Exploring Speech-Language Pathologists’ experiences supporting social communication for autistic adolescents in the context of the neurodiversity movement

Purpose: Speech-Language Pathologists (S-LPs) play a key role in supporting social communication for autistic adolescents. Many autistic adolescents face difficulties interacting in neurotypical-dominated social contexts due to differences in their social communication style, and experience negative consequences as a result. Now, thirty years since it began, the neurodiversity movement is gaining traction in the field of speech-language pathology. For example, Speech-Language and Audiology Canada (SAC) has recently endorsed neurodiversity-affirming practices as evidence-based service provision for autistic individuals. The current study therefore aimed to explore the experiences of S-LPs in British Columbia (BC) who support social communication for autistic adolescents, and the influence of the neurodiversity movement on their clinical practices. Methods: This qualitative study followed an Interpretative Phenomenological Analysis (IPA) approach. Homogenous sampling was used to recruit participants. The sample consisted of five private practice S-LPs registered in BC who had been practicing for at least 5 years, and who had experience supporting more than one autistic adolescent with social communication in the past 10 years. Data was collected through online qualitative interviewing, based on an interview topic guide. Analysis followed an IPA framework, which consisted of an in-depth exploration of the subjective experiences of the individual S-LPs, followed by a cross-case analysis of the similarities and differences among the participants. The rigour of the study was enhanced through reflexive journalling, the use of an audit trail, and two reporting checklists for qualitative research. Results: Four themes were revealed across the participants: 1) the neurodiversity movement as a turning point, 2) re-examining and reconciling one’s clinical practice, 3) shifting gears: changing the focus of social communication supports, and 4) finding a way forward. Each theme included a number of subthemes. Conclusion: The findings indicate that the participating S-LPs' clinical practices with autistic adolescents have been influenced by the rise of the neurodiversity movement, with participants describing shifting away from deficit-focused approaches. This study also highlights that S-LPs would benefit from greater guidance to transition toward more neurodiversity-affirming clinical practices.