Neuroaffirming care values the strengths and differences of autistic people, those with ADHD or other profiles. Here’s how

10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

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?

Unsplash

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.

girl sits on couch with colourful fidget toy
Neuroaffirming care can look different in a school or clinical setting. Shutterstock/Inna Reznik

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.

open meeting room with people putting ideas on colourful notes on wall
In the workplace, we can acknowledge how difference can fuel ideas. Unsplash/Jason Goodman

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.

Don’t Forget…

Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

Recommended

    • This Chair Rocks: A Manifesto Against Ageism – by Ashton Applewhite
      Ageism isn’t merely about job prospects as retirement looms; it’s about confronting our self-imposed biases and embracing life at every stage, as “This Chair Rocks” reveals.

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

    • Better With Age – by Dr. Alan Castel

      10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

      This one isn’t about the biology of aging, so much as (as the subtitle promises) the psychology of it.

      Dr. Castel first covers the grounds of what “successful aging” is, and the benefits that can be expected from doing it right. Spoiler, it’s not just “reduced decline”, there are numerous things that actually get better, too.

      We also learn how our memory works differently—it can be worse, of course, but it can also be just different, in a way that tends to tie in with vastness of the accumulated knowledge over the years, allowing for easiest access to the things the brain thinks are most important—ranging from expertise in a certain field, to life-experience “wisdom”.

      There’s a lot of advice that’s mostly not going to be anything new to regular readers of 10almonds, in terms of staying sharp with an active lifestyle and a well-nourished brain.

      The style is very soft pop-science; there are citations dotted throughout, but mostly this is more of a “curl up with a book” book, not a textbook.

      In the category of subjective criticism, it can be a little repetitive (but for those who like repetition for ease of learning, you will love this), and his name-dropping habit gets quite eyeroll-worthy quite quickly.

      Bottom line: if you’d like to learn about the very many ways in which “over the hill” is simply defeatist pessimism, then this book can help you to ensure you do better.

      Click here to check out Better With Age, and get better with age!

      Share This Post

    • To Pee Or Not To Pee

      10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

      Is it “strengthening” to hold, or are we doing ourselves harm if we do? Dr. Heba Shaheed explains in this short video:

      A flood of reasons not to hold

      Humans should urinate 4–6 times daily, but for many people, the demands of modern life often lead to delaying urination, raising questions about its effects on the body.

      So first, let’s look at how it all works: the bladder is part of the urinary system, which includes the kidneys, ureters, urethra, and sphincters. Urine is produced by the kidneys and transported via the ureters into the bladder, a hollow organ with a muscular wall. This muscle (called the detrusor) allows the bladder to inflate as it fills with urine (bearing in mind, the main job of any muscle is to be able to stretch and contract).

      As the bladder fills, stretch receptors in that muscle signal fullness to the spinal cord. This triggers the micturition reflex, causing the detrusor to contract and the internal urethral sphincter to open involuntarily. Voluntary control over the external urethral sphincter allows a person to delay or release urine as needed.

      So, at what point is it best to go forth and pee?

      For most people, bladder fullness is first noticeable at around 150-200ml, with discomfort occurring at 400-500ml (that’s about two cups*). Although the bladder can stretch to hold up to a liter, exceeding this capacity can cause it to rupture, a rare but serious condition requiring surgical intervention.

      *note, however, that this doesn’t necessarily mean that drinking two cups will result in two cups being in your bladder; that’s not how hydration works. Unless you are already perfectly hydrated, most if not all of the water will be absorbed into the rest of your body where it is needed. Your bladder gets filled when your body has waste products to dispose of that way, and/or is overhydrated (though overhydration is not very common).

      Habitually holding urine and/or urinating too quickly (note: not “too soon”, but literally, “too quickly”, we’re talking about the velocity at which it exits the body) can weaken pelvic floor muscles over time. This can lead to bladder pain, urgency, incontinence, and/or a damaged pelvic floor.

      In short: while the body’s systems are equipped to handle occasional delays, holding it regularly is not advisable. For the good of your long-term urinary health, it’s best to avoid straining the system and go whenever you feel the urge.

