ARU is committed to supporting and celebrating our neurodiverse learners in their journey to becoming qualified healthcare professionals. We have outlined the following guidance and information for our practice partners in how to support neurodiverse learners.
Neurodiversity may sound complicated but it’s actually very simple. Those with neurodiversity simply have brains that process information differently. Think of the brain like electrical wires: the wiring works but it is just laid out differently. This is why the myth of 'everybody is a little bit neurodiverse' is not factually correct and undermines the lived in experiences of neurodiverse individuals.
Neurodiversity does not mean low intelligence, in fact many people with neurodiversity are of high intelligence. They just process the world differently. This can be a huge asset in the workplace, but they may also need some support.
The most common types of neurodiversity are:
Neurodiversities may overlap and share common traits. It is common for people to identify as more than one. However, everyone is unique with their own lived experiences and strategies.
There are many misconceptions and myths out there about neurodiversity, especially in healthcare.
We know that the MMR does not cause autism, but this myth is still circulated even amongst healthcare professionals.
It is important to remember that neurodiversity is not a disorder and cannot be cured. In fact, many neurodiverse people would not wish their neurodiversity away as it is what makes them who they are.
The main barriers that neurodiverse people face is stigma, prejudice and bullying from the neurotypical world as they do not appear to 'fit'. However, neurodiverse people can bring a unique and creative outlook on the world which is an asset when they are fully supported and accepted for who they are.
Even though everybody is unique, some common traits of neurodiversity are having a specialist interest, struggling with eye contact, stimming, difficulties with co-ordination, difficulties in staying still for long periods of time, and both hyper and lack of focus. It can also take time to process text-based, visual or audio information.
To support our neurodiverse learners, we recommend incorporating an affirmative, strengths-based approach that recognises and gives space to the value of different lived experience. One that acknowledges that there are societal and structural expectations, experienced as barriers to their working lives, that will be difficult for them to overcome as individuals. That the opportunity to be positive about who they are, what they bring and how we can co-operate to identify good working strategies is key.
20.2% of the NHS workforce declares a disability (NHS England, 2021). This is at the upper end for estimates for the general population. However, misconceptions persist, eg autistic individuals can’t be nurses for instance as they 'do not feel empathy'.
Healthcare can be rigid in its expectation of what makes the ideal professional. Colleagues are less likely to disclose as they are promoted (NHS England, 2021). Neurodiverse people can struggle to fit in and may feel that they need to mask, try and change themselves, and may suffer faster burnout as a result.
Adopting an open and honest work environment where neurodiverse people feel confident to be open about their neurodiversity as well as the application of reasonable adjustments will go a long way to supporting them in their chosen profession.
It is common for neurodiverse people to 'mask' and this is it try and camouflage in the world around you. All humans do this but for neurodiverse people, masking is far more entrenched and is detrimental to health and wellbeing. As neurodiverse people understand social norms differently there is far more pressure for them to mask their true and authentic selves to try and fit in with the neurotypical world. This involves supressing natural behaviours like stimming and downplaying their intense interests due to the fear of being deemed ‘strange’ and the prejudice that often comes with that label.
This is one of the reasons learners may be reluctant to disclose their neurodiverse status, not because they are embarrassed but because they fear that they will be treated differently.
Masking can be exhausting as people may feel that they must rewrite their entire personality to fit in; this can lead to ‘meltdowns’ once in a safe space.
Suggestions for clinical colleagues supporting neurodiverse learners:
Remember, most neurodiverse learners want to do well and fit into the work environment so can be reluctant to express what they really need.
In the Equality Act 2010 employers have a legal obligation to make reasonable adjustments for their employee with disabilities; this includes neurodiversity.
Reasonable adjustments are meant to provide adaptations to the workplace so that the individual can perform their work comfortably and to the best of their abilities. It is important to note that reasonable adjustments are not an advantage given to these employees, but they are to level the playing field.
Reasonable adjustments need to be tailored to the individual’s needs rather than the type of neurodiversity, as neurodiverse people all have unique needs.
Adjustments also need to be reasonable for the workplace, so for instance it would not be reasonable for a learner not to work shifts as this is a reality of healthcare. However, it would be reasonable that the learner does not work three long shifts in a row due to burnout.
Simple changes can make the world of difference to a neurodiverse learner such as a day planner, a quiet space to work on documentation or short breaks away from the busy environment. Remember, these small changes are vital to these learners and are not an advantage or giving them an easier time, they need these to be able to function and work to be part of the team.
Start by asking learners what you can do to support them and what reasonable adjustments they may need but they may need time to think about the answer. It’s difficult for neurodiverse people to know 100% what they need in a brand-new environment, and these may change as the placement progresses so it’s important that staff keep regular check ins with their learners. Neurodiverse learners can be reluctant to say what they really need as they wish to not 'be a bother' and sometimes due to negative previous experiences fear that if they are honest, they may be treated negatively.
We are excited to announce the roll-out of our process to support learners reasonable adjustments in the practice environment – the Wellness and Reasonable Adjustments Placement Plan, or WRAPP, in 2024.
This package of support aims to keep the learner at the centre of discussion, promotes self-advocacy and allows for full and transparent communication between ARU, the learner and their practice area.