Abstract
The concept of neurodiversity poses a challenge to service providers, urging them to shift away from pathologizing frameworks and exclusionary notions of expertise. More research is needed on how to build upon the concept of neurodiversity to improve direct practice with neurodivergent individuals and communities. This paper presents findings from interviews with 60 differently positioned people in Southern Ontario, Canada, about how they used the concept and language of neurodiversity. While people varied in their specific experience and their understanding of who or what neurodiversity included, they all used the concept and language of neurodiversity to explain how they wanted systems and practices to change. Participants identified ways that providers fail to meet the needs of neurodivergent people and offered alternative suggestions for practice. Neurodivergent providers described bringing useful knowledge to their work but meeting barriers in their organizations. A tip sheet of practice guidelines is presented, and implications are discussed.
Keywords
Neurodiversity, as a concept and as a movement, has important implications for the work that service providers do and how they do it. The term and concept of neurodiversity first emerged in the 1990s, when it was created, refined, and developed across disability communities and autistic advocacy groups (Botha et al., 2024). Neurodiversity movements and paradigms pose a direct challenge to dominant, pathologizing beliefs that denigrate and marginalize the knowledge and experience of people who are deemed outside of a neurotypical norm, particularly targeting those with intellectual and neurodevelopmental disabilities (Walker, 2021). Neurodiversity emerged as a justice-seeking framework that starts from the premise that it is expected and morally neutral (or possibly beneficial) that people differ widely in how they think, learn, communicate, and behave across various contexts (Walker, 2014). Neurodiversity critiques argue that when we respond to such differences as only and always “problems” to “fix,” we inevitably reproduce normative pressures on individuals rather than creating more flexible and responsive social practices and relations (Kapp, 2020; Zaneva et al., 2024). Neurodiversity scholars and activists do not deny that significant disability can be a part of “neurodivergence” (such as ADHD, autism, and intellectual disabilities; Bertilsdotter Rosqvist et al., 2025). Instead, they deploy a social model of disability that understands disability to be produced through social processes and contexts, including processes of exclusion and oppression (den Houting, 2019).
The last 10 years have seen an explosion in the use of the language and concept of neurodiversity across academic, social, and professional discourses. Social work and education scholars have taken up the topic of neurodiversity in various ways, although the academic literature has lagged behind community uptake and development of the concept (Benson, 2023; Botha et al., 2024; Livingstone et al., 2023). While this increased attention to the concept of neurodiversity represents an opportunity to rethink sociocultural norms and institutional practices, it is not clear what different people mean by neurodiversity or how they want to see it brought into everyday practices. Indeed, people have expressed concerns that organizations and individuals sometimes adopt the term while making only superficial changes, an approach that Neumeier (2018) refers to as “Neurodiversity lite.” There is a danger that if providers, policymakers, and scholars understand the changes demanded by the concept of neurodiversity as primarily semantic, important justice-based critiques and calls from neurodivergent communities will remain unheeded.
In this article, we present findings from an ethnographic project on the concept of neurodiversity, with a focus on what 60 interview participants shared regarding the practices of service providers and the systems within which they work. Participants came from a variety of backgrounds, including some who identified as neurodivergent, some as service providers, and some as family members of neurodivergent people. Many belonged to more than one group. Our starting research questions, those reflected in recruiting strategies and interview guides, did not focus on service systems apart from asking service provider participants how they used neurodiversity in their work. However, through these interviews, we learned that participants intimately connected the concept of neurodiversity with their desire to see significant change across many domains of service provision, including fields such as education, social work, and counseling. In discussing what neurodiversity meant to them, participants offered examples of problems that they had encountered and shared suggestions on what was needed. We conclude with implications for practice, including a set of 10 practice suggestions or “tips” for providers.
Background
While the first uses of the term neurodiversity have often been attributed to Harvey Blume (1998) and Judy Singer (2017), community members and scholars have more recently argued that there is a long history of collective creation and development of the term, particularly emerging from Autistic online communities in the 1990s (Botha et al., 2024). Over the ensuing decades, subsequent discussion and development of what neurodiversity means and how it should be enacted have continued to take place primarily across disability justice, autistic activist, and online spaces (Livingstone et al., 2023).
