Abstract
Most neurodivergent students attend mainstream schools; however, it can be difficult to make and keep friends, and it is common for neurodivergent people to feel excluded at school. Neurodivergent peer support is the idea that young neurodivergent people spend time together, which provides the opportunity to spend time with like-minded others as well as to learn about neurodivergence. This might help make being at school more welcoming. In this study, we asked four schools to run neurodivergent peer support groups using materials called the Neurodivergent peer Support Toolkit (NEST). These materials were co-designed with neurodivergent young people, and we wanted to find out if the groups that used them thought the materials worked for them. We wanted to find out whether NEST-based peer support groups were suitable for mainstream school settings. Students and staff took part in focus groups and interviews to give feedback and results were generally promising. Students enjoyed spending time with their peers and doing new activities. Staff enjoyed facilitating the group and felt it was useful for the young people too.
Introduction
Recent population data indicates that 16% of students in Scottish schools are neurodivergent, a category that incorporates students with diagnoses including autism, ADHD, dyslexia, dyspraxia, and dyscalculia (Maciver et al., 2023). 95% Of these students are educated within mainstream classes (Scottish Government, 2023). However, attending a mainstream school does not necessarily mean that neurodivergent students feel included there. Inclusion is a complex and multifaceted process involving myriad factors, including the social and communicative relationships between students, staff and families; physical characteristics of the classroom, corridors and outdoor space; the ethos and attitudes of the school towards diversity and difference; and an understanding that attainment levels are only one metric of academic success (Morewood et al., 2011).
A classic response to difficulties neurodivergent young people can face in peer relationships is to offer interventions focused on teaching neurotypical social skills (Gates et al., 2017), often via pairing them with neurotypical students (Bertilsdotter Rosqvist, 2019). However, this puts pressure on neurodivergent students to ‘fit in’ at school (Chapman et al., 2022) and inherently promotes the idea that neurodivergent people should ‘mask’ traits which may be considered atypical (Kosaka et al., 2019; Walker et al., 2021). Masking requires a prolonged and exhausting effort for neurodivergent people (Bargiela et al., 2016; Hull et al., 2017; Kosaka et al., 2019; Walker et al., 2021), can generate anxiety about ‘being found out’ (Pearson & Rose, 2021), and is associated with a range of negative long term outcomes including stress, depression, and burnout (Arnold et al., 2023; Cage et al., 2018; Cassidy et al., 2018; Chapman et al., 2022; Mantzalas et al., 2022; Miller et al., 2021).
More generally, adolescents often have negative perceptions of being neurodivergent (Dewey & Volkovinskaia, 2018), believing that they have a ‘bad brain’ (Hodge et al., 2019; Humphrey & Lewis, 2008), which may have a long-term effect on self-perception and wellbeing (Maughan et al., 2020; Wilmot et al., 2023). Encouraging (implicitly or explicitly) neurodivergent students to strive towards neurotypical norms not only puts them at risk, it simultaneously perpetuates the stigma associated with neurodivergence (Bottema-Beutel et al., 2018). Thus, finding a way to support and embrace neurodivergent difference within mainstream school environments is imperative.
Over recent years, there have been repeated calls for research into peer support programs for neurodivergent people (Cusack & Sterry, 2016; Harper et al., 2019; Iemmi, 2017). However, to date, most work has focused on autistic adults (Bertilsdotter Rosqvist, 2019; Crompton et al., 2022; Crane et al., 2021, p. 2023; Shea et al., 2022; Valderrama et al., 2023). Autistic adults have reported increased feelings of comfort and ease around other autistic people (Crompton et al., 2020; Sinclair, 2022) and feeling part of an autistic community reduces suicidality (Cassidy et al., 2018). While to our knowledge, no research has examined the potential for peer support for neurodivergent young people, neurodivergent adults have stated that peer support in school would have been useful to them when they were younger (Crompton et al., 2023). Teachers have also suggested that a framework which encourages neurodivergent students to engage with one another might be beneficial (Hodge et al., 2019).
Peer support programmes for other minority groups (e.g. LGBTQ+ students) have helped minimise the negative consequences of marginalisation for students, providing a space for them to find community and develop their own identities (Fetner et al., 2012). Adolescence is a key time of identity development, and peer support for neurodivergent individuals may help them develop self-advocacy skills and a positive self-perception (Camus et al., 2023; Maitland et al., 2021).
