Comic-style image themed to depict a reader overwhelmed by online marketing claims pressuring user to buy products and courses to be considered a neurodiversity-affirming SLP

Summary: This post is for any SLP feeling overwhelmed when it comes to neurodiversity-affirming speech therapy and associated marketing. The neurodiversity movement advocates for accepting brain differences and trying to understand and accommodate rather than change individuals. Listening to your students and being open to learning about their views and experiences are totally free.

Neurodiversity can be overwhelming. But it doesn’t have to be.

When I was first exposed to neurodiversity, I certainly found it overwhelming. (Although, spending hours hyperfocused on learning everything I can find on a new topic of interest will do that.) Now, there’s even more information available about neurodiversity and it’s growing every day. That is exciting! But it can also be overwhelming if you’re not sure where to start.

It can be overwhelming if you hold yourself to unrealistic standards of needing to “get neurodiversity perfect” or it’s not worth even trying. This kind of thinking isn’t helpful; it’s always worth trying.

Trying is how we learn. And that means we’re going to fail sometimes, and we first have to be comfortable with and realistic that we’re not going to be perfect neurodiversity-affirming therapists instantly. Neurodiversity-affirming practice is a lifelong commitment to learning, growing, and doing a little better than you did yesterday.

Neurodiversity isn’t a product to buy.

Contrary to some of the marketing I’ve seen online, you don’t need to spend money to be a Neurodiversity-Affirming SLP. If you’re feeling overwhelmed, take a deep breath.

You’re not automatically an ableist SLP if you don’t buy a certain course or training. You’re not disrespecting the neurodivergent community by ignoring marketing claims that you NEED a certain assessment or therapy material to be neurodiversity-affirming. You do not need to feel guilty for not paying for every neat and useful neurodiversity resource out there.

Now, some paid products can certainly help with implementing neurodiversity-affirming practices. I’m not arguing against charging for someone’s time and effort. If someone is selling you a product that’s neurodiversity-affirming, they’ve likely put in a lot of work, research, design, and overall thought into it. Paid products can be convenient, quick, simplify the process, and look professional, but remember they are not necessary to consider yourself a neurodiversity-affirming therapist.

To be a neurodiversity-affirming SLP, you simply need to understand what the neurodiversity movement is, why it’s important, and make an effort to adapt your practices based on that knowledge to align yourself with the neurodiversity movement.

I’m going to break down the broad definition of neurodiversity, describe the social and medical models of disability, and discuss some changes you can make to be more neurodiversity-affirming. Because once we know better, we can do better.

What is neurodiversity?

The word “neurodiversity” can be broken down into two parts: neuro = brain, diversity = different. Simply put, neurodiversity means there are many kinds of brains that exist and different ways brains operate. Neurotypical is a brain that operates “typical” to our societal social norms, and a brain that operates differently, we call neurodivergent, diverging from typical.

There’s a huge range of conditions established from birth that can make a brain operate differently – it’s not only autism and ADHD – although these conditions tend to be at the forefront of discussions centered around neurodiversity. Other neurodivergence may come from developmental disorders, learning disabilities, dyslexia, stuttering/cluttering, epilepsy, just to name a few. In addition, neurons can be rewired to operate differently after birth, so mental illness and trauma disorders are also considered neurodivergence.

Sometimes it can be difficult to discern whether a brain is neurodivergent from a biological condition, like autism or ADHD, or an environmental one like trauma, or both. Regardless, neurodiversity is simply a fact of nature – brains are different.

This makes sense, but the neurodiversity movement takes a stance on the subject. These differences should be accepted as natural human variation. Just because neurotypical may be the majority brain, doesn’t mean that it is the right brain.

Contrary to our testing materials, there is no “gold standard” of brains.

The neurodiversity paradigm that underpins the movement proposes that each neurotype (type of brain) has a distinct profile of strengths and weaknesses and emphasizes they are all valuable.

Social model of disability vs medical model of disability

The neurodiversity movement promotes adopting a social model of disability, a stark contrast from the standard way we view and treat disability, the medical model.

The medical model of disability operates under the belief that the individual is disabled and needs to be fixed. While the social model considers that the world is disabling and needs to be fixed. Why focus on molding individual trees when we can improve the environment for the entire forest?

Consider the advocacy efforts by physically-disabled people to make all spaces accessible for wheelchair users. Despite having a physical impairment, the lack of ramps and elevators were more disabling than their physical disability.

