Understanding Neurodiversity

Neurodiversity describes the natural variation in human brains and neurological development.

People differ in how they think, learn, process information, communicate, regulate attention and emotions, experience sensory information and respond to their environment. These differences are part of the diversity of human neurology.

Neurodiversity is not a diagnosis. It is a way of understanding and recognising variation between people.

The term is often used when discussing neurodevelopmental differences including autism, ADHD, dyslexia, dyspraxia and Tourette syndrome.

There is no single definition of neurodiversity, and language in this area continues to develop. What matters clinically is understanding the individual rather than relying on terminology alone. (National Autistic Society)

What is Neurodivergence?

Neurodivergence is a non-diagnostic term used to describe neurological development or functioning that differs from what is considered typical or predominant.

It is not a clinical diagnosis, and there is no single universally agreed definition of neurodivergence. The term is used in different ways across healthcare, education, employment and within neurodivergent communities. (NHS England)

People may describe themselves as neurodivergent because they are autistic, have ADHD, dyslexia, dyspraxia or Tourette syndrome, among other neurodevelopmental differences.

The terminology can be useful in helping people understand themselves and communicate about their experiences, but it does not replace clinical assessment where assessment or diagnosis is appropriate.

Neurodiversity and Everyday Life

Neurodivergence can influence many aspects of everyday life.

For some people, difficulties may be particularly noticeable in executive functioning - such as planning, prioritising, organising, initiating or completing tasks. For others, sensory processing, attention, communication, emotional regulation, motor coordination or managing energy may have a greater impact.

These differences can affect everyday occupations such as:

• getting ready and managing routines
• preparing and eating meals
• managing household tasks
• attending appointments
• studying or working
• managing finances and administration
• maintaining relationships
• accessing leisure and interests
• managing rest and recovery
• maintaining health and wellbeing

A person may understand exactly what needs to be done and still experience considerable difficulty organising, initiating or sustaining the activity.

Understanding this distinction can be important when considering what support may be helpful.

The Person and Their Environment

The way a person functions cannot always be understood by looking at the individual alone.

Occupational performance is influenced by the interaction between the person, the activity and the environment.

A person may manage well in one environment and experience considerable difficulty in another.

Noise, lighting, interruptions, time pressure, social expectations, changes in routine, unclear communication and competing demands can all affect participation.

Equally, appropriate structure, predictability, communication, sensory adjustments and environmental adaptations can reduce barriers and make participation more manageable.

This is one of the reasons that occupational therapy considers the whole situation rather than focusing solely on a diagnosis.

A Neuro-Affirming Approach

A neuro-affirming approach recognises neurological difference and respects the individual's identity, preferences and way of experiencing the world.

It also recognises that neurodivergent people may experience genuine difficulties, disability and substantial support needs.

Both are important.

Neuro-affirming practice involves understanding the individual profile of strengths, needs, preferences and challenges, alongside the environments and occupations in which these arise.

This may include consideration of:

• sensory processing
• executive functioning
• communication
• attention and regulation
• energy and fatigue
• routines and transitions
• environmental demands
• relationships and social participation
• work or education
• independence

The approach is individualised because there is considerable variation between neurodivergent people, including people who share the same diagnosis.

NHS England similarly describes neurodivergent-affirming care as recognising strengths and capabilities alongside challenges. (NHS England)

Neurodiversity and Disability

Neurodivergence and disability are not interchangeable terms.

Some neurodivergent people experience significant disability and require substantial support. Others may experience fewer barriers in particular environments.

The impact can also change over time and according to circumstances.

For example, someone may manage the demands of employment but have very little capacity left for household tasks or social activity. Another person may function well in a familiar environment but experience significant difficulties in a busy or unpredictable setting.

Understanding the person's circumstances is therefore an important part of understanding their occupational needs.

The Role of Occupational Therapy

Occupational therapy is concerned with enabling people to participate in the activities, roles and routines that are important to their lives.

For neurodivergent adults, this may include support with:

• planning and organisation
• task initiation and completion
• routines and transitions
• sensory processing
• managing energy and fatigue
• self-care
• domestic activities
• work and education
• relationships and social participation
• leisure and meaningful activity
• independence
• reasonable adjustments

Occupational therapists consider the relationship between the individual, their occupations and their environment.

This can help identify what is creating difficulty, what is already working well and where changes may improve participation.

RCOT states that occupational therapy support for neurodivergent adults should be available according to occupational need rather than diagnosis, and identifies areas including routines, environmental adaptations, sensory needs, executive functioning, occupational performance and participation. (Royal College of Occupational Therapists)

Diagnosis and Understanding Yourself

For some people, receiving a diagnosis can provide an important explanation for experiences that have previously been difficult to understand.

It may help someone develop a clearer understanding of themselves, communicate their needs, access appropriate support or request reasonable adjustments.

However, a diagnosis does not describe everything about an individual.

Two people with the same diagnosis can have very different strengths, difficulties, circumstances and occupational needs.

Occupational therapy therefore considers the person's actual experience and occupational needs alongside any diagnosis that may be relevant.

At Empower Neurodiversity

At Empower Neurodiversity, I combine occupational therapy expertise with a neuro-affirming understanding of neurodivergence.

I take time to understand the individual and the occupations that matter to them, including the demands of their environment, relationships, responsibilities and daily routines.

Together, we can explore what is proving difficult, understand the factors contributing to those difficulties and identify practical approaches that fit the person's circumstances.

This may involve executive functioning, sensory processing, routines, energy management, self-care, work, relationships, independence or other areas of everyday life.

The focus is on meaningful outcomes: supporting participation, wellbeing, confidence, independence where appropriate and a sustainable way of managing everyday life.

Further Reading

For more information about the terminology and the difference between neurodiversity and neurodivergence, see:

What is the Difference Between Neurodiversity and Neurodivergence?

Evidence and Further Reading

This information has been informed by current professional and UK guidance relating to neurodiversity and occupational therapy.

Royal College of Occupational Therapists - Adult Neurodiversity (Royal College of Occupational Therapists)

NHS England - guidance relating to neurodiversity and neurodivergence (NHS England)

GOV.UK - Inclusive language: words to use and avoid when writing about disability (GOV.UK)