In the first stage of this research, researchers, neurodivergent young people and the adults who support them co-designed a package of materials to facilitate neurodivergent peer support in mainstream secondary schools: the Neurodivergent peer Support Toolkit (NEST) (Fotheringham et al., 2023). The toolkit is outlined in Appendix 1. While the initial role of the group is to bring neurodivergent students together in a social group, we were also interested in the potential for it to have wider benefits: cultivating positive self-identity, advocacy, feelings of belonging, and well-being. This study evaluated the feasibility (participation and continuity across the school year) and acceptability (view of the peer support group, perceived effects on students) of NEST-based peer support groups in mainstream schools.
Method
Methodological approach
This study used a qualitative design, with data collected using semi-structured interviews and focus groups. Ethical approval was granted by the Moray House School of Education and Sport (University of Edinburgh) Research Ethics Committee (ref SFOL19072022). The presentations of our Methods and Results are aligned with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (Tong et al., 2007).
Participants
Four mainstream state secondary schools in Scotland participated, implementing a NEST-based peer support programme between October 2022 and June 2023. The schools varied in terms of size, urbanity, and affluence (see Table 1).
Descriptive demographics of the schools, students, and staff involved in the NEST pilot.
Scottish Index of Multiple Deprivation Decile: This indicates the relative deprivation of the area where the school is located, indicated by the school's postcode. SIMD considers income, employment, education, health, access to services, crime and housing. The decile indicates which bracket the school falls into: 1 would indicate that the school is in the most deprived 10% of postcodes; 10 would indicate that the school is in the least deprived 10% of postcodes. (Scottish Government, 2020a).
The Urban/Rural was defined using the Scottish Government Urban Rural Classification index (Scottish Government, 2020b), which ranges from 1 (large urban area) to 6 (remote rural area).
Students at School D did not participate in the focus group as this the group had temporarily paused at the time of data collection. While we did approach the school to invite students to attend a focus group session, most of the students at School D were in the older school years and the focus group was at the end of the semester, at exam time. As running a focus group would involve a special re-convening of the group for this specific purpose, and could cause disruption and additional time stress on the students, it was decided not to pursue a focus group at this school.
Focus group participants were students who had regularly attended NEST groups (n = 24). They were students aged 11–17 who had a range of neurodivergent conditions (diagnosed and awaiting diagnosis) including autism, ADHD, dyslexia, and dyspraxia. In the interest of data minimisation and confidentiality, we did not collect demographic data for these participants.
The staff members who facilitated the NEST group in each school were invited to participate in interviews (n = 5). These staff had a range of professional experience including as subject-specific teaching staff, pupil support, guidance teachers, and senior leadership. In School C, two members of staff completed a joint interview as they were equally involved in the day-to-day running of the group.
Procedure and materials: Focus group
Focus groups were held in the same location and on the same day and time as each school's usual NEST session, which was during the students’ lunch break, for around 40 minutes. During the focus group, the students, staff facilitator(s), and researcher were present. Participants were informed in advance that the focus group would be held on that day. Information sheets and consent forms were handed out 2 weeks in advance: written consent was opt-in for students and opt-out for their parents. As far as we are aware, no students opted out of participating in the focus group, though some may have informally opted out by not attending the focus group session.
The semi-structured schedule for the focus groups (see Appendix 2A) focused on student experiences of being part of a NEST group. Questions were designed to generate group discussion, and the schedule was designed to be flexible and to allow for ad hoc follow-up questions as required. Prior to use, the accessibility of language in the schedule was reviewed by a neurodivergent young person who was not part of a NEST group; no changes were required following this. Teachers were given the questions in advance so that these could be shared with students. As all but one student in the NEST groups communicated verbally during the NEST sessions; the focus groups were based around participants engaging verbally, with one participant communicating through their phone (typing into their phone with this read out by a pupil support assistant). Focus groups were audio recorded for later transcription. Due to school holidays and to minimise additional work for school staff, transcripts were not returned to participants for comment or correction. Field notes were not made during or after the focus group.
Procedure and materials: Interviews
Interviews happened after the focus group had taken place; four staff members chose to have their interview in person directly after the focus group session, and one chose to have an interview via Zoom at a later date. The semi-structured interview schedule (see Appendix 2B) focused on staff experiences of facilitating the group, perceptions of student experiences, and perceptions of change (if any) in students during the NEST group. Interviews lasted around 40 minutes and were audio recorded for later transcription. Transcripts were not returned to participants for comment or correction. Field notes were not made during or after the interviews.
