Two things can be true at once.

Social media often glamourizes doing things independently, but the grass isn't always greener. And while I wouldn't change my decision (at least not at this point of my life), I don't think it's representative to not share these aspects as well, especially for SLPs or other healthcare professionals thinking of starting a business. Ultimately it comes up to weighing sacrifices and rewards, and there's no decision that's best for *everyone.*

We often hear the term "presuming competence," but what exactly does that mean in practice?

It can look like...

• understanding that minimally speaking children can understand more than they can express, so we should assume that they are understanding everything we are saying and not talk about them as if they aren't there or use "baby talk"
• believing that a child starting out with an AAC device will be capable of using it and growing their language, so providing them with the most buttons (words) available instead of limiting their choices to what *we think* they know
  
• including a child's interests, but also providing age appropriate content and opportunities for social inclusion and engagement with peers
• teaching vocabulary that is relevant to a child's life (protesting, gossiping, joke telling, etc.) - many minimally speaking kids get BORED when they are repeatedly asked the same questions to answer with their device every day (wouldn't you too, if you always were expected to answer what the weather is outside?)
• setting high expectations and working in the zone of proximal development! Kids with disabilities are too often underestimated which results in setting low or repetitive goals.

Presuming competence is part of using neurodiversity-affirming practices, and kids can achieve great things if we just believe and work alongside them!

What are some ways your kids *surprised* you with their progress on goals, when you just presumed competence?

We often hear the term "strength-based" tossed around, but what does that really mean? 

Traditionally, medical professions have followed a "medical model of care," which focuses on diagnosing, pathologizing, and fixing a "problem." And in many facets of healthcare, we need this (think: acute care or conditions)!

More recently, developmental & rehabilitative professionals have been moving towards a "strength based model of care." This means there is LESS focus on fixing a "problem" or comparing to norms. This is especially important when looking at intervention for those who aren't neurotypical and/or interact with the world in different ways, or those with chronic conditions.

However, we NEED both models, and like anything, it's about balance! You wouldn't want to show up to the ER and not have your bloodwork compared to norms; you NEED that diagnostic information. Similarly, many autistic children need the medical model for diagnosis in order to receive funding. What's important is understanding that there are various models, and for caregivers to know that they can advocate for strength-based interventions.

Really inspired by everyone's vulnerability and human-ness with this trend, and I think the messaging is so important.

Social media can make us feel like everyone else "has it all together" when that is very rarely the case.

These things will continue to be stigmatized (and hidden) unless we talk about it.

Self-advocacy is SUCH an essential communication skill for all kids, but especially for our autistic kids who likely have sensory preferences or needs. Neurodiversity-affirming goals should therefore incorporate the specific needs of the child, including sensory needs.

I know I didn't learn much (or anything...!) about creating neurodiversity-affirming goals in school, and it can seem overwhelming at first. However, when we put our kids' needs first and eliminate compliance-based therapy, it makes a lot of sense.

I knew today we wouldn't get access to the school's sensory room (which is a reality, by the way! How cool is that?) so I made sure to bring materials with me that would allow for sensory breaks.

This was his first time seeing this seat spinner, so I just modelled how it can be used. I even demonstrated (or tried to demonstrate) how it can be used. Maybe one day he will use it, maybe he won't, but he will learn from me that he can always ask for his needs to be met.

At HAEPI SLP, our goal is to provide neurodiversity-affirming speech and language therapy to all of our clients.

But what is neurodiversity affirming therapy anyways?

Neurodiversity-affirming therapy involves understanding the unique obstacles that neurodivergent individuals face, and validating their experiences while celebrating their differences.

At HAEPI, we celebrate the strengths a child already has (using a strength-based instead of deficit-based approach), and allow each child to be their truest, most authentic self by working within while gently expanding their comfort zones.

We are committed to fostering connection OVER compliance. The ways we do this include:

• Child-led therapy
• Using special interests to guide therapy
• Encouraging the movement of bodies/stimming
• Creating goals that focus on advocating for one's needs

So how do we do this in practice?

I'll give an example from this week! One of my clients LOVES letters, and instead of "worrying" about a fixation of his interest, I used it in therapy! I hid pieces of a letter puzzle all around a playground, and he was super motivated to find them. I modelled the gestalts "let's find it," "keep looking," "I see it," got it!," "put it together," etc., in play. It was also a joint session with his OT, and because some of his OT goals included climbing on the equipment, he was motivated to do this while searching for his letters. It was also a great opportunity to discuss gestalt language strategies with his OT, and for them to see it work in practice.

My therapy feels much more meaningful using these practices, and my clients show MORE speech and language progress when we focus on connection first.

We've taken this past month to listen to Autistic and LGBTQ2S+ communities, and wanted to share some of the things we have learned. 

It is so important to understand that we cannot be neurodiversity-affirming without also being LGBTQ2S+ allies.

We hope you celebrated this month with lots of love and pride!

Real talk: I used to always use person-first language (e.g., person with Autism). I even had a disagreement in my grad school class with a prof who stated that identity-first was better since it made the disability "less memorable" if it was near the start of the sentence versus the end of the sentence. Cue a bunch of random research that didn't have anything to do with what each individual community preferred...

Since that time, I've committed to learning and listening to Autistic voices, and something that has been expressed by the majority of Autistic individuals is the preference towards identity-first language, but not for the reason my prof said (actually quite the opposite!).

Identify-first language reflects the belief that being Autistic is an inherent part of a person's identity, while person-first language reflects the belief that Autism can be separated from an individual. We know that Autism is a neurodiversity that results in a different way of seeing and interacting with the world, so it makes sense that many Autistic individuals would prefer language that is validating to their experiences and is not pathologizing. 

While speech-language *pathologists* do treat communication concerns, being Autistic is not - and should not be considered - one of them.

This is going to be a vulnerable post, because part of reducing stigmatization involves being vocal and encouraging healthy discussion! 

I've struggled with anxiety and intrusive thoughts my whole life. While the earliest memories that I have are from age 7, my mom remembers my symptoms appearing as early as age 2. I had periods of time that were "easy" and periods of time that were… really hard.

I didn't understand that this was obsessive compulsive disorder (OCD) until I was 23, and it was even later that I identified as neurodivergent.

The larger neurodiversity movement helped me identify my own neurodivergence (i.e., being on the obsessive compulsive spectrum), and this has brought me more inner peace than I can articulate (but if I were to try, I'd say I finally started to feel seen, validated, affirmed, reassured, and understood).

I never thought I could (or would!) share this information with the public. Over the years, I've felt a lot of shame and masked a lot of my feelings and symptoms because I wanted to appear "normal." At other times, I felt like I wasn’t neurodivergent *enough* to seek the supports/information that would help me thrive. But understanding that my brain is just wired differently, that my caudate nucleus (along with other areas in my orbital cortex) is hyperactive — and that other people experience the same thing!?! — has been life-changing.

I now view my OCD as information (about me and about my brain) and it is something (neutral, neither good nor bad) that I simply have to manage as I move through life. Since it is a part of me, though, it also contributes to who I am as a clinician.

I feel like I can better relate to my clients who have anxiety and sensory preferences. My attention to detail is a strength. I can use my own neurodiversity to help my clients feel empowered by theirs. I can demonstrate how to focus on one's strengths, and to give grace to areas that may need more support. Most importantly, I can create a therapeutic environment that will prevent the internalization of shame.

Because there is nothing shameful about it.