Does neuro-affirming always live up to what it’s cracked up to be? – Sarah E Boon

Having been in neurodivergent spaces for a while now, I’ve been noticing a new term ‘neuro-affirming’ is increasingly being used in the last year or so. Although I am not aware of a formal definition of neuro-affirming that exists – the general consensus seems to be that neuro-affirming is an approach used in professional practice (such as therapy) that does not try to fix neurodivergent people into being neurotypical. Instead, somebody who is ‘neuro-affirming’ recognises neurodivergent people as part of the natural diversity of human minds and that each of us will have our own strengths and challenges. While I was writing the draft version of this blog post, The Psychologist magazine released a special edition ‘Neurodivergence: Change, complexity, and challenge’ (which I would highly recommend reading by the way!). One article ‘What does it mean to be neurodiversity affirmative?’ shares the principles created by primarily neurodivergent professionals (and some allies) which outline how services and professionals can become neuro-affirming in their practice for autistic people. These principles are 

  • Reframe the Autistic experience from a disorder to a neurotype.
  • Stop pathologising Autistic ways of being.
  • Supports should target needs and challenges that autistic people experience, not Autistic ways of being.
  • Ensure the Autistic voice is at the centre of everything you do.
  • Respect Autistic culture and identity.
  • If you have the power, employ autistic and otherwise neurodivergent team members. If you don’t have the power, advocate others to do so.
  • Recognise that there is immense value in diversity.
  • Recognise that there is value in living a disabled life.
  • Ensure that all neurodivergent people (including those with Significant Learning Disability and High Support Needs) have power, a place at the table, and are supported and advocated for. 
  • Reject compliance-based behaviour approaches, e.g., Applied Behaviour Analysis (ABA).
  • Reject neurotypical social skills training.
  • Advocate for systems and environmental changes.
  • Support fostering a positive Autistic identity as a priority goal.

Although the principles centred around autism are very much welcomed, I would like to think that these types of principles are extended to other neurodivergent people too and those who are autistic and multiply neurodivergent. As long as autistic people are consenting to these services, then neuro-affirmative practices appear to be a positive shift in how neurodivergent people are seen and supported when accessing professional services. However, I am not convinced this is translating into practice a lot of the time. One example of this was shared by Dr Robert Chapman on twitter based on their past experiences with an individual who is now advertising themselves as ‘neuro-affirming’ 

Firstly, anybody can brand themselves as ‘neuro-affirming’. Although some may genuinely be neuro-affirming who do this, it is not a regulated term and there is no certification or verification professionals have to go through before they can advertise themselves as neuro-affirming. Literally anyone can claim they are ‘neuro-affirming’ based on their own opinion and nothing else. I also suspect many are using the term as a marketing technique and/or as a buzzword, without understanding or caring about truly being neuro-affirming. 

Also when researching for this blog post I came across a therapy organisation seeking to educate others about ‘neuro-affirming’ practises while also advertising their ABA services on the side of the webpage. For those of you who have not come across ABA, it is short for Applied Behaviour Analysis which is considered a form of conversion therapy by many autistic people. ABA’s approach focuses on reinforcing neurotypical norms onto autistic people’s behaviour. So the complete opposite of what true ‘neuro-affirming’ practice is. There have been many critiques of ABA already and to write about them here would only be rehashing with what others have written before. However, I would recommend reading “Invisible Abuse: ABA and the things only autistic people can see”  to better understand the consequences of ABA for autistic people. 

Ultimately if people’s practice is aligned with their claims of being neuro-affirming then there’s no problem. However, I am worried that people will take self claimed ‘neuro-affirming’ adverts at face value, and find themselves in a situation where it is not neuro-affirming at all, and at worst it is harmful. My main message here is to stay critical friends, and to ask more questions before committing to therapy or support that claims to be neuro-affirming. 

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