How can you be more neuro-inclusive?
Being more neuro-inclusive
Neurodiversity is an umbrella term that includes a range of neurodivergent conditions including Autism (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Dyspraxia, Dyscalculia, Dyslexia and Tourette’s Syndrome.
Around 15% of the population is thought to have a neurodiversity so it’s essential that we all look at the way our workplaces are set up for both the people that use our services (customers, clients, or in the case of an organisation like NCH&C, patients and their families and carers), and our staff. If one in seven people are neurodivergent, our processes and ways of working also need to be considered from the perspective of someone from this community otherwise we may be making situations more uncomfortable than they need to be and ultimately excluding people from accessing jobs or healthcare that they need.
We spoke to Dr Stephanie Summers, Clinical Psychologist and Clinical Lead for our Neurodevelopmental Service, about what NCH&C is doing for staff and patients and their families, in terms of adapting the way we provide our services.
“I work for NCH&C’s multi-professional neurodevelopmental service (NDS), which assesses children where there are concerns regarding possible neurodevelopmental disorders such as Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).
“We work with a range of children, young people, and their families through their ASD/ADHD assessments. As a team we’re constantly reflecting on and adapting our service to make our approach more neuro-inclusive; not only for the individuals we support but for the staff working in NDS too.
“The Equality Act (2010) says that reasonable adjustments should be made for individuals with ASD and ADHD (an official diagnosis is not required), to ensure they are not substantially disadvantaged when accessing services such as education, employment, and health care.
“Within the UK there is a strong neurodivergent community that re-frames neurodiversity as a difference with brain development that can bring many strengths. They highlight that it is environments, and lack of understanding, that can result in these differences disabling people with ASD/ADHD from participating alongside the rest of their community. This is a valid reminder for services, employers, and the education system to consider if what they are providing is neuro-inclusive.
“Some of the things that we do to help our families access our service, despite their developmental differences, along with some additional suggestions of what might be helpful for other healthcare services to consider for their patients and staff could be:
It’s a good place to start by asking individuals/families if they have a diagnosis that might require reasonable adjustments e.g., ASD and ADHD. Not everyone with a neurodiversity will think to offer this information to you and your service.
Using neuro-inclusive communication
Neurodivergent people process information in different ways. Ensure you have a range of ways of sharing information, for example, easy read documents with pictures, plain English documents or social stories, to help prepare them for appointments.
Many neurodivergent thinkers prefer visual/written information instead of verbal. You can ask the individuals/families you provide services for how they prefer to receive information i.e. with pictures, written or verbally.
Consider using stock images or those found at ‘easy on the i’ (https://www.learningdisabilityserviceleeds.nhs.uk/easy-on-the-i/) to create easy read letters and social stories.
Making reasonable adjustments for neuro-divergent communication styles
Neurodivergent people communicate in different ways. Some people, particularly autistic individuals, may find talking on the phone or talking with someone face-to-face difficult. Some reasonable adjustments to consider are:
- Asking if they would prefer communication over e-mail or text rather than by phone
- Offering video calls instead of face-to-face appointments
- Providing information on the appointment or topics you are going to talk about ahead of the appointment
- Gaining information via written questionnaires rather than verbal interview
Other reasonable adjustments to consider
“Some people with ADHD find it very difficult to remember, manage, and attend health care appointments. This can look like disengagement to professionals if they’re unaware that this person has ADHD. Here are some reasonable adjustments you can provide to support them:
- Text/phone call reminders 1-2 days before the appointment
- Reduce additional administration demands e.g., send home blood forms so they don’t need to pick these up in person, complete forms whilst in a face-to-face appointment so that they don’t need to organise to send these in at a later date
- Take short breaks throughout the appointment to enhance concentration and focus
- Use movement breaks can help manage symptoms of restlessness and hyperactivity
“People with ASD often have sensory sensitivities and can find noisy, bright, and busy environments difficult to manage. Talk with the individual/their families about their sensory differences and make adaptations e.g. smaller/quieter waiting areas, turning down/off the lights.
“Those with ASD can also find meeting unfamiliar people and going to new places difficult. You can make adaptations by offering subsequent appointments with the same professional and providing information about the location of the appointment ahead of time e.g. plain English written information and/or pictures.
“As a service you may want to consider writing a neuro-inclusive/neurodiversity service policy or procedure outlining the reasonable adjustments you offer.
Listen to feedback
“As part of our aim to provide a neuro-inclusive service, we often ask for feedback from young people/families about our service and what was helpful and what could have been better.
“Consider asking for feedback specifically from individuals with ASD/ADHD and make further adaptations/changes where possible.
“Think about appointing a neurodiversity champion, either a professional or a service user. This person can help with seeking and reviewing feedback.”
How can I learn more?
- Click here to read about supporting Neurodivergent colleagues in the NHS
- Click here to watch some puppetry videos from Heidi Buckell, the Disability Champion at West Hertfordshire Hospital, that help to explain Cerebral Palsy
- Click here to see several resources to help you support Neurodiversity at work
Join our NDS team
NCH&C is currently recruiting Clinical/Counselling Psychologists to its NDS. These posts would be involved in shaping psychological provision within our Learning Disability Child and Adolescent Mental Health Service (Starfish) and/or Neurodevelopmental Service (NDS).
Roles are available within either team or, if of interest, as a split post across both teams. Posts are available across Norfolk; including Kings Lynn, Norwich and Great Yarmouth. Bases are negotiable and flexible working is supported and includes agile/home working where relevant.
We welcome applications for this role to join our outstanding NHS trust and help us continue to provide services to the population of Norfolk and Waveney. This role also comes with a £2k welcome incentive.