Over the last decade, scholars have shown a dramatic increase in their interest in the concept of neurodiversity across a wide range of disciplines, including sociology, medicine, law, and cultural studies. Researchers in applied human services fields, such as education, clinical psychology, occupational therapy, and social work, have also used neurodiversity language and paradigms, particularly when addressing how practitioners work with neurodivergent individuals and communities (Guthrie, 2023; Krcek, 2013; Long, 2023; Sarchet, 2024). Much of this research is focused on practice with people who have particular diagnoses or identities. The most common diagnostic grouping that these researchers have addressed is autism (Kapp, 2020; Rodgers et al., 2018). There is also an important body of neurodiversity scholarship that considers other kinds of neurodivergence, including attention deficit and hyperactivity disorder or ADHD (Bertilsdotter Rosqvist et al., 2023), dyslexia (Wilmot et al., 2024), learning difficulties/disabilities (Sewell, 2022), Tourette’s (Graber & Rizzo, 2024), and mental health/psychiatric disabilities (Graby, 2015).
Some scholars have focused on how their fields could become more open to neurodiversity as a concept or a practice principle, or as a basis of advocacy and justice work. In critical public relations research, for example, Branton and colleagues (2023) have examined how the concept of neurodiversity is being mobilized by employment organizations. Similarly, in social work, Morris and colleagues (2025) synthesized qualitative research to explore how employment practices can better include neurodivergent workers and integrate lived experience as a valued resource. Disability studies scholars in education have provided a notably abundant domain of neurodiversity-related scholarship. For example, David Shannon (2020, 2024) has explored primary classroom musical composition work as a domain of neuroqueer possibility.
Such research offers a strong starting point for practitioners who are interested in integrating some of the critiques of neurodiversity advocates. However, little of this work has been empirically based upon the ideas and critiques of diversely situated community members. Instead, many researchers have used questions and methods that center the knowledge and experience of researchers and biomedical providers foremost, paid some attention to educators/providers and occasionally parents/family members, and more rarely developed practice research with neurodivergent people themselves ((Bex) Twinley, 2024; Botha, 2021; McLennan et al., 2025).
At the same time, many disability scholars have highlighted the need for research that builds from the knowledge and priorities of disability communities. Autistic scholars such as Remi Yergeau, Robert Chapman, Nick Walker, Michelle Wallace, Damian Milton, and Monique Botha bring important critiques of “practice-as-usual” across multiple disciplines (Botha, 2021; Chapman, 2023; Milton, 2014; Walker, 2021; Yergeau, 2017). The development of a field dubbed “neurodiversity studies” heralds the possibility of further scholarship (Bertilsdotter Rosqvist et al., 2020).
There continues to be a need for research about how people use neurodiversity across more applied areas of practice that build from the knowledge and experience of multiply positioned people. Unless we know what people are doing across the different contexts of their work and lives, we are unlikely to develop and support practices that can respond to a true diversity of needs and experiences.
Method
The larger project, entitled Neurodiversity Matters: An Ethnographic Investigation into Discourse, Practice, and Identity, was guided by the following research questions:
Research question 1. How are people and documents currently using the term, concept, and identity of neurodiversity and its associated critique of dominant ideas about autism spectrum disorder and other diagnoses (e.g., intellectual, developmental, psychiatric, and learning disabilities)?
Research question 2. What do meanings, associations, and practices of neurodiversity reveal about contemporary social relations and discourses?
The Neurodiversity Matters project was designed with two primary branches: (a) a discourse analysis that examined how academic writers were using neurodiversity across published works (Livingstone et al., 2023), and (b) an ethnographic investigation of how differently positioned people were using the language and idea of neurodiversity. The overall project received funding through an Insight Development Grant from the Social Sciences and Humanities Research Council of Canada (SSHRC). The larger project team included people from four academic institutions (University of Waterloo, University of Toronto, University of Guelph, and Brandon University), with the principal investigator located at the University of Waterloo, as well as a team of five collaborators from different practice and community settings who conferred on the project’s design and scope. The grant officially ran from 2019 to 2022, although timelines were adjusted somewhat due to the unanticipated challenges of the COVID-19 pandemic.
This article presents findings from the ethnographic section of the project. This part of the study used a combination of interviews and observations rooted in methods from institutional ethnography (IE) (Campbell, 2015; DeVault, 2012; Smith, 2005). Findings and methods from the observation of online events have previously been published (Gibson et al., 2024), as has an analysis of how the neurodivergent subset of interview participants talked about texts (Gibson et al., 2025). An article on the subset of interviews that addressed ADHD and neurodiversity is also being published (Urquhart et al., 2025). The current analysis is derived from our analysis of all 60 ethnographic interviews conducted from January 2020 to January 2021.
