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Adult neurodiversity

Neurodiversity is a term used to describe natural differences in the way people learn and think. Although there is no universally recognized definition of neurodiversity, the term is usually used to include autism, ADHD, dyspraxia/developmental coordination disorder (DCD) and dyslexia. Other neurodevelopmental conditions may also be included under the neurodiversity umbrella. Neurodiversity describes differences that are present from birth, rather than those that are acquired following illness or injury. 

RCOT recognizes that the language of neurodiversity is evolving and that people with lived experience have their own language preferences. RCOT supports the use of identity-first language such as ‘autistic people’. We recognise that we don’t always use language that sits comfortably with individuals, but it is not our intention to upset people. We respect people's right to use the language they prefer. 

Occupational therapists make an important contribution to the health and wellbeing of neurodivergent adults (whether they have or want a diagnosis) in all areas of practice. This includes physical and mental health, work, education, prisons, social care and learning disabilities. The number of specialist adult neurodiversity or adult neurodevelopmental services is increasing across the UK, with occupational therapists included as key members of the multidisciplinary team. Increasing awareness of neurodiversity is also reflected by growing numbers of occupational therapists who identify as neurodiverse, and those whose families include a neurodivergent person. 

Occupational therapy role

A key function of occupational therapy is supporting neurodivergent adults to carry out the daily activities, roles and routines they need, want or have to do. We consider:

  • Routine helping people create routines that meet their health and well-being needs
  • Personal care helping people develop skills and strategies to manage personal care activities such as eating, choosing clothes, grooming, sleeping
  • Household management developing skills and strategies to budget, cook, clean, do the laundry 
  • Organisation helping people use tools and strategies to manage their time and possessions, to prioritse and make plans  
  • Employment supporting neurodivergent people access and maintain employment and fulfil their potential at work
  • Education supporting people to access and stay in education and reach their academic potential
  • Relationships and social connections helping people develop supportive networks and relationships. Supporting individuals to connect with others and access groups and activities in the community
  • Leisure helping people develop a balance of occupations that includes time for leisure and relaxation
  • Accessing the community helping people develop the skills and confidence to use public transport, access community services, and go to the shops 
  • Environmental adaptations identifying strategies and adaptations that reduce the impact of environmental challenges (including sensory simulation) on people’s engagement and participation at home, at work/college and elsewhere 
  • Well-being supporting people to understand and adapt to their diagnosis (where relevant) and its impact on their mental health. Developing strategies to protect mental health and well-being.
  • Identity supporting people to understand themselves, their needs and preferences. Helping their identity and use strategies and tools that enable their occupational performance and engagement. Empowering individuals to develop a positive sense of identity that incorporates their strengths and differences. Supporting individuals to disclose their diagnosis, if that is right for them. 

The occupational therapy approach

  • We take a strengths-based approach, supporting people to understand how they can meet their own needs in a society that often doesn’t
  • We consider the whole person, working with individuals to identify any physical, mental health, learning and/or sensory needs that affect their daily life and well-being. Occupational therapists are skilled in working with complexity and supporting people with multiple co-occurring conditions or needs that affect their daily lives 
  • We take a person-centred approach, delivering services in a way that respects an individual’s personal, spiritual, religious and cultural needs, values or choices. We recognise that people are unique, even if they share the same diagnosis.  
  • We work across traditional service boundaries, addressing physical and mental health and working with other agencies (housing, employment, education etc) to enable people to fulfil their potential and live their best lives. 
  • We grade activities and work with individuals in context to enable them to take positive risks, master skills, grow and thrive. We recognise that performance may vary from day to day and help individuals find ways to accommodate this. 
  • We work with individuals, employers and others to identify reasonable adjustments that support well-being and enable neurodivergent people to fulfil their potential 
  • We make no assumptions about a person’s abilities or interventions/support needs based on their diagnosis or any other factor.
  • We enable people to use anxiety management and relaxation strategies to help them engage in social and other activities of daily living 
  • We understand that sensory differences can affect a person’s mental health, daily activities and interactions. We help neurodivergent people and those who live or work with them gain a better understanding of a person’s sensory needs and identify ways to manage these. 
  • We understand and work with individuals to manage problems with executive functions affecting their attention, memory, time management, and ability to start/stop activities. 
  • We take a trauma-informed approach, recognising that trauma experiences are common in the lives of neurodivergent people. We understand the impact of trauma on people’s occupational performance, participation and mental health, and use this knowledge to co-create intervention/support plans. 
  • We work collaboratively with individuals using coaching approaches to enable self-management and problem-solving skills. 
  • We work with families, partners, caregivers and others to help them understand and support neurodivergent people
  • We co-produce resources with neurodivergent people to raise awareness of the challenges experienced and reasonable adjustments that can help neurodivergent people participate and achieve

Occupational therapy and the diagnostic process

Occupational therapists recognise neurodiversity as a difference in the way that people experience the world and not as a deficit that needs to be labelled or ‘fixed’. Occupational therapy support should be available according to a person’s occupational need (RCOT 2021) and should not depend on a diagnosis. However, timely access to a person-centred diagnostic assessment is important to many neurodivergent people and can help their occupational performance, engagement and participation by:

  • Providing an explanation for the difficulties they experience in their daily lives
  • Leading them to trusted, relevant sources of information and support
  • Enabling access to services and support, for example reasonable adjustments in the workplace

An occupational therapy assessment can play a key part in the diagnostic process and may include assessment of a person’s motor function and consideration of differential diagnoses where relevant. 

Our main focus however, is supporting neurodivergent people to live happy and fulfilled lives.  

RCOT resources

Weighted blankets for children and adults

We’ve updated our guide to help occupational therapists make decisions about the use of weighted blankets with children and adults. Members of the public considering weighted blankets for their personal use may also be interested.