Building resiliency for neurodivergents
In terms of neurodivergent affirming care, if your approach does not include knowledge of systemic adversities and a commitment to continually educate yourself on the different types of systemic oppression neurodivergent individuals face, including considerations of intersectionality, then you are NOT truly providing neurodivergent-affirming care.
In terms of neurodivergent affirming care, if your approach does not include knowledge of systemic adversities and a commitment to continually educate yourself on the different types of systemic oppression neurodivergent individuals face, including considerations of intersectionality, then you are NOT truly providing neurodivergent-affirming care.
This is a point I made at my ASHA presentation in 2023:
If you cannot honestly acknowledge the reality that neurodivergent people will face discrimination, bias, and stigma, throughout their lives, you are not fostering resilience in them.
That is, for any marginalized group, there is not and never will be a" perfect strategy” to avoid systemic adversity.
And I get it. As experts in communication difficulties, it is incredibly hard for speech-language pathologists (SLPs) to admit that there is no perfect way to communicate or advocate that guarantees all needs will be met in all environments with all people. A neurodivergent child could be taught to advocate clearly for their sensory needs, but if the adult in charge assumes it's an avoidance tactic, the child’s needs still won’t be met. Communication can bridge gaps, but it cannot overcome deeply entrenched biases or power differentials.
The reality is that individuals do not have the power to “fix” the systemic adversity they will face. And for a member of any marginalized group, acknowledging the limits of individual power in the face of entrenched societal bias is essential for teaching resilience. As much as we want to fix things, we must accept that some things cannot be changed within our lifetimes. It is knowledge of societies’ faults and systemic oppression that allows for marginalized groups to build safe communities where they can learn to cope.
Let’s face the facts: Attributing mistreatment to the behavior of the marginalized individual is victim blaming.
For all children, the power dynamics between them and adults are beyond their control. Especially in the case of young children, adults almost always have more physical power than them and are usually authorities over them (e.g., parents, guardians, teachers). And for neurodivergent children, their treatment is entirely dependent on adults’ interpretations of what their behaviors mean. Most adults will also face an imbalance of power in the workplace. And neurodivergent adults will very likely face ableist bosses and/or systemic bullying at some point in their career.
Without awareness of systemic oppression, this leads to the neurodivergent (and other marginalized people) to internalized that they deserved the chronic mistreatment they’re experiencing. That it is their fault for not advocating well enough, not meeting expectations, not being “good enough” to deserve equity. And guess what? There’s widespread evidence to show that this has extremely negative impacts on a person’s mental health throughout their life. Hence, I believe it would be incredibly difficulty (if not impossible) for a marginalized individual to build true resiliency without an understanding of the systemic sources for their adversities.
What does this mean for the SLP? While it breaks our hearts, we have to face the truth that there is no way to communicate so perfectly that all your needs will be met and everyone will accept you and love you. That's not going to happen for ANYONE, much less so for neurodivergents. Anyone who is a part of any marginalized group that's had any level of systemic adversity can tell you there is no perfect way to maneuver through systemic adversity and oppression such that it never impacts you. For example, if you take like a neurodivergent child and you teach them this perfectly polite, crystal-clear way of advocating for their sensory needs but then you put them in a classroom where staff members assume that the child is “avoiding” or “manipulating” rather than requesting a need, then guess what? That child’s needs are going to be neglected.
As SLPs, if we promote communication as a universal fix, we set our clients up for failure. While it might seem like dealing with the systemic adversities faced by neurodivergent individuals is outside our scope, it isn’t. And we already deal with similar issues when working with people who stutter (re: facing societal bias and stigma). This isn't new to our practice — what’s new is shifting our perspective and accepting that our neurodivergent clients will face social adversity. If we do that, we can help them to understand that mistreatment from bias and discrimination is not something they can prevent nor is it their fault for not communicating “right.”
Communication can bridge a lot of things, but it is not a guaranteed defense against deeply entrenched societal biases — especially those held by people in positions of power.
Examples of how to start building resiliency and understanding of systemic adversity:
“You’re doing great at knowing what you need to calm your body, but a lot of adults DON’T know this and aren’t as good at it as you are.”
NOTE: I used this exact line with autistic preschoolers (who had an, IMHO, anxious teacher), so this can be used with any school-aged child.
In terms of respect, understanding, and trust, real friendships go both ways — in regards to shifting from thinking of teaching masking to “help them make friends."
Non-apparent neurodivergents (i.e., those that have the option to mask) will NOT be able to unmask 100% of the time in all contexts.
That is, the world is not 100% understanding and accepting of neurodivergents, so they will not feel safe to unmask in all contexts.
Intersectionality exists and impacts both apparent and non-apparent neurodivergents.
