8 Ways to Do Neurodiversity Affirming Therapy

Exploring Neurodiversity Podcast – Episode 13

by Adina Levy

Play. Learn. Chat - Exploring Neurodiversity Podcast Logo

Show Notes:

I’m sharing 8 key ways you can do Neurodiversity Affirming Therapy – You can find all of the points I discuss on the free PDF download here:
Neurodiversity Affirming Speech Therapy Practices for SLPs supporting Autistic Children: https://playlearnchat.ck.page/76b2db1d09

Here are the 8 key practices that I encourage you to do, as a Neurodiversity Affirming Therapist:

  1. Accept all forms of communication as valid – actions, gestures, sounds, signs, AAC, visuals
  2. Plan sessions around using child’s interests and motivating topics as the main activities
  3. Join the child (sometimes), playing in their way. Or let them play in their way solo
  4. Support the child to listen and attend to others in their own way
  5. Observe & use the child’s sensory preferences to build engagement and support their participation at all times
  6. Assess children using holistic tools and qualitative approaches that consider child & family perspectives & quality of life
  7. Set collaborative goals that are for the child’s benefit – leading to wellbeing and connectedness
  8. Set collaborative goals that are about changing the world around the child (other people, environments, expectations) to be most supportive

If you’re a Speechie and you’re keen to learn more with me, hop on the Waitlist for my upcoming course – Affirming Communication for Autistic Children! You’ll be first to hear when doors open and get a bonus and discount!: https://playlearnchat.com/speechie-course/




Welcome to the Exploring Neurodiversity Podcast. I’m Adina Levy from Play. Learn. Chat. I’m a neurodivergent speech therapist. And I’m obsessed with creating a world when neurodiversity is understood, embraced, supported, and celebrated. Join me as we have conversations about autistic, ADHD, neurodivergent experiences, and I share how you can support neurodivergent children in your world.

Let’s all work together to make change where change is needed so that the world can be a more friendly place for neurodivergent people and for everyone.

A couple of weeks ago, I released a free handout called Neurodiversity Affirming Speech Therapy Practices for Autistic Kids. Now, a few of you astutely noticed that this does not just apply to speech therapists. It is a checklist that describes what good therapy practices look like, what neurodiversity affirming practices look like, whether you’re a speech therapist, an ot, a psychologist, a social worker, and it even absolutely translates to teachers, support workers, anyone supporting not just autistic kids, but to anyone supporting neurodivergent kids or in fact anyone. They don’t have to be a child. They don’t have to be neurodivergent.

You can grab the free checklist by tapping the link in the show notes, and you can also find it at playlearnchat.com/freebies.

So in this episode, I’m going to go through eight ways that neurodiversity affirming therapy should look, and I hope that it sparks some reflection for any of you, whether you’re a therapist or if you’re a parent or a carer supporting your child to access therapy so you get really clear on what are the features, what does it look like when neurodiversity affirming approaches are actually being put into practice.

It’s not just a label being slapped onto the website, but it’s actually a philosophy and approach that the therapist and the practice truly gets. At the core of it, neurodiversity affirming practice is all about meeting children where they’re at, supporting them with the supports that they need to thrive, to be happy, to have positive self-concept, wellbeing,

all of that. I’ve talked about this before, it’s a human affirming approach.

Now today, I’m going to go through pretty quickly each of the eight aspects of neurodiversity affirming therapy.

At the moment, I am deep, deep, deep in planning, researching, collating writing, and soon recording mode for my upcoming course for speech therapists.

It is the affirming communication for autistic children online course, and I am so excited to bring together 11 years of clinical practice, my lived experience as an autistic A D H D, my perspectives that I share from collaborating and connecting with other autistic people in the community. Pairing that with evidence-based approaches that are affirming, looking at the evidence with a critical eye.

This course is going to be huge and it’s something I’ve been working on ticking away in the background for so, so long.

I’m creating this to answer the question, what does it look like? How exactly do I do speech therapy? What exactly does affirming speech therapy and assessment look like when I support autistic children?

So the doors are opening in late July. And anyone on the wait list is going to get special bonus offer before the door’s officially open.

The course is going to be released throughout August, so speech therapists are totally welcome to play along with the live pacing. And then we have discussions week by week that align with the module released each week. And there’s also 12 months access. So that means that if that’s not quite the right time for you to complete the course, you’ll be able to access it any time in the next 12 months.

