This is an image of a rainbow-colored infinity sign. The sign is considered a symbol of the neurodiversity movement.

Advice for Therapists from a Neurodiversity Advocate

Thanks to the success of Steve Silberman’s ‘Neurotribes,’ therapists and service providers have become aware of neurodiversity. On one hand, this is wonderful. A concept Autistic self-advocates have been celebrating for years has hit the mainstream. It seems that therapists and service providers are finally listening to autistic people speak. On the other hand, there seem to be many misunderstandings about what neurodiversity, and by extension allyship, entails. Therapy can only be enriched by neurodiversity, if therapists will let it.

A common misconception about neurodiversity is that we are pushing the idea that autism is not a disability. It’s true that in general, neurodiversity advocates believe that autism is not a ‘disorder.’ You’d be hard pressed to find advocates who don’t consider autism a disability, though. We know, through our lived experience, that autism is a disability. The world we live in was not built for us. Or at least if it had been built for us, it would involve a lot more trampolines.

The distinction people are making is between the medical model and social model of disability. The medical model of disability, for those who may be unfamiliar, puts an emphasis on a disability being something ‘wrong’ with a person. In that model, disability is something to be corrected. Disability itself is seen as a source of reduced quality of life. The social model of disability, on the other hand, focuses on negative attitudes and physical barriers imposed by society, rather than perceived “flaws” in the individual. Neurodiversity rejects the medical model. It does not reject the concept of disability or deny that impairments exist. The primary difference is how disability and impairments are considered and addressed.

Rather than treating autism as something that needs to be corrected, advocates want it to be seen as something to be accommodated, and that disability is largely situational. If someone is in a wheelchair, you can either focus on curing the reason they’re in the wheelchair and let them wait at the bottom of the stairs until you’re done, or you can build a ramp. Neurodiversity advocates want ramps for our brains. What exactly that looks like is still a work in progress, but I encourage professionals to embrace it. Work with us so we can live our best lives.

A white person with brown hair is sitting in a wheelchair at the bottom of a flight of stairs. The person is gesturing in frustration.
I’ll just wait here, then.

I encourage you to consider what the goal of therapy is. Is your therapy designed around compliance and getting an individual to desist from harmless differences like nonviolent stimming or not making eye contact? That’s in opposition to neurodiversity’s goal of making a wider range of behaviors acceptable. This is one of the many reasons neurodiversity advocates oppose applied behavior analysis, or ABA. Being more “normal” shouldn’t be a goal. This is true for a number of issues, not only disability. If a little boy likes wearing dresses and other children are jerks about it, that’s not his cross to bear. The problem is the bullies, not the little boy wearing a dress. People who object to someone fiddling with a toy or not responding immediately with an expected response should be more tolerant of difference. Unfortunately, there is no therapy to make non-disabled people approach people who are different with an open mind.

It’s pretty easy to tell if someone finds a therapy helpful or not, regardless of whether they are verbal. How is the person’s mood? Do they find therapy sessions distressing? If it’s the latter, maybe that kind of therapy isn’t the best fit. Being unable to speak and being unable to communicate at all are not the same thing. Listen to your clients, especially the ones who do not speak. They’re the ones who need you to listen the most.

So what kind of therapy is compatible with neurodiversity? The answer is surprisingly simple. Is your therapy designed to improve communication, reduce anxiety and/or redirect harmful behaviors?  That’s not in opposition to the neurodiversity paradigm at all. Neurodiversity does not mean that we want a hall pass to smash windows or bite our fingers until we bleed. It doesn’t mean that we are ignoring the reality of our lives. It doesn’t mean that those of us who are verbal and/or who need fewer supports aren’t thinking about our nonverbal peers. It means understanding, to paraphrase Martin Luther King Jr., that a riot is the language of the unheard. Listen to us. Please. This is an image of a rainbow-colored infinity sign. The sign is considered a symbol of the neurodiversity movement.

12 thoughts on “Advice for Therapists from a Neurodiversity Advocate”

  1. psychology student here, I love you article. I also became less confused about therapies compatible with neurodiversity. My main scope is employment for disabled people, but still, this was informative and articulate.

  2. Fantastic article.

    A point though.

    I agree that by and large autism is not a disability. However living without diagnosis and help leads to disability.

    I’m mildly autistic and mildly dyspraxic.

    However growing up in a world that didn’t understand me and didn’t want to. Being told I was wrong. I was bad. I was stupid. I was a trouble maker.

    It all lead to me spending years homeless. Led to a personality disorder. Social anxiety. I’m now considered mentally ill as a side affect of living as an autistic in a world not designed to have me in it.

    The world needs to be redesigned to have autistics in it. But care needs to be given to those being messed up by it in the mean time.

  3. sorry. sorry, im in the UK and the words disablement and disability seem to have subtely different meanings.

    Autism on the level I have it is only a disability because the world is not built to accept it. it NEED NOT be a disability.

    with other forms i can not speak for. but my main point remains. disability/illness is caused not by the autism but by the affects of being ill treated due to it.

  4. A great example is expecting clients with autism to follow the same rules as other clients. If you ave a 48 hour cancelation policy and your client has time management deficits, appoint a family member to remind them, or set upa system so they can avoid late fees. After the fourth time my daughter was held responsible for paying a 100.00 late fee, even though I like the therapist, it is not in the budget to stay with him. I told him several times to copy me on appointment emails. Seems simple enough, I have power of attorney, but he would not do it.

    1. This is enlightening to me. Being a paernt of a 5 year old boy with autism, I’m quite sure I’m exactly the classic paernt you are speaking of. I often wonder how much of my son’s therapies are helping and how much of his progress is due to his own natural development. I won’t stop therapy and hope for him to progress naturally. What if the therapies help and I withheld them? I won’t give money to places like Autism Speaks or alternative medicines or GFCF diets which I don’t believe in. I will fight for him to be treated well and with respect. I want to do the right things for him. No one knows what’s right for someone else but I have to do my best to make it right for my son. Maybe I won’t make all the right choices but I will try. Thanks for sharing this.

  5. “Unfortunately, there is no therapy to make non-disabled people approach people who are different with an open mind.”

    This is, thankfully, not *quite* true! And forgive me for not looking up a source citation at the moment…. But there was actually a study done on young school-age kids, in which it was found that autistic students’ apparent social and communication skills improved…when their non-disabled classmates were trained in interacting respectfully with them.

    Magic, right?

  6. Love your work Sara.
    As a 58yr old, 5yrs after dx. (hf asd. et al ) it’s a thrill to read these stories.
    Viva diversity. It seems I’ve found my tribe/ label; you beautiful gifted people !
    Always remember:

    ”You are a totally unique person, just like everybody else.”

    There was no ‘confirm’ button in my email so maybe this will do or I’m in already.
    Either way I hope to hear more in 2016

  7. Amazing video and extremely worhty cause. I really want to attend this dinner I have two friends with children who have autism. They are beautiful children and so lovable. Autism needs much more funding, please open your hearts and minds to support these children, adults and families.

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