We interviewed 60 people about what neurodiversity means to them, and what practices they associate with it. Our approach to interviewing was rooted in IE, which uses interviews and other forms of data to illuminate larger social relations. While our interview questions were open to a range of possible definitions and experiences of neurodiversity, we paid particular attention to the ways in which institutional contexts and documents might influence everyday actions. All procedures followed the ethics protocols approved by the research ethical review boards at the University of Waterloo, University of Toronto, University of Guelph, and Brandon University.
The 60 interview participants were recruited from the Southwestern area of Ontario, ranging from the Greater Toronto area through the Hamilton–Waterloo–London corridor. Participants were recruited through organizations (e.g., autism services, counseling programs), self-advocacy groups, university accessibility services, disability-related research networks, and social media (Facebook/Meta). Initial screening emails/telephone calls gave people information about the study and allowed the research team to gather relevant information and assess eligibility. Participants needed to be 18 years of age or older, live in the study’s geographic boundaries, be capable of giving informed consent, and be able to participate in an English-language interview. They also needed to be prepared to discuss the language and concept of neurodiversity and identify as a member of at least one of the groups in the study, for which we had target recruiting numbers:
People who identified themselves as neurodiverse, 1 neurodivergent, or neuroqueer (target 25)
People used neurodiversity ideas in their work as service providers, such as counselors, teachers, or social workers (target 25)
People who had one or more neurodivergent family members (target 10).
We also asked demographic questions to allow us to select a diverse sample: gender, race, socioeconomic and employment status, region, profession (if applicable), familial relationship (if applicable), diagnosis/neurodivergent identity (if applicable). Initially, we received more expressions of interest from women and people who identified their race as white. We did an additional recruiting call for participants who were from racially minoritized communities and/or men to increase the diversity of the sample. The demographics of the selected interviewees can be found in Table 1. The numeric breakdown of participants’ relationships to neurodiversity (i.e., neurodivergent person, service provider, and/or family member) of the participants can be found in Table 2. The high numbers in each group show that many participants were members of more than one eligible group (e.g., a service provider and a neurodivergent person and a family member to a neurodivergent person). Participants’ stated neurodivergent identities are provided in Table 3, and service provider participants’ professions are given in Table 4.
Participant Demographics.
These participants reported that they would be struggling to meet their basic needs if they didn’t have ongoing financial support from parents, partners, or friends. Some lived with parents because of this financial pressure.
Interview Participant Numbers by Group.
Some participants belonged to multiple groups.
Neurodivergent Identities.
Some participants belonged to multiple groups.
Professions of Service Providers.
The first 24 interviews were conducted in-person (from January to March 2020), and then, with the advent of the COVID-19 pandemic and associated public health measures, all remaining interviews were conducted via Zoom (from June 2020 to January 2021). No changes were made to the interview guide or protocol since participants had already been offered the choice of remote interviews in the original protocol. All participants were sent the interview guide in advance and were offered breaks and the opportunity to use text or request other accessibility supports. The interviews lasted between 45 minutes and two hours. Each participant received a $50 Canadian honorarium and was offered reimbursement for any costs incurred in conducting the interview, up to $100 Canadian.
Interviews were recorded, either using an audio recorder device when interviews were conducted in person or using Zoom audio recording on the researcher’s computer when they were conducted remotely. All interviews were transcribed and anonymized by a professional transcriptionist and checked by team members. The research team and trainees then used NVivo data analysis software to organize the data, using “codes” to be able to identify and find passages of transcripts that addressed important and related topics. Three master’s students and one research assistant collaborated with the principal investigator to analyze and code the transcripts. Those doing this analysis of transcripts often worked together to develop and coordinate each person’s understanding of and confidence in the analytical priorities and procedures of the project. All data analysis was supervised and reviewed by the first author/principal investigator. An additional master’s student and an undergraduate student helped in the final edits of the resulting tip sheet found in the implications section of this article.
For the analysis presented in the current paper, the first author re-immersed herself in the coded transcripts and memos, paying particular attention to the ways in which participants described existing services and service providers, what problems and solutions they identified, and what work they were required to do in everyday encounters. Following ethnographic principles, these analyses broadened to investigate what these interviews told us about contemporary social relations, addressing the core research questions of the project.
