Neurodiversity-Affirming Practices in our Speech Therapy

10 Key Principles We've Learned Along the Way

January 5, 2024

If you’ve explored the Curated Communication website/social media, then you may have come across the term "neurodiversity-affirming". 

Neurodiversity is the concept of differences in individual brain function amongst a group of people. 

To be neurodivergent, is to have a brain that operates in a way that is different from what is considered ‘typical’. This includes but is not limited to autism, ADHD, dyslexia, anxiety, and Down syndrome. Curated Communication is committed to providing neurodiversity-affirming practices. We cultivate an environment that embraces individual differences, values and supports those differences, and strive to reduce stigma and increase acceptance in society. But what does that look like within our therapy sessions? 

Here's what you can expect:

1. Using inclusive, non-judgemental language

We write reports and speak about our clients in a way that recognizes their differences, emphasizes their strengths, and acknowledges what support helps them succeed. For example, “Client has difficulty maintaining attention” would be instead modified to “Client benefits from use of fidgets to maintain attention”. We also use preferred terminology (e.g. ‘autistic’ vs ‘has autism’), and describe support needs rather than using functioning labels (“high- and low-functioning”).

2. Following a strengths-based approach

To focus on strengths and abilities rather than deficits means that we gather information about the client’s strengths, then use that information to develop strategies that support their learning. 

3. Prioritizing client’s interests

Interests are utilized as a foundation of therapy, and activities are selected based on the interests of the client. This inherently creates more natural and motivating learning opportunities.

4. Accommodating for sensory needs

Because sensory regulation is a pillar of successful therapy, we adapt the environment to suit the needs of the client. Guiding our clients in maintaining sensory regulation can include providing flexible seating/standing options, movement when needed, and calming input when highly active. This helps clients achieve optimal learning. 

5. Valuing connection over compliance

The most successful therapy is built on respect, empathy and trust. We believe that “kids do well if they can” (Dr. Ross Greene), so if a child is showing avoidance or not doing well in an activity, we affirm and honor their wishes and modify the activity accordingly.

6. Fostering intrinsic motivation

Offering rewards for an already internally rewarding behavior reduces motivation (Levy, A., DeLeon IG., Martinez CK., et al., 2017; Warneken F. & Tomasello M., 2008; Lepper, M.R., Greene, D., & Nisbett, R.E., 1973; Deci E. 1971). Rather than offering rewards, we foster intrinsic motivation by giving choices over the environment and activities, creating opportunities to accomplish challenges, and selecting activities that relate to our clients on a personal level. Learn more about intrinsic motivation on our blog here.

7. Presuming Competence

We will always assume our clients have the ability to understand, think, and learn. This gives clients the opportunity to demonstrate their true capabilities.

8. Respecting bodily autonomy

We use methods that allow children to exercise their right to bodily autonomy and self-advocacy. This includes obtaining consent from the child before touching/picking them up, honoring their protests, and if necessary, utilizing hand-under-hand support (therapist’s hand is under the client’s, which allows the client to withdraw their hand at any time).

9. Honoring all forms of communication

Communication is a human right and we accept it in all of its forms. We give access to multiple communication modalities, whether that be sign language, AAC device, mouth words, facial expressions, or body language. We educate our families that no single form of communication is superior and that introducing multiple options removes barriers to communication.

10. Writing neurodiversity-affirming goals

Taking all of these principles into consideration, we create goals that encourage self-advocacy, prioritize functional communication, strengthen problem-solving, emphasize emotional regulation, are important to the client, and do not contradict their natural neurodivergent functioning. For that reason, we avoid goals that focus on neurotypical social skills (e.g. eye contact, conversation maintenance, ‘appropriate play’, facial expressions, etc.). Those goals encourage masking which can lead to depression, anxiety, and burnout. We advocate that the neurodivergent way of communicating is valid.

Our goal is to teach neurodivergent children skills that will help make their life easier, foster a positive self-identity, and accept themselves. We hope to be examples for our peers, and teachers to our clients and their families…. then maybe make a change in our society’s comfort of normative culture.