As a pediatric occupational therapy practice committed to excellence, we are continually learning from research and the stories of those kids and families we serve. One of the biggest revolutions in the pediatric therapy community in the last decade is the neurodiversity movement.
The movement is centered on inclusion and identity around the concept of neurodiversity¹. To be clear, neurodiversity has always existed. What is different now is how we’re taking what we’re learning from research and neurodiverse experiences to change the default expectations that are based on neurotypical preferences.
So what does the term neurodiversity mean?
Neurodiversity is a term defined by sociologist Judy Singer. Her work spotlighted the range of variations in the human brain that lead to differences in how people think, learn, and perceive the world². Her stance initially felt new and revolutionary to many people but in reality, she merely pointed out natural differences that have always existed and inclusion-based solutions everyone could understand.
Prior to this, neurodevelopmental diagnoses like Autism or ADHD were seen as conditions that needed to be fixed and that individuals were deficient if their brains worked differently. With the neurodiversity movement, the emphasis moves to seeing brain differences as part of the person and honoring both the strengths and challenges of a neurodevelopmental diagnosis.
In the real world, this shifts our thinking to providing inclusion and accommodation over “fixing” the condition and focusing our efforts and support on advocacy and empowerment. These changes help give confidence to kids so they feel affirmed as themselves versus fighting an uphill battle that works against their neurology to fit the expectations of “typical” learners.
As we say at Bearfoot OT, “We don’t ‘fix’ kids (they’re not broken!). But we do address the underlying challenges so daily life feels easier and more joyful.”
Here are some diagnoses that fall under the neurodiversity umbrella:
ADHD
Autism
Dyslexia
Sensory Processing Disorder
Tourette Syndrome
Dyspraxia
Let’s take a closer look at how neurodiversity-affirming practices show up in our work with kids.
We’ll discuss:
The language we use
Responses and expectations
Strategies we use and recommend
Many of these ideas easily carry over to how you can support your neurodiverse child or neurodiverse children in your life!
Neurodiversity Impacts the Kinds of Words We Use
A shift has come out of the neurodiversity movement regarding changes in the language that is used. Advocates, along with those in the disability community, correctly pointed out that commonly used phrases like “person with autism” or “low functioning autism” were weighted with stigma.
So what you’ll see with the shift to neurodiverse-affirming practices is much-needed language updates that affirm identity, spotlight strengths, and decrease negative labels.
Switching to Identity-First Language
This means including the divergent label in front of the personal noun. A common example of identity-first language is “autistic child” versus “child with autism.”
Here’s why this matters:
A difference in the brain is part of a person’s ongoing identity that is not going to resolve, so we need to reflect that in the language we use. This is not only preferred but putting the identity in front of the personal noun helps to reduce social stigma related to disability³.
This preference comes out of survey results from autistic adults who indicated they preferred identity-first language. This language pattern better reflects that neurodiversity is not a negative thing a person is expected to cure or overcome. For instance, compare this to saying a “person with depression” or a “child with cancer.”
Other examples of neurodiversity-affirming language:
Avoid labels like low and high functioning
Substitute the term “non-speaking” for the term “nonverbal”
A child doesn’t “have autism,” they “are autistic”
“Individual needs” versus “special needs”
Another example is simply using the term neurodivergent. As in, “I have a neurodivergent child.”
Want more ideas? Head to this resource for a more complete list of ideas to use yourself or share with others!
At the center of our language choices are the unique preferences of the child and their family. Terminology can continue to shift and evolve throughout the journey. As a practice, Bearfoot OT leans towards identity-affirming language but ultimately honors the preference of each individual family.
Adjusting Our Responses and Expectations
When switching to neurodiversity-affirming practices, instead of working to eliminate the effects, you honor differences, accommodate, teach others how to support a child, and find mutually beneficial ways of interacting with each other.
As therapists or parents, this looks like adjusting our responses so we don’t jump to labeling a kid’s actions or emotions. It’s far too easy to struggle in the situation with a child and think, “They need to try harder” or “They’re doing it wrong or being difficult.”
Instead, we look at what their actions, emotions, and bodies are telling us about their needs or experience of the world.
For instance, if a child is struggling to follow directions during a therapy session, we don’t automatically assume they aren’t paying attention. Our response is to reevaluate the task, environment, or our therapeutic approach to see if it’s meeting their needs.
This is where providing occupational therapy in nature works to meet the needs of neurodiverse kiddos. That’s because nature provides endless possibilities for adjusting our expectations and responding in different ways.
Need to be constantly moving? Nature is full of open spaces for safe running and jumping.
Learn best through hands-on activities? Nature offers hands-on learning for every subject.
Get overwhelmed easily by lighting and noise? Nature is a sensory oasis that makes it easier to pay attention.
Prefer to do things your own way? There are no right or wrong ways to experience nature.
Imagine the freedom children can experience when we start by seeing their possibilities instead of asking them to constantly make changes that go against how their brain and nervous system work.
It’s a life-changing shift for sure!
The Focus of Our Therapy Strategies
We create success in therapy for neurodiverse children by putting our emphasis on working in alignment with their strengths and personality.
There still is a place for having a child practice an important skill or work on a behavioral challenge (especially when safety is involved). However, we’re not going to train away behaviors or give rewards for behaviors. Instead, we’re going to start by looking for ways to understand your child and adjust a task or environment to get different results.
We show you how to address your child’s high energy or big emotions without crushing their special spark.
Accepting your child doesn’t eliminate the real challenges your child and family face. Especially when it comes to maintaining physical safety and a household that functions for all members.
Our understanding of what it takes to support a neurodiverse child (and their family) is a big reason for creating an occupational therapy practice with such a strong emphasis on parent education and empowerment. Every family that works with Bearfoot receives a combination of services so they receive needed support beyond the therapy hour.
Ultimately, when you understand your child and how they think and learn — you’re better able to make accommodations and successfully navigate daily life.
And there's a big payoff to this. You’re creating immense opportunity as your child feels comfortable in their own skin while staying safe and living in harmony with friends and family.
Let’s Embrace Neurodiversity Solutions for Kids Together!
It all comes down to a deep respect for kids. Whether a child is neurodiverse or neurotypical, we respect kids in everything we do — from our words to our actions. We want kids to experience a place where their bodies, experiences, abilities, and preferences are respected and celebrated.
At the end of the day, we’re here for the ups and downs of problem-solving and building relationships with kids of all types. It’s a great privilege to provide outdoor OT where meaningful outdoor adventures support incredible kids who face some extra struggles.
If you’re a Bay Area parent who is looking for a neurodiversity-affirming option for occupational therapy, learn more about how we provide therapy services.
References
1. den Houting, J. (2019). Neurodiversity: An insider’s perspective. Autism, 23(2), 271–273. https://doi.org/10.1177/1362361318820762
2. Xiao, Z., Qiu, T., Ke, X., Xiao, X., Xiao, T., Liang, F., Zou, B., Huang, H., Fang, H., Chu, K., Zhang, J., & Liu, Y. (2014). Autism spectrum disorder as early neurodevelopmental disorder: evidence from the brain imaging abnormalities in 2-3 years old toddlers. Journal of autism and developmental disorders, 44(7), 1633–1640. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057630/
3. Gernsbacher M. A. (2017). Editorial Perspective: The use of person-first language in scholarly writing may accentuate stigma. Journal of child psychology and psychiatry, and allied disciplines, 58(7), 859–861. https://doi.org/10.1111/jcpp.12706
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