IE is an approach to social research that seeks to understand social structures, relations, and discourses starting from everyday encounters, activities, and texts (Campbell, 2015; DeVault, 2012; Lund & Nilsen, 2019; Smith, 2005). By starting from what people do and how they understand their experiences, IE allows researchers to build an analysis from the bottom up, piecing together the ways in which individual understandings and activities are coordinated by larger discourses and hierarchical power arrangements. Researchers who use IE do not prioritize areas of agreement across interviews—rather, IE understands how we see the world through feminist standpoint theory’s concept of partial knowledge (Doll & Walby, 2019; Rowland et al., 2019; Talbot, 2024). Researchers work with people’s situated knowledge of the world to learn about the larger relations that structure and produce these particular standpoints and practices—even as these structural relations have often been deliberately obscured from any individual’s view. IE is committed to locating specific actions in what people do rather than in abstract concepts or processes, working with elements such as texts in ways that focus on how they are created, circulated, and acted upon by people across different places and times (Campbell, 2015; DeVault, 2012).
The interviews followed this approach with a focus on how the differently positioned participants understood the language and concept of neurodiversity and how they felt about it. The two interviewers, HM and MG, asked participants to share everyday examples as well as broader observations and opinions. In the analysis, we paid attention to the work that participants did in their everyday lives and what larger social relations shaped and necessitated this work. In this context, “work” was taken to include anything involving time and effort, including research, relational negotiation, waiting, coping with emotions, and more (Smith, 2005). Institutional roles and affiliations were considered throughout, in terms of understanding provider training, textual production, and the ways in which ideas became enacted as practices.
We defined “service provision” to include practices and programs offered through social service, health care, education, and mental health organizations, including private professional practice (e.g., counseling). Our data included many people’s experiences of seeking or using services; working or training as a provider; and encountering the words and ideas of providers across settings such as policy and online discourse. We considered what these interviews about neurodiversity reveal about how our current institutions and practices are organized, highlighting ways in which social power is reproduced or challenged through people’s engagement with neurodiversity. We integrated these findings into a set of recommended principles for practice, which we present in the final section.
Recruiting, interviewing, and analysis throughout were influenced by the positionality of the different team members, including those who have authored this article. All members on the project grant had experience either as service providers (social workers, counselors, and/or educators), neurodivergent community members, or family members to neurodivergent individuals—and most belonged to more than one group. The interviews and screening interviews were conducted by the principal investigator (MG) and a research assistant (HM): both identify as white, queer, and as social workers; one identifies as a cisgender woman and one as agender, one as autistic and one as nonautistic, one as a parent to an autistic person and one as a nonparent. The other authors of this article bring a range of identities and experiences in terms of neurodivergent/disability identity, gender, practice experience, and research role. Throughout our research process, we have been consistently attentive to the ways in which who we are—and who participants have understood us to be—might connect to the larger issues of power and privilege that surround conversations about neurodiversity, service provision, and knowledge. Our protocols have deliberately sought out a range of perspectives and experiences, while recognizing the very real divisions that such differences can impose in our larger cultural landscape.
Findings
In this section, we first present our findings in relation to the project’s overall research questions. We start by describing how people were using the concept and language of neurodiversity, and outline the kinds of broader critiques and goals they associated with the term. Following IE methods, this first section zooms out to reflect on what these conversations reveal about larger systems and discourses from participants’ varying standpoints and range of lived experiences (DeVault, 2012). Next, we present more specific findings on services and what our interviews told us about the experiences of both seeking/using services (such as counseling or education) and working in/training for service provision. In this second section, we include more specific examples and quotes from the interviews to illustrate the kinds of objections and suggestions that people had for service providers.
People Use the Concept and Language of Neurodiversity When They Want Systems and Practices to Change
Participants were eager to talk about neurodiversity. They described this word as encompassing the many ways that human beings experience the world, and as an opportunity to value differences. For example, one neurodivergent social worker explained: Well, I mean, like, literally and technically, it’s a term that describes how differently—how wildly people’s sensory perceptions vary and how differently people’s brains work, like all the different ways that our brains can work when faced with a specific problem and all the different ways that people can perceive things, like the same sensory inputs and stuff. Less technically, I think neurodiversity is just magical. I think it’s so cool how complex the human brain is and how many different ways people are able to perceive and process information.
This was a particularly enthusiastic response, but the participant was not alone in their understanding of neurodiversity as encompassing everyone. While most people went on to discuss particular forms of neurodivergence and/or diagnoses, the usual starting point for a definition of neurodiversity was that we can expect people to have different ways of understanding, communicating, sensing, and behaving. In this sense, neurodiversity was presented as either a value-neutral difference or, as in the above quote, a source of potential benefit to the community as a whole. Many participants talked about associated concepts, such as biodiversity, and described wanting a concept that went beyond diagnostic categorization of what could be considered normal or medically deemed pathological.