Positionality statement
The authors comprise both neurodivergent and neurotypical academics. The author who conducted the focus groups and interviews was a female neurodivergent post-doctoral researcher with experience in data collection with young people in school settings. Though their experiences and views were not discussed during data collection, this may have influenced the framing of follow-up questions during focus groups and interviews. The researcher had been in contact with the staff facilitators prior to the interviews as she was involved in helping set up the groups at the start of the study. The research is grounded in a neurodiversity framework which may have impacted which schools volunteered to be involved in the study.
Data analysis
Data were analysed using framework analysis (Furber, 2010), a type of qualitative content analysis used to systematically identify where similarities and differences arise within a qualitative dataset. It is a useful method to compare and contrast data to give a descriptive overview of a dataset that has been collected using different methods, for example, focus groups and interviews (Gale et al., 2013). The framework also allowed for a top-down deductive approach, which facilitated examining the data with feasibility and acceptability in mind, rather than a more inductive generation of themes, though initial codes were inductively generated to ensure no useful information was missed. Whilst the principle of data saturation could not feasibly be applied (since data were gathered from all schools who had undertaken a NEST group, and no further data collection was possible), there was a similarity in the codes across the transcripts from the four schools. The aim of the analysis was to understand end-users’ experiences of the NEST programme to inform future iterations.
The seven steps of framework analysis were followed (Gale et al., 2013) and are outlined in Table 2 with further detail below.
Framework analysis procedure, and authors involved at each stage.
Codes could refer to particular events, structures, behaviours, values or emotions expressed (Saldaña, 2009). In step 3, we used an ‘open coding’, inductive approach, which involved coding all components which we felt might be important, rather than (deductively) working with a pre-existing list of codes. In step 4, the authors decided to create two frameworks: one for the student focus groups and one for the staff facilitator interviews, as although there was overlap between what students and staff had reported, their experiences and roles within the NEST group were distinct and warranted separate reporting.
Results
Student evaluation of the NEST group
An overview of student responses are shown in Figure 1.
NEST roles and relationships
Friendship
By providing dedicated time and space for neurodivergent students to be together, NEST groups facilitated the establishment of friendships between students. Students reported that they had experienced feelings of loneliness at school ‘because neurodivergency can feel really lonely…like everyone is in on a joke and you are not in on it’. (School A). The NEST group had provided new opportunities, enabling students to ‘see different people, get to know different people, open up to different people’. (School B) and reduced feelings of loneliness: ‘I have found people similar to me and I don’t feel alone again’. (School A).
Conceptual framework of student experiences of the NEST.
Being with other neurodivergent people allowed students to ‘open up’ and behave in a way that felt natural and comfortable to them: ‘It is more relatable in here than out there’. (School C). Students felt less of a need to ‘mask’ within the NEST group: ‘You get to be yourself and not hide your true personality away from the world’. (School A); ‘it just feels, like, amazing to come here and, like, be myself’. (School A).
Communicating with others in the NEST group felt comfortable and relaxed: ‘It's not like you are flung into something and have to talk. You can just slowly open up’. (School B); ‘You can just observe as well and learn about the other people’ (School B).
Leading and mentoring
A core aspect of NEST groups is student leadership. Students led creation of the groups’ identity, with students in three of the schools choosing the group's name and designing a logo: ‘It was [the name of the group] with a rainbow…everybody drew it…we used the logo on the noticeboard to raise awareness of the group’. (School B). This is something that the students enjoyed, and that gave them a sense of group ownership. Students were also encouraged to choose the group's activities, which included boardgames, litter-picking, and making a podcast: ‘I get to talk about my experiences and also get to do some fun things…I’ve been wanting to do some kind of podcast for a while now and I finally get to do one’ (School A).
Some older students also took on a mentoring role for younger members of the group. Younger students found that spending time with older neurodivergent students was reassuring: ‘I quite liked it ‘cause it kind of showed me that there was still people with similar conditions in every part of the school, every area…it kind of gives me a bit of a reassurance’ (School B).
The older students thought the mentoring aspect of the group may help boost self-acceptance of younger neurodivergent students: ‘For me it is kind of fulfilment…I am influencing younger people in a good way and not in a bad way. I am trying to prevent letting people grow negatively’. (School B)
Working with the facilitator
The staff facilitator plays a key role in the NEST group. All groups reported getting on well with their facilitator: ‘They are cool and they understand’ (School A); ‘He's my bestie’; ‘He's funny’; ‘you can trust him’ (School C); ‘She is really nice’ (School B). Students highlighted staff understanding of neurodiversity and being able to relate well to the students: ‘I feel like it is just better with these two because they have a better understanding of neurodiversity than any of the other teachers’. (School C). Students also thought that the NEST group allowed for a more relaxed staff–student connection than in class, which they enjoyed.