If this is sounding interesting and helpful for you, I hope you’ll hop on the wait list so you can be the first to hear about it and get the special offer that I will be extending to those on the wait list. The link is in the show notes, and you can also find it at playlearnchat.com/speechie- course.

That’s. S P E E C H I E-course, and that’s where you’ll be able to hop on the wait list, and I will keep you updated as soon as the doors are open for those who are keen to get in early.

Yeah. All right, so let’s dig into our eight ways to do neurodiversity affirming therapy.

Number one is accept all forms of communication as valid. That includes actions, gestures, sounds, signs, whether that’s simplified sign language or full sign language, a a c augmentative and alternative communication visuals.

And on the flip side, what we don’t want to be doing is prioritising, waiting or pushing, coercing, encouraging speech over all the other ways of communication. All of these other communication methods are not a stop gap. We’re not just supporting a child to use these alternative ways of communicating on the way to speech, in some cases, speech will never be appropriate for a child, or it will never be their main or primary mode of communication.

If you want to know more about why speech might be difficult for an autistic child, check out episode seven on my podcast. It’s called All Communication is Valid. Why It might be hard for an Autistic child to Speak. So, So let’s just leave ourselves here with this really important point that all methods of communication are valid and useful and absolutely fine.

They don’t need to be temporary measures.

And so what that looks like in therapy, in practice is modeling, supporting, honoring any way that a child communicates and communicating with the child in varied ways as well. Multimodal communication that refers to using a range of communication methods essentially at the same time or within a context.

That’s something that we all naturally do in our communication with each other, and we want to really consciously support children. By showing them how to use various modes of communication and by honoring the best way, whatever way they want to share messages with you in that moment.

Number two on our list of ways to do neurodiversity affirming therapy is all about planning sessions around using the child’s interests and motivating topics as the main activities. The flip side, what we don’t want to be doing is this more traditional behaviorist approach of now and next.

Now you do the boring thing that I ask you to do the ‘work’, let’s say in inverted commas. And next you do the fun thing that you want. We need to flip this concept on its head. The best work that we can do with kids

is any work that is aligned with their interests, their motivation, something that is enjoyable, engaging, and fun. I’m sure as adults we all have experiences of trying to learn something that is within or aligned with our interests compared with trying to learn something that is so. Not.

So what this looks like in practice is pairing up what the child is into in that exact moment, which as we know with kids, can change quite quickly and match that with the goal that you are supporting the child with. There’s a whole other discussion to be had about what affirming goals are. But today we’ll focus on the activity.

So let’s say that the autistic child you’re supporting is really into sensory play and comes into your session with a pile of leaves.

And one of the goals you’re supporting them with is around expressive language and adjectives. Adjectives are those descriptive words like big, green, bumpy. So, Rather than pull out a worksheet that shows pictures of different things that may have different features, and writing down what the adjectives may be,

if the child is not into that. How about we just go with the interest of leaves and we model, we talk, we compare, we discuss and use the leaves as the context for the learning and the practicing and the modeling of all of those beautiful adjectives. This leaf is bumpy. This one’s spiky. My brown leaf is crunchy.

If you’re not used to working in this way, it can take quite a lot of creativity, but once you get into the habit of matching a learning goal with an interest with what the child loves in general, but especially what they’re interested in, in that moment. It actually can help you become a more lazy therapist with much bigger impact.

And I say lazy with love. You don’t have to come with all the activities, you don’t have to come with all the ideas. It becomes a cognitive practice for you to be pairing up that interest in the moment with something that you’re supporting that child to learn.

And truly not every moment has to be about learning as well. Sometimes connection, relationship building, sensory joy, that is absolutely a valid way to be spending your therapy sessions as well.

Number three on our list of ways to do neurodiversity affirming therapy is to join the child sometimes playing in their way. And sometimes let them play in their way solo

neurodiversity affirming practice is about meeting a child where they’re at. If somebody is not feeling that they’re ready or wanting to share an activity with somebody else, we need to honor that. So perhaps traditionally, some of us were taught. That we need to sabotage and intrude and join in play, and I’m sure we’ve all seen with autistic kids and certainly my own experience, in fact, any, anyone, you may experience this yourself, there are some moments where you just want to do a thing alone. It’s lovely to have other people nearby and have them ready to join in with your thing.

