Neurodivergence refers to people who think, behave, and experience the world in a different way to the average or ‘neurotypical’ person within their own culture. It is thought that approximately 15-20% of people are neurodivergent[1], although it is difficult to estimate this accurately. This means that between 4 and 6 students in a classroom are likely to be neurodivergent. Types of neurodivergence include (but are not limited to) autism, Attention Deficit Hyperactivity Disorder (ADHD), Developmental Coordination Disorder (DCD or dyspraxia), dyslexia, dyscalculia, Tourette’s Disorder, Developmental Language Disorder (DLD), and sensory processing differences (SPD).
The social model of disability frames neurodivergence as disabling due to society’s failure to accommodate needs, rather than neurodiversity being inherently disabling. In other words, the world is built for neurotypical people, which can create challenges for neurodivergent people. The following examples illustrate some of the kinds of challenges a neurodivergent person might experience in everyday situations.
Rory needs to collect medication from the pharmacy, which is located inside a shopping mall. The mall is bustling with people who keep getting too close to Rory. The lights are bright and loud music is playing. No-one else seems to be bothered by this, but for Rory it is unbearable. There is also no map of the mall, and Rory does not know where the pharmacy is. Overwhelmed, Rory goes home without the medication.
Despite having the necessary qualifications and experience, Rowan often encounters difficulties in job interviews because typical interviewing practices require candidates to express their social skills in a particular way. Workplace hiring practices are often predicated on the neurotypical norm and do not consider alternative methods for assessing candidates. This discriminates against Rowan as a neurodivergent candidate, as it is more challenging for neurodivergent people to showcase their abilities in typical job interviews.
The demands involved in navigating these and many other challenges can lead to mental health difficulties and poorer wellbeing among neurodivergent people.
Mental health and wellbeing for neurodivergent people
The term ‘mental health difficulties’ encompasses a wide range of conditions, but the two most common are anxiety and depression. These can be experienced in the short or long term, and tend to be diagnosed by a clinician. Wellbeing refers to a person’s ability to cope and thrive in everyday life and is sometimes also referred to as quality of life. Someone experiencing intense worry, low mood, or feeling anxious may not meet the criteria for a diagnosis of anxiety or depression, but may still experience increased challenges at school or work, and have a poor quality of life.
Mental health difficulties are much more common for neurodivergent people. Research has shown that neurodivergent adolescents may be up to ten times more at risk of mental health difficulties compared with their neurotypical peers. This can have life-threatening consequences; autistic people, for example, are at higher risk of suicide than non-autistic people[2].
Neurodivergence and mental health at school
As previously mentioned, the world is not designed to take into account the challenges often faced by neurodivergent people, and this includes school culture and the school environment. In order to access school life and succeed in school settings, neurodivergent students must adapt, or overcome barriers that are not present for their neurotypical peers. This can lead to poor wellbeing and increased risk of mental health difficulties. There are many reasons why neurodivergent students may experience mental health difficulties at school, but below are described some of the common difficulties experienced, and how they relate to mental health and wellbeing.
Sensory processing differences
Neurodivergent students are likely to experience some differences in the way they receive and interpret information from the senses (such as vision, sound, smell, and touch). This can mean that they have increased or decreased sensitivity to different sensory stimuli. This is explained in more detail in a guide on sensory processing differences in the classroom.
People with increased sensory sensitivity are also more likely to have higher symptoms of anxiety. Some neurodivergent people feel anxious about being in environments such as classrooms because of potential sensory stimulation that makes them unable to focus on learning, or even causes them distress. Some neurodivergent students may also have food-related sensory sensitivities. In settings where school lunches are provided, they may worry about whether they will be able to eat the food available at school, as options are often limited. This may lead to them not eating at school, which could impact their wellbeing.
Social and communication differences
Due to a mismatch in the way that neurodivergent and neurotypical people communicate, neurodivergent students are more likely to experience social difficulties compared with their neurotypical peers. This can lead to social vulnerability, such as misunderstanding a person’s intentions, being manipulated, or being a victim of bullying. Neurodivergent students in these situations may feel highly anxious about school, and it may even prevent them from attending.
Neurodivergent students are also at risk of feeling lonely or isolated. They may have fewer friendships, or feel ‘different’ from their peers. Social connectedness is extremely important for the wellbeing of all students, and research has shown that loneliness is linked to depression and poor wellbeing[3].
Masking and burnout
‘Masking’ is when someone acts differently by hiding their true self to fit in with those around them. Research has shown that this is something that some neurodivergent people do in order to avoid stigmatisation and discrimination[4]. Some people are aware when they are masking, whilst for others it may be a learned behaviour that they do automatically.
Neurodivergent students may mask their behaviour or aspects of their personality at school, which can be exhausting to maintain. For example, some neurodivergent people engage in behaviours known as stimming(such as flapping their hands, rocking back and forth, or pacing) as a strategy to regulate their emotions. From a neurotypical perspective, this behaviour may appear unusual and lead to stigmatisation. Neurodivergent students may therefore inhibit this, which in turn prevents them from being able to self-regulate.
These students may also have poor self-image, feel lonely or disconnected from others, and experience low mood because they are masking. Research shows that people with increased masking behaviours have poorer mental health outcomes such as anxiety and depression[5]. Masking can also lead to burnout. Burnout happens when a neurodivergent person is exhausted from masking and/or dealing with the challenges imposed upon them by their physical and social environment. As well as exhaustion, students experiencing burnout may also experience a loss of skills, negative impacts on their health, and reduced quality of life including suicidal behaviour[6].
Recognising when a student is struggling
Neurodivergent students experiencing poor wellbeing or mental health difficulties may experience distraction or decreased motivation, which can lead to disengagement from learning. They may also have poorer attendance, meaning they could miss out on learning. If this is prolonged, it could lead to them not meeting expected targets. This can also exacerbate their mental health difficulties, particularly if they feel like they are falling behind their peers.
Some students may experience emotional dysregulation, particularly if they are experiencing burnout. This can lead to emotional outbursts, in response to a situation or aimed at another student or teacher. After it happens, they can experience feelings of shame, which may then feed back into the student’s mental health difficulties.
Students may also be noticeably isolated from their peers. They may be alone in the playground, or avoid engaging in group work. This may be by choice, as there may be situations where a student needs time to be alone and regulate. Another possibility is that the behaviour is because the student is finding it difficult to form friendships with their peers, or it may be due to bullying victimisation. If they are regularly isolated, it is important to establish the reasons behind this behaviour by speaking with the student.
Considerations for teaching practice and the learning environment
Awareness of neurodivergence and how it might affect students at school is key to being able to support neurodivergent students with their mental health and wellbeing. Adopting a whole school approach to neurodiversity, so that staff and students have an understanding of differences in thinking, behaviour, and communication, can reduce stigmatisation and discrimination against neurodivergent students.
Creating an environment where neurodivergent students can unmask and be themselves can reduce the risk of students being overwhelmed and experiencing burnout. If awareness and acceptance is developed through a whole school approach, neurodivergent students will in time become more comfortable to be themselves at school. In the meantime, it is also important to provide private spaces such as a quiet room or sensory room that students are able to access whenever they need to, without judgement or persecution. This will allow students to self-regulate in a private and safe space. Even allowing neurodivergent students a little additional time to transition between lessons and spaces can provide a valuable opportunity for them to self-regulate.
Students struggling with emotion regulation may benefit from support. This can start with supporting students to recognise the signs they are dysregulated. Then teachers, students, and family members can work collaboratively to identify strategies or solutions, and schools can facilitate students’ access to those solutions. These strategies and resources should be age-appropriate and tailored to the individual’s needs, so it is essential to include students and their families in these conversations. Involving students in this process will also give them a sense of agency, although it is important that they are supported by a member of staff who can advocate for them.
Finding appropriate ways of reducing pressure on neurodivergent students may decrease their risk of experiencing burnout, and the associated risk of mental health difficulties. This could take the form of allowing extensions to deadlines, tailoring curriculum materials to reflect students’ interests and passions, and being mindful of putting pressure on the student to achieve certain grades.
Approaching sensitive topics with students can be challenging, and even more so with the addition of neurodivergent and neurotypical communication differences. An important first step is to create a safe space in which the student feels comfortable and free from judgement. Building rapport with the student and having conversations early on about their preferred communication methods can form the basis of this.
Any student can experience mental health difficulties, but neurodivergent students are at an increased risk due to challenges they face at school. While any support offered to a neurodivergent student experiencing poor wellbeing or mental health difficulties needs to be tailored to the individual student’s situation and needs, awareness of and sensitivity towards neurodivergent students is key, and will help teachers to identify and support struggling students. Finally, it is worthwhile to remember that anything that is done to support the mental health or wellbeing of neurodivergent students will likely benefit all students.
Endnotes
[1] Doyle, N. (2020). Neurodiversity at work: a biopsychosocial model and the impact on working adults. British Medical Bulletin, 135(1):108-125. doi: 10.1093/bmb/ldaa021. PMID: 32996572; PMCID: PMC7732033.
[2] Accardo, A. L., Pontes, N. M. H., & Pontes, M. C. F. (2022). Heightened anxiety and depression among autistic adolescents with ADHD: Findings from the National Survey of Children’s Health 2016-2019. Journal of Autism and Developmental Disorders, 3:1–14. doi: 10.1007/s10803-022-05803-9. Epub ahead of print. PMID: 36327018; PMCID: PMC9630808.
[3] Mushtaq, R., Shoib, S., Shah, T., & Mushtaq, S. (2014). Relationship between loneliness, psychiatric disorders and physical health ? A review on the psychological aspects of loneliness. Journal of Clinical and Diagnostic Research, 8(9):WE01-4. doi: 10.7860/JCDR/2014/10077.4828. Epub 2014 Sep 20. PMID: 25386507; PMCID: PMC4225959.
[4]. Miller, D., Rees, J., & Pearson, A. (2021). ‘Masking Is life’: Experiences of masking in autistic and nonautistic adults. Autism in Adulthood, 3(4),330-338. http://doi.org/10.1089/aut.2020.0083
[5] Cook, J., Hull, L., Crane, L., & Mandy, W. (2021). Camouflaging in autism: A systematic review. Clinical Psychology Review, 89, https://doi.org/10.1016/j.cpr.2021.102080.
[6] Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Delos Santos, A., Kapp, S. K., Hunter, M., Joyce, A., & Nicolaidis, C. (2020). ‘Having all of your internal resources exhausted beyond measure and being left with no clean-up crew’: Defining autistic burnout. Autism in Adulthood, 2(2), 132-143. http://doi.org/10.1089/aut.2019.0079
