Bridging the Gap: What Neurodiversity-Affirming Practice Actually Looks Like for SLPs
In recent years, the field of speech-language pathology has undergone a significant shift—one that centers on the voices and lived experiences of neurodivergent individuals. This evolving lens is called neurodiversity-affirming care. But what does it mean to be a neurodiversity-affirming speech-language pathologist (SLP), especially in a school-based setting?
Let’s unpack the term, examine what it looks like in practice, and explore how we can dismantle ableism within our profession.
What Is Neurodiversity-Affirming Care?
Neurodiversity-affirming care recognizes that neurological differences—such as autism, ADHD, and other cognitive variations—are natural forms of human diversity rather than deficits to be corrected. As Gaddy & Crow (2020) emphasize, this approach moves away from pathologizing neurodivergence and toward respecting and supporting individuals’ unique communication styles, sensory needs, and ways of being in the world.
The ASHA Leader article “What It Means to Be a Neurodiversity-Affirming SLP” (2025) further clarifies that affirming care is not about ignoring challenges. Rather, it’s about co-creating goals that are meaningful to the individual and grounded in their identity, autonomy, and real-world participation, not compliance with neurotypical norms.
Three Examples of Neurodiversity-Affirming Practice in School-Based SLP Services
Redefining “Functional” Communication Goals
Instead of targeting “expected” eye contact or tone modulation, affirming SLPs ask: Is this goal meaningful to the student’s communication success? For example, supporting an AAC user in expanding vocabulary around their interests is more affirming than insisting on full sentence responses that align with neurotypical standards.Offering Choice and Autonomy in Sessions
Therapy becomes more respectful when students can choose how they engage—sitting on a yoga ball, engaging in self-stimulatory behaviors (stimming) freely, or scripting during play. This approach respects regulation and identity, rather than imposing conformity.Centering Student Identity in IEP Planning
Inclusive IEP practices, as discussed by Heilmann et al. (2022), mean involving students in decisions about their communication goals. A neurodiversity-affirming SLP might ask, What do you want to be able to say or do? Instead of assuming what’s “appropriate” based on developmental checklists.
How Ableism Shows Up in Traditional Practices
Ableism—the belief that typical neurological development is superior—pervades many traditional practices in our field. Bottema-Beutel et al. (2023) call attention to the ableist language often used in clinical reports and IEPs, such as describing a student as “noncompliant” or “lacking social skills,” when in fact they are expressing autonomy or communicating in ways that make sense to them.
Traditional goals can unintentionally prioritize masking over meaningful communication. For example, teaching an autistic student to suppress hand-flapping or to use “expected” facial expressions sends the harmful message that their authentic self is not acceptable.
Practical Takeaways and a Call to Reflect
Audit Your Language: Avoid pathologizing phrases like “problem behaviors” or “fix speech.” Instead, describe communication differences in context and with respect.
Redefine Goals: Ask if your therapy goals align with the student’s self-defined success, not just curriculum benchmarks or adult preferences.
Learn from Lived Experience: Follow neurodivergent voices in research and on social media. Their insights are critical to unlearning internalized ableism.
Collaborate More Deeply: Involve students and their families in therapy planning and goal-setting, honoring their knowledge and priorities.
A Final Word
Neurodiversity-affirming practice is not a checklist—it’s a paradigm shift. As SLPs, we must move from viewing neurodivergence as something to fix, toward embracing it as something to understand, support, and celebrate.
Take a moment to reflect on your current caseload. Are your goals affirming or correcting? Are your practices inclusive or unintentionally ableist? Change begins with honest self-reflection and a willingness to grow.
Let’s bridge the gap—together.
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References
Gaddy, S., & Crow, K. (2020). A Primer on Neurodiversity-Affirming SLP.
Bottema-Beutel, K., et al. (2023). Recognizing and Resisting Ableist Language.
Heilmann, J., et al. (2022). Inclusive IEP Practices.
ASHA Leader (2025). What It Means to Be a Neurodiversity-Affirming SLP.