When we asked people what neurodiversity meant to them and how they used it, we found that they very quickly started to talk about the problems that they saw in current systems and practices. Participants used the concept and language of neurodiversity to address the many ways in which participants found that our current institutional frameworks and practices fail to support and value people. For example, another participant, a neurodivergent teacher, described neurodiversity as follows: Neurodiversity, to me, means the idea that there’s a range of ways to be, think, communicate, act, and understand. By trying to stick everyone in the same box, we intentionally Other people who do not naturally fit in that box. So, someone like myself, who can pass very easily [as neurotypical], isn’t as pushed aside or marginalized the same as students in the classroom, who are—because they learn differently, act differently, behave differently—assigned to a special section with special instructors and special techniques that we wouldn’t use with anyone else.
As seen in this quote, participants described being drawn to the language and concept of neurodiversity as a framework that could challenge current systems and practices. Participants’ critiques of systems varied in terms of how radically they wanted such change to occur, ranging from more minor adjustments in language to fundamental shifts in capitalist and colonial structures. At the same time, participants were united in identifying current structures and practices as inadequate and harmful. Service providers—including educators, counselors, medical practitioners, psychologists, and social workers—constituted one of the central groups that participants stated that they hoped to reach and challenge through the language and concept of neurodiversity. This degree of consistency across interviews was notable given the diversity of perspectives represented (neurodivergent individuals, service providers, and family members).
There was a wider range of opinions among the people we spoke with about who, exactly, they thought about when discussing neurodiversity. Often, people focused on autism, ADHD, and learning disabilities. Some specifically talked about intellectual disabilities, dyslexia, Tourette’s syndrome, and other diagnoses. Some wanted to connect their critique of normative practices with experiences of sexually minoritized individuals through the use and exploration of the term “neuroqueer” and analogies of how diagnostic terms had become socially reclaimed identities and movements. There was less agreement on how to think about mental illness diagnoses or “Mad” identities and neurodiversity: while many interview participants thought these definitely needed to be considered under discussions and actions related to neurodiversity, others divided these experiences out as something else.
There was also an overall division into two main groups in terms of how familiar and connected people felt to neurodiversity conversations. Some people belonged to communities and attended online or activist spaces where neurodiversity was commonly discussed and acted upon. Others were newer to the term and did not always have many places where they had heard about it, or many opportunities to think about how the concept of neurodiversity might be put into practice. Nevertheless, all participants had a lot of passion for talking about how services and systems could be improved, and everyone had thoughts to share about their own work and/or service experiences.
People Believe That Service Providers Are Not Meeting the Needs and Desires of Neurodivergent People
People believe providers can be “out of touch” with discussions about neurodiversity that could help improve their approach, and they often resist critiques of current practices. Across these 60 interviews, when asked about neurodiversity, participants characterized existing services as inadequate, inaccessible, and often harmful to neurodivergent people. This assessment of the service landscape was endorsed by neurodivergent individuals, service providers, and family members alike. The people we heard from shared their experiences looking for, using, and/or providing services and supports for neurodivergent people of all ages, and they identified the problems across these services as widespread and systemic. They detailed how hard it was for neurodivergent people to find supports that they could access without enduring long waiting lists or paying steep fees. Interview participants described how multiply marginalized people encounter even more barriers in finding respectful and affirming services, especially if they did not have the economic resources or employment benefits to pay for private supports.
When we asked people about neurodiversity, we often heard that providers were “out of touch” with broader community conversations about neurodiversity and neurodivergence, even as more and more individuals and families are seeking different approaches. For example, one person described service providers who work with autistic children: [Providers are] kind of out of touch with the dialogue [about neurodiversity]. They are living 20 years ago . . . most of them are not really having these discussions. They have a good-paying job working with kids in a segregated environment and a lot of them just don’t really have . . . the interest or the creativity to do a paradigm shift, but the paradigm shift is happening without them because the parents are connecting with autistic people online and they’re shifting the paradigm and they’re rejecting the traditional services.
While this individual focused on services with children, the description of providers being “out of touch” with neurodiversity resonated across discussions of adult services as well. Indeed, many people talked about ways in which it was even harder for adults to find appropriate services.
