Spotlight on Neuroaffirming Inclusion

Neurodiversity recognises that differences in human brain development, cognition, learning, communication and behaviour are natural forms of human diversity rather than deficits that must be cured or eliminated. Neuroaffirming practice acknowledges that neurodivergent people experience, process and interact with the world differently and that these differences are valid, valuable and deserving of respect.

Within assistance animal organisations, occupational therapists work with neurodivergent handlers, family members, volunteers, students, trainers, assessors and colleagues. Neuroaffirming inclusion therefore extends beyond supporting individual clients—it influences organisational culture, communication, education, assessment, workplace practices and leadership.

A neuroaffirming approach does not ignore disability or minimise genuine support needs. Rather, it seeks to maximise participation by adapting environments, reducing unnecessary barriers and recognising individual strengths alongside support requirements.

What is Neurodiversity?

Neurodiversity refers to the natural variation in human brains and nervous systems.

Every person’s brain develops differently, resulting in differences in:

• thinking;
• learning;
• communication;
• attention;
• memory;
• executive functioning;
• movement;
• sensory processing;
• emotional regulation;
• problem solving;
• creativity.

Some people identify as neurotypical, while others identify as neurodivergent.

Neither is inherently superior.

Human diversity includes neurological diversity in the same way it includes cultural, linguistic and physical diversity.

Neurodivergence

Neurodivergence is an umbrella term describing individuals whose neurological development differs from what society considers typical.

Examples include:

• autism;
• ADHD;
• AuDHD;
• dyslexia;
• dysgraphia;
• dyscalculia;
• dyspraxia (Developmental Coordination Disorder);
• Tourette syndrome;
• sensory processing differences;
• auditory processing disorder;
• intellectual disability;
• acquired brain injury;
• fetal alcohol spectrum disorder;
• some mental health conditions where appropriate;
• other neurological differences.

Many individuals experience more than one neurodivergence simultaneously.

Every neurodivergent person is unique.

If you have met one autistic person, you have met one autistic person.

Core Principles of Neuroaffirming Practice

Neuroaffirming practice is built upon several core principles.

Acceptance

Accept neurodivergent individuals as they are rather than attempting to make them appear more neurotypical.

Respect

Treat neurodivergent communication styles, sensory experiences and ways of learning as valid.

Strengths-Based Practice

Recognise abilities, interests and talents alongside areas requiring support.

Inclusion

Adapt environments rather than expecting individuals to constantly adapt themselves.

Empowerment

Support autonomy, informed choice and self-advocacy.

Collaboration

Work with individuals as equal partners in decision-making.

Individualisation

Avoid assuming that one neurodivergent person’s needs apply to another.

Neurodiversity Is Not One Profile

Neurodivergence presents differently in every individual.

Two autistic people may have entirely different:

• communication styles;
• sensory profiles;
• executive functioning;
• interests;
• support needs;
• emotional regulation;
• adaptive functioning.

Support should therefore always be individualised.

Avoid statements such as:

• “People with autism always…”
• “People with ADHD can’t…”
• “All autistic people like routine.”

Instead ask:

• “What works best for you?”
• “How do you prefer to communicate?”
• “What adjustments help you participate successfully?”

Strengths-Based Practice

Neuroaffirming practice intentionally looks beyond deficits.

Examples of strengths may include:

• creativity;
• innovation;
• honesty;
• persistence;
• deep focus;
• attention to detail;
• pattern recognition;
• visual thinking;
• analytical reasoning;
• empathy;
• problem solving;
• loyalty;
• exceptional memory;
• artistic ability;
• musical ability;
• technical expertise;
• systems thinking.

Not every neurodivergent person will possess these strengths, and strengths should never be assumed.

Rather, practitioners should identify each individual’s unique abilities and build upon them.

Giftedness and Twice-Exceptionality

Neurodivergence and exceptional ability frequently coexist.

Some individuals are intellectually gifted while also being neurodivergent.

Others demonstrate exceptional ability in one or more domains despite experiencing significant disability in others.

This is often referred to as twice-exceptionality (2e).

Examples include individuals who are:

• highly gifted and autistic;
• gifted with ADHD;
• gifted with dyslexia;
• gifted with dysgraphia;
• gifted with dyspraxia;
• gifted while living with multiple neurodevelopmental conditions.

Similarly, some individuals demonstrate highly specialised talents or “splinter skills” in particular areas, such as:

• mathematics;
• music;
• art;
• animal behaviour;
• programming;
• engineering;
• languages;
• visual memory;
• factual recall.

A small proportion of individuals may also demonstrate savant abilities, where extraordinary skill exists alongside disability.

Occupational therapists should avoid assuming that disability excludes giftedness, or that giftedness removes the need for support.

Exceptional ability and significant support needs can exist simultaneously.

