Think SPACE!
- Sensory and processing: Give clients specific examples of what happens in Autistic/ADHD context, as many will likely have developed unconscious coping strategies.
- Planning: Planning for preventing and managing distress will demonstrate acceptance and empathy for a Neurodivergent client’s needs.
- Predictability: Planning will provide reassurance and predictability about what will happen in the event that a distressing event occurs.
- Relationship building: Getting to know your client in this way provides the foundations for a trusting, working relationship.
KEY ISSUES
Getting to know a client, their specific challenges, how these manifest for them, and what strategies they deploy to manage these will enhance practitioners’ confidence to support them during an intervention, minimise harm to the client and increase their chance of engaging effectively. It is therefore important that practitioners can recognise signs of distress and dysregulation. These may not always be obvious as many Neurodivergent people have learned to masked this to fit in and reduce stigma harm. Similarly, distress may present in different ways (e.g., meltdown/ shutdown), which 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 manage distress.
PRACTICAL TIPS
Explore distress and coping strategies
- What does being Neurodivergent mean for you? (e.g., how does it feel in your body and mind; consider communication, social, family/intimate relationships, friendships, and formal experiences).
- Do the challenges you experience ever result in you feeling distressed (challenges can include sensory, communication, social interactions, hyper/hyposensitivites)?
- What do you do to manage this across settings? What resources do you tend to use to help reduce dysregulation/make you feel better? (e.g., stimming, routine, planning, alcohol, drugs, withdrawal).
- How will I know you are in distress? (e.g., what does it look like)?
- What can I say or do to support you in that moment? (an action, a word)?
- What can you do/say in that moment?
- How do you experience distress across different settings (public spaces, official appointments)
- How do you manage this?
- How do you behave (e.g., angry, aggressive, withdraw, mirror) towards others in these contexts (e.g., towards boss, colleagues, general public)?
- Do you have any experience attending other groups/services?
- What was it like and how did you manage in that context?
- What worked/didn’t work for you?
- What can I do to support your participation?
- What have others done to support your participation in the past? (It may be useful to give examples and to allow extra processing time).
OTHER CONSIDERATIONS
- Need to be aware that some Neurodivergent individuals will not always be consciously aware of nervous system responses and resources used to support regulation.
- Practitioners will need to be observant for signs of sensory discomfort and/or distress.
- Getting to know and being curious about clients and how they present over time will aid in such observations.