic and Statistical Manual (DSM-5) to make a formal diagnosis of Autism Spectrum Disorder (ASD).
Speech pathologists are often asked to conduct a pragmatic (social communication) language assessment as part of this process.
Currently, the language used in the DSM-5 does not align with the principles of the neurodiverse community, as Autistic people do not see Autism as a disorder.
However, this assessment is a requirement to receive a formal diagnosis and to then access certain funding supports such as National Disability Insurance Scheme (NDIS).
At Box Hill Speech Pathology, we work collaboratively with families to evaluate the potential implications of seeking a formal diagnosis, which may have both positive and negative impacts on the person’s wellbeing.
Wherever possible when writing reports, we seek to provide a description of the person’s communication preferences and support needs, rather than a list of deficits.
We aim to continue learning and adapting to the needs of our Autistic clients, particularly as new information becomes available regarding neurodiversity-affirming best practice.
We also aim to advocate for the communication preferences and support needs of our Autistic
clients at both an individual and societal level.
*This document reflects the current practices of Box Hill Speech Pathology as of May 2024.
We understand that this area is continually evolving and we will update our practice as needed.
We acknowledge previously written reports or therapy experiences may not be reflective of current practice.*
References:
Speech pathology Australia Position Statements:
https://www.speechpathologyaustralia.org.au/Public/Public/About-Us/Our-organisation/Core-documents/Autism.aspx#:~:text=Speech%20Pathology%20Australia%20recognises%20that,the%20individual%20and%20their%20family.
Trembath, D., Varcin, K., Waddington, H., Sulek, R., Pillar, S., Allen, G., Annear, K., Eapen, V.,
Feary, J., Goodall, E., Pilbeam, T., Rose, F., Sadka, N., Silove, N., Whitehouse, A. (2022).
National guideline for supporting the learning, participation, and wellbeing of autistic children and their families in Australia: Draft Guideline for public consultation. Autism CRC. Brisbane.
