Neuro What?
Neurodiversity (“neuro” = brain + “diversity” = varieties) is a term used to describe differences in the ways individuals’ brains work. This is in contrast to neurotypical brains that function within an established range of expected development. So, what falls under neurodiversity? Any person with a brain difference is neurodivergent, including those who are gifted, autistic, and/or have genetic variations, ADHD, learning difficulties, mental health challenges, and more. It is important to understand that not all brains function the same way; they are diverse.
Can you fix my child?
A neurodivergent person does not need “fixing” because they are not “broken.” Instead, they may (or may not!) encounter challenges in academics, social relationships, language development, emotional regulation, or other everyday situations. For someone who is neurodivergent, the best way to support their brain and its unique functioning is by utilizing the individual’s strengths, talents, and interests to meet their goals and support/compensate for their areas of difficulty. An example of strengths-based intervention is using visuals (lists, models, pictures) for people who process visual information easily but struggle with auditory recall or processing. Clinicians design intervention plans with the clients and family that identify their goals and strengths in relation to support areas. Test results can help guide these conversations, but treatment goals are never developed from age-equivalency norms or testing in isolation. A collaborative strengths-based approach allows for focus on natural language and communication motivation as a foundation for all interactions.
How does strengths-based therapy work?
Historically, goals and objectives have been developed focusing solely on a child’s deficits or weaknesses with resulting intervention that drills these skills to perfection. This is because the child is being compared to their neurotypical peers and what is “socially acceptable”. Children may feel inadequate, overly challenged, and distressed in this model. Using a strengths-based treatment model, the adult working with the child would identify the child’s strengths & interests and develop goals and objectives from these to grow the child’s skills. When children feel successful and motivated, they enjoy the time and make better progress!
How will this look in a therapy session, you ask? The clinician will aim to find what is intrinsically motivating to the child, or what the child is naturally interested in, and develop a therapy plan around this to foster connection over compliance. Additionally, the clinician would utilize the child’s strengths (perhaps visual, perhaps memory, perhaps social, perhaps music) in conjunction with the motivating activities to build success with the therapy activities. For example, a child who is motivated by dinosaurs might be presented with exciting dinosaur themes throughout treatment to elicit target support areas. Here are some examples:
Vocabulary: Let’s discover all the dinosaur names, colors, habitats, and foods!
Directions: Let’s have the dinosaurs complete lots of fun tasks!
Play: Let’s take the dinosaurs on an adventure!
Articulation: Let’s use dinosaur names to address certain speech sounds or multi-syllabic words like “tyrannosaurus”!
This focus on intrinsic motivation and strengths-based intervention is in contrast to extrinsic motivation, in which the child is encouraged to participate or complete a task to receive a reward or incentive. For example, a child who completes a worksheet in class might receive a sticker. Certainly, some learners enjoy extrinsic motivation, and that can be one tool a clinician may use to engage a child. However, intrinsically motivating tasks often enhance the enjoyment and carryover of learned skills since the skills were practiced and achieved within a naturally-occurring context.
Do all therapy sessions look the same for all neurodivergent children?
Absolutely not! To maintain a neurodiversity-affirming approach to speech and language therapy, we can provide varying levels of structures within sessions, depending on the individual’s support needs. One child may need less support from the adult and prefer child-led play-based therapy. This may look like the child is selecting the activities/games/toys, and the adult is embedded language content within to the chosen task. Another child may feel more comfortable with more structure from an adult and prefer adult-led activities. This may look like the adult selecting a book or game they think the child will enjoy and giving the child clear, predictable expectations and instructions. However, a strengths-based approach would continue to be implemented even within more structured activities to ensure the child is motivated, comfortable, and feels successful throughout their session.
To do ABA, or not to do ABA: That is the question.
When children are recognized as neurodivergent, well-meaning professionals often recommend a host of interventions, some of which do not honor neurodiversity and strengths-based treatment. Applied Behavior Analysis (ABA) is somewhat controversial in the field of child development. ABA is a behavior modification therapy typically used for children with Autism in order to reinforce “desired” behaviors and discourage “unwanted” behaviors. Due to this outlook of “fixing” a child’s deficits, it is inherently not strengths-based and focuses on compliance over connection. It sends the message to neurodivergent people, namely Autistic individuals, that they are broken and need fixing. Over the past decade, the Autistic community has consistently reported the harm ABA has caused them and continues to cause others. While early research suggested ABA was effective at training Autistic kids to seem less Autistic (aka masking), current research indicates that masking causes intense trauma and does not result in significant positive outcomes (https://therapistndc.org/applied-behavior-analysis-aba/). Instead, strengths-based interventions can be more effective at improving the lives of clients.
Neurodiversity-Affirming Care at Stewart SLP
At Stewart SLP, we embrace neurodiversity-affirming practices. We want to honor your child for their strengths and interests, whatever their neurotype. We strive to meet children and families where they’re at and help them reach the goals that are most meaningful to their lives. Please note that Stewart SLP does not utilize ABA-based strategies and instead implements strengths-based intervention. We understand that some families choose to pursue ABA, and that is fully within parents’ prerogative. We welcome ALL clients and families and will joyfully support them, regardless of any other therapies that may be pursued in other contexts.
