In this section we will provide guidance for practitioners if a Neurodivergent client is referred to your service, and to explore how best to prepare and support their engagement. We will cover how to make your organisation and processes Neurodivergent friendly more generally, and share tips and advice for gaining understanding of clients’ individual needs to support their participation, learning and managing distress. It is important to see the individual as separate to the abuse to get an understanding of what being Neurodivergent means for that person. Practitioners need to take into consideration that the Neurodivergent person they are working with may have experienced discrimination, marginalisation, and isolation throughout their life, and will need to build trust before providing information that they may feel/have experienced it being used against them in the past.
Firstly, when assessing needs and planning for adaptations, it is important to understand that Neurodivergent people have ‘spiky profiles’ with great fluctuating capacity (see Part 2 of this Guide). This means that they can have great strengths in some areas and support needs in others in relation to, for example, social communication, sensory processing, fatigue, emotional regulation and executive function. The environment a Neurodivergent person is in can be enabling or disabling, particularly for those with multiple and intersecting forms of neurodivergence (e.g., someone who is both Autistic and has ADHD). Competing needs will also need to be considered when assessing suitability for intervention format (e.g., one to one or group) and group members.
Knowing whether an individual is Neurodivergent can help practitioners to plan for their clients’ support and adjustment needs. Neurodivergence may be documented in referral forms or other official documents (e.g., pre-sentence reports) at the point of referral. However, it may not always be known whether an individual is Neurodivergent when they are first referred. Some individuals may self-identify as Neurodivergent, while others may never have contemplated this at all. Some Neurodivergent people may have experienced stigma harm after disclosing their neurodivergence and be reluctant to disclose this again for fear of further harm and discrimination.
It is good practice when contacting any client to ask about what barriers they might experience in respect of attending appointments, and to identify appropriate adjustments that match their preferences. However, practitioners should not be afraid to ask someone how they identify; for example, whether they have received a diagnosis, self-identify or have ever considered they were Neurodivergent. However, these questions should be explored sensitively and supplemented with exploratory and needs-based questions.
It is also important that practitioners are observant for signs of discomfort and distress. While there can be obvious signs, distress may not be easily recognised by practitioners as it can show up in ways that are not understood by neurotypical people. Many Neurodivergent people have also learned to mask their distress for fear of other people’s reactions. Similarly, the ways that distress can present (e.g., meltdown, shutdown) can be missed or misconstrued. It is important to get to know your client early on so that a plan of support can be put in place to recognise how discomfort or distress is experienced, what it looks like, and what to do if this happens when working with a client during the intervention.
Practitioners may also need to revisit these questions during the client’s engagement as neurodivergence may only become more apparent as practitioners get to know the client better. Support and planning can then be put in place, tailored to the client’s needs.
Section 5.2 will cover the following areas:
- Initial contact and planning.
- Initial appointment and exploring neurodivergence.
- Exploration of needs and adaptations.
- Managing distress: identifying coping strategies.
- Identifying communication and learning needs.