If and when you’re ready. But there are some moods, some moments where I just want to do my thing in my way by myself. That is completely valid. The autistic kids that you’re supporting, absolutely have a right to have the space for themself, have an activity for themself.

It’s quite counterproductive to be intruding on someone’s play when they’re not ready for it. They’re not open to it. It’s too overwhelming. They’re not in the right sensory space to receive that.

And the flip side of this is intruding, sabotaging, changing a child’s play, feeling that you need to hop in on their play and shift it to something in inverted commas ‘more functional’. So this comes to the idea of all play is okay. I mean, it rhymes. So that’s beautiful. A real core of the neurodiversity affirming approach is respecting that there are differences between neurodivergent, and neurotypical ways of being and acting.

These are differences. They are not wrong. So we don’t need to be changing a child’s play to have it seem more typical or to follow a traditional developmental trajectory.

And in fact in doing so, it’s very counterproductive.

On one hand, it can teach autistic kids that the way that they want to experience the world is wrong. And honestly, we get enough of that throughout our lives in subtle ways, and we, the grownups supporting autistic kids need to be really careful that we’re giving as many messages as possible to each child to let them know that their way, their preference, their way of wanting to experience the world is right, unique, special, fantastic.

And maybe sometimes we need a boundary. So the boundary I’m thinking about is, let’s say if the child wants to throw Lego at another person’s head, That’s a boundary we can put in place that’s valid. It’s okay to have boundaries. We don’t need to affirm every single action that a child does, but what we’re aiming to do is undo all of this traditional tick a box fit in the box therapy that many of us have practiced, have been taught to practice over the years. Kids don’t need to play in any particular way.

Play needs to be fun, needs to flow, needs to be enjoyable. And the moment we jump in and try to change their play, we’re undoing all of that, all of the playfulness of that moment.

So what to do is recognise how a child plays, watch them enjoy learning about how the child likes to experience the world, and sometimes join in their way. You can learn from a child and other times let them keep playing on their own. That is completely fine and sometimes necessary.

Our next very important point about how to do neurodiversity affirming therapy is to support children to listen and attend to others in their own way. This means eye contact goals or praising or encouraging eye contact is out. Why?

First of all, eye contact is not necessary for communication. Second of all, eye contact

can be very overwhelming For an autistic person, it can feel confusing. It can feel distracting. It can feel painful. It can be so overwhelming that the act of looking in someone’s eyes can take all of the cognitive power, meaning that an autistic child isn’t able to Actually, join in and connect and actually have that communication because they’re so busy trying to look at their communication partner’s eyes, something that has been perhaps taught and modeled and praised over time.

Raise your hand if you’ve ever had an eye contact goal written down for an autistic kid. Keep your hand up if you currently have that in your children’s goal plans. As soon as you hop off this podcast, please review that, remove that goal. It’s not necessary and it can in fact be quite damaging.

I, for one, do some of my best listening while my hands are busy and perhaps even my eyes are looking at what my hands are doing.

I got through my two uni degrees by doodling and looking down at what I was doodling almost the entire time, to the point that I couldn’t really tell you what some of my lecturers looked like at all. That is how I processed the world. So it’s very individual, but we need to agree to leave eye contact prompts in the past.

And let the child join in and engage in a way that their body and brain needs.

The fifth way to do neurodiversity affirming therapy is to observe and use the child’s sensory preferences to build engagement and support their participation at all times. Sensory breaks are kind of a thing of the past. Sensory breaks as a reward for doing the work or at the end of other activities.

Let’s pop that in the bin. Supporting sensory needs throughout every moment of a session is the way that we’re going to get kids in their best learning space, in their best connecting space.

Whether it’s about walking around the room while having a chat or whether it’s about.

Supporting a child to engage with their parent while they’re on the enjoyable swing. Perhaps it’s about giving their hands something busy to do while you’re playing a board game and they’re waiting for their turn.

When you support autistic children in therapy, no matter what your job is, no matter what your role is, you absolutely have an obligation to understand sensory challenges, sensory needs, and help each child be in their best sensory space before and during your sessions as much as possible.

Number six on our list of ways to do neurodiversity affirming therapy is to assess children using holistic tools and qualitative approaches that consider the child and family perspectives and quality of life. Okay, that is a really big, huge point, all bundled into one sentence. What we don’t want to be doing is only using quantitative, standardised assessment tools.