Masking and Camouflaging

Many neurodivergent people consciously or unconsciously hide their natural behaviours in order to fit social expectations.

Examples include:

• suppressing stimming;
• forcing eye contact;
• rehearsing conversations;
• copying facial expressions;
• mirroring body language;
• suppressing sensory needs;
• pretending to understand social situations.

Masking may help individuals navigate environments temporarily but often comes at considerable psychological cost.

Long-term masking has been associated with increased anxiety, exhaustion, autistic burnout and reduced wellbeing.

Practitioners should avoid rewarding masking or interpreting it as evidence that support is no longer required.

Sensory Differences

Many neurodivergent individuals experience the world differently through their senses.

Sensory differences may involve:

• sound;
• light;
• touch;
• smell;
• taste;
• movement;
• body awareness;
• internal body sensations.

Individuals may experience either heightened or reduced sensory responsiveness.

Occupational therapists should consider environmental adjustments before assuming behavioural problems.

Executive Functioning

Executive functioning differences may affect:

• planning;
• organisation;
• initiation;
• working memory;
• prioritisation;
• emotional regulation;
• task switching;
• time management.

Executive functioning challenges are neurological—not a reflection of laziness, poor motivation or lack of intelligence.

Environmental supports often improve participation far more effectively than repeated verbal reminders.

Monotropism and Special Interests

Many autistic individuals experience monotropism, meaning attention becomes deeply focused on a limited number of interests.

These interests are sometimes incorrectly described as “obsessions.”

In reality, they often provide:

• enjoyment;
• emotional regulation;
• learning opportunities;
• motivation;
• expertise;
• identity;
• social connection.

Rather than discouraging special interests, occupational therapists should consider how they may be incorporated into assessment, intervention, learning and vocational planning.

Stimming

Self-stimulatory behaviours (“stimming”) include behaviours such as:

• rocking;
• hand movements;
• pacing;
• humming;
• fidgeting;
• repetitive movements.

Stimming often serves important functions including:

• sensory regulation;
• emotional regulation;
• concentration;
• stress reduction;
• communication.

Practitioners should not discourage harmless stimming simply because it appears unusual.

Instead, intervention should only occur where behaviours create significant risk or interfere with participation.

Communication Differences

Neurodivergent communication may differ from neurotypical expectations.

Examples include:

• reduced eye contact;
• literal interpretation;
• delayed processing;
• direct communication;
• scripted language;
• echolalia;
• AAC use;
• different facial expressions;
• different body language.

These differences should not automatically be interpreted as poor social skills, disinterest or disrespect.

Communication differences represent diversity—not deficiency.

Universal Design Benefits Everyone

Many neuroaffirming adjustments improve accessibility for everyone.

Examples include:

• providing written and verbal instructions;
• visual schedules;
• predictable routines;
• quiet environments;
• sensory-friendly spaces;
• flexible appointment formats;
• regular breaks;
• plain language;
• additional processing time;
• multiple methods of communication.

Good accessibility benefits neurodivergent and neurotypical individuals alike.

Avoiding Ableism

Ableism occurs when society assumes neurotypical functioning is superior or expects neurodivergent people to conform unnecessarily.

Examples include:

• forcing eye contact;
• discouraging harmless stimming;
• rewarding masking;
• interpreting differences as behavioural problems;
• assuming intelligence from communication style;
• describing neurodivergent people as “broken” or “less capable.”

Neuroaffirming practitioners focus on removing barriers rather than changing people to fit environments.

The Role of Occupational Therapists

Occupational therapists promote neuroaffirming inclusion by:

• respecting neurodivergent identities;
• recognising strengths alongside support needs;
• adapting environments;
• supporting self-advocacy;
• promoting occupational justice;
• reducing unnecessary barriers;
• educating multidisciplinary teams;
• advocating for inclusive organisational cultures;
• balancing participation, wellbeing and safety for both handlers and assistance animals.

Reflective Questions

• Am I adapting the environment or expecting the person to adapt?
• Have I recognised this person’s strengths as well as their support needs?
• Could behaviour I perceive as “challenging” actually be communication, sensory regulation or executive functioning differences?
• Have I unintentionally rewarded masking rather than authentic participation?
• Am I respecting the person’s preferred communication style and identity?

Key Message

Neuroaffirming inclusion recognises neurodivergence as a natural and valuable part of human diversity. Occupational therapists should move beyond deficit-focused models by recognising individual strengths, respecting neurodivergent identities, adapting environments and supporting meaningful participation. Neuroaffirming practice acknowledges that disability and exceptional ability can coexist, that support needs vary greatly between individuals and across the lifespan, and that inclusion is achieved not by asking people to become more neurotypical, but by creating environments in which diverse ways of thinking, learning, communicating and interacting are welcomed, respected and enabled to thrive.