On-Demand: Decoding Behavior: Understanding Autism through a Neurodiversity-Affirming Lens

Pediatric PTs and PTAs working with autistic children have likely experienced this scenario: an autistic patient’s challenging behaviors prevent them from accomplishing their physical therapy goals. This can be frustrating for the therapist, the child and their family. Historically, these behaviors have been addressed using strategies to extinguish unwanted behaviors and maximize compliance. However, the tides are currently changing as autistic self-advocates publicly describe the negative effects of their own experiences undergoing compliance-based approaches. The Neurodiversity Paradigm proposes that natural variations in human neurology contribute to our rich human diversity and should be embraced, rather than “cured.” This movement has gained traction in other rehabilitation professions such as Speech and Occupational Therapy in recent years. In alignment with our oath to “do no harm,” the field of Pediatric Physical Therapy faces a similar moral imperative. Practitioners who utilize the principles of the Neurodiversity Paradigm are called “neurodiversity-affirming.” Adopting a neurodiversity-affirming lens helps us reframe problem behaviors as a need for regulation, and investigate the internal experience of the individual. We can then provide compassionate, culturally competent, and effective support strategies that meet the patient’s underlying needs. This ultimately leads to mutual trust between the patient and practitioner, and improves the autistic child’s self-directed outcomes. In this course, designed for both PTs and PTAs, we discuss the Neurodiversity Paradigm, how it is used to “get to the bottom of” challenging behaviors, and provide strategies to reduce harmful behaviors while maximizing the autistic individual’s well-being and autonomy in physical therapy sessions.