NEST activities and attendance
Fun and socialising
Students found being part of the NEST group fun: ‘It is fun coming here’. (School C). They enjoyed spending time with other students: ‘It is nice to be with people that are nice’. (School C), and enjoyed the activities ‘I love them [the activities] all…they are all pretty great. I find this group to be very helpful in my opinion’ (School A). Many of the students stated that they generally didn’t enjoy school very much and that NEST was a positive contrast to this.
While some activities were more structured (e.g. working on a neurodiversity podcast), other sessions were more unstructured, with students encouraged to choose an activity which they enjoyed. Often, this included board games, which seemed to facilitate building friendships and were a fun way to spend time together. Students said that games, including role-playing games like Dungeons and Dragons, gave them space to be creative and imaginative: ‘I get to take my own little character and go on adventures’ (School A).
Students also enjoyed having a social space to talk about everyday things: ‘We’ll sometimes talk about our pets and things’. (School A student), which they didn’t experience generally at school: ‘I can socialise for a change. I don’t usually talk to people much and I talk to people here so that is fun’. (School C).
NEST also provided a space for students to talk about their special/specific interests in a way that was framed positively: Student 1: I got absolutely lonely in primary because anyone I tried to socialise with would just ignore me because I am ‘too annoying’ because all I talk about is my special interests. Student 2: But here everybody wants to hear about your special interests. Student 1: Yeah. (School A students)
Learning about neurodivergence
Many of the students hadn’t had the opportunity to discuss and reflect on neurodivergence and neurodiversity before engaging with NEST and found this to be a positive experience. Part of this process included reflecting on how neurodivergence is portrayed in the media: ‘Autism is highly mischaracterised…autistic people (are portrayed) as unfeeling robots… which we aren’t. We feel just like you’. – School A. Students also discussed the similarities and differences between neurodivergent group members: ‘I’ve quite enjoyed the group because it has gave you a sort of wider view on how not everybody is the same. Everyone is different and you get to understand that on a deeper level in a way’. (School B).
Environment and attendance
Students understood that schools might not have an ideal space for the NEST group, but did highlight that a comfortable sensory environment was important, with suggestions that gentle lighting would be preferred: ‘maybe little string lights and decorations’ (School A). Students also highlighted the importance of a consistent space for the group to meet.
The NEST groups found that there was generally a core of regular attenders to the group, and that the students tried to ‘come as regularly as possibly’ (School A). The students generally reported very positive experiences of engaging with the group: ‘I won’t say there is really anything that I would change. I wouldn’t honestly’. (School B), and would recommend the NEST to other schools: Interviewer: Do you think other schools should have a group like this? All students: Definitely (School A).
NEST and the school community
NEST as a safe space within school
Students said that the NEST group felt more comfortable than the wider school environment, in because ‘there is way less people’ (School C); because ‘It's quiet’ (School A), because the space was comfortable (‘it's a really nice open space’ – School A), and because the people in the group were familiar (‘these people, I know all these people’ – School A). This meant they felt happy and safe when attending the group: ‘I have found a safe space… a quiet safe space’ (School A). Additionally, being in a space with other neurodivergent students meant that students felt the group was a safe space to be themselves: I feel really great to come to the group, because often when I am with other people that aren’t like me, I feel like I can’t really do anything because I am afraid to be who I am, because they might make fun of me for it. So it just feels like amazing to come here and like be myself. (School A)
Sharing information about neurodiversity within School
The students recognised that neurotypical students in the wider school community were likely to have misconceptions about neurodivergence, in part due to media portrayals. Autism is highly mischaracterised…it is always white man, white man, white man…and the only movie about not white and not a man having autism is “Music”. I am the exact opposite of what that movie characterises, I am extremely emotional. (School A).
Students said that they wanted to help their neurotypical peers learn about neurodiversity and have a positive influence on the school community: ‘We want to speak to the masses about how our brains work’. (School A); ‘We want to use the podcast to tell everyone about what autism is really like…it isn’t like a fixed thing’ (School A); ‘We destroy ableism with an iron fist, hah!’ (School A).
Staff facilitator evaluation of the NEST group
An overview of staff facilitator responses are shown in Figure 2.
