In recent years, it has become more recognized that a shift in societal perspectives is necessary for true inclusion, specifically regarding (but not limited to) autism and ADHD. Historically, autism and ADHD have been pathologized to focus on the way areas for growth impair a person’s “normalness”, rather than the constructive ways that individuals use their unique strengths. Neurodiverse children and adults do experience difficulties related to living in a world that is not accommodating and understanding of differences. The neurodiversity movement does not seek to trivialize how challenging growing up neurodiverse can be, but rather help focus on building shared understanding of the value neurodiverse individuals have just as they are.
Pediatric therapists learning how to become more neuro-affirming are motivated to understand a child and family’s lived experience, provide validation of individual strengths, interests, and challenges. Neuro-affirming therapists help promote a more aligned match between a child’s comfortable skill set and their supports at home or in their school environment to facilitate access to mutual communication, play, learning, self-help routines, and relationships.
Therapists have a unique responsibility to utilize a social model of disability perspective while operating within a payer system (health insurance) which has historically relied on a medical model of disability. That history includes a culture of identifying and remediating individual “deficits” and documentation of progress through reducing “delays” and “deficits” to continue to provide access to valuable therapeutic interventions. Below are some of the ways that therapists at PlayWorks Therapy are working to evolve in their daily practice.
- At PlayWorks Therapy, we acknowledge that learning and growing are a part of who we are, and working to be more neuro-affirming is an ongoing process that occurs with each client family. We recognize that this process progresses with necessary stumbling blocks as opportunities for development. We are not perfect. We do not know all the right answers, or always know the right things to say. However, we are eager to absorb knowledge from all sources and try our best to unlearn ableism that exists in the field of child development.
- Therapists are not automatic experts on neurodiversity because we work with neurodiverse individuals. Neurodiverse individuals are the experts on their experience with neurodiversity. Thus, our current practices are informed by what we learn from each individual client family and their preferences as well as autistic voices and autistic therapists that share what has/would have been helpful to them.
What are we doing to grow?
- We respect and incorporate a child’s interests and access to their sensory needs into their goals and therapy process.
- We honor all forms of communication whether it be speaking through voice, sign, or augmentative and alternative communication as well as non-speaking communication such as body language and gestures as valid ways to communicate. We offer models of multimodal communication to help children find (a) method(s) that most consistently meet(s) their needs.
- We value a child’s self-determination, self-advocacy, and autonomy. A successful therapeutic relationship includes therapists creating a fun and safe environment where children want to work on their goals. Our goals may include a child being able to communicate “no”, request accommodations or help from others, exercise choices, and access their regulating tools with increased independence.
- We develop goals that are person and family-centered, participation-focused, and independence-driven goals in therapy. We use self-report and involve the client in goal creation where applicable. We want our outcomes to be meaningful to our client families. Our goals do not include decreasing our client’s uniquely neurodiverse qualities in favor of neurotypical expectations (e.g., eye contact, the absence of stimming, behaviors that promote masking).
- We strive to use language that aligns with our values in documentation and conversation including:
- Highlighting unique strengths
- Identity-first language for autistic people (individual preferences are also respected when applicable)
- Moving away from pathological terms related to autistic traits/characteristics (e.g., red flags, deficits, symptoms, nonverbal) as well as false dichotomy classifying systems that do not account for a full picture of a person’s independence and multiple areas of development (e.g., high functioning vs low functioning)
- Identifying and transitioning to assessment tools that are referenced to the individual’s progress towards their goals over time, are participation-based, and are accepted by funding sources.
- We focus on play as an essential part of goals and relationship-building rather than a reward for meeting goals.
- We have neurodiverse members of our therapists/staff and have regular discussions to challenge each other.
- We host social groups programs that focus on meaningful outcomes such as play participation, using preferred communication methods with peers, accessing regulating strategies, and sharing interests.
- We assert that all children are whole and valued, just by existing, full stop.
What related information do we ask of families?
- Learn with us and teach us. We all want to both advocate for and listen to.
- Don’t be afraid to get it “wrong” or to let us know when we do.
- Help us get to know your child and see their strengths the way you do!
- Austistic Self-Advocacy Network (ASAN)
- Emily Lees
- Meaningful Speech
- Play Spark
- The Autistic Advocate
- Therapist Neuroiversity Collective
Questions or concerns?
If you have questions or concerns about any of the above information, please contact us at email@example.com or 773-332-9439.
Caroline Stevens, MS, OTR/L
Scott Webb via unsplash.com