That is, racism, sexism, queerphobia, fatphobia, etc… all exist — and they all impact how other people will perceive you before they even know of your neurodivergency.
“A lot of employers won’t understand or be willing to accommodate X, but some will.”
You don’t have to “love yourself” to be deserving of friendship or romance. But, when you have access to a safe community, you can fall in love with being yourself.
Reframing Autistic Labels: Beyond Severity and Functioning
It all begins with an idea.
Ah. Social media. The dumpster-fire of our lives. Where the discourse around who’s is really autistic or ADHD is raging out of control:
“Oh, you think you have autism, do ya? Well, you’re not severe enough to have autism! A friend of mine has a coworker with a child who is profoundly autistic. They’re so low functioning they can’t even talk! That’s what autism REALLY is. You just want attention. You faker.”
Honestly, I’ve had an issue with the labels we use to talk about all the different needs neurodivergents face. This is particularly evident in autistic discourse and has gotten even more heated over the years. As more and more late-diagnosed, adult advocates show up online, more and more people start to debate gatekeep the term AUTISM and who really has the “right” to that term.
“Is it for seemingly “low support needs” people? Should it only be for the “severe-to-profound” autistics? Are late-diagnosed autistics burying the voices of “higher support needs” autistics? What about the non-speakers? Do the same advocacy messages still apply to them? ”
One of the core issues here, as I see it, is in how we categorize and label the incredibly diverse spectrum of neurodivergents — and how incorrect labels can all too easily derail discussions about societal barriers . I think I might have come up with a solution to help.
You might have heard terms like "high-functioning" or "low-functioning" used a lot. These are NOT preferred labels. They can be pretty dehumanizing. Imagine being told you’re "low-functioning” as a human – not a great feeling, right? And as a speech-language pathologist in the schools, all too often I would hear staff talking about how “low” a student was when what they were really saying was the student was non-speaking.
The reason for this disability stigma and is something called the “spread effect” — where people assume one aspect of a person’s disability impacts the whole person. It is biased on dangerously discriminatory and blatantly erroneous assumptions.
So, instead of relying on these labels, the current best-practice is to focus on the type of support the neurodivergent needs. I think this is great when we’re talking about individuals! It’s super important for education teams and service providers to know if someone needs physical supports for ambulation or if they have a cochlear implant for hearing, etc.
But here's the thing – a lot of people have adopted this to talk about the amount of support groups of neurodivergents need. And I’ll give you one guess as to who someone’s talking about when they say “high support needs.”
Yup. Non-speakers again. Same stigma. Same bias. Same dehumanization. Ugh.
As I see it, the issue is we’re trying to apply terms intended to indicate individualized care to groups of people and the barriers to support that they face. And when you’re talking about a HUGE spectrum of highly diverse people, individualized terms will never apply well to a large group. However, for the sake of advocacy for systemic change and even for research into best practices, categorization by groups does matter.
So, here’s my proposal: Let's shift the conversation to focus on the social barriers that neurodivergents face. To do this, I think it comes down to two main categories based on disability type: apparent or non-apparent disabilities.
NOTE: It's important to remember that these categories aren't set in stone. They can change depending on all sorts of factors like age, different environments (noisy vs quiet), and health status changes.
Apparent neurodivergents have one or more “obvious” disabilities.
They might have muscle impairments, significant sensory needs, selective mutism, co-morbid severe-to-profound hearing loss, etc. People know they’re disabled from looking or hearing them, and so they’re immediately treated differently. Due to this, they’re not really given the option to mask socially — they’re just stigmatized immediately: Socially isolated from their peers, denied access to supports (i.e., not presumed competent), and have overtly costly medical support needs that aren’t always met by the system. Additionally, their parents/guardians/family caregivers are grossly under supported and are in desperate need of: More time off from caregiving duties to actually enjoy their time with their family member, waaayyyyy more access to free mental health support and more ethical answers to “what happens to them if I’m not around?”
Non-apparent neurodivergents do not have “obvious” disabilities.
Most late-diagnosed adults fit into this category as children — with the exception of BIPOC and women who are often misdiagnosed or just missed altogether. They could have significant mental health issues, learning disabilities, auditory processing issues, etc., but not any obvious visual and/or auditory “tell.” When other people meet them, they think “this person is like me.” Due to that, they are initially accepted by friends, teachers, etc., but then experience social rejection and isolation. This results in them learning to mask their differences to try to be safe from rejection. However, masking doesn’t usually work perfectly, so they still experience bullying/teasing from both peers and adults and they have their disability denied over and over, usually with the accompanying shame of “you’re just lazy” or “you’re too sensitive.”
Ultimately, let's stop focusing on what we think people can't do and start focusing on what the system needs to do.
