Neurodiversity-Affirming Report Writing for Professionals

Sep 11, 2022

Neurodiversity-Affirming Report Writing for Professionals
In January 2022 I opened an email attachment with my autism assessment, it read ‘you meet the criteria for ASD (Autism Spectrum Disorder). Below, was listed a list of evidence for each domain of the DSM-5 used for diagnosing autism.

You display ‘repetitive and restricted behaviours with fixated interests that are atypical in intensity’, ‘persistent difficulties in social communication’ and ‘difficulties in forming and maintaining relationships’. It was like reading a list of traits about someone else. Although my report featured far less ableist and dehumanising language than those that I have read of my clients, it still isn’t nice to hear yourself described in such a way.

I didn’t feel like I had a condition or a disorder but the words on the page clearly stated I did. I wasn’t sure how to feel about what I read and the more I reflected on it the more I realised this must be the feeling my clients will have if they ever read the reports I’ve wrote about them. I decided there and then that things had to change in the way I approached speech therapy.

Where did I start?

As with every special interest it all began with research and there was lots of it. Podcasts, blogs, books, research papers, you name it. I attended training courses and journaled my thoughts. I discussed it at length with my colleagues and then I wrote my first report since my diagnosis.

It took me about three hours because I just couldn’t get the words right, I often found myself slipping back into medical model terminology and coming from a deficit-based angle. Once I had finished, it felt like the biggest weight off my shoulders and for the first time in my career I knew I was doing exactly the right thing for my clients.

I would like to explain that even with the vast amount of knowledge my sponge brain has absorbed on neurodiversity-affirming practice I do not know it all. I, just like everyone else going through the process of transitioning to a strengths-based approach will forever be learning what is best for my clients. I can only share with you what I know so far.

Respect the person’s choice on how they wish to identify 

The majority of the autistic community have a preference for identifying as ‘autistic’ but there are some of us who prefer ‘person with autism’, there should be no judgement either way. Some of us believe that when people say ‘person with autism’ it takes away the autism from the person, and it is an integral part of our identity, not something we carry around with us in a bag.

The preference your client states should be reflected in the report in line with their wishes. This also applies for their pronouns. We know that a significant number of neurodivergent people, compared with the rest of the population, identify as ‘they/them’ or are transgender and our reports must reflect that preference.

Autistic people generally do not like the terms ASC (Autism Spectrum Condition) and ASD (Autism Spectrum Disorder), there is no need to use these terms in diagnostic reports, despite that being the official diagnostic label.

Be kinder with the words you use to describe autistic people 

I recently read a report that described an autistic person as ‘patronising’ because of their tone. So many negative words are used to describe autistic styles of communication, something that needs to change.

Please don’t label autistic clients as ‘controlling’, ‘inflexible’ or ‘attention seeking’ instead try ‘has a high need for predictability’, ‘has a preference for sameness’ and ‘connection/safety seeking’. It is very difficult to hear your actions described as ‘challenging behaviour’, instead try ‘communicating distress’ so that the blame is not focused on the individual.

Scrap the medical model terminology, it’s dehumanising 

Terms such as ‘deficit’, ‘impairment’ and ‘abnormalities’ should not be used to describe an autistic person’s differences, ever. Imagine someone describing your personality as ‘disordered’ and ‘abnormal’, how would you feel?

The more we use dehumanising terminology like this the more it becomes acceptable to mistreat, dismiss and abuse autistic people because they are viewed as less human. This is dangerous, as our history shows in the mistreatment of disabled people.

The outcomes you set shouldn’t encourage masking 

Any goals set around turn-taking, giving eye-contact, appropriate greetings or whole body listening are not ethical because they encourage masking, which we know has significant implications on mental health. By making someone wait their turn in a conversation we place stress on them to constantly monitor their communication, leading to exhaustion.

I still see autism assessment reports which suggest social skills training, which I refuse to complete. I cannot knowingly teach a child to suppress their natural communication style and ‘autisticness’ in order to make other people feel more comfortable. It is immoral and a violation of my HCPC standards. Knowing the effects masking creates, professionals should not be suggesting any form of social skills training or ABA (Applied Behavour Analysis).


In summary…

The way we talk about autistic people matters, even if you think it’s ‘only words’. The way we describe people affects our and others’ viewpoints of that person and how we treat them. Remember to think ‘would I like to read this about myself’ when you write your reports about autistic clients because someday they may read your words.


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Need help?

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