Safely and Effectively Serving Neurodivergent Survivors: Supporting Healing Through Accommodation and Understanding Kaitlin Shetler Activating Change Image: Activating Change logo This project was supported by Grant No. 15JOVW-24-GK-03011-MUMU awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this program are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women In this webinar, we will: Define disability and neurodiversity, and describe common risk factors for abuse; Explain how neurodiversity impacts the survivor experience; Discuss accommodations and accessibility in survivor spaces; Explore solutions for neurodivergent survivors that promote healing, safety, and continued trauma-informed support Disability, Neurodivergence, and Abuse Setting the Stage: Disability Disability can be a: ¥condition ¥lived experience ¥culture ¥diagnosis Image: Colorful silhouettes of people walking and rolling in wheelchairs The Impact of Disability ¥Disability is personal, individualized, but also shared among communities: ¥Shared in challenging ways: stigma, barriers, attitudes, access ¥Shared in positive ways: identity, socialization, beliefs, behaviors ¥Disability is often an identity ¥Not all the timeÑsome people, especially with acquired disabilities, may not see their disability as anything but a diagnosis or a challenge to overcome ¥But for many, disability is an important and vital piece of them. It shapes their experiences and thoughts and beliefs. Neurodiversity Image: Silhouettes of people with different designs in their brains. ¥Neurodiversity is: ¥The idea that people experience and interact with the world around them in many ways, with no one "right" way of thinking, learning, and behaving, and differences are not deficits. ¥Referring to someone as neurodiverse or neurodivergent is a way to focus on the positive aspects of their differences and what that can bring to the group setting. (NIH) Neurodivergence Silhouettes of people with different designs in their brains. ¥Neurodivergent is a broad umbrella term meaning having a brain that works differently from the average or neurotypical person; people are not diagnosed with neurodivergence. ¥Types of Neurodivergence: ¥Dyslexia, Autism, ADHD, Intellectual Disabilities, Learning Disabilities, Mental Health Conditions Remember: Neurodivergence is on a spectrum, not a fixed point. ¥When we say someone is neurodivergent, we recognize that person may have different strengths and challenges than those without brain differences. ¥These differences may range from difficulties with executive functioning, communication, and cognitive processing to social and emotional challenges. ¥Their presentation is unique to someoneÕs lived experiences. A Note on Language (1) ¥When working with neurodivergent individuals, ask how they identify and which terms resonate with them, and mirror their language to best honor their identities and perspectives. ¥ Some prefer people-first language (i.e., Òperson with autismÓ), while others prefer identity-first language (i.e., Òautistic personÓ). ¥Some people with autism are diagnosed with ÒAutism Spectrum DisorderÓ while others never receive that diagnosis. ¥Some neurodivergent individuals may refer to themselves as having a disability while others may not. A Note on Language (2) ¥For survivors of sexual assault, a person may have a preference on what kind of language they want used to describe their experience. ¥Some prefer ÒvictimÓ and ÒvictimizedÓ because it gives focus to the experience and harm enacted, while some prefer ÓsurvivorÓ because it highlights healing. ¥Some people use these interchangeably. Neither are wrong. ¥It remains important to center someoneÕs narrative and naming, no matter what direction they choose. Sexual Assault and Neurodivergent Survivors: Unique Dynamics ¥Communication ¥Things like consent, understanding conflicting wants/needs, communicating boundaries, being able to put unsafe feelings Òinto wordsÓ can be difficult for neurodiverse people. ¥Support ¥Support systems, if they exist, may emphasize paternalism and protection over autonomy and safety. ¥Social and Emotional ¥Figuring out expectations of dating, socializing, friendships, family relationships can be challenging when someone struggles with reading nonverbal cues, engaging in the nuanced and ever-changing social rules of different communities. Sexual Assault and Neurodivergent Survivors: Unique Dynamics ¥Executive Functioning ¥Executive functioning is the brainÕs ability to organize, plan, manage, and regulate things like emotions, time, behavior, and needs. When someone has difficulty doing these things, they are at higher risk of victimization. ¥Knowledge/Education ¥Many neurodiverse people (especially autistic people, people with learning disabilities, and mental illness) are denied sex education. Conversations about the body, about consent, and about healthy relationships are skipped because of perceived ineptitude or belief that they are asexual/childlike. ¥Social Skills Classes ¥People are taught how to mask their neurodivergence through agreeability and compliance. Barriers to Reporting and Justice ¥ÒThey donÕt know what they want.Ó ¥ÒThey encouraged it.Ó ¥ÒThey seem fine. It obviously didnÕt affect them.Ó ¥ÒThey donÕt understand what happened to them.Ó ¥ÒThey arenÕt great historians. How do we know it is true or they didnÕt misremember?Ó ¥ÒThey are lying for attention.Ó ¥ÒServices donÕt work for them. They are too high needs.Ó Sexual Assault and Neurodivergent Survivors: Consent ¥Consent is often tied to navigating social cues, communication styles, and emotional regulation. It is often mistaken as only being a verbalized Òyes.Ó Sometimes it is taught as an Òenthusiastic yes.