      For more on all of this, enjoy:

      Click Here If The Embedded Video Doesn’t Load Automatically!

      Want to learn more?

      You might also like to read:

      Keeping your kidneys happy: it’s more than just hydration!

      Take care!

      Share This Post

    • Vegan Eager for Milk Alternatives

      10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

      It’s Q&A Day at 10almonds!

      Q: Thanks for the info about dairy. As a vegan, I look forward to a future comment about milk alternatives

      Thanks for bringing it up! What we research and write about is heavily driven by subscriber feedback, so notes like this really help us know there’s an audience for a given topic!

      We’ll do a main feature on it, to do it justice. Watch out for Research Review Monday!

      Share This Post

    Related Posts

      • 5 Ways To Avoid Hearing Loss

        10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

        Hear Ye, Hear Ye

        Hearing loss is often associated with getting older—but it can strike at any age. In the US, for example…

        • Around 13% of adults have hearing difficulties
        • Nearly 27% of those over 65 have hearing difficulties

        Complete or near-complete hearing loss is less common. From the same source…

        • A little under 2% of adults in general had a total or near-total inability to hear
        • A little over 4% of those over 65 had a total or near-total inability to hear

        Source: CDC | Hearing Difficulties Among Adults: United States, 2019

        So, what to do if we want to keep our hearing as it is?

        Avoid loud environments

        An obvious one, but it bears stating for the sake of being methodical. Loud environments damage our ears, but how loud is too loud?

        You can check how loud an environment is by using a free smartphone app, such as:

        Decibel Pro: dB Sound Level Meter (iOS / Android)

        An 82 dB environment is considered safe for 16 hours. That’s the equivalent of, for example moderate traffic.

        Every 3 dB added to that halves the safe exposure time, for example:

        • An 85 dB environment is considered safe for 8 hours. That’s the equivalent of heavier traffic, or a vacuum cleaner.
        • A 94 dB environment is considered safe for 1 hour. That might be a chainsaw, a motorcycle, or a large sporting event.

        Many nightclubs or concert venues often have environments of 110 dB and more. So the safe exposure time would be under two minutes.

        Source: NIOSH | Noise and Hearing Loss

        With differences like that per 3 dB increase, then you may want to wear hearing protection if you’re going to be in a noisy environment.

        Discreet options include things like these -20 dB silicone ear plugs that live in a little case on one’s keyring.

        Stop sticking things in your ears

        It’s said “nothing smaller than your elbow should go in your ear canal”. We’ve written about this before:

        What’s Good (And What’s Not) Against Earwax

        Look after the rest of your health

        Our ears are not islands unaffected by the rest of our health, and indeed, they’re larger and more complex organs than we think about most of the time, since we only tend to think about the (least important!) external part.

        Common causes of hearing loss that aren’t the percussive injuries we discussed above include:

        • Diabetes
        • High blood pressure
        • Smoking
        • Infections
        • Medications

        Lest that last one sound a little vague, it’s because there are hundreds of medications that have hearing loss as a potential side-effect. Here’s a list so you can check if you’re taking any of them:

        List of Ototoxic Medications That May Cause Tinnitus or Hearing Loss

        Get your hearing tested regularly.

        There are online tests, but we recommend an in-person test at a local clinic, as it won’t be subject to the limitations and quirks of the device(s) you’re using. Pretty much anywhere that sells hearing aids will probably offer you a free test, so take advantage of it!

        And, more generally, if you suddenly notice you lost some or all of your hearing in one or more ears, then get thee to a doctor, and quickly.

        Treat it as an emergency, because there are many things that can be treated if and only if they are caught early, before the damage becomes permanent.

        Use it or lose it

        This one’s important. As we get older, it’s easy to become more reclusive, but the whole “neurons that fire together, wire together” neuroplasticity thing goes for our hearing too.

        Our brain is, effectively, our innermost hearing organ, insofar as it processes the information it receives about sounds that were heard.