They may feel like an easy go-to. They may feel like, oh, well the system needs it. The system needs the numbers. For early career therapists, they might feel like the clearest way to understand what a child can and can’t do.

There are so many considerations when it comes to neurodiversity, affirming approaches to assessing autistic children. So much so that the first module of my speechie course is actually about affirming assessments, so it’s much more than we can go into in this one episode or in this one eighth of the episode.

And if you’re feeling like you need more support to understand what different types of assessments might look like and the considerations for how you choose what types of assessments to do with autistic kids, I hope that you’ll join me in the Affirming Communication for Autistic Children course.

Broadly, what we need to be considering with assessments is that regardless of what scores we have to show or if there are any constraints from the systems that we’re working in, we need to make sure that we are doing assessments that really help us understand how this child exists in their world.

What are the barriers? What are the challenges? What are the supportive strategies? What are the wishes and dreams of the child and their family and caregivers?

Those are some of the big considerations we need to keep in mind when doing affirming assessments.

Our last two points are about goal setting, so number seven, we want to set collaborative goals that are for the child’s benefit leading to wellbeing and connectedness. Notice here what we’re not doing is asking the child to change, to fit the rest of the world, to look more like other kids, to make everyone else’s life easier.

At the heart of our affirming speech therapy approach, we must be keeping in mind that this is for the child.

What is going to help the child feel most supported?

What is going to help them thrive in their daily life?

We’re not into fixing a child. We’re not into asking autistic kids to act more neurotypical, and there’s probably a lot of undoing of goal practices and habits and goals that we already have written for the kids that we’re supporting that we might need to adjust and adapt and shift.

Remember that this takes time. It is a process. And as long as you’re moving forward each day and each week with adopting neurodiversity affirming practices more and more, and undoing some of the non affirming approaches of the past, we’re heading in the right direction.

Our final point for what Neurodiversity affirming therapy and support looks like is about setting collaborative goals that are about changing the world around the child. That means changing other people, changing the environments around them, changing the schedules and the expectations that we impose on children to be most supportive for that child.

It’s not enough to only set goals that are about changing a child’s skills. For many of us, the service delivery models that we work in or the habits that we’re in about what goals look like for any of the children that we support are about teaching a child something, and we want the child to learn something or change their skills or change the way that they do something.

Those are valid well, they can be.

In many cases, it is valid to be supporting children to learn new things, but it can’t be the only support that we’re offering. We are not going to get a lot of mileage by just asking an individual to change. We actually want to change the world, so we want to change the world around them so that they are supported in most situations by the people around them, by the spaces that they exist in, and the expectations that we have of that child.

One of the four modules in my upcoming course, is all about zooming out, heading into that big picture world. So I teach and share how you can go about actually doing that, change the world around the child idea. How you can do parent coaching, teacher coaching, how you can build that into the support that you already offered to this child.

It’s an area I’m so delightedly passionate about and it’s a way I’ve always practiced my speech therapy approach and it’s just so fun to be able to share this with many of you now.

So that my friends is our eight ways to do neurodiversity affirming therapy for autistic children. But yes, as we discussed at the start, most of these points relate to supporting anyone no matter whether you are a speech therapist or a different therapist, or a parent or carer, a perhaps, even if you’re supporting a child who is not autistic.

A lot of these approaches just reflect treating humans like the valid little humans that they are.

So you can get the PDF that outlines all of these points. Then you can actually use it as a self assessment to check in with yourself and to identify some learning areas where you want to go deeper and understand more about why and how to do that particular point to be a more affirming therapist.

So head to play, learn chat.com/freebies, and I’ll also pop the link straight to this download in the show notes. If you are a speech therapist, a speech language therapist, a speech pathologist, a speech language pathologist, yes, we have many terms, which is why I love the word speechies. I am going to be so thrilled to invite you into this speechie course Affirming Communication for Autistic Children.

So please, please hop on the wait list. You are going to get an awesome bonus and discount offer if you’re in there before the doors open. So grab your spot on the wait list at playlearnchat.com/speechie- course or tap the link in the show notes and I’m really looking forward to sharing more with you soon.


If you found this episode helpful, please share it with a friend and join me on Instagram and Facebook. I’m @play.learn.chat

that’s Play.Learn.Chat, you’ll find all the links that we discussed in the show notes. Have a spectacular day.


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