Abstract
Purpose
The purpose of this article is to address some common concerns associated with the neurodiversity paradigm and to offer related implications for service provision to school-age autistic students. In particular, we highlight the need to (a) view first-person autistic perspectives as an integral component of evidence-based practice, (b) use the individualized education plan as a means to actively address environmental contributions to communicative competence, and (c) center intervention around respect for autistic sociality and self-expression. We support these points with cross-disciplinary scholarship and writings from autistic individuals.
Conclusions
We recognize that school-based speech-language pathologists are bound by institutional constraints, such as eligibility determination and Individualized Education Program processes that are not inherently consistent with the neurodiversity paradigm. Consequently, we offer examples for implementing the neurodiversity paradigm while working within these existing structures. In sum, this article addresses key points of tension related to the neurodiversity paradigm in a way that we hope will directly translate into improved service provision for autistic students.
Supplemental Material

References
-
Abrahams, K., Kathard, H., Harty, M., & Pillay, M. (2019). Inequity and the professionalization of speech-language pathology.Professions & Professionalism, 9(3), e3285. https://doi.org/10.7577/pp.3285 -
Alvarez, G. A., Bebbington, K., Cleary, D., Evans, K., Glasson, E., Maybery, M. T., Pillar, S., Uljarevic, M., Varcin, K., Wray, J., & Whitehouse, A. J. (2019). The misnomer of ‘high functioning autism’: Intelligence is an imprecise predictor of functional abilities at diagnosis.Autism, 24(2), 221–232. https://doi.org/10.1177/1362361319852831 - American Academy of Child and Adolescent Psychiatry. (2020, February). Screen time and children. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx
- American Speech-Language-Hearing Association. (2005). Evidence-based practice in communication disorders
[Position statement] . https://www.asha.org/policy/PS2005-00221/ - American Speech-Language-Hearing Association. (2016). Scope of practice in speech-language pathology. https://www.asha.org/policy/SP2016-00343/
-
Angulo-Jiménez, H., & DeThorne, L. (2019). Narratives about autism: An analysis of YouTube videos by individuals who self-identify as autistic.American Journal of Speech-Language Pathology, 28(2), 569–590. https://doi.org/10.1044/2018_AJSLP-18-0045 -
Armstrong, T. (2010). Neurodiversity: Discovering the extraordinary gifts of autism, ADHD, dyslexia, and other brain differences (1st ed.). Da Capo Lifelong Books. - Ask Autistic Adults - Resource for Parents of Autistics. (n.d.) Facebook. https://www.facebook.com/groups/2138776736451241/
- Autistic Self Advocacy Network. (2014, January). 2014 Joint letter to the sponsors of Autism Speaks. https://autisticadvocacy.org/2014/01/2013-joint-letter-to-the-sponsors-of-autism-speaks/
- Autistic Self Advocacy Network. (2016). Nothing about us without us. https://autisticadvocacy.org/home
-
Bagatell, N. (2010). From cure to community: Transforming notions of autism.Journal of the Society for Psychological Anthropology, 38(1), 33–55. https://doi.org/10.1111/j.1548-1352.2009.01080.x -
Bailin, A. (2019, June). Clearing up some misconceptions about neurodiversity. Scientific American. https://blogs.scientificamerican.com/observations/clearing-up-some-misconceptions-about-neurodiversity/ -
Baron-Cohen, S. (2019, April). The concept of neurodiversity is dividing the autism community. Scientific American. https://blogs.scientificamerican.com/observations/the-concept-of-neurodiversity-is-dividing-the-autism-community/ -
Beck, J. S., Lundwall, R. A., Gabrielsen, T., Cox, J. C., & South, M. (2020). Looking good but feeling bad: “Camouflaging” behaviors and mental health in women with autistic traits.Autism, 24809–821. https://doi.org/10.1177/1362361320912147 -
Bulluss, E., & Sesterka, A. (2020a, June). Reframing professional language around autism: Reflecting on our use of language in professional contexts. Psychology Today. https://www.psychologytoday.com/au/blog/insights-about-autism/202006/reframing-professional-language-around-autism -
