Reflections on Practice: Being a Neurodiversity-Affirming Speech Therapist

In speech therapy, new trends and buzzwords often come and go. One topic that has been gaining momentum is “neurodiversity”. Unlike some fleeting trends, however, this concept has truly reshaped the way I approach my work and the people I support.

So, what is neurodiversity? It’s the understanding that all brains are different. Rather than focusing on what’s “wrong” or needs to be “fixed,” neurodiversity encourages us to view different ways of thinking, learning, and communicating as natural variations of the human experience.

Reflecting on my own practice, I can see how much my approach has evolved over the years.

Early in my career, I often focused on helping children “fit in” or reach typical milestones. This

sometimes meant using compliance-based strategies, such as structured play, prompts, and

rewards—methods that, despite my best intentions, didn’t always honour a child’s individuality.

Over time, I’ve shifted to prioritising trust and connection. I focus on building a safe, consistent

relationship first, before moving on to communication goals, and I strive to support each child in ways that feel meaningful and authentic to them.

From Compliance to Connection

Building trust and connection has now become a core pillar of my therapy approach. Traditional speech and language assessments still have their place, but they often favour children who can sit still, follow instructions, and stay engaged—conditions that don’t always reflect the reality for many neurodivergent children.

As my understanding of neurodiversity deepened, I realised that these tools often overlook a

child’s true abilities, especially when those abilities don’t show up in typical or expected ways. Building connections is not just helpful, it is essential. When a child feels safe and supported, they are more likely to reveal their unique, natural self though gestures, sounds, scripts, or other forms of communication, uncovering strengths that a standard test might miss.

Embracing Individual Language Development

Understanding sensory processing, regulation, and gestalt language processing, which is a way of learning language in chunks or whole phrases rather than word by word, has been eye-opening. For example, behaviours like echolalia, the repeating of words or phrases, are often seen as something to correct. However, in Gestalt language processing, they can be a meaningful step in language development.

By taking a more curious and respectful approach instead of relying on scripts, and observing how and why a child uses certain phrases, I can support their communication in ways that align with how they naturally process language.

Through my work, I’ve come to realise that our brains experience and respond to the world

differently, especially when it comes to sensory input. Embracing this diversity has made me a

more empathetic and responsive therapist. While these approaches have been very helpful,

research in this area is still limited. I hope to see more studies in the future to better guide speech therapists and strengthen our understanding so we can more effectively support neurodiverse children.

Listening to Lived Experience

One of the most powerful lessons comes from listening to the voices of neurodivergent individuals. Every client teaches me something new, and their lived experiences help make therapy not just clinically effective, but genuinely meaningful.

I once worked with a young boy who struggled with aggression and was often placed in isolation to calm down. Rather than jumping straight into therapy plans, I focused on building trust, co-regulation, and supporting his interests. Over time, we introduced an augmentative and alternative communication (AAC) system, which gave him new ways to communicate, reduce his frustration, and regain a sense of control.

A Shift in Perspective

Being a neurodiversity-affirming therapist isn’t just about changing methods and assessments—it’s about changing perspective and beliefs. This hasn’t always been easy, but, like anything in life, change is the only constant. As a therapist, I try to approach that change with an open mind and an open heart. The more we listen to and learn from the lived experiences of our clients, the more our perspectives evolve and expand in positive ways.

My goal is simple: to keep learning, to keep growing, and to continually strive to do better as I come to know better.