Neurodivergent people recounted largely negative experiences across social services, health care, and education. Some talked about instances where their mental health struggles were minimized, misinterpreted, or responded to in unhelpful ways. Several talked about service providers ignoring or denying their experiences of violence (e.g., parental abuse, bullying). Many described educational spaces where neurodivergent people faced segregation, pathologization, invalidation, and violence. Language was one way in which some providers might show that they were unfamiliar with community ideas about neurodiversity and more recent developments in disability activism. A number of participants preferred “identity-first” language, such as “disabled person” or “autistic person,” but they often encountered service providers and organizations that insisted on “person-first” language, such as “person with a disability” or “person with autism.”
More broadly, participants described encountering providers who were unwilling to listen to any critiques of their practices and theories. For example, one person described the challenge of being heard by providers: I think part of [the challenge with providers] does have to do with respect and establishment within the community and, like, “This is what all this research says.” But all of that research is biased and based on assumptions that are centuries old, about disabled people, and here you have this new, emerging field of studying neurodiversity and critical disability studies and all these things that these other people who have been in the field for years don’t have the time for, don’t want to make the time for because, “Well, I’ve done my education, I already know what’s up, I’ve been in this field for 30 years and that’s all I need, and you can’t teach me anything new.”
Participants recounted finding such resistance to change across different provider professions, systems, and institutions.
Even organizations that had official mechanisms for “community consultation” or described their work using the language of neurodiversity could be seen as resistant to the changes that neurodiversity advocates might suggest. For example, several participants shared experiences being on advisory boards for organizations that incorporated neurodivergent community members in token roles. One person talked about being on an autism policy advisory board of 20 people that had only two autistic people on it. Another individual described challenges that could occur even when advisory groups were specifically for neurodivergent members:
I was on the [redacted organization] advisory—adult autistic advisory committee . . . and we would put through our suggestions, and they would all get turned down for various reasons, and they eventually shut down the group. [laughs]
They shut down their advisory group entirely?
Yeah. We only did it for just over a year or something in the [redacted place] region.
What do you think was going on there? Why do you think they started it and why do you think they stopped it?
Well, a lot of the workers think it’s a good idea, but I guess the higher ups don’t so much and they don’t want to put the money out for the things we suggest, and the government gives them money, and now they’re seriously involved in [Applied Behavioural Analysis (ABA)] because at the time I think they were just getting involved in ABA.
These experiences illustrated ways in which apparent efforts to include the expertise of community members could be perfunctory and ineffectual when it came to challenging everyday practice.
The widespread use of applied behavioral analysis, or ABA, was a core concern of many participants. This practice paradigm has been condemned by many autistic community members, even as it has continued to dominate many of the autism service organizations and systems in the province of Ontario (and many other places in Canada and the United States). Interview participants shared concerns about the ethics and efficacy of ABA and expressed anger that the opposition to ABA from many neurodivergent people (as well as some family members and providers) had not resulted in meaningful systemic and structural change. Participants described the challenges of convincing many parents, providers, and policymakers that concerns about ABA could be valid when such practices are so entrenched in practice and policy. One participant summarized: The dominant narrative right now is put your kid through 40 hours of ABA every week. The autistic people saying, “Hey, that’s really harmful,” sound like we’re off our rockers because that doesn’t match with the dominant narrative. So, we sound like conspiracy theorists about aliens or something. [laughs]
Participants shared ways in which the ubiquity and structural centrality of behaviorist practices in the Ontario region made it more difficult for providers to hear and respond to critiques of ABA, even from other providers. Across our interview sample, concerns about the dominance of ABA were identified by people across all three groups: providers, family members, and neurodivergent people.
Providers Can Improve Their Practices With Neurodivergent People
Providers can improve their practices, especially if they are open to hearing different perspectives from neurodivergent communities, including neurodivergent providers. When discussing neurodiversity, many participants talked about how this concept could be a helpful means to introduce more responsive and respectful practices. Participants said that service providers could be responsive to neurodivergent communities, but they often were not even aware that critiques of dominant practices existed. Interviewees discussed ways in which online organizing and information sharing on neurodiversity make these alternative perspectives on conventional practices more readily accessible.
Throughout the interviews, professional training emerged as a central concern and a space where interviewees believed that change could occur. These conversations challenged commonly circulating ideas about who should be considered an “expert.” One person who worked in a school objected to the way that she and others who worked in an autism program were seen as the people to consult: I’d almost rather have a teacher in my program, if they had a question about autism, to go to any of the students, which wouldn’t be their initial thought, but I might challenge them to . . . connect with members of that community more than people working in the community.