Bulluss, E., & Sesterka, A. (2020b, June). Reframing professional language around autism in practice: A practical guide to using respectful language in the professional context. Psychology Today. https://www.psychologytoday.com/au/blog/insights-about-autism/202006/reframing-professional-language-around-autism-in-practice -
Cage, E., Di Monaco, J., & Newell, V. (2018). Experiences of autism acceptance and mental health in autistic adults.Journal of Autism and Developmental Disorders, 48(2), 473–484. https://doi.org/10.1007/s10803-017-3342-7 -
Cage, E., & Troxell-Whitman, Z. (2019). Understanding reasons, contexts and costs of camouflaging for autistic adults.Journal of Autism and Developmental Disorders, 49(5), 1899–1911. https://doi.org/10.1007/s10803-018-03878-x -
Cain, S. (2012). Quiet: The power of introverts in a world that can't stop talking. Broadway Books. -
Crossman, C. (2019, September). Why the autism community prefers identity first language. In the Loop about Neurodiversity. https://intheloopaboutneurodiversity.wordpress.com/2019/09/04/why-the-autistic-community-prefers-identity-first-language/ -
den Houting, J. (2019). Neurodiversity: An insider's perspective.Autism, 23(2), 271–273. https://doi.org/10.1177/1362361318820762 -
DeThorne, L. (2020). Revealing the double empathy problem.The ASHA Leader, 25(3), 58–65. https://doi.org/10.1044.leader.FTR2.25042020.58 -
Donaldson, A., Krejcha, K., & McMillin, A. (2017). A strengths-based approach to autism: Neurodiversity and partnering with the autism community.Perspectives of the ASHA Special Interest Groups, 2(1), 56–68. https://doi.org/10.1044/persp2.SIG1.56 -
Harrison, K. (2019). Rude or shrewd? Reframing media devices as care structures and child use as accommodation.Journal of Children and Media, 13(3), 1–9. https://doi.org/10.1080/17482798.2019.1628192 -
Harrison, K., Vallina, L., Couture, A., Wenhold, H., & Moorman, J. D. (2019). Sensory curation: Theorizing media use for sensory regulation and implications for family conflict.Media Psychology, 22(4), 653–688. https://doi.org/10.1080/15213269.2018.1496024 -
Hillary, A. (2015). Autism and language.InM. Sutton (Ed.), The real experts: Reading for parents of autistic children (pp. 35–36). Autonomous Press. -
Hughes, J. A. (2020). Does the heterogeneity of autism undermine the neurodiversity paradigm?.Bioethics, 00, 1–14. https://doi.org/10.1111/bioe.12780 -
Jaarsma, P., & Welin, S. (2012). Autism as a natural human variation: Reflections on the claims of the neurodiversity movement.Health Care Analysis, 20, 20–30. https://doi.org/10.1007/s10728-011-0169-9 -
Jess. (2013, November). No more—A letter to Suzanne Wright.A Diary of a Mom. https://adiaryofamom.com/2013/11/12/no-more-a-letter-to-suzanne-wright/ -
Jones, R. S. (2015). ABA–Applied behavior analysis.InM. Sutton (Ed.), The real experts: Reading for parents of autistic children (pp. 50–59). Autonomous Press. -
Kapp, S. K., Gillespie-Lynch, K., Sherman, L. E., & Hutman, T. (2013). Deficit, difference, or both? Autism and neurodiversity.Developmental Psychology, 49(1), 59–71. http://doi.org/10.1037/a0028353 -
Kapp, S. K., Steward, R., Crane, L., Elliott, D., Elphick, C., Pellicano, E., & Russell, G. (2019). ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming.Autism, 23(7), 1782–1792. https://doi.org/10.1177/1362361319829628 -
Kasari, C., Rotherham-Fuller, E., Locke, J., & Gulsrud, A. (2012). Making the connection: Randomized controlled trial of social skills at school for children with autism spectrum disorders.The Journal of Child Psychology and Psychiatry, 53(4), 431–439. https://doi.org/10.1111/j.1469-7610.2011.02493.x -
Kenny, L., Hattersley, C., Molins, B., Buckley, C., Povey, C., & Pellicano, E. (2016). Which terms should be used to describe autism? Perspectives from the UK autism community.Autism, 20(4), 442–462. https://doi.org/10.1177/1362361315588200 -
Lai, M. C., Lombardo, M. V., Ruigrok, A. N. V., Chakrabarti, B., Auyeung, B., Szatmari, P., Happe, F., & Baron-Cohen, S. (2017). Quantifying and exploring camouflaging in men and women with autism.Autism, 21(6), 690–702. https://doi.org/10.1177/1362361316671012 -
Law, B. M. (2016). Interpreting autism.The ASHA Leader, 21(4). https://doi.org/10.1044/leader.FTR1.21042016.44 -
