As clinicians, we know there isn’t a one-size-fits-all approach to treatment. We recognize that our clients are unique individuals, with their own experiences, needs and viewpoints. Being informed about neurodiversity is simply another way to recognize and support those differences.
What Clinical Providers Can Learn From the Neurodiversity Movement
We’ve learned a lot about autism over the last 20 years or so, not just because of new research, but because of the neurodiversity movement. The neurodiversity movement aims “to increase acceptance and inclusion of all people while embracing neurological differences” – and has made important strides in doing so.
However, there are still many who see autism as something that needs to be ‘cured’ and that’s especially true in the medical and mental health communities. Christina Nicolaidis, MD, MPH, thinks that we all could learn something from the neurodiversity movement.
Dr. Nicolaidis’ son was diagnosed with autism at three years old. She and her husband were bombarded with recommendations of “intensive treatments” that needed to be started as quickly as possible, along with a “pep talk saying that if we did these things there was a good chance we could ‘fix’ him.”
It wasn’t until Dr. Nicolaidis discovered the neurodiversity movement that, for the first time since her son’s diagnosis, she felt hopeful.
She says:
“Most of us have been trained to think about autism using a deficit model. Such a model, which focuses almost exclusively on impairments and limitations, ultimately leads us to see autistic individuals as broken people who are ill and, as my child’s first psychologist explained, need to be fixed. The neurodiversity movement challenges us to rethink autism through the lens of human diversity.”
When we accept autism, it doesn’t mean that we don’t recognize that neurodivergent people struggle. It means that we help them by offering therapies meant to address communication, behavioral and social challenges, as well as mental health services and other supports as needed.
Most autistic people are very open to therapies and programs that can make their lives easier. They just don’t want autism to be seen as something that has to be eradicated, like a disease, but instead as a facet of human diversity.
The Impact of Neurodiversity Training Programs
The Impact of Neurodiversity Training Programs on Clinical Providers
A systematic review of neurodiversity training programs by Lauren Clarke, BS, MHA, and Lawrence K. Fung, MD, PhD, measured practitioner knowledge, self-efficacy and practice behavior after neurodiversity training.
Clinical Provider Knowledge
The review found that after completing knowledge-based programs, clinicians showed an increase in both general autism knowledge and physician-specific autism knowledge, but that general autism knowledge decreased after six months, indicating the need for recurring training. However, this also suggests that some training is better than none.
Clinical Provider Self-efficacy
One study found that, after training, doctors were “more comfortable with identifying the symptoms of [autism], making appropriate diagnoses and referrals, and providing care to autistic children.”
Another study found that these levels of self-efficacy stayed after six months, suggesting that training programs have a “lasting impact on physicians’ confidence in their ability to provide care to autistic individuals.”
Practice Behavior of Clinical Providers After Neurodiversity Training
Of the six studies that measured changes in autism screening rates following training, four (67%) reported significant increases in screening rates, suggesting that neurodiversity training programs make clinicians more aware of autism and more likely to screen for it when symptoms are present.
The Impact of Neurodiversity Training Programs on Clients
When clinicians are educated in neurodiversity, the positive impacts for neurodiverse clients are considerable.
After completing training in neurodiversity, clinical providers may more easily recognize:
- The symptoms of autism
- The different ways that depression and anxiety present in autistic individuals
- The different ways that autistic individuals may manage their emotions and respond to life’s stresses
This allows them to adjust their methods accordingly and implement techniques tailored to neurodiverse needs.
When clinicians provide neurodiversity-focused treatment, autistic clients:
- Can learn to embrace their differences and recognize their unique strengths
- Can better understand themselves
- Can learn to manage their emotions and life’s stresses
- Can learn to manage sensory and emotional overwhelm
- Can learn to manage unpredictability in their lives
- Can learn life skills that may help them with time management, getting and keeping a job, and social and communication concerns
The Importance of Neurodiversity Training for Clinical Providers
Anita Lesko, BSN, RN, MS, CRNA, CAS, a provider who is also on the autism spectrum, says that a “lack of specific training and knowledge in the healthcare field is constantly leading to people with autism not being diagnosed or treated properly as well as often avoidable situations that impede timely or effective care.”
She notes the importance of neurodiversity training among all clinical staff, not just practitioners:
“The experience of a person with autism starts when they arrive at your facility and first get to intake, so the importance of training does not stop with the medical staff. It actually starts with the non-medical staff in intake, as often times overwhelm can start before the person with autism has even seen their healthcare provider, adding sometimes insurmountable challenges to effective care.”
Lauren Clarke, BS, MHA, co-author of the aforementioned review of neurodiversity training programs, says that a major impediment to getting autistic people the care they need quickly is that, in the medical community, there’s a common sentiment that anyone with special needs, like someone with autism or intellectual disability, should be automatically referred to a specialist. She feels that many clinicians see anything like that as “someone else’s problem.”
Lauren goes on to say:
“…It’s not necessarily that people are bad, I don’t think that’s the case. It’s that, you know, as medical students and physicians, we’re scared of what we don’t know. And we’re scared of doing the wrong thing and messing up…and it’s because we don’t have education. And so I really do believe that if we educate people, then we won’t be afraid. And we won’t be seeing the problems that we have now.”
The Future of Neurodiversity in Health Care
The goal of neurodiversity training is to help clinicians to better understand how to help neurodivergent clients embrace their differences, work through their challenges, and achieve their personal mental health and life goals. When institutions provide appropriate training and clinicians complete it, we’re all more prepared to create a better future for all, but especially for the roughly 20% of people worldwide who are neurodivergent.
As Dr. Nicolaidis says:
“Who knows what the future will bring? Maybe research will discover a ‘cure’ for autism. Maybe scientists will identify an autism gene and parents will choose to abort all autistic fetuses before they are born. Maybe we will find ways to better accommodate and support autistic individuals so that they are afforded the same opportunities as typical peers, while maintaining their autistic strengths and differences. Maybe we will look back at our current understanding of autism and shudder at our many misconceptions. Which future do you hope for?
Regardless of how each of us answers that question, I believe it is our responsibility to try to understand our patients as well as possible, to value them as human beings deserving of our full respect, to recognize their strengths and the richness of their existence, to minimize the harm caused by negative, dehumanizing images and concepts, and to accommodate their needs as well as possible. I cannot possibly do justice to the many voices of autistic individuals, but I hope my random musings entice you to further explore their world. Let them challenge your thinking – who knows what you may learn?”