Participants who were service providers described receiving almost no relevant training in their formal education that helped them in supporting neurodivergent communities. Furthermore, many described having to actively unlearn much of what they had previously been taught to support neurodivergent people effectively. For example, some people talked about having to unlearn what they had initially believed about the effectiveness and ethics of ABA. People who worked as service providers reported that they needed to look outside their training to develop educational and counseling approaches that were effective for neurodivergent individuals. Many talked about sharing books and blog posts with their colleagues or their own providers to help them develop an understanding of neurodiversity and how to support neurodivergent communities. Providers talked about learning new practices from groups and books that focus on neurodiversity-affirming approaches. For example, counselors talked about developing alternatives to presumed “best practices,” such as the common practice of giving homework sheets between sessions. While such practices might work well with some clients, they can be unhelpful or actively harmful with many neurodivergent individuals with ADHD.
Interviewees appreciated when providers listened to their concerns and were willing to learn more about neurodiversity and neurodivergence. Many talked about sharing neurodiversity resources and related websites with providers (see also Gibson et al., 2025). At the same time, they also described how having to explain neurodivergence to providers took time and energy. One person summarized their experience with a counselor, saying: “I felt like I had to spend 70% of our sessions explaining what autism is and then, at the end of the session, I pay her for the education that I just gave her.” Others said that providers who know about neurodiversity-related critiques usually have been taught these by previous clients/students.
Several interview participants recounted how beneficial it was when they found neurodivergent providers who were already familiar with their experiences and with the limitations of dominant paradigms and practices for neurodivergent individuals. Providers who were also neurodivergent found this combination of experiences and knowledge valuable for the work that they could do with others. As one person explained: Being a neurodiverse person myself, I felt uniquely positioned to support and make sense of behaviors that come up that neurotypical people might find disruptive or what have you, and also modeling for myself . . . being neurodiverse in a facilitator or helping role, how that looks in those spaces.
Across these interviews, neurodivergent providers described bringing important ideas and representation to the work that they did. Many talked about becoming providers, in part, because they wanted to help other neurodivergent people get better supports than they themselves had received.
While neurodivergent providers talked about their lived experience as a valuable resource in their work, they also described how social service and education institutions can push neurodivergent professionals out of the workplace, or force them to be very careful about disclosing their own disability or neurodivergence. While people recounted that some organizations hired openly neurodivergent providers, they were not likely to be given higher status or management roles. Many organizations and settings that focused on supporting neurodivergent communities had no openly neurodivergent staff members at all. People who had worked in such places talked about their struggles to disclose their own neurodivergence; some had lost jobs or opportunities to advance upon disclosure.
Implications for Practice
Throughout the 60 interviews, participants from all groups listed practices and approaches that they thought were helpful—and others that they thought were best avoided. We have put these suggestions together into a tip sheet presented in Table 5. These are not intended to be comprehensive for all settings and professions, but offer a widely applicable starting place for people who would like to enhance their skills and understanding for working with neurodivergent people in a respectful and nonpathologizing way.
Tips for Service Providers.
These tips cannot fully cover all work with the neurodivergent individuals and communities across the wide range of settings and roles of service provision. Instead, these tips are presented as starting points in questioning and adjusting dominant approaches to develop more neurodiversity-affirming practices. They offer principles to guide further thinking and learning, rooted in the things that people shared in these interviews. There is an urgent need for further research on how different domains of human services and education can nurture and assess a wider range of practices for supporting and working with diverse neurodivergent communities. This tip sheet also highlights the need for organizations to become more explicit in their commitment to developing responsive practices, and to creating working environments that welcome neurodivergent service providers and support their crucial contributions and leadership.
Neurodiversity offers a paradigm shift to service providers of all kinds: educators, counselors, social workers, psychologists, health care professionals, and more. While current practices and systems have usually relied on a dichotomizing of “normative” from “pathological” in how people communicate, sense, respond, and behave, neurodiversity paradigms invite us all to become more imaginative and inclusive (Baggs, 2014; Chapman, 2023; Long, 2023; Piepzna-Samarasinha, 2018; Walker, 2021). Discussions of neurodiversity can encourage more responsive and individualized practices.
At the same time, these findings highlight that formal educational programs for service providers are seriously lacking in current and community-engaged content on neurodiversity-affirming practices. This inadequacy in training must be remedied since all service providers will work with neurodivergent people, whether this is their specialization or not. It is also critical to recognize that core elements of training for people specializing in working with neurodivergent people (e.g., special education, autism support therapists) have been critiqued by members of the communities that these approaches purport to support. It is incumbent on all providers to learn about disability justice and neurodiversity advocacy, and to re-assess the effectiveness of their own practices with diverse neurodivergent individuals and communities (Botha et al., 2024; Mingus, 2011; Piepzna-Samarasinha, 2018; Sins Invalid, n.d.; Walker, 2014).
