Defining Neurodiversity Affirming Psychology Practice for Autistic Adults: A Delphi Study Integrating Psychologist and Client Perspectives

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Flower, R. L., Benn, R., Bury, S. M., Camin, M., Muggleton, J., Richardson, E. K., Bulluss, E., Calabria, B., Curran, A., Giugni