Because neurodivergencies are generally based on a deficit model, the focus of many medical professionals is to “fix” what they think they can. What this means is that a diagnosis focuses on what a person can’t do – in comparison to an average neurotypical person – rather than on their strengths. It also rarely takes into account that many neurotypical people aren’t strong across all areas of their lives either, but aren’t forced into therapies to improve. So how do we, as parents, know when to accept the help to improve our child’s abilities or skills, and when to embrace our child as they are or offer accommodations?
The Neurotypical Experience
Unless a neurotypical person asks for help, or shows a severe deficit in an area of their life, they are usually left to their own devices.
Consider, for example, when you were at school. There were always the kids who weren’t great at reading aloud; not problematically, but mispronounced words, lost their place occasionally, sounded bored, and didn’t enjoy the task. When you were picking sports teams there were always the kids towards the back of the group; not seriously uncoordinated, but just not particularly good at sports. There were the kids who didn’t get jokes as easily, who weren’t as kind, whose report cards were average, who were never going to receive a handwriting award. And that was fine. Those kids are fine. You can’t be good at everything.
While the school system seeks to help each kid improve, they are rarely referred to therapy unless there is a marked problem.
This is the neurotypical experience.
The Deficit Model
While neurodivergent people often demonstrate significant strengths in comparison to the average neurotypical person, diagnosis focuses on deficits and weaknesses. And the professional response to this is usually to recommend therapies to address them.
This could include:
- social skills courses (which largely teach neurotypical social skills, rather than improving neurodivergent social skills)
- teaching apraxic kids to speak
- focusing on reading skills for dyslexic children
- physiotherapy for dyspraxic children
- food exposure courses for children with ARFID
- and many, many more
Should We Do The Therapies?
If you can perceive a genuine benefit, absolutely. Not a “my child will be more normal” pseudo-benefit. A real benefit.
- Helping your child communicate their needs and feelings better.
- Improving muscle tone and coordination to reduce pain levels and increase their enjoyment of physical activities.
- Working on emotional regulation so they’re less stressed and overwhelmed when faced with big feelings.
Do not dismiss all therapies as an attempt at turning your neurodivergent child into passing as neurotypical. Do, however, be mindful of the approaches taken by therapists. Are they actively teaching skills and strengths, or simply encouraging your child to mask, act and suppress their authentic selves?
Setting Goals
Just as many neurodivergencies are fluid, and change over time, goals set for your child need to remain fluid too.
If an initial assessment of an apraxic child indicated that they were likely able to learn to speak clearly enough to communicate, it would be a natural response to aim for that goal.
Some speech therapists avoid additional communication aids during this time, to encourage the child to focus on speech. This means alternate skills such as sign language, or the use of AAC devices, might be ignored.
But what happens if your child struggles to reach the goals original set?
Reassess. If your child is distressed, or not improving, consider what the alternatives are, and whether they’d be of greater benefit at this point in time.
There is a fine line between being optimistic and helping to motivate your child towards achieving their goal, and pushing them beyond their comfort or ability levels.
And yes, there is a difference between the two. And no, not all medical professionals agree.
Comfort vs Ability
Masking is common amongst neurodivergent people, and can be hugely taxing and exhausting. Just because a person can achieve something, should they be pushed to do so despite a high cost and potential eventual burnout?
If an apraxic child can speak if they focus very heavily on constructing their sentences before they speak, and on their enunciation of each word, but it leads to burnout or decreased communication, is this genuinely a better option than arming this child with an AAC device?
When an autistic child can make eye contact with their teachers and peers when spoken to, but it leads to burnout or the Coke Bottle Effect at the end of the day, is this a smarter choice than allowing them to maintain different or less eye contact than their neurotypical peers?
If a child with ADHD can sit still for a lesson, but it means they can’t focus on as much of the lesson content and leads to dysregualtion, is this really more important than allowing them to use a fidget toy and letting them learn?
Similarly, in therapies, just because your child is able to adopt strategies and skills, it doesn’t mean they should. Many therapists will push your child to achieve their highest ability, without recognising the cost. It is important to monitor their levels of fatigue and distress, and weigh this up against the impact of using alternative accommodations.
How Can I Help?
- Decide in advance which recommended therapies will be of use to your child and their future experience; just because a report recommends something, it doesn’t mean you have to do it.
- If your child has the necessary cognition and communication skills, include them and their preferences in your decision making process.
- Seek neuroaffirming therapists and practitioners.
- Monitor your child for fatigue and distress when in therapy sessions, and practising skills.
- Observe your child for masking / acting / faking, and encourage authentic behaviour.
- Advocate for your child’s right to rest. Weeks packed full of a variety of therapies and practise are not conducive to a happy and healthy child. Consider staggering your therapeutic approach, or spacing out appointments, so your child has time to process, practise, and relax in between.
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