While a good first step is to learn from each individual or group what they want and what has been helpful to them, relying too heavily on neurodivergent people to educate providers places an additional burden on service users and students. Furthermore, not all neurodivergent people will be knowledgeable of alternative practices and frameworks, or agree on the best approaches. Providers must not assume that all practices they have been taught are “evidence-based” and will work in the same way for all people. It is also important not to put all neurodivergent people in the same category, even when they share a diagnosis. An embrace of professional “unknowing” and willingness to reflect and adjust can allow providers to hear and respond to a range of perspectives, rather than settling on a singular approach and closing off further conversations (Jackson-Perry, 2025).
Our research and the resulting tip sheet have some important limitations. First, the interviews were all conducted with people in South-Central Ontario, particularly in the area around Toronto. Other regions have different policies related to education and practice; for example, some other provinces and countries have been less broadly influenced by behaviorist modalities in autism services. In inviting people who wanted to discuss neurodiversity, this research also relied upon a sample of people who volunteered to discuss neurodiversity in a research study. Such a group is not necessarily representative of all service providers or community members. Because these findings come from interviews, only people who were able to communicate in spoken English participated. While other modalities were offered in the recruiting call, there were no participants who were primarily nonspeaking, although some described spoken language as sometimes difficult or unavailable for them. As seen in our demographics, there were more white participants than those of other racial/ethnic backgrounds, and most participants were women. Given that we recruited service providers who are generally from professions that have more women, this sample is perhaps not surprising. In addition, the historical moment of 2020 to 2021 brought additional stressors and uncertainties to participants, providers, and researchers with the advent of the COVID-19 pandemic. It is possible that people’s responses would have been different at other times—although there was a notable consistency in critiques and contributions across the interviews before and after the pandemic was declared. Any systemic changes arising in the post-pandemic period would not be captured here.
If providers are to be truly accountable to neurodivergent community members—including neurodivergent social workers and other providers—we need to be prepared to shake up the assumptions of our training and traditions of our organizations (Gibson et al., 2024, 2025; Krcek, 2013; Silvester & Rankine, 2024). Furthermore, the COVID-19 pandemic has shown both our professional abilities to shift the ways in which we work with people, and the steep costs when we are not able to support them adequately (Brotman et al., 2021). Community concerns about the impact of applied behavioral therapies warrant particular attention and responsiveness for providers, even as such practice approaches may be institutionally encouraged or even mandated (Douglas, 2024; Gibson & Douglas, 2018; Gruson-Wood, 2016; Yergeau, 2017).
Service providers who want to become more affirming of neurodiversity can access a range of resources and supports to help them do so. Some organizations are explicitly committed to making services more responsive to the needs and critiques of neurodivergent communities; these often curate resources and offer trainings or places for discussion (see, e.g., Therapist Neurodiversity Collective, https://therapistndc.org/neurodiversity-affirming-therapy/; resources at The Thinking Person’s Guide to Autism, (https://thinkingautismguide.com/resources). Starting in the United Kingdom in 2018, Neurodiversity Celebration Week has become an opportunity for people to attend workshops and trainings, or join in discussions about how to make services more responsive and accessible (https://www.neurodiversityweek.com/). Disability justice and autistic advocacy groups have publications and presenters who can work with providers and offer supports for training programs (see, for example, Autistics for Autistics Ontario, https://a4aontario.com/), and many have also produced accessible publications (e.g., Autistic Women and Nonbinary Network, https://awnnetwork.org/). Many writers and scholars in critical disability and neurodiversity studies have also written work that is accessible for the broader community (Baggs, 2014; Mingus, 2011; Piepzna-Samarasinha, 2018; Walker, 2014). As a part of ethical practice, providers need to engage with the critiques and ideas of communities whose perspectives and knowledge have been marginalized within our research, practice, theory, and policy. The Neurodiversity Matters Project has found that many people are not only eager to see these domains of practice change but are ready to help researchers and practitioners in improving what we do.
Footnotes
Disposition editor:
Cristina Mogro-Wilson
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this research came from an Insight Development Grant from the Social Sciences and Humanities Council of Canada, a University of Waterloo-SSHRC Research Grant, and a Renison Research Grant.
Ethical Approval
Approval for this research was given by the research ethics board at the University of Waterloo (protocol #41334).
