A STUDENT PERSPECTIVE: HOW HISTORY LEADS US TO NEURODIVERSITY-AFFIRMING OT PRACTICE

Hello readers, this is Angela Lumpert Palacios, SPOT Europe’s Social Media Coordinator and Occupational Therapy (OT) student from Spain. I’m very glad our blogger Aleyna Kayım invited me to discuss this topic for OT Month and Autism Awareness or Celebration Month.  

What is neurodiversity?  

Before diving into this topic; what does “neurodiversity” even mean? The term neurodiversity was coined in 1998 by the Australian sociologist Judy Singer, and it embraces the natural variation of brain functioning within the human species, this is the variety of human neurotypes.  

Neurodiversity is an umbrella term, which encompasses both neurotypical minds and the neurological differences that come with clinical labels such as autism, attention deficit and hyperactivity disorder (ADHD), dyslexia, or dyscalculia among others.  

Going into this read, it’s important to understand that the concept of neurodiversity is built around the idea that neurodivergent people just experience the world differently, rather than in a pathological way.  

What does neurodiversity-affirming OT practice consist of and what are the roots and connections of it to OT history?

Neurodiversity-affirming OT practices are consistent with the assumption that neurodivergent minds are not to be seen or treated as pathological.  

But how can we not see these cases as pathological when neurodivergent individuals are often good candidates for OT therapy? The key is to differentiate between the traits that make them neurodivergent and the aspects of their situation that are a barrier to their goals.  

Going back in history on this subject, if we take a look at the connections between OT history and disability history, we realize OT has historically distanced itself from the biomedical model of disability, which tends to put the focus and even blame on the individual without taking into consideration how the environment plays a role in the person’s ability to participate in activity, occupations and society. Instead, OT framed itself around the biopsychosocial model of disability, for instance, when developing the well-known Canadian Model of Occupational Performance and the Model of Human Occupation.  

Furthermore, and subsequently, to Occupational Science principles and OT practice framework (American Occupational Therapy Association, 2020), our interventions should revolve around occupational health, performance, and goals. This leaves us total space for practices that offer resources, tools, and strategies intending to increase their autonomy, functionality, engagement, and satisfaction in their activities of daily living (ADL) and significant occupations. In the same way, neurodiversity-affirming OT practices avoid setting goals aiming to make the client appear neurotypical or promoting the masking of neurodivergent traits.  

In brief, neurodiversity-affirming OT practices aim to switch perspectives from a fixed approach to embracing the different neurotypes, and so accommodating and adapting to their needs to achieve their occupational goals.  

Personal/reflections/opinions

As an ADHDer or someone born with ADHD who considers themselves part of the neurodiversity community and is studying to become an occupational therapist, I try to make sure when setting goals for neurodivergent individuals that these goals we are setting are respectful of purely neurodivergent traits and centering the intervention around the clients’ needs and wants.   

I hope to have given an insight into the possibility of neurodiversity-affirming practices in our profession and maybe even have sparked some curiosity on how to integrate that into your professional practice.  

REFERENCES

1. Santhanam, S. P. (2023). An interactive and neurodiversity-affirming approach to communication supports for autistic students through videogaming. Language, Speech, and Hearing Services in Schools, 54(1), 120–139. doi:10.1044/2022_LSHSS-22-00027 

2. Dallman, A. R., Williams, K. L., & Villa, L. (2022). Neurodiversity-affirming practices are a moral imperative for occupational therapy. The Open Journal of Occupational Therapy, 10(2), 1–9 doi:10.15453/2168-6408.1937  

3. Kornblau, B. L., & Robertson, S. M. (2021). Guest Editorial—Special issue on occupational therapy with neurodivergent people. American Journal of Occupational Therapy, 75, 7503170010. https://doi.org/10.5014/ajot.2021.753001  

1. Strand, L. R. (2017). Charting relations between intersectionality theory and the neurodiversity paradigm. Disability Studies Quarterly, 37(2). https://doi.org/10.18061/dsq.v37i2.5374  

1. American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001  

2. Toro, J., Kiverstein, J., & Rietveld, E. (2020). The ecological–enactive model of disability: Why disability does not entail pathological embodiment. Frontiers in Psychology, 11, 1162. https://doi.org/10.3389/fpsyg.2020.01162  

3. ARMSTRONG, T. (2011) The power of neurodiversity: unleashing the advantages of your differently wired brain. Boston: Da Capo Lifelong Books. 

4. AUSTIN, R.D. and PISANO, G.P. (2017) Neurodiversity as a competitive advantage. Harvard Business Review. Available at: https://hbr.org/2017/05/neurodiversity-as-a-competitive-advantage [Accessed 6 October 2017].  

5. Neurodiversity at work | CIPD. (n.d.). CIPD. https://www.cipd.co.uk/knowledge/fundamentals/relations/diversity/neurodiversity-work