Lutz, A. S. (2013, January). Is the neurodiversity movement misrepresenting autism?. Slate. https://slate.com/technology/2013/01/autism-neurodiversity-does-facilitated-communication-work-and-who-speaks-for-the-severely-autistic.html -
Neumeier, S. M. (2018, February). ‘To Siri with love’ and the problem with neurodiversity lite. Rewire News. https://rewire.news/article/2018/02/09/siri-love-problem-neurodiversity-lite/ -
Ochs, E., & Solomon, O. (2010). Autistic sociality.ETHOS, 38(1), 69–92. https://doi.org/10.1111/j.1548-1352.2009.01082.x -
Opar, A. (2019, April). In search of truce in the autism wars. Spectrum News. https://www.spectrumnews.org/features/deep-dive/search-truce-autism-wars/ -
Park, M. M. (2010). Embodied pleasures for a child diagnosed with autism in a sensory integration based clinic.Disability Studies Quarterly, 30(1). https://dsq-sds.org/article/view/1066/1232 -
Pellicano, E., Dinsmore, A., & Charman, T. (2014). What should autism research focus upon? Community views and priorities from the United Kingdom.Autism, 18(7), 756–770. https://doi.org/10.1177/1362361314529627 -
Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Santos, A. D., & Nicolaidis, C. (2020). “Having all of your internal resources exhausted beyond measure and being left with no clean-up crew”: Defining autistic burnout.Autism in Adulthood, 2(2), 132–142. https://doi.org/10.1089/aut.2019.0079 -
Roberts, J. (2020, August). On writing masking goals for autistic middle school girls—Stop it!. Therapist Neurodiversity Collective. https://therapistndc.org/masking-goals-autistic-middle-school-girls/ -
Robertson, S. (2010). Neurodiversity quality of life, and autistic adults: Shifting research and professional focuses onto real-life challenges.Disability Studies Quarterly, 30(1). https://dsq-sds.org/article/view/1069/1234 -
Russo, F. (2018, February). The costs of camouflaging autism. Spectrum News. http://www.spectrumnews.org/features/deep-dive/costs-camouflaging-autism -
Shore, S. M. (n.d.). Self-advocacy. Autism Research Institute. https://www.autism.org/self-advocacy/ -
Sibley, K. (2015). The cost of indistinguishability is unreasonable.InM. Sutton (Ed.), The real experts: Reading for parents of autistic children (pp. 43–47). Autonomous Press. -
Silberman, S. (2015). Neurotribes: The legacy of autism and the future of neurodiversity. Avery Publishing. -
Sinclair, J. (2013). Why I dislike ‘person first’ language.Autonomy, the Critical Journal of Interdisciplinary Autism Studies, 1(2). http://www.larry-arnold.net/Autonomy/index.php/autonomy/article/view/OP1/pdf -
Singer, J. (1999). ‘Why can't you be normal for once in your life?’ From a ‘problem with no name’ to the emergence of a new category of difference.InM. Corker & S. French (Eds.), Disability discourse (pp. 59–67). McGraw-Hill Education. -
St. Pierre, J., & St. Pierre, C. (2018). Governing the voice: A critical history of speech-language pathology.Foucault Studies, 24, 151–184. https://doi.org/10.22439/fs.v0i24.5530 -
Strauss, J. (2013). Autism as culture.InL. J. Davis (Ed.), The disability reader (4th ed., pp. 460–484). Routledge. -
Vidal, V., Ernat, C., & DeThorne, L. (2018). I think he wants you to play the guitar: Use of behavioral interpretation as a strategy for facilitating peer interaction across autistic and non-autistic peers.Perspectives of the ASHA Special Interest Groups, 3(1), 68–83. https://doi.org/10.1044/persp3.SIG1.68 -
Vidal, V., Robertson, S., & DeThorne, L. (2018). Illustrating a supports-based approach toward friendship with autistic students.American Journal of Speech-Language Pathology, 27(2), 592–601. https://doi.org/10.1044/2018_AJSLP-17-0075 -
Williams, K. (2019, April). The fallacy of functioning labels. National Centre for Mental Health. https://www.ncmh.info/2019/04/04/fallacy-functioning-labels/ -
Wolfberg, P., McCracken, H., & Tuchel, T. (2008). Fostering peer play and friendships: Creating a culture of inclusion.InK. D. Buron & P. J. Wolfberg (Eds.), Learners on the autism spectrum: Preparing highly qualified educators (pp. 182–207). Autism Asperger Publishing Company. - World Health Organization. (2002). International classification of functioning, disability and health. https://www.who.int/classifications/icf/icfbeginnersguide.pdf