Embrace Neurodiversity-Affirming Therapy with These Three Simple Shifts

The conversation around autism and providing social-communication interventions for this population is changing for the better! Many of us received our education and training in a paradigm that focused on "fixing" the characteristics of autism to make autistic children look more neurotypical. This included treating characteristics of autism like stimming and echolallia as "undesirable behaviors" that needed to be extinguished.

The shift toward neurodiversity-affirming therapy allows us to look at the whole child rather than treating them as a collection of behaviors. It encourages us to focus on connection over compliance and build on the strengths and interests of each individual child. It prioritizes relationship-based approaches that help our children flourish!

Start embracing neuro-diversity affirming therapy with these three simple shifts:

1. Change the way you talk about autism.

2. Focus on connection instead of compliance.

3. Build on strengths and interests rather than "trying to fix" deficits.

Let's spend a little time talking about each of these points and what this may look like in practice.

1. Change the way you talk about autism.

Avoid language with a negative connotation. You can discuss the characteristics and signs of autism without alluding to "red flags". You can step away from presenting a stereotypical view of autism and educate families on the spectrum of differences in language, interaction, interests, and sensory experiences. The reality is no two children with autism present exactly alike. We can talk about autism as a different neurotype and "a different way of being" and educate families on these brain differences without assigning value to them. The more we understand these brain differences, the more equipped we are to provide appropriate support and intervention!

2. Focus on connection over compliance!

If I am being honest, a LOT of what I learned about autism early in my career centered around compliance. Therapy was focused on diminishing a "negative behavior" or teaching a "positive behavior" and using rewards as the primary teaching tool. I think so many of us can relate to that gut feeling that this approach didn't feel right. For me, it didn't feel right because it felt like training instead of teaching and lacked connection. Connection is the foundation of communication and focusing on connection first and foremost in therapy can change everything!

Connection looks like following the child's lead, incorporating their interests, focusing on fun, modeling without expectation, and acknowledging their communication cues while responding accordingly. We are letting children protest and teaching them to say no! We are concerned with building a relationship, not forcing task completion. We are also stepping away from compliance-based strategies like using hand-over-hand prompting and withholding favorite items or sensory breaks. Instead, we are using child-led play and sensorimotor activities as the therapy, not the reward!

3. Build on strengths and interests.

Start from the beginning by using a strengths-based caregiver questionnaire (linked below). Asking questions like "when is your child happiest?", "what do you enjoy doing together?" and "how do they like to play?" will provide you with a starting point in your relationship-based therapy sessions. You can connect with a child by embracing these unique interests and build on their strengths to better support communication skills. When we focus on the unique strengths and interests of each child, we can write goals that support the child and their family and meet them where they are. We can focus on providing access to communication, supporting regulation, and teaching self-advocacy skills, rather than goals that are written to make a child look more neurotypical.

As early intervention providers, we have a unique opportunity. We are often the first professionals to talk to families about autism. We can truly set the tone for the way a family thinks about autism and views their child's journey. We can celebrate their wonderful child and also sit with them in the challenges. A neurodiversity-affirming approach allows us to better connect with a child and their family, while providing meaningful support that positively impacts their daily life.

Early intervention is a magical, exhausting, inspiring place to be.

Keep doing great things!

Laura Brown, MA, CCC-SLP

Strengths-Based Caregiver Questionnaire

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