What is neuroaffirming care and practice?

Neuroaffirming care and practice recognizes neurological differences, such as being Autistic, ADHD and other types of neurodivergence, as natural variations of the human experience rather than deficits to be corrected or having to be cured from. The focus changes from fixing individuals to understanding and supporting their unique needs. This approach highlights the uniqueness of how neurodivergent brains work and creates customized plans to support individuals rather than using a one-size-fits-all approach.

The medical model of disability and all classification systems arising from using diagnostic assessment tools such as the DSM-5-TR and ICD-11 are based on neuronormative assumptions. Being autistic is a different, valid, neurotype with its own developmental trajectory. Being autistic is a way people are, not a thing that people have, and a different way of experiencing the world.

The way autism is currently assessed pathologizes autistic ways of being. If we look at the topic of communication, autistic culture values communicating in-depth on one topic rather than making small talk. When a person is info-dumping, turn-taking still happens but a different pace. When the neuromajority views and interprets behavior, it is often through a judgmental lens. We assign meaning and value to autistic interactions which are held to our system of beliefs and ways of being. This is not neuroaffirming.

Neuroaffirming care acknowledges the specific hurdles, barriers, and necessities faced by neurodivergent people. Therapeutic strategies are customized to meet an individual’s unique circumstances, not altering who they are but rather focusing on the difficulties that can arise from being neurodivergent. This type of care care focuses on providing supports, accommodations, and skill developments that empower neurodivergent individuals to thrive authentically as themselves.

The Four Core Principals of Neuroaffirmative Practice

In the article Embracing neurodiversity affirmative practice: A path to inclusive support for autistic people, authors Helen Edgar and Tanya Adkin list these four core principals of a neuroaffirmative practice.

1. Reframing neurodivergence: Neurdivergence is not seen as a disorder but rather differences are viewed through a neuroaffirmative lens. This means each neurotype has its own dynamic and unique trajectory. This reframing helps reduce stigma and promotes a more inclusive understanding and acceptance of neurological differences.
2. Challenging pathologization: Current medical diagnostic assessments pathologize autistic ways of being. Neuroaffirmative practice shifts the view of autistic behaviors as problematic and deficit based to seeing how autistic differences may be misunderstood due to societal norms and expectations.
3. Promoting agency and autonomy: Neuroaffirmative practice believes that all individuals, including autistic people, should have control over their lives. We have to listen to autistic voices and acknowledge their experiences. We must be flexible and make accommodations, support choices and respect all communication styles so people are involved in their decision-making processes.
4. Create inclusive environments: Neuroaffirmative practice advocates for modifying environments to meet diverse and fluctuating needs and spiky profiles. This encompasses sensory-friendly spaces, flexible communication methods and personalized support strategies in all settings. Understand the double empathy problem which is a communication gap between people with and without autism which may occur not only because autistic people have trouble understanding non-autistic people, but also because non-autistic people have trouble understanding them.

What are some neuroaffirming ways to support autistic people?

1. Supports should target needs and challenges that autistic people experience. Don’t focus on changing or treating autistic neurology, but rather support self-advocacy and self-determination. Develop an understanding of specific perception and sensory differences, empower self-advocacy and support those close to the person to appreciate autistic experience through a neuroaffirmative lens.
2. The autistic voice should be at the center of everything we do. This goes beyond just listening to autistic people. Autistic people need the power to choose for themselves how their experience is explored, understood, identified, and supported.
3. Respect autistic culture and identity. Autistic people have distinct ways of being in, exploring and learning about the world. The only way to become familiar with and keep up to date with any of these is by listening to autistic people and understand what they are saying.
4. Reject compliance-based behavior approaches. Compliance should never be the goal! There is a real danger in expecting and insisting on compliance. While it teaches short-term obedience, it doesn’t build long-term skills like body trust, self-regulation, collaboration, or feeling safe. It also doesn’t support autonomy.
5. Reject neurotypical social skills training. Neurotypical social skills training encourages neurodivergent people to hide their true selves and promotes masking. It leads to internalized feelings of shame and ableism, and the person’s core ways of being and interacting are presented as something to hide and change. Honor autistic communication styles and social interactions that are meaningful to them.
6. Support interests and passions. Autistic people need to be supported in pursuing and engaging in their interests and passions. When they engage in their interests, not only do they show remarkable concentration and dedication to their interest, but they also get great joy and happiness from it. Sometimes this can lead to a person entering a flow state which supports well-being.

While the concept of neuroaffirming care and practice is still relatively new to the public and often hard to find, we need to be aware of its core principals and start putting those into action. Neurodivergent brains are unique so a one-size-fits-all approach won’t work. Be flexible, curious, kind, and collaborative; an autistic person’s happiness and well-being depend on it.

References

Edgar, H. and Adkin, T. (August 11, 2025). Embracing neurodiversity affirmative practice: A path to inclusive support for autistic people. National Autistic Society

Hartman, D. et al. (January 2, 2024). What does it mean to be neurodiversity affirmative? The British Psychological Society

Laube, A. (November 23, 2023). What is neuroaffirming care and why does it matter? Autism BC

Neff, M. (February 7, 2024). What Is Neurodivergent Affirming Therapy – and Why Does It Matter? Neurodivergent Insights