How I Make My Practice Neurodivergent-Affirming

Once upon a time, the goal of a lot of therapies and early interventions for neurodivergent children (primarily autistic children, but this could also include other types of neurodivergence, such as attention-deficit/hyperactivity disorder, or ADHD) was to ensure neurodivergent children could assimilate into a neurotypical world. Here’s the thing - we now know that forcing neurodivergent children to assimilate the best they can leads to dysregulation and, potentially, autistic burnout. Autistic burnout occurs when autistic people are forced to mask for prolonged periods of time, which can lead to exhaustion, a diminishment in skills, and low tolerance to stimuli. When we take a step back, it’s also important to question why neurotypical traits are considered to be the default.

In all of my work, whether children are neurodivergent or not, my goal is to provide a safe space where children can show up authentically and explore their own intensity and challenges so they eventually learn how to regulate through those experiences. Masking essentially teaches kids that they need to compartmentalize their own feelings and needs and have to show up as someone other than who they truly are to be accepted and successful.

So, what does my work look like to ensure neurodivergent kids can show up as their authentic selves and feel affirmed? Read more below.

1. My treatment goals never include things related to appearing more neurotypical or getting better at masking.

You won’t catch me forcing children to make more eye contact or limiting how much they can talk about their special interests. Treatment goals are individualized based on individual needs and challenges, but when working with neurodivergent kids, I’m often focused on how we can increase regulation and be able to identify feelings and needs so children can receive the appropriate support. This allows children to experience what it feels like to show up authentically and start to learn how to self-advocate for their needs outside of sessions.

2. I’m mindful of sensory needs.

We all have unique sensory needs, but this becomes especially important when working with neurodivergent kids. Some kids require more sensory input and focus better when they’re able to incorporate movement or multitask. Some kids are extra sensitive to sensory input, and we can figure out what would help - dimming the lights? Using noise-cancelling headphones? Making sure the scents in the office aren’t overbearing? Again, sessions become an opportunity to better understand your child’s unique sensory profile, identify ways to meet needs, and figure out how those needs can be met outside of sessions.

3. I understand stimming is a regulation strategy.

I’m always looking at what children naturally gravitate toward when identifying regulation strategies that support them - stimming gives us so much information about how children are already regulating. I’m always scanning for where the energy naturally seems to be going for kids (for example, do their stims focus on releasing movement via their hands) and movements that seem to be regulating, such as spinning or hanging upside down. If stims are causing some sort of self-harm, I’ll work with children and families to identify replacement strategies that still honor the regulatory need but reduce harm.

4. Sessions are child-led.

This is another one that applies whether children are neurodivergent or not, but neurodivergent children, in particular, seem to interact with so many spaces in which they’re told how to behave (and often given the message, either directly or indirectly, that how they act is “wrong” in some way). Play therapy sessions are ultimately the child’s space. Children are allowed to tell me when they want to pause or stop an activity. Children can move around or multitask as we talk and play. And I make time and space for kids to engage in and talk about special interests. Ultimately, I trust that children naturally know what they need and how to heal when they’re given the space to do so - I know sessions will unfold in the way that they need to.

5. My work is not just in sessions - it’s also collaborating with systems and advocating as necessary.

Neurodivergent kids might meet with a variety of providers and might need more support at school. I highly value collaborating with other providers and systems to ensure we’re all providing the best support we can and advocating for extra support if needed.