        There are neurological hearing problems that can show up without external physical hearing damage (auditory processing disorders being high on the list), but usually these things are comorbid with each other.

        So if we want to maintain our ability to process the sounds our ears detect, then we need to practice that ability.

        Important implication:

        That means that if you might benefit from a hearing aid, you should get it now, not later.

        It’s counterintuitive, we know, but because of the neurological consequences, hearing aids help people retain their hearing, whereas soldiering on without can hasten hearing loss.

        On the topic of hearing difficulty comorbidities…

        Tinnitus (ringing in the ears) is, paradoxically, associated with both hearing loss, and with hyperacusis (hearing supersensitivity, which sounds like a superpower, but can be quite a problem too).

        Learn more about managing that, here:

        Tinnitus: Quieting The Unwanted Orchestra In Your Ears

        Take care!

        Don’t Forget…

        Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

        Learn to Age Gracefully

        Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

      • Keep Your Wits About You – by Dr. Vonetta Dotson

        10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

        Dr. Dotson sets out to provide the reader with the tools to maintain good brain health at any age, though she does assume the reader to be in midlife or older.

        She talks us through the most important kinds of physical activity, mental activity, and social activity, as well as a good grounding in brain-healthy nutrition, and how to beat the often catch-22 situation of poor sleep.

        If you are the sort of person who likes refreshers on what you have just read, you’ll enjoy that the final two chapters repeat the information from chapters 2–6. If not, then well, if you skip the final 2 chapters the book will be 25% shorter without loss of content.

        The style is enthusiastic; when it comes to her passion for the brain, Dr. Dotson both tells and shows, in abundance. While some authors may take care to break down the information in a way that can be understood from skimming alone, Dr. Dotson assumes that the reader’s interest will match hers, and thus will not mind a lot of lengthy prose with in-line citations. So, provided that’s the way you like to read, it’ll suit you too.

        Bottom line: if you are looking for a book on maintaining optimal brain health that covers the basics without adding advice that is out of the norm, then this is a fine option for that!

        Click here to check out Keep Your Wits About You, and keep your wits about you!

        Don’t Forget…

        Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

        Learn to Age Gracefully

        Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

      • Overcome Front-Of-Hip Pain

        10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

        Dr. Alyssa Kuhn, physiotherapist, demonstrates how:

        One, two, three…

        One kind of pain affects a lot of related things: hip pain has an impact on everything that’s connected to the pelvis, which is basically the rest of the body, but especially the spine itself. For this reason, it’s critical to keep it in as good condition as possible.

        Two primary causes of hip stiffness and pain:

        • Anterior pelvic tilt due to posture, weight distribution, or pain. This tightens the front muscles and weakens the back muscles.
        • Prolonged sitting, which tightens the hip muscles due to inactivity.

        Three exercises are recommended by Dr. Kuhn to relieve pain and stiffness:

        • Bridge exercise:
          • Lie on a firm surface with your knees bent.
          • Push through your feet, engage your hamstrings, and flatten your lower back.
          • Hold for 3–5 seconds, relax, and repeat (10–20 reps).
        • Wall exercise with arms:
          • Stand with your lower back against the wall, feet a step away.
          • Tilt your hips backwards, keeping your lower back in contact with the wall.
          • Alternate lifting one arm at a time while maintaining back contact with the wall (10–20 reps).
        • Wall exercise with legs:
          • Same stance as the previous exercise but wider now.
          • Lift one heel at a time while keeping your hips stable and your back against the wall.
          • Practice for 30–60 seconds, maintaining good form.

        As ever, consistency is key for long-term relief. Dr. Kuhn recommends doing these regularly, especially before any expected periods of prolonged sitting (e.g. at desk, or driving, etc). And of course, do try to reduce, or at least break up, those sitting marathons if you can.

        For more on all of this plus visual demonstrations, enjoy:

        Click Here If The Embedded Video Doesn’t Load Automatically!

        Want to learn more?

        You might also like to read:

        How To Stop Pain Spreading

        Take care!

        Don’t Forget…

        Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

        Learn to Age Gracefully

        Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: