Neurodiversity-Affirming Approaches

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young girl looking at you

Do you ever find yourself wondering about things like, “what does it mean to be neurodiversity-affirming?”, “why do many autistic children have pronoun reversals”, “what is gestalt language processing”, “why should we honor protests from autistic children”, or “why aren’t WH question goals appropriate for many young autistic students”?. If you are curious about these questions and more…you are going to want to read about my conversation with Emily Byer. She’s a speech/language pathologist and she was so kind to let me ask her a variety of questions that are often brought to me by my community. 

A Conversation on Supporting Neurodivergent Children

Tara: Emily, it’s wonderful to have you here. Can you tell me a little bit about yourself?

Emily: I’m a speech language pathologist and have been at a clinic called Pediatric Therapy Playhouse in Los Angeles for almost six years. I have a pretty diverse caseload. I work with families with kids with various goals and I’m also the program director there. So I supervise clinical fellows and lead the clinics team through meetings and trainings. But lately I’ve become so passionate about supporting autistic and neurodivergent children using a neurodiversity affirming approach and I’m constantly learning.

Tara: Your dedication is inspiring, Emily. I’m curious about pronoun reversals, a topic you’ve discussed. Could you shed some light on why they occur in autistic children?

Emily: Pronoun reversals occur when individuals mix up personal pronouns, like saying “you” instead of “I”. In autistic children, this can stem from echolalia, where they echo phrases without fully grasping their meaning. It’s crucial to understand that this is part of their language development journey, and our focus should be on supporting overall language growth rather than correcting specific pronouns prematurely.

Tara: For some kids it probably corrects itself or you can teach it. In some autistic individuals, it might be long-lasting. If we understand what they mean, that’s the important part.

Gestalt Language Processing

Tara: Let’s talk about gestalt language processing. Can you explain its significance in language development?

Emily: So in a nutshell, because it is complex, it is a different way of processing language. It’s processing early language and whole strings of sounds or words rather than processing and learning one word at a time. That’s called analytic language processing. An analytic language processor might learn ball and they say that single word ‘ball’, then they add ‘blue ball’, then they add ‘want blue ball’ and it builds into a longer sentence. But with our gestalt language processors, they learn whole strings of sounds, a whole chunk of language as one unit. Then later that unit is broken down into individual words that can be later used flexibly and self-generated sentences using grammar down the line. It’s almost like a reversed order of things, but it’s totally a natural way of acquiring language.

Tara: Thank you for spreading the word about that. I always think of this student that I had two years ago she was three years old and she came over and she was sitting by me and she fell off her chair because she was wiggling around a little bit.

She fell off and she looked up at me and she goes, ‘We all fall down’. And I was like, yes we do. She was trying to say I fell, you know? She just didn’t have the spontaneous speech to develop that sentence. Maybe she didn’t even understand what fall meant, but she knows that phrase from London Bridge is falling down, we all fall down. I think it’s great when kids can apply it to situations like that and you can acknowledge it.

Emily: So echolalia or scripts, repeating phrases that a child has heard in their environment has historically been viewed as meaningless. But now we understand it’s not meaningless, it is meaningful, and it does hold communicative intent a lot of the time.

Tara: I’m really glad you pointed that out because I remember back when I started Echolalia was viewed that way. For those people that are in every day working with autistic kids, you realize quickly it is not useless, it has meaning and you figure out pretty quickly what the meaning is. So I’m so glad the word is spreading about that because it’s crucial that people understand that.

WH Questions

I’ve heard you talk about why WH question goals might not be appropriate for gestalt language processors. Why would that be?

Emily: So WH question goals focus on a child’s ability to answer questions beginning with W like who, what, when, where, why, and how. Those questions typically aim to test a child’s comprehension ability to retrieve the information and then answer the question. They’re not appropriate for early Gestalt language processors because those questions require breaking down language into separate parts to understand the meaning of the question.

So GLP’s on the other hand process language in chunks or holes. A question like ‘What color is the apple?’ will be challenging for an early GLP to answer because they may have challenges understanding what information is being asked and then formulating a response with a single word unit. We often see that the child may repeat the question back as a whole. We really want to focus on modeling meaningful phrases in context for the child to hopefully pick up as a gestalt and then later break down into single words.

Tara: That’s a great explanation. I have written so many WH question goals. When people learn about the stages of gestalt language processing and they learn about those early stages, it’s going to take the pressure off of you as a therapist to have to work on these goals that are just not right at the moment for that child.