Ó But for neurodivergent people, things like tone and other communication cues can be difficult. ¥Sometimes, neurodivergent people are ÒtrainedÓ out of saying no. When you have social skills classes teaching you to be agreeable and polite, or when the only Òhealthy relationshipsÓ you see modeled are those in movies or TV shows, consent is muddied. ¥Consent isnÕt just verbal. Consent can be withdrawn. Consent isnÕt just your body saying yes, but your brain and emotions being in sync with that yes. Neurodivergent Survivors Impact of Victimization ¥Sleep difficulties ¥Depression and anxiety ¥Withdrawn behavior ¥Increased dysregulation (ÒmeltdownsÓ) and/or stimming (especially new stims, or harmful stims) ¥Self-injurious behavior ¥Change in eating habits or behaviors ¥Changes in communication ¥Changes in care for self and body ¥Emotional regulation ¥Seeking reassurance (which can sometimes look like seeking out unhealthy relationships) ¥Storytelling Support Considerations ¥Communication is not just verbal. ¥Story is not always linear. ¥Validity isnÕt tied to behavior. ¥There is no ÒidealÓ survivor. ¥Emotions donÕt have to Òmake sense.Ó ¥Sensory seeking doesnÕt equal instability. ¥Time does not matter. ¥Meaning can change, trauma can hide, healing can look different. Poll What could keep a neurodivergent survivor from seeking healing services? ¥Choose: ¥Lack of Access ¥Lack of Knowledge ¥Inadequate orUnsupportive SupportSystem ¥Discomfort ¥Other (in chat) Accessibility of Healing Services Questions to ask: ¥Are we prepared? ¥Are we educated? ¥Can a survivor find us? ¥What makes us welcoming? ¥What makes us safe? ¥When they come, will they have communication access? ¥When they come, will they have understanding? ¥What internalized beliefs do our organizations hold about neurodivergent survivors? Stigma? ¥Are education and outreach materials accessible? Accommodations Picture Guide and Communication Board Image: A sample information page with a graphic or icon next to each paragraph. Image: A communication board with boxes of images and words Plain Language Materials Image: A poster using plain language to explain plain language Alternative ways to fill out forms and providing an aide Image: A tablet with a tablet pen Image: A Black person with an afro filling out a form on a clipboard next to a white woman watching Sensory-friendly spaces, weighted blankets, stuffed animals, and fidgets Image: A dimly lit room with mats and cubes to sit on, a TV playing an underwater scene, and sensory water tubes. Image: A stuffed animal sloth with fuzzy fur. Image: Fidget toys sitting on a table. Modified safety plans Image: Safety Planning with People with Disabilities and Deaf People: A Working Guide by Stop Abuse for Everyone. Emotional support animals Image: A golden retriever. A person is reaching across to cradle the side of its face. Remember: Neurodivergent survivors donÕt owe anyone access to their story or their trauma. ¥Neurodivergent survivors are often infantilized and told Òthe right wayÓ to respond to their victimization ¥ It is important to check in with your own biases and see if the reason you are trying to control the process is because you feel uncomfortable with how to communicate with someone who is neurodivergent. Remember: Trauma is not a monolith and neither is neurodivergence. ¥Just like you canÕt expect people to process trauma in the same way, you canÕt expect neurodivergent individuals to Òbe neurodivergentÓ in the same way. ¥When you make sure your services are person-centered, rather than streamlined, you have a better chance at providing comprehensive, responsive, effective services Masking ¥For neurodivergent survivors, who are battling stigmatization and ostracization due to their disability, they may be more aware of needing to ÒmaskÓ when discussing their assault. Image: A sad-looking woman with long dark hair and light skin holding a smiling mask in front of her face. Consider This: Access ¥Neurodivergent survivors may need different access to services than neurotypical survivors. They shouldnÕt be an afterthought, but access should be Òbaked in.Ó ¥Accommodations should be determined based on changing needs, not static ones. Image: A watercolor painting of swirls around a figure's head. Poll What barriers do you perceive being the greatest to neurodivergent survivors in your organization? Why? ¥Choose one: ¥Accessibility ¥Accommodations ¥Attitudes ¥Outside barriers ¥Policies and procedures ¥Other (in chat) Removing Barriers: Solutions Policies and Procedures ¥Intake and hotline policies ¥Communication and language access policy ¥Sensory-friendly spaces ¥Emotional support animal and service animal policies ¥Behavior expectations ¥Confidentiality and mandated reporting Materials ¥Large-print, bulleted lists ¥Plain language ¥Definitions of commonly used terms ¥Visual aids ¥Fidget or stim toys ¥Options vs. open-ended questions ¥Modified resources ¥For example, a safety plan for a neurodivergent survivor might include a communication guide, social story, options for including sensory or comfort items, step-by-step instructions, question guide Trainings ¥What is our philosophy on mandated reporting? How do we communicate that? ¥Do our staff and leaders understand neurodiversity and neurodivergence? ¥How do we help when a survivor is dysregulated? What intake skills are needed when arranging services? ¥How can we teach healthy relationships and consent? ¥What are we communicating about this population online, in person? When serving neurodivergent survivors, autonomy, self-determination, and self-identification are values that must be upheld through policy, procedure, and practice. Image: A sign that reads Nothing About Us Without Us!!! held up by two hands. art by Adriana Morales-D’az, 2023 Question: What can you do to better serve neurodivergent survivors? What will you share with your colleagues about serving neurodivergent survivors? Questions? Image: Raised hands in a variety of skin tones Kaitlin Shetler, MSW Senior Program Associate Activating Change