A Paradigm Shift? Speech-Language Pathologists’ Perspectives and Practices with Neurodiversity-Affirming Approaches

Date of Award

12-2024

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Diane Powers Dirette, Ph.D.

Second Advisor

D’Jaris Coles-White, Ph.D.

Third Advisor

Mary Lagerwey, Ph.D.

Keywords

Autism, neurodiversity, speech-language pathology

Abstract

Autistic individuals report difficulties in communication and subsequently utilize services from speech-language pathologists (SLPs), though have reported concerns with traditional, deficit-based interventions focused on normalizing autistic traits and characteristics based on neurotypical behaviors. Autistic individuals have expressed their preferences for neurodiversity-affirming approaches, which align with the provision of evidence-based practice mandated in the SLP scope of practice. Researchers have outlined ways in which neurodiversity-affirming practices can be implemented by SLPs in various practice settings; however, there is no current research to date regarding whether this knowledge has translated into clinical practice.

The primary aim of this study is to identify SLPs’ reported alignment with neurodiversity-affirming approaches when working with autistic individuals. Additionally, this study aims to identify SLPs’ alignment with neurodiversity-affirming approaches, factors that influence the goals and targets SLPs focus on when implementing these approaches, as well as identify any associations between practice setting, education and training in autism and neurodiversity. This study utilized a convergent mixed methodology design, with 49 SLPs completing the quantitative survey and 36 SLPs offering insights and perspectives via responses to open-ended questions. The data were analyzed to determine reported alignment with neurodiversity-affirming approaches, as well as identify any associations between practice setting and education and training in autism and neurodiversity and reported alignment these approaches. Reflexive thematic analysis was used to identify how SLPs define neurodiversity-affirming approaches in clinical practice, factors that influence implementation of these approaches, as well as to explore how quantitative results converge with participants’ experiences. Results from all data were integrated to provide an understanding of the translation of neurodiversity-affirming approaches into clinical practice.

The results of the convergent mixed methods used in this dissertation provide insights into SLPs’ reported practices with autistic individuals. Overall, SLP participants reported alignment with neurodiversity-affirming approaches, with 53% reporting a neurodiversity-affirming approach to clinical practice and 47% reporting a mixed approach. While no associations were found between practice setting or education and neurodiversity-affirming alignment, qualitative analysis revealed that SLPs experienced their traditional education and training as a barrier to implementing neurodiversity-affirming practices. SLPs defined neurodiversity-affirming practices with many of the same key components that are found in the literature base, and the factors they reported as influencing the implementation of these approaches in practice were consistent with recommendations found in published articles. The results from this study have the potential to influence translational research on neurodiversity-affirming approaches and guide education and training programs on autism and neurodiversity for SLPs.

Access Setting

Dissertation-Abstract Only

Restricted to Campus until

12-1-2026

This document is currently not available here.

Share

COinS