Emily: Yes, it’s about supporting a child where they are in that moment. If they’re repeating the question back then they’re not ready yet for that goal.

Tara: I love to think of it like you’re narrating, you’re helping narrate what they’re doing or what’s going on. A lot of people in the past maybe thought, well if I model, they’re not going to know how to do it. They’re not paying attention. It seems over the years that’s been debunked.

Modeling AAC Without Expectation: Fostering Natural Communication

Tara: Can you speak to modeling AAC without expectation?

Emily: Modeling AAC without pressure allows children to explore communication at their own pace. By integrating AAC into natural interactions and play, we create a supportive environment where they feel empowered to express themselves authentically. Play is powerful. It is a child’s way of interacting with the world. When a child or individual is interested, that’s the posture that will lead to the most learning. It’s about nurturing their confidence and relationship with AAC without coercion.

Tara: What are some ways that we can focus on prioritizing building connections with our students?

Emily: Focusing on prioritizing regulation, and building connections is what I like to call the base of the pyramid. Then we build on them to support engagement language, higher level language, and cognitive skills. To do this, we first educate ourselves about neurodiversity affirming practices, especially if it’s with a neurodivergent student.

Then we need to understand that specific individual and their unique strengths and support needs. When we do that, we step into their world. We’ve built trust, the student feels safe, and then there’s a spark for learning. You have to set yourself aside a little bit and lean into the child and what they’re interested in.

Navigating Planned Ignoring: Rethinking Behavioral Approaches

Tara: Emily, what are your insights on planned ignoring? Can you elaborate on why this approach matters?

Emily: Planned ignoring is a behavior modification technique that involves withholding attention from that specific unwanted behavior. It can be harmful, particularly when used with autistic and neurodivergent individuals. The autistic community has been pretty loud about how harmful it was to them. It seems to misinterpret behavior as solely attention seeking when instead we want to focus and understand the why of a behavior.

I have found that when we get on the floor with a child, we offer co-regulation, then we create a safe and supportive environment and those behaviors go down. When planned ignoring has been used, the child feels unheard and not safe. And the behaviors increase. It’s about validating their experiences and building trust, ultimately promoting self-advocacy and emotional regulation.

Valuing Communication Beyond Requests

Tara: Along the lines of meltdowns, one other thing that I’ve heard talked about recently is honoring protests from autistic children. What does it mean and why is it so important?

Emily: Protesting is important and it’s a way for all kids to communicate their disagreement. If we think about the way we adults communicate, we need to be able to request things. But we also protest, we express our likes and dislikes. When protests happen, no matter the modality, whether it is spoken or non-spoken, they are met with understanding and support, then kids learn to express their emotions more constructively. Then they can develop more healthy mechanisms for emotional regulation because they’re being heard and validated.

Neurodiversity Affirming Practices

Tara: Thank you for emphasizing the importance of understanding and validating children’s communication. Finally, could you summarize what it means to be neurodiversity-affirming?

Emily: So it means a lot of things, and I’m learning all the time even more. To summarize, it means that we understand that there is a natural diversity of the human brain and no type of brain function is right or better than the other. All people deserve rights, equality, and inclusion regardless of neurological differences. Neurodivergent people are not broken or incomplete versions of neurotypical people. It’s just a different way of being human as Dr. Barry Presant says.

If you think about just the word neurodiversity affirming, we affirm those variations and we listen to individuals so we can support them the way that feels best to them. There’s no shame if we’ve had an approach previously that we don’t agree with now, but as you said, when we know better, we do better.

Tara: Yes, it’s baby steps. For some people taking one piece at a time of one of the things you heard us talk about today and implementing that. Then when you’re comfortable and you have your team on board, then try another one. It doesn’t have to be overnight.

Emily, thank you for sharing your expertise and passion with us. It’s been an enlightening conversation!

Follow Emily on Instagram @ndaffirming-slp

Related Topics:

Gestalt Language Processors

Early Language Development in Autistic Children

To listen to the podcast episode click here

Watch the interview here:

If you use visual supports in your classroom or home, you are going to want to sign up for this free Visual Supports Starter Set ASAP! Click here to have one sent to your inbox. Also, be sure to read more about visual supports and how they can help autistic children here.

a picture with a variety of visual supports for autistic children there is an all done symbol, a wait mat, a first-then board, a visual schedule, an adapted book and a change card

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