The Neurodiversity Training Gap: Bridging the Divide for Better Healthcare

The Landscape of Neurodiversity

Neurodiversity encompasses the natural variation in human brain function. An estimated 1 in 17 people globally live with a neurodevelopmental differences like autism, attention deficit hyperactivity disorder (ADHD), dyslexia, and learning difficulties.

There is a significant barrier that exists for many neurodivergent individuals when it comes to healthcare: a lack of training among healthcare professionals (HCPs) on recognising and understanding neurodiversity which can have a huge impact on the level of care provided as well as diagnosis given.?

The Consequences of the Gap

The consequences of this gap are far-reaching. Studies have shown that negative interactions with the healthcare system are common for neurodivergent individuals.?

Research by the Autism Self Advocacy Network found that 42% of autistic adults reported experiencing medical abuse due to a lack of understanding of their needs.

This gap in understanding can lead to misdiagnosis, inadequate treatment plans, and feelings of frustration and disenfranchisement for patients.?

For instance, autistic individuals may struggle with communication or express pain differently, leading to misinterpretations by HCPs. ?

Individuals with learning disabilities may face communication breakdowns due to sensory sensitivities or challenges with processing information.?These misunderstandings can have a detrimental impact on health outcomes.

Statistics that Underscore the Problem:

The gravity of this issue is highlighted by concerning statistics. Research by the Tizard Centre found that adults with learning disabilities are two to three times more likely to die prematurely compared to the general population.

Additionally, Learning Disability England reports that people with learning disabilities experience higher rates of preventable physical health conditions like diabetes, heart disease, and respiratory problems.?

The Need for Change: Equipping HCPs for Neurodiversity

Investing in neurodiversity training for HCPs is crucial for creating a more inclusive healthcare system. Equipping HCPs with additional knowledge about neurodiversity can significantly improve patient experiences and outcomes.?

Here's what such training programs should address:

• Understanding the spectrum of neurodiversity: HCPs should gain a foundational understanding of common neurodevelopmental conditions, their presentations, and the range of experiences within each diagnosis.
• Recognising signs and symptoms: Training can equip HCPs with the skills to identify potential neurodivergence during consultations, considering factors like communication style, sensory sensitivities, and social interaction patterns.
• Communication strategies: HCPs can learn effective communication techniques for interacting with neurodivergent patients, including using clear and concise language, allowing for processing time, and offering alternative communication methods if needed? like picture boards or communication apps.
• Creating a sensory-friendly environment: Simple adjustments like offering noise-canceling headphones or reducing visual clutter can make a big difference for patients with sensory sensitivities. Creating a sensory-friendly environment is vital to creating a safe space for patients.

Benefits of a Neuroinclusive Healthcare System

Investing in neurodiversity training for HCPs has numerous benefits:

• Improved patient outcomes: When healthcare professionals understand a patient's neurodivergence, they can provide more accurate and timely diagnoses, develop effective treatment plans, and deliver better overall care.
• Increased patient satisfaction: Positive interactions with the healthcare system can foster trust and encourage neurodivergent individuals to seek necessary care.
• Enhanced healthcare delivery: A neuroinclusive approach can lead to more efficient consultations, improved communication, and better utilisation of healthcare resources.

Training Structures and Understanding Intersectionality Within Neurodivergence:

It is vital that this training is undertaken with the utmost seriousness and is not treated like another tick box task that can be brushed aside.

Making this training aligned with a uniform understanding test which requires X percentage to pass - this will ensure that healthcare professionals are treating this training as essential.?

Also having this training as an annual review training to make sure that healthcare professionals are up to date with current changes or alternative and new approaches to better supporting patients who have neurodevelopment differences.

Healthcare professionals should also be trained to understand the nuances of intersectionality within neurodivergence; presentations of neurodevelopmental differences can show differently for a variety of reasons.

Typically in minority ethnicities neurodivergence and mental health is not openly discussed which can lead to issues of:

Misdiagnosis or under-diagnosis:

Cultural norms and limited awareness can make it difficult for South Asian individuals with neurodivergent traits to receive proper diagnoses. This can delay access to crucial support and interventions.

Isolation and stigma:

The lack of open conversation can create a sense of isolation for neurodivergent South Asians. The fear of judgment or being seen as "different" can prevent them from seeking help or openly discussing their experiences.

Inadequate support systems:

Support systems for neurodiversity are often designed with a dominant cultural perspective in mind. This can leave the specific needs and experiences of South Asian neurodivergent individuals unaddressed.?

Healthcare professionals understanding this can provide increased support for patients and they are also more likely to feel comfortable and understood.

Training for All Staff: A Holistic Approach

Investing in comprehensive training for all healthcare staff, not just doctors, is essential for creating a truly inclusive environment:

• Nurses: Train nurses to recognise the specific healthcare needs of neurodivergent patients and provide compassionate care that addresses their unique challenges.
• Reception Staff: Equip receptionists with strategies for clear communication during appointment scheduling and arrival processes. Training should emphasise active listening and providing clear instructions.
• Support Staff: Train support staff to create a welcoming and accessible environment for neurodivergent patients. This could involve offering assistance with paperwork, providing clear directions within the healthcare facility, and being mindful of potential sensory triggers.

Thinking Beyond Training...

Training is just one piece of the puzzle. Here are additional steps towards a more inclusive healthcare system:

• Pre-Appointment Communication: Offer online scheduling and communication tools, and provide pre-appointment information packages in clear language with visuals.
• Support During Appointments: Allow patients to bring a support person, offer alternative communication methods, and chunk information to allow for processing.
• Post-Appointment Care: Provide clear written instructions and follow-up materials, and offer phone or video consultations for further questions.
• Leveraging Existing Resources: Utilise resources offered by organisations like the National Autistic Society and Learning Disability England.

There are wider considerations that need to be given; as an example in England, learning disability nurses are only available Monday-Friday during office hours (9-5) which patients with a learning disability have access to.?

This is also not readily available if the patient is accessing care A&E or if it’s a weekend.?

After consultation with a number of patients and carers, there is also now an increasing trend of more & more appointments being offered over the weekend, which presents increased challenges.?

The solution of reallocating resources to ensure learning disability nurses are available on weekends too is important and also encouraging medical professionals to offer an appointment early in the morning or the last appointment of the day. Reasonable adjustments asked for, quieter waiting room or offering an appointment on a day when it’s less busy.?

Larger structural changes are a topic for another day and require a deeper dive into the healthcare system itself.?

Conclusion: A Future of Understanding

The neurodiversity training and understanding gap is a critical issue that needs to be addressed. By equipping healthcare professionals with the knowledge and skills to understand and recognise neurodiversity, we can create a more inclusive healthcare system that delivers quality care for all. This, in turn, fosters a future where neurodivergent individuals can thrive and contribute their unique talents to society.