Neurodiversity : affirming practice through the lens of lived autistic experience

The neurodiversity paradigm is emerging in disability communities and the scientific literature. Although the paradigm continues to develop, there are no clear definitions or established guidelines of what makes clinical practice neurodiversity-affirming. A better understanding of neurodiversity-affirming practice from the perspective of the consumers of these services, for the purpose of this study, namely autistic adults, is essential for improving the mental health and well-being of neurodivergent individuals. The aim of the current study was to work with autistic adults who identify as neurodivergent and autistic to define neurodiversity-affirming practice grounded in their experiences and perspectives. A grounded theory methodology was used, guided by a social constructivist epistemology and critical disability theory. Methods used to collect data included a background information survey, semi-structured interviews (live or written, depending on participant preference), e-journals, and individual debriefs. Thirty autistic adults participated in the study. The data was analyzed through coding (i.e., open, axial, and selective coding) and memoing. The rigour of this research project was ensured through multiple raters, member-checking, and triangulation. A grounded theory was created from the analysis through coding, sorting, and ongoing conversations between the two raters. The theory shows that to be neurodiversity-affirming, the neurodiversity paradigm and social model of disability must influence the practitioner’s clinical lens. Consistent aspects of practice were defined as being neurodiversity-affirming, including the service provider's approach/way of being, the environment in which the service takes place, and actions that the service provider takes in their professional development and work with clients. These factors contributed to the neurodivergent person’s experience and influenced society to become more neurodiversity-affirming. The findings can inform service providers’ practices to be more neurodiversity-affirming for neurodivergent individuals. This is important for improving the mental health and well-being of neurodivergent individuals and their families. It will also build on the research for and facilitate the continued emergence of neurodiversity-affirming practice.