Neuroaffirming care values the strengths and differences of autistic people, those with ADHD or other profiles. Here’s how
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We’ve come a long way in terms of understanding that everyone thinks, interacts and experiences the world differently. In the past, autistic people, people with attention deficit hyperactive disorder (ADHD) and other profiles were categorised by what they struggled with or couldn’t do.
The concept of neurodiversity, developed by autistic activists in the 1990s, is an emerging area. It promotes the idea that different brains (“neurotypes”) are part of the natural variation of being human – just like “biodiversity” – and they are vital for our survival.
This idea is now being applied to research and to care. At the heart of the National Autism Strategy, currently in development, is neurodiversity-affirming (neuroaffirming) care and practice. But what does this look like?
Reframing differences
Neurodiversity challenges the traditional medical model of disability, which views neurological differences solely through a lens of deficits and disorders to be treated or cured.
Instead, it reframes it as a different, and equally valuable, way of experiencing and navigating the world. It emphasises the need for brains that are different from what society considers “neurotypical”, based on averages and expectations. The term “neurodivergent” is applied to Autistic people, those with ADHD, dyslexia and other profiles.
Neuroaffirming care can take many forms depending on each person’s needs and context. It involves accepting and valuing different ways of thinking, learning and experiencing the world. Rather than trying to “fix” or change neurodivergent people to fit into a narrow idea of what’s considered “normal” or “better”, neuroaffirming care takes a person-centered, strengths-based approach. It aims to empower and support unique needs and strengths.
Adaptation and strengths
Drawing on the social model of disability, neuroaffirming care acknowledges there is often disability associated with being different, especially in a world not designed for neurodivergent people. This shift focuses away from the person having to adapt towards improving the person-environment fit.
This can include providing accommodations and adapting environments to make them more accessible. More importantly, it promotes “thriving” through greater participation in society and meaningful activities.
At school, at work, in clinic
In educational settings, this might involve using universal design for learning that benefits all learners.
For example, using systematic synthetic phonics to teach reading and spelling for students with dyslexia can benefit all students. It also could mean incorporating augmentative and alternative communication, such as speech-generating devices, into the classroom.
Teachers might allow extra time for tasks, or allow stimming (repetitive movements or noises) for self-regulation and breaks when needed.
In therapy settings, neuroaffirming care may mean a therapist grows their understanding of autistic culture and learns about how positive social identity can impact self-esteem and wellbeing.
They may make efforts to bridge the gap in communication between different neurotypes, known as the double empathy problem. For example, the therapist may avoid relying on body language or facial expressions (often different in autistic people) to interpret how a client is feeling, instead of listening carefully to what the client says.
Affirming therapy approaches with children involve “tuning into” their preferred way of communicating, playing and engaging. This can bring meaningful connection rather than compliance to “neurotypical” ways of playing and relating.
In workplaces, it can involve flexible working arrangements (hours, patterns and locations), allowing different modes of communication (such as written rather than phone calls) and low-sensory workspaces (for example, low-lighting, low-noise office spaces).
In public spaces, it can look like providing a “sensory space”, such as at large concerts, where neurodivergent people can take a break and self-regulate if needed. And staff can be trained to recognise, better understand and assist with hidden disabilities.
Combining lived experience and good practice
Care is neuroaffirmative when it centres “lived experience” in its design and delivery, and positions people with disability as experts.
As a result of being “different”, people in the neurodivergent community experience high rates of bullying and abuse. So neuroaffirming care should be combined with a trauma-informed approach, which acknowledges the need to understand a person’s life experiences to provide effective care.
Culturally responsive care acknowledges limited access to support for culturally and racially marginalised Autistic people and higher rates of LGBTQIA+ identification in the neurodivergent community.
Authentic selves
The draft National Autism Strategy promotes awareness that our population is neurodiverse. It hopes to foster a more inclusive and understanding society.
It emphasises the societal and public health responsibilities for supporting neurodivergent people via public education, training, policy and legislation. By providing spaces and places where neurodivergent people can be their authentic, unmasked selves, we are laying the foundations for feeling seen, valued, safe and, ultimately, happy and thriving.
The author would like to acknowledge the assistance of psychologist Victoria Gottliebsen in drafting this article. Victoria is a member of the Oversight Council for the National Autism Strategy.
Josephine Barbaro, Associate Professor, Principal Research Fellow, Psychologist, La Trobe University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Behind Book Recommendations
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It’s Q&A Day!
Each Thursday, we respond to subscriber questions and requests! If it’s something small, we’ll answer it directly; if it’s something bigger, we’ll do a main feature in a follow-up day instead!
So, no question/request to big or small; they’ll just get sorted accordingly
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Q: What’s the process behind the books you recommend? You seem to have a limitless stream of recommendations
We do our best!