Establishing the group
Alignment between NEST and the school
Staff facilitators were interested in establishing a NEST group as it aligned with their school's ethos and filled a gap within an existing equality and rights approach: Inclusion in the school is very important…we try as a whole school, all the staff members, to make it as inclusive as possible…We have got the LGBTQ clubs and…we’ve got the school paper one…there is things for different pupils. So it is good to have one that is just for neurodivergent pupils. (School B)
Conceptual framework of staff facilitators’ experience of the NEST.
Being a NEST facilitator requires a time commitment from staff who may already be stretched: ‘We are kind of relying on people like [co-facilitator]…giving up her lunch to have this run to make it work, otherwise it wouldn’t run at all’. (School C). Facilitators noted that it was important to reflect on whether they had capacity to take this role before establishing the group.
Promoting the group and identifying students to join
As NEST facilitators were establishing the group, they were involved in the initial promotion of the group within their school, and reaching out to students who might be interested in attending. Facilitators did this in a range of ways: I went round all the registration groups…and did the presentation to all the kids, which was useful to explain what neurodiversity is because I think a lot of them equate it with just autism. And posters…I got teachers to put those in all the other classrooms. (School D) I didn’t do…the full advertising, to everyone in the school…I knew there would be certain dynamics between certain pupils that I already knew about…and I thought if they were all in one little space together it just wouldn’t be a benefit. So, I did kind of seek out people initially…and I feel like now they are kind of established…when more people come in it is not going to be such a big deal. (School B) I spoke to the people in the [Support for Learning base] first, because I thought they would be an appropriate audience for it, and I called a meeting that was after school…I presented this idea and what it was all about and whether they’d want to be involved. (School D).
Staff thought that some students might not be familiar with the term ‘neurodivergent’ and felt it may be helpful to explain what this means when establishing a group. I was hearing more conversations about what neurodivergent…what it is. So, I did, like, a display [about] what neurodivergence means and what it is. And I think people with like-, we have a lot of people that are dyslexic, and they hadn't kind of recognized that it included them. (School D)
The facilitators were aware that not every neurodivergent student will want to attend, and decisions about attending should be student-led. Facilitators had various ideas about why some students might not attend: ‘It is not wanting to be seen as different’ (School A); ‘a formalised group is maybe not their kind of thing’ (School A); ‘I asked one boy and he was like “och I just like having time to just zone out” and he didn’t really want to have an activity…I think he just needed that time to just go and be on a computer for half an hour’ (School B).
The staff felt that there is also a potential stigma around engaging with a group that is affiliated with an additional support needs department: ‘I think some young people might be a bit worried about being associated with the department. There is a stigma and that is something that is part of the group's purpose, to break that down’ (School A). They also recognised that it can be difficult to reach out to certain students who don’t already have good existing connections with the school staff.
Using the handbook
Facilitators found that the NEST handbook was generally very helpful in setting up their group: ‘some of the bits were amazing, in terms of “here is what you need” and it broke it down perfectly’. (School C); ‘I feel like it was very well put together. The ideas that were there. Everything was covered. Every eventuality. Everything’ (School B). It offered ‘a lot of choices about how to go about things’ (School A). The NEST handbook was also seen as helpful in prompting staff and students to generate their own ideas for the group: ‘The podcast kind of grew out of that as well…looking at all the prompts within the pack’ (School A).
Not all the materials in the NEST handbook were used, and facilitators felt that the toolkit should be used flexibly to accommodate the preferences of students: ‘when we tried to do some autism stuff…they weren’t interested. I think they weren’t interested because a) it was lunch time, it was their own time, and b) there was just too much going on in the room’. (School C).
The NEST environment
Facilitators, like the students, noted the importance of having a quiet space for the NEST group to meet away from the rest of the school. A space up here for kids to come up and chill…play some games, have a laugh, get them away from the big bad world down there. Cause a lot of them just need that space. There is too much going on down in the canteen, too much going on outside. (School C)
They also noted that consistency of location was important: ‘We had to change location initially…we moved up to the art studio upstairs…I kept trying to catch up with folk and get them along but it just wasn’t the same’. (School B).
Facilitating the group
Student leadership and mentoring
The NEST handbook encouraged staff facilitators to support students to lead the group. One facilitator noted how this happened organically: They kind of got their own dynamic by themselves without my involvement really and it was actually just much more enjoyable to see that…I was trying to step back and be the facilitator…and yeah, they felt confident with coming up with what they wanted to do…it was relaxed and it was their group really. I was just there. (School B).
As neurodivergent students may like to know what to expect from a group before they attend, the focus on student leadership might be a barrier to attending NEST in its early sessions. One facilitator noted that it might be useful for the students to: …make a video that could be shown in classes about what they do and who they are and what the space looks like….cause when you think about a neurodiversity support group it might not sound that fun but if we actually talk about what we do or what we could do or what we are planning and make it really obvious to people how it will work, that might work better. (School A).
Like the students, facilitators reported that the mentoring role between the older and younger students was beneficial to both: The juniors meeting the seniors has been the biggest benefit: I think the seniors enjoy the feeling of being a mentor…and the younger ones…when they come from the primary school…into such a big school…seeing the visible success of two seniors…how they are coping with it all and thinking ‘that is going to be me in a couple of years’, they were great role models to them. (School B).
Challenges in facilitating a student-led group
Facilitating a student-led group can be challenging. Facilitators had to support conflicting needs and preferences within the group, for example: ‘I have kids walk in and go “woah” and then walk out again because it is too loud…It is the kids who want a quiet space because they are in sensory overload but they make loud sounds’. (School C). One NEST group found having autonomy and choice over activities somewhat overwhelming, which the staff member supported by ‘…having a little bit more structure in there. So still leaving the decisions down to the students. but having a handful of choices, not necessarily in either or, but maybe 4 or 5 choices’. (School D). The sense of freedom that a student-led group provided was also a particular challenge in one school: I think where we've fallen down is having it purely peer led…it was their ideas, but I would facilitate it… but I think, having more structure, having more sort of repetition… because I think they didn't know what to do with all that freedom. We did it on the Tuesday after school, which meant we got the run of the whole nurture base… it's a nice big area. Unfortunately, it wasn't big enough for them, and they run off around school. It was getting chaotic, unfortunately. and that is dangerous…so …we had to kind of wind it up. (School D).
However, even in this case – which was clearly challenging – the facilitator planned to run the group again in the next academic year: Now we've got a little break, and we've got a new cohort coming in, and we've got…a lot of neurodivergent kids coming up into S1. And I think there's more of a need than ever…so, I think it would be really nice to do something a little bit more structured in the new term. (School D).
Who joins the NEST group?
Facilitators found that the popularity of the NEST group was consistent across the year, with some students attending regularly and some sporadically: ‘the core group kept coming back’. (School B). Some facilitators had been surprised by which students engaged with the group: One thing I have liked about it is that kids have turned up that I wouldn’t have expected to turn up… [student name] is one of the few that doesn’t turn up for Dungeons and Dragons, he doesn’t turn up for the LGBT, he saw that poster and said ‘that is for me, that is a space I am supposed to go to’…I think that is really positive in a totally different way from everything else. (School C).
NEST group activities
Facilitators used voting systems and informal discussions to help students choose activities democratically: ‘it was a majority decision…there are a couple that weren’t too happy, but once they got there enjoyed themselves, which is super’ (School D). Students often chose to play board games, which facilitators noted were a good way to build friendships and be creative: They were developing their characters [for Dungeons and Dragons] and they were sort of drawing them out…doing all the preparation stuff that they have to do, and that again was another nice connecting thing, and it was lovely their sort of conversations they were having. (School D)
The facilitator's role also included supporting students in planning and structuring their activities: The podcast, they’ve got lots of ideas, the actual physical doing of it, they are finding that quite hard to organise…the ideas are all there, the plans for each episode are all there, and that is again something we could share with the wider school but it is actually just getting the time and the organisation to do it. (School A).
Facilitator experiences and responsibilities
Facilitating staff noted that their role could be difficult to fit in with other demands on their time, and especially during particularly busy times of the school year such as exam periods. However, they all found it to be an enjoyable role: ‘I feel like it has been really positive, I have really enjoyed doing it’. (School B), and that it had a positive impact beyond the NEST group itself: ‘I am having a lot of conversations…correcting people's perceptions of neurodiversity. That's positive…I would like to deliver something to the whole staff at an INSET [training] day’. (School D). All facilitators planned to continue the group beyond the end of the feasibility study into the next academic year.
Experiences and outcomes
Neurodivergent identity: Confidence and community
NEST groups provided a space where young people could speak openly and informally about their experiences of being neurodivergent: ‘They really enjoy just getting a chance to talk about being neurodivergent’. (School A).
Facilitators reported students reflecting specifically on how neurodivergence is represented, and how to develop a positive neurodivergent identity: A couple of times we have just spent the day looking up memes and ‘does that speak to you, does that speak to you?’. I think that is really valuable…they don’t always talk about their own diagnosis or their own feelings about that, so this is a chance to explicitly talk about that, and they seem happy. I don’t know if that is a direct result of that but they seem really content with who they are and very strong in their own identity in a way that I don’t think they did before…it is lovely. It is really lovely. You don’t often get that with kids these days. (School A)
This also provided an opportunity for them to find shared experiences with their peers: ‘I mean, you could just see the faces light up on how it was nice to be recognized of, “Oh, okay, it's not just me”’ (School D). This has been a boost to self-confidence for some: I have seen a huge growth in [student's] confidence…[student] just seems so articulate when speaking about her experience and how she feels about things and it amazes me, because she struggled in first year just to get used to a new place and how she fitted in and to hear her talk so positively about her experience, and so eloquently about her experience is really lovely. I think it has helped her self-confidence and quite a few of the others as well. (School A)
Some students found having a space to be with neurodivergent peers to be validating: They were saying they felt they were part of something and they liked that feeling of belonging and they felt like they could just be themselves and they could express, they could talk about what they wanted to. (School B)
Being part of a NEST group also helped some students become more comfortable in identifying as neurodivergent: ‘I am hearing words more like them saying “autistic”. … saying it out loud rather than being embarrassed about it which I think is really important’. (School C). These benefits also applied to students who didn’t have a diagnosis: ‘We have got some kids…who are waiting for assessment…who haven’t been diagnosed but they are now feeling like they are part of something…they are now finding a spot where they do fit in’. (School C).
Enjoyment of the group
Facilitators reported that the group was enjoyable and fun: ‘I think the group has been good. I think the kids have actually enjoyed it. I think the kids have got a lot out of it’. (School C). The students felt relaxed in each other's company and got on well: ‘it was nice to see the side of the personality where they were relaxed enough to be joking with each other…they know each other's interests and they were good on connecting at that level’. (School D).
Often students had a difficult time with peers outside the NEST group, though enjoyed spending time with others in the group. One facilitator said their students felt ‘comfortable with their peers in here. Which is not the case outside…they know who to talk to now and they know other people who are similar to themselves, not the same, but similar’. (School C). Students were also ‘linking between year groups in a way I don’t think they would have’ (School C).
Wider school impact
Facilitators felt that students had improved self-esteem out with the NEST group setting: ‘I think they are far more confident around the school’ (School C), and felt that they belonged in the wider school community: ‘that came across for most of them very, very strongly…that they felt they belonged, and it was quite a contrast’ (School A).
There was also a positive impact on the inclusive ethos of the school: ‘it has highlighted across the school for everyone…we have got a group, if you need help there are people here, we will support you’. (School C). There have also been suggestions for engagement between the NEST group and the rest of the school more broadly, for example through a comic in the school newspaper (school B) and an assembly (school B). One facilitator also felt that the NEST group might positively impact how students engage with their academic work: ‘it made them feel…more positive over lunchtime…they have maybe faced the afternoon a little bit better…hopefully that would have a positive effect on their lessons’ (School B).
Discussion
This study explored whether neurodivergent peer support was feasible and acceptable within mainstream secondary schools, and provided information about which factors might enhance the success of neurodivergent peer support. This study also examined the experiences of neurodivergent students engaging with a NEST group in their school, and the experiences of staff members facilitating the group, highlighting potential benefits and challenges. To our knowledge, this is the first study examining neurodivergent (rather than diagnosis-specific) school-based peer support groups for adolescents.
Overall, the findings confirmed the feasibility and acceptability of the NEST groups: the groups were sustained for several months, were consistently attended by mixed student groups, and all groups intended to continue in the following academic year beyond the end date of the research study. Staff facilitators generally found the NEST handbook and materials helpful in setting up and sustaining the group. They also reported some challenges in facilitating a student-led group and shared some of the ways in which they supported students to take a lead.
The success of the NEST groups was doubtless driven by the visible benefits reported by both students and staff. Students found that the NEST groups provided a safe space within the school for making friendships, having fun with peers and engaging in enjoyable activities. It provided a space for them to learn about neurodiversity, explore their feelings relating to their own neurodivergence, and in some cases, consider how to engage with the wider school community to share information about neurodiversity. This aligns with existing evidence showing that a positive neurodivergent identity correlates with better mental health (Cassidy et al., 2018). It also fits more broadly with Rajotte et al.'s (2024: 7) notion of a ‘neuroinclusive school’, which emphasises the provision of caring, safe spaces, and the celebration of neurodiversity. Aligning with the findings of Crompton et al. (2023) there appeared to be value in a broad neurodivergent peer support group, rather than one that was diagnosis-specific, with the students highlighting the opportunities the NEST group provided to learn about diversity within neurodivergence.
Facilitators also enjoyed their role and thought that the NEST groups had enhanced the confidence and well-being of the students. The groups also provided an opportunity for some young people to take on aspects of leadership and mentoring and to be role models for younger students. O’Hagan et al. (2023) note the importance of neurodivergent young people having such leadership opportunities and report similar benefits (e.g. personal growth, positive social connections) in their non-school-based mentor programme for autistic youth to those shared by the young people in our study. Our qualitative findings suggest that variables such as student well-being, school belongingness, quality of life, school attendance, leadership skills and a positive sense of self should be incorporated in future research evaluating peer support models in school.
While the experience of students and facilitators was generally positive, one school did experience challenges regarding the students’ response to having more unrestricted choices than they perhaps typically experienced. Finding the balance between a structured and unstructured approach, and between a staff-guided and a student-led ethos will clearly be important considerations for schools seeking to implement a NEST group in the future. Facilitators may also have to fine-tune their approach over time according to the particular students and the broader school context involved. No other risks were identified in this study, though we didn’t have individual interviews with students which might have made it harder for students to share any individual reservations or negative experiences.
There are limitations to this research. First, in the interest of data minimisation, we did not collect information on participant age, gender, or neurodivergence, so we are not able to examine diversity in the sample. This also means that we are not able to examine specific details about participants who generated specific quotes and are unable to examine whether, for example, younger pupils contributed as much as older pupils. Efforts were however made by the researcher to ensure that all focus group participants had opportunities to contribute to the discussion. Similarly, although we sought detailed quantitative data on the number of NEST group sessions which took place in each school, and the number of students attending each session, it was not possible for all staff facilitators to provide this: broader information was therefore drawn from focus groups, interviews, and correspondence with staff facilitators. Detailed quantitative data will be useful in future research on neurodivergent peer support. Second, not all neurodivergent young people engaged with the NEST group in their school, and we did not explore which factors affected individual student choice on whether to participate or not. Neurodivergent peer support will not be something that all neurodivergent students want to engage with: not all will have being neurodivergent as a strong aspect of their self-identity (Camus et al., 2023) and a group-based activity may not suit all students (Calder et al., 2013). Some may also have concerns about the risks of being more open about their neurodivergence at school (Aubé et al., 2021) – though we note in our sample there was no evidence of this occurring for those who attended the group. Third, at the time of data collection, one school had temporarily paused their group, and so we were not able to run at focus group at that school to elicit the views of those students, though we were able to do an interview with the facilitator of the group. Fourth, students were asked to provide feedback within the peer support group environment. Although many expressed how comfortable they felt within this group, the setting may nevertheless have impacted on some students’ willingness to share things that they disliked or didn’t enjoy about the group. Finally, the schools who participated in the study were self-selecting: they had identified a support need for their neurodivergent students, had an ethos and culture aligned with the concept of neurodivergent peer support, and had school/staff capacity to set up and maintain a NEST group. Schools who are not in this position may be less interested in NEST or have a less successful experience if it is attempted.
In conclusion, this feasibility study indicated that NEST-facilitated peer support for neurodivergent students in mainstream schools is possible, sustainable, desirable and potentially beneficial. While many previous ‘peer support’ interventions for neurodivergent students have involved a neurotypical peer, this is the first study to examine school-based support between neurodivergent peers. These promising findings open up potential avenues for further examination and evaluation relating to specific well-being and educational factors. This may include whether neurodivergent peer support can enhance attendance for neurodivergent students (who may be more likely to miss more days of school, Adams, 2022); engagement in class; feelings of belonging within the school community; well-being and mental health outcomes; and academic performance. It may also include exploration of the extent to which benefits of neurodivergent peer support extend across the whole school, for example via the staff and students involved sharing their knowledge of neurodiversity in order to create more neuro-affirming school communities.
Footnotes
Acknowledgements
We would also like to thank the students and staff facilitators who participated in the evaluation focus groups and interviews and the local authorities who facilitated our research in schools.
We would like to thank our two co-design groups who helped create the NEST materials. We would also like to thank Dorian Poulton, Youth Research Panel member, Regulating Emotions – Strengthening Adolescent Resilience programme, King's College London, for their feedback, and the staff of Kirkcaldy High School for their helpful advice.
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
This work was funded by a Salvesen Mindroom Research Centre Scientific Advisory Board Research Grant.
