After two decades of working with children and youth with ADHD, autism or AuDHD, I have come to understand that there are some basic core strategies or approaches that, I think, are essential to neurodiversity-affirmative practice. Some of these strategies are straight forward and some require a deeper confidence and foundation of knowledge in neurodiversity which I hope to share with you on this platform. 

1. I find out about their sensory sensitivities, and I give them plenty of options in my office or playroom to create an environment where they feel safe and comfortable.

One of the biggest obstacles neurodiverse children and youth face, is navigating environments that are too overwhelming or underwhelming. It's almost impossible to be emotionally regulated when sensory sensitivities are triggered. I let my clients know that I understand and empathize with the impact of sensory sensitivities and we work together to modify the space as best we can to increase comfort, safety and connection. Imagine what it would be like for a neurodiverse child or youth to have their counselor do this in the first session when so many other people in their lives have no idea how difficult sensory sensitivities can be!

2. I provide my clients with fidgets, art supplies, or different kinds of sensory toys, and I allow them to move about my room in any way that makes them feel comfortable

Neurodiverse children and youth are almost always asked to just sit still and focus! But sometimes this can feel almost impossible due to a lack of important neurotransmitters and/or difficulties with their interceptive, vestibular, or proprioceptive senses. Some of my clients pace around my office the entire session. Others play with fidgets. Some lie down on the couch and others prefer to draw and color while we talk. It's all fine with me! I always think about what it must feel like for my clients to be seen and understood in this way from the onset of therapy!

3. I help them understand how their brain ACTUALLY works beyond the phrase that they normally hear, which is "your brain just works differently".

Often, well meaning adults will minimize traits of neurodiversity in children and youth in an attempt to protect these kids from feeing different than their peers. In my experience, most neurodiverse children youth already know that they are different, and they just really want to understand why! They are almost always open to, and curious about, what it actually means to have ADHD and/or autism.  Imagine what it would be like for a neurodiverse child or youth to have their counselor explain (and normalize) why they struggle at some things and excel at others!

4. I help them to understand that they're not bad kids. They're just trying to navigate an environment that wasn't built for them.

This is really important! And I often explain this to parents and teachers as well. EVERYONE can think mean thoughts. EVERYONE gets mad and overwhelmed.  The difference between neurodiverse children and youth and their neurotypical peers and family members, is that the neurotypicals are better able to inhibit the expression of these thoughts and feelings whereas many neurodiverse kids struggle to do so. Then they get the reputation of being angry or rude or mean, which results in a lot of negative feedback that exacerbates feelings of rejection sensitivity. And this, along with sensory overwhelm, stresses these kids out even more which makes it even more difficult next time to inhibit their big emotions!

5. I engage in conversation with them about their hyper focuses or their special interests, and I use that information as a way to creatively explain different concepts or different coping strategies.

As clinical counselors we know that generally we are supposed to allow the client to lead the session. And yet, so many times those working with children and youth - and especially neurodiverse children and youth - seem to feel the need to direct the session. They sometimes fall into teaching mode or act in response to the real, or perceived, pressure of parental expectations of therapy. As a neurodiversity affirmative therapist, I am clear with parents that my focus is the relationship above all else. As a result, I may spend quite a few initial sessions simply allowing my clients to just be themselves and talk about what they're passionate about. So many times, these kids are told that it is socially inappropriate to talk too much about what they love. But once I find out what they love, I can use that information to help them shift their perspective or to implement a new coping strategy in service of their goals.

It has taken me many years of experience to become comfortable adapting my approaches to work with neurodiverse children and youth. My master class, Beyond the Basics of Neurodiversity-Affirmative Therapy was designed to distill and share all this expertise with counsellors who are interested in expanding into neurodiversity-affirmative practice. Let me know what you think!