The books we recommend are books that…
- are on Amazon—it makes things tidy, consistent, and accessible. And if you end up buying one of the books, we get a small affiliate commission*.
- we have read—we would say “obviously”, but you might be surprised how many people write about books without having read them.
- pertain in at least large part to health and/or productivity.
- are written by humans—bookish people (and especially Kindle Unlimited users) may have noticed lately that there are a lot of low quality AI-written books flooding the market, sometimes with paid 5-star reviews to bolster them. It’s frustrating, but we can tell the difference and screen those out.
- are of a certain level of quality. They don’t have to be “top 5 desert-island books”, because well, there’s one every day and the days keep coming. But they do have to genuinely deliver the value that we describe, and merit a sincere recommendation.
- are varied—we try to not give a run of “samey” books one after another. We will sometimes review a book that covers a topic another previously-reviewed book did, but it must have something about it that makes it different. It may be a different angle or a different writing style, but it needs something to set it apart.
*this is from Amazon and isn’t product-specific, so this is not affecting our choice of what books to review at all—just that they will be books that are available on Amazon.
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5 Things To Know About Passive Suicidal Ideation
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If you’ve ever wanted to go to sleep and never wake up, or have some accident/incident/illness take you with no action on your part, or a loved one has ever expressed such thoughts/feelings to you… Then this video is for you. Dr. Scott Eilers explains:
Tired of living
We’ll not keep them a mystery; here are the five things that Dr. Eilers wants us to know about passive suicidal ideation:
- What it is: a desire for something to end your life without taking active steps. While it may seem all too common, it’s not necessarily inevitable or unchangeable.
- What it means in terms of severity: it isn’t a clear indicator of how severe someone’s depression is. It doesn’t necessarily mean that the person’s depression is mild; it can be severe even without active suicidal thoughts, or indeed, suicidality at all.
- What it threatens: although passive suicidal ideation doesn’t usually involve active planning, it can still be dangerous. Over time, it can evolve into active suicidal ideation or lead to risky behaviors.
- What it isn’t: passive suicidal ideation is different from intrusive thoughts, which are unwanted, distressing thoughts about death. The former involves a desire for death, while the latter does not.
- What it doesn’t have to be: passive suicidal ideation is often a symptom of underlying depression or a mood disorder, which can be treated through therapy, medication, or a combination of both. Seeking treatment is crucial and can be life-changing.
For more on all of the above, here’s Dr. Eilers with his own words:
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Want to learn more?
You might also like to read:
- The Mental Health First Aid You’ll Hopefully Never Need ← about depression generally
- How To Stay Alive (When You Really Don’t Want To) ← about suicidality specifically
Take care!
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Black Beans vs Soy Beans – Which is Healthier?
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Our Verdict
When comparing black beans to soy beans, we picked the soy.
Why?
Quite some heavyweights competing here today, as both have been the winners of other comparisons!
Comparing these two’s macros first, black beans have 3x the carbs and slightly more fiber, while soy has more than 2x the protein. We’ll call this a win for soy.
As a tangential note, it’s worth remembering also that soy is a complete protein (contains a full set of the amino acids we need), whereas black beans… Well, technically they are too, but in practicality, they only have much smaller amounts of some amino acids.
In terms of vitamins, black beans have more of vitamins B1, B3, B5, B9, and E, while soy beans have more of vitamins A, B2, B6, C, K, and choline. A marginal win for soy here.
In the category of minerals, however, it isn’t close: black beans are not higher in any minerals, while soy beans are higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. An overwhelming win for soy.
It should be noted, however, that black beans are still very good for minerals! They just look bad when standing next to soy, that’s all.
So, enjoy either or both, but for nutritional density, soy wins the day.
Want to learn more?
You might like to read:
Plant vs Animal Protein: Head to Head
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The Coffee-Cortisol Connection, And Two Ways To Tweak It For Health
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Health opinions on coffee vary from “it’s an invigorating, healthful drink” to “it will leave you a shaking frazzled wreck”. So, what’s the truth and can we enjoy it healthily? Dr. Alan Mandell weighs in:
Enjoy it, but watch out!
Dr. Mandell is speaking only for caffeinated coffee in this video, and to this end, he’s conflating the health effects of coffee and caffeine. A statistically reasonable imprecision, since most people drink coffee with its natural caffeine in, but we’ll make some adjustment to his comments below, to disambiguate which statements are true for coffee generally, and which are true for caffeine:
- Drinking
coffeecaffeine first thing in the morning may not be ideal due to dehydration from overnight water loss. Coffeecaffeine is a diuretic, which means an increase in urination, thus further dehydrating the body.- Coffee contains great antioxidants, which are of course beneficial for the health in general.
- Cortisol, the body’s stress hormone, is generally at its peak in the morning. This is, in and of itself, good and correct—it’s how we wake up.
Coffeecaffeine consumption raises cortisol levels even more, leading to increased alertness and physical readiness, but it is possible to have too much of a good thing, and in this case, problems can arise because…- Elevated cortisol from early
coffeecaffeine drinking can build tolerance, leading to the need for morecoffeecaffeine over time. - It’s better, therefore, to defer drinking
coffeecaffeine until later in the morning when cortisol levels naturally drop. - All of this means that drinking
coffeecaffeine first thing can disrupt the neuroendocrine system, leading to fatigue, depression, and general woe. - Hydrate first thing in the morning before consuming
coffeecaffeine to keep the body balanced and healthy.
What you can see from this is that coffee and caffeine are not, in fact, interchangeable words, but the basic message is clear and correct: while a little spike of cortisol in the morning is good, natural, and even necessary, a big spike is none of those things, and caffeine can cause a big spike, and since for most people caffeine is easy to build tolerance to, there will indeed consistently be a need for more, worsening the problem.
In terms of hydration, it’s good to have water (or better yet, herbal tea) on one’s nightstand to drink when one wakes up.
If coffee is an important morning ritual for you, consider finding a good decaffeinated version for at least your first cup (this writer is partial to Lavazza’s “Dek Intenso”—which is not the same as their main decaf line, by the way, so do hold out for the “Dek Intenso” if you want to try my recommendation).
Decaffeinated coffee is hydrating and will not cause a cortisol spike (unless for some reason you find coffee as a concept very stressful in which case, yes, the stressor will cause a stress response).
Anyway, for more on all of this, enjoy:
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You might also like to read:
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Fat’s Real Barriers To Health
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Fat Justice In Healthcare
This is Aubrey Gordon, an author, podcaster, and fat justice activist. What does that mean?
When it comes to healthcare, we previously covered some ideas very similar to her work, such as how…
There’s a lot of discrimination in healthcare settings
In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
Read more on this topic: Shedding Some Obesity Myths
Does she have practical advice about this?
If she could have you understand one thing, it would be:
You deserve better.
Or if you are not fat: your fat friends deserve better.
How this becomes useful is: do not accept being treated as the problem!
Demand better!
If you meekly accept that you “just need to lose weight” and that thus you are the problem, you take away any responsibility from your healthcare provider(s) to actually do their jobs and provide healthcare.
See also Gordon’s book, which we’ve not reviewed yet but probably will one of these days:
“You Just Need to Lose Weight”: And 19 Other Myths About Fat People – by Aubrey Gordon
Are you saying fat people don’t need to lose weight?
That’s a little like asking “would you say office workers don’t need to exercise more?”; there are implicit assumptions built into the question that are going unaddressed.
Rather: some people might benefit healthwise from losing weight, some might not.
In fact, over the age of 65, being what is nominally considered “overweight” reduces all-cause mortality risk.
For details of that and more, see: When BMI Doesn’t Measure Up
But what if I do want/need to lose weight?
Gordon’s not interested in helping with that, but we at 10almonds are, so…
Check out: Lose Weight, But Healthily
Where can I find more from Aubrey Gordon?
You might enjoy her blog:
Aubrey Gordon | Your Fat Friend
Or her other book, which we reviewed previously:
What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon
Enjoy!
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Aging Minds: Normal vs Abnormal Cognitive Decline
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Having a “senior moment” and having dementia are things that are quite distinct from one another; while we may very reasonably intend to fight every part of it, it’s good to know what’s “normal” as well as what is starting to look like progress into something more severe:
Know the differences
Cognitive abilities naturally decline with age, often beginning around 30 (yes, really—the first changes are mostly metabolic though, so this is far from set in stone). Commonly-noticed changes include:
- slower thinking
- difficulty multitasking
- reduced attention
- weaker memory.
Over time, these changes have what is believed to be a two-way association (as in, each causes/worsens the other) with changes in brain structure, especially reduced hippocampal and frontal lobe volume.
- Gradual cognitive changes are normal with age, whereas dementia involves a pathological decline affecting memory, problem-solving, and behavior.
- Mild Cognitive Impairment (MCI) involves noticeable cognitive decline without disrupting daily life, while dementia affects everyday tasks like cooking or driving.
- Dementia causes significant impairments, including motor challenges like falls or tremors, and dementia-induced cognitive decline symptoms include forgetfulness, getting lost, personality changes, and planning difficulties, often worsening with stress or illness.
To best avoid these, consider: regular exercise, a nutritious diet, good quality sleep, social interaction, and mentally stimulating activities.
Also, often forgotten (in terms of its relevance at least): managing cardiovascular health is very important too. We’ve said it before, and we’ll say it again: what’s good for your heart is good for your brain (since the former feeds the latter with oxygen and nutrients, and also takes away detritus that will otherwise build up in the brain).
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
Is It Dementia? Spot The Signs (Because None Of Us Are Immune) ← we go into more specific detail here
Take care!
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