In our last blog, Therapy Hive member Dr. Stuart Robinson shared his wisdom and experience with the subtle differences between a childhood and adult presentation of Autism Spectrum Disorder (ASD). Dr. Robinson shared so much valuable information that we have an extension of his interview, this time all about the strategies, treatments, and accommodations a neurodivergent adult may benefit from.
Neurodiversity is the concept that normal human variance includes nuerological differences, what we call ASD, attention deficit/hyperactivity disorder (ADHD), or learning differences, among other things. The neurodiversity movement includes acceptance of these differences, and moves away from a “cure” or “disease” model. Instead, neurodiversity advocates for proper supports and strategies to benefit all, including those with neurological differences.
Patients, parents, and family members often inquire about non-medication supports and treatments for individuals with executive functioning differences, such as ADHD. Dr. Robinson shared a support for cognitive behavioral therapies that reduce anxiety and increase self-esteem, as well as therapy that supports time-management training, organizational supports, and planning. In terms of other therapies, such as cognitive training therapies that make claims to “cure” or “erase” symptoms of ADHD and ASD, the research doesn’t support it. Dr. Robinson added that many appear to work, yet the benefits drop off as soon as the training is concluded. This is similar to other findings, in which participants in a study on cognitive training strategies appear to improve temporarily only on the specific task being trained on, with little carry-over into broader applications. Dr. Robinson added that he is a “strong advocate of low doses of short-acting ADHD meds,” particularly during the initial phases of treatment and therapy. As adults improve, they may consider talking with their psychiatrist about taking medication on an as-needed basis, and may find other strategies to manage their symptoms.
As adolescents age from high school to a college or career setting, they may find that accommodations and supports for ADHD and other executive functioning difficulties change in their scope and purpose. Dr. Robinson commented that high-school accommodations often relate to extended time, or format, for tests. However, college accommodations have a “focus on all aspects of college living, both in and outside of the classroom.” He included a list of accommodations that he has encountered, including: reduced course load, course substitutions, living alone, living with an emotional support animal, being excused from group assignments, ability to test in a quiet place, ability to have test questions read aloud, use of noise cancelling headphones, use of other technology, extra-time on test and assignments, allowing use of written formulas, and more. Disabilities are covered under Section 504 law, and each college and campus has specific requirements, documentation, and formats for offering accommodations.
Within the workplace, supports may be similar, and are also covered under Section 504 law and the Americans with Disabilities Act. Communication about the supports needed can be an artful balance, and having external support, as well as human resources support, is recommended. We are fortunate to have knowledgeable and experienced providers within our network, and appreciate Dr. Robinson for sharing his wisdom with Therapy Hive!