That is very different thinking from the medical realm, including speech-language pathology. We deal in medical diagnoses, disability criteria, goals, treatment. Where is there room for considering a social model of disability? you might ask.

Advocacy work and societal change is not an easy undertaking. But they remain important. Because every person deserves to be treated like a unique individual to accommodate rather than a disability to fix.

When we see neurodiversity as a form of natural variation of human brains, we let go of fixating on those differences we consider disabilities. This doesn’t mean a person is no longer disabled; it means we accept that disabilities are a natural occurrence. Our focus becomes helping the person navigate their disability rather than treating and eliminating it.

Therapy aligned with the medical model

Therapy that operates under the medical model of disability will center their care on eliminating or mitigating the disability’s impact on society.

What does that look like in SLP?

  • Be more fluent – eliminate or dramatically reduce the stutter so it is not noticeable to others
  • Articulate each sound properly and without errors or distortion
  • Converse using turns of equal length and asking follow-up questions
  • Speak like a typical child is expected to
  • Quiet hands, quiet body, “active” listening and making eye contact
  • Use conventional social greetings and engage in small talk
  • Initiate conversation on non-preferred topics
  • Reduce discussing special interests and monitor whether the listener appears bored
  • Make and rehearse social scripts for certain scenarios or situations

If we think about it, most of what we do as speech-language pathologists is historically based on the medical model of disability. In the schools, the student may become eligible to receive speech/language services after they are labeled with a disability. These services are to service the disability rather than the child.

Adopting a neurodiversity-affirming speech therapy mindset

We can’t throw out the medical model completely, even if we wanted to. And I’m not saying we need to stop doing ALL of the above items I listed as examples of the medical model of disability. Some of these practices I still do, like making social scripts, but we can adjust how we’re viewing our therapy when working with our students or clients. We can still make social scripts, but teach the scripts as an option the student has to reduce their anxiety in a specific situation, not to master performing “expected” behaviors in front of others.

We want to emphasize therapy as reducing negative impact their disability has on them, not remediate their disability.

I remind my students that because of my job, I still have to make a specific goal and take notes on that goal. But real-person Ms. Julia is not concerned about my students meeting their on-paper goals or achieving perfect accuracy; I am concerned about whether their communication is negatively impacting them.

Many of my students are surprised when I tell them this. Or they’re unsure, ask if I’m serious. But no student has ever told me I shouldn’t care so much about them and should care more about their disability. And more of my students are progressing after embracing the social model of disability over the medical one. Because suddenly the therapy becomes about them, not just about their disability.

Some examples of practicing the social model of disability:

  • Build comfort with stuttering so they participate more and share what they want to say
  • Work on speech to reduce their anxiety with speaking or reduce frustration
  • Compensatory strategies
  • Self-advocacy skills
  • Understand the purpose of small talk and examples (so the student can decide whether they want to engage in it or not)
  • Make and rehearse social scripts for certain situations to reduce anxiety or avoidance
  • Presume competence in AAC / No pre-requisites for access to low or high tech AAC
  • Working with Natural Language Acquisition/Gestalt language processing

Not all goals need to change when adopting a social model of disability. Sometimes you can work on the same goals if you adjust the lens from which you’re viewing and framing the therapy, such as using social scripts. Some goals, such as eye contact and “active listening” body language, are not fitting for a social model of disability.

When we focus on helping the child vs their disability, when we have the mindset to see and meet their individual needs, only then can they begin to thrive.

Where to go from here

Practicing the social model of disability does not inherently cost money. Work to emphasize accommodating a person’s needs and abilities in your therapy, not rehabilitating a disability to accommodate society’s expectations.

Remember, the neurodiversity movement is not about finding a holy-grail product; it is about treating people with different types of brains with dignity and respect for their individual views and experiences.

This post was just a start when it comes to the wealth of knowledge out there on neurodiversity. I encourage you to continue reading and learning more from listening to people with disabilities and their experiences. Similar to developing cultural competence, you’re not going to completely reverse internalized ableism in one training, one course, with one assessment or therapy material. It’s an understanding we continually mold throughout our lives.

Just by getting here, you’re certainly off to a good start. If you want to learn more about the neurodiversity movement and neurodiversity-affirming speech therapy, you can check out the Therapist Neurodiversity Collective which was started and is run by an Autistic SLP.

If you found value in this post, please let me know by commenting below.

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