Understanding the Neuro-Affirming Movement & Gentle Sensory's Approach

By Maria-Louise SAMMUT

The neuro-affirming movement is a social and intellectual paradigm shift that reframes neurological differences, such as autism, ADHD, dyslexia, and Tourette's syndrome, as natural variations of the human brain rather than pathologies to be "fixed" or "cured." It advocates for the acceptance, support, and inclusion of neurodivergent individuals by challenging the prevailing medical model of disability, which views these differences as deficits. Drawing heavily on the psychosocial model of disability, the movement suggests that many of the challenges faced by neurodivergent people stem from societal barriers and a lack of accommodation, not from their intrinsic neurology.

Key principles of the neuro-affirming movement include:

• Rejection of the "Deficit" Model: It moves away from language that pathologises neurodivergence, such as "disorder" or "impairment," and instead uses neutral or positive, identity-first language (e.g., "autistic person" rather than "person with autism"), reflecting that neurotype is an integral part of a person's identity.
• Focus on Strengths and Abilities: This approach emphasises the unique talents and perspectives that neurodivergent individuals possess, including creativity, hyperfocus, pattern recognition, and a strong desire for justice.
• Emphasis on Environmental Adaptation: Rather than forcing neurodivergent individuals to conform to neurotypical standards of behaviour and communication, the movement advocates for modifying environments and systems to be more inclusive and accessible. This can include changes in workplaces, schools, and social settings.
• Respect for Autonomy and Self-Advocacy: It prioritises the voices and choices of neurodivergent individuals in decisions about their own lives, including therapeutic goals and support strategies.
• Critique of "Normalisation" Therapies: The movement is often critical of therapies that aim to suppress neurodivergent traits or teach masking (the conscious or unconscious suppression of natural behaviours to appear more neurotypical), arguing that these can be harmful to mental health and a sense of self.

How the Gentle Sensory Approach aligns with the Neuro-Affirming Movement 

Historically, many therapeutic interventions for neurodivergent individuals, such as Peer-Based Intervention & Instruction and Positive Behaviour Support, were designed to make the individual appear more neurotypical. The focus was on compliance, suppressing "challenging" behaviours, and teaching social skills that mirrored those of their neurotypical peers, often without regard for the individual's internal experience, autonomy, or well-being. Despite the history of these services, it does not mean that evidence-based approaches must be ignored or abandoned. Instead, those using these approaches must fundamentally shift their philosophy and application. The goal shifts from normalisation to supporting well-being, improving connection, and developing skills for self-advocacy and environmental navigation. 

Neuro-Affirming Peer-Based Approaches

The focus shifts from "teaching skills" to "facilitating connection."

• Mutual Mentorship and Shared Interests: Instead of a tutor-tutee dynamic, peers are brought together based on shared, authentic interests (e.g., a LEGO or Minecraft group). The goal is for genuine friendship and understanding to emerge naturally. The facilitator's role is to support connection, not to drill social skills.
• Embracing the Double Empathy Problem: The program actively teaches all participants about different communication styles. The neurotypical peer learns that an autistic person might show they are listening without making eye contact, or that their direct communication style is a sign of honesty, not rudeness. It becomes a two-way cultural exchange.
• Neurodivergent Peer Groups: The most affirming peer-based approach often involves connecting neurodivergent individuals with one another. This creates a space where they do not have to mask their identities, where their communication styles are the norm, and where they can build a positive identity around their shared neurotype.

Neuro-Affirming Positive Behaviour Support

This involves a radical reframing of "behaviour" and "support." It is sometimes referred to as "Collaborative and Proactive Solutions" or simply "needs-based support."

• Assume Competence and See Behaviour as Communication: This is the foundational shift. Every behaviour is seen as a valid attempt to communicate an unmet need or a response to a stressor. The question is never "How do we stop this behaviour?" but rather, "What is this person trying to tell us, and how can we help them meet their need?"
• Collaborative and Empathetic FBA: The Functional Behaviour Assessment is done with the individual (to the greatest extent possible), not to them. It is a tool for deep curiosity.
  • Non-affirming FBA: Observes that a child runs out of the classroom. Concludes the function is "escape." Implements a reward for staying in their seat.
    
  • Neuro-affirming FBA: Observes the child exiting the classroom. Considers the antecedents: "This happens 10 minutes into math, when the air conditioner kicks on, and after the teacher said 'get your books out'." It explores sensory profiles, processing speed, and potential anxiety triggers. The team collaborates with the child and discovers that the hum of the AC is painful and the visual clutter of the math worksheet is overwhelming.
• Focus on Proactive, Environmental, and Skill-Building Supports: The intervention emphasises modifying the environment and empowering the individual.
  • Environmental Support: Instead of forcing tolerance, the environment is adapted. The child is offered noise-cancelling headphones, a different seat away from the AC unit, or a worksheet with fewer problems per page.
  • Skill Building: The focus isn't on compliance, but on building authentic skills. Instead of teaching a child to suppress their feelings, you teach them to recognise their sensory overload and give them the language and autonomy to request a break before they feel the need to run. This is building self-advocacy, a crucial life skill.

Bringing Awareness to the Concerns

Concerns within the community regarding behavioural interventions, such as Positive Behaviour Support (PBS) and Peer-Based Instruction and Intervention, are deeply rooted in the traumatic history of Applied Behaviour Analysis (ABA), from which they evolved. Early ABA, pioneered by figures like Ivar Løvaas, utilised aversive methods, including physical punishments, to make autistic children "indistinguishable" from their peers, a legacy that has created lasting distrust. This focus on modifying behaviour to fit neurotypical norms is seen as a form of social control that can lead to long-term psychological harm, such as chronic anxiety, burnout, and PTSD from the practice of "masking" one's authentic self. Therefore, the core of the controversy is the belief that these interventions seek to "fix" or "normalise" autism rather than accepting neurodiversity and providing supports that respect autistic identity and autonomy.

Despite the historical harm caused by these practices, providers who work within the allied health industry are bound by the requirements of the various insurance and government agencies, such as the NDIS, which require services to be "evidence-based".  For providers to overcome these industry barriers as well as ensure no further harm to the autistic community, evidence-based approaches must be altered to reflect the neuro-affirming movement. Although the names of the evidence-based approaches and most of their core principles must be maintained to minimise confusion amongst agencies, we must adopt the neuro-affirming philosophy into everything we do. 

References Informing Our Approach

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Fletcher-Watson, S., Adams, J., Brook, K., Charman, T., Crane, L., Cusack, J., ... & Pellicano, E. (2019). Making the future of autism research a priority. Autism, 23(2), 273-275.

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Milton, D. (2012). On the ontological status of autism: the ‘double empathy problem’. Disability & Society, 27(6), 883-887.

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