Do Nurses Know Enough About Neurodiversity?

Up to 20% of the population, including healthcare workers, may be neurodivergent. That includes your patients and the colleagues working beside you. Most neurotypical nurses were never trained for it.

Neurodivergent people process information differently than neurotypical people. The terms you will hear include neurodivergent, neurodistinct, neuroatypical, and neurodevelopmental. The global neurodiversity movement reframes these differences through a human rights lens instead of a deficit-and-disease one. As Timothy Frawley, an associate professor in mental health nursing at University College Dublin and lead author of a Journal of Clinical Nursing paper on the profession's awareness of neurodiversity, put it: "The neurodiversity movement is very much a human rights-based movement, and it is about variation, as opposed to deficit or disease."

Key facts and statistics

Several neurodevelopmental conditions sit under the neurodivergence umbrella:

• Autism Spectrum Disorder (ASD): A broad range of presentations, including difficulty with communication and socialization, rigid routines, repetitive actions, and learning differences. Abilities vary widely from person to person. The World Health Organization estimates about 1 in 100 children have ASD.
• Attention Deficit Hyperactivity Disorder (ADHD): Inattentiveness, hyperactivity, and impulsivity. Girls often present differently than boys, and many people are not diagnosed until adulthood. Roughly 129 million children ages 5-19 have ADHD worldwide, along with 366 million adults.
• Dyslexia: A neurological difference that makes connecting letters and sounds for fluent reading difficult. About 20% of children and adults have dyslexia, accounting for roughly 80-90% of learning disabilities.
• Dyspraxia: Affects coordination of movement.
• Dyscalculia: A learning disorder related to numbers and math.
• Tourette's syndrome: A nervous system condition causing uncontrollable, repetitive movements or tics.

Differences, not deficits

Recognizing variation in how the brain is wired is the starting point for inclusion and for sharper nurse-patient interaction. Moving from a deficit model, which tries to correct differences, to a strength-based model is the shift most care teams need.

Nurses need a working understanding of the types of neurodivergence and what they mean for care. One size does not fit all. "Nurses understanding of neurodivergence can be reflected in care plans and treatment contexts," Frawley said. "The individuality of each person is key."

Neuroatypical nurses

Little research exists on autistic nurses. Through a deficit lens, some assume autistic people cannot be nurses because of a perceived lack of empathy. Recent research suggests the tools used to measure empathy create more misconceptions about autistic people than they resolve. Neurodivergent nurses have areas of difficulty, but they also bring strengths and skills that are real resources to their teams.

Many neurodivergent healthcare providers never disclose their status at work for fear of discrimination. Women in particular tend to mask, or pretend to be neurotypical, which can erode their emotional and psychological wellbeing. As Frawley noted, ADHD was long treated as a condition of childhood, but it is now recognized in adulthood, where it brings both challenges and a range of skills and talents.

Guidance moving forward

Start by challenging the unconscious biases you and your colleagues hold around neurodivergence, then request inservice training. Frawley's paper argues for mandatory, repeated neurodiversity training for all public-facing professionals as part of continuing professional development, co-delivered by neurodivergent professionals for better outcomes.

Reasonable accommodations matter as much as training. Disability access law covers physical disabilities, but not every need is visible. Patients with neurodevelopmental differences may need accommodations too, such as reduced sensory input from noise and lights, so they can access their appointments. The same accommodations let aspiring neurodivergent nurses build careers. The National Institutes of Health offers an online Reasonable Accommodation Program intake form for workplace accommodation requests.

Sources

• Autism (2023). World Health Organization
• Duong D, et al. (2022). Untapped potential: embracing neurodiversity in medicine. Canadian Medical Journal Association
• Frawley T, et al. (2023). Enhancing the nursing profession's awareness of neurodiversity. Journal of Clinical Nursing
• General Prevalence of ADHD (2023). CHADD
• Hedlund, A. (2023). Autistic nurses: do they exist? British Journal of Nursing
• Song P, et al. (2021). The prevalence of adult attention-deficit hyperactivity disorder: a global systematic review and meta-analysis. NIH
• What Is Dyslexia? (2023). The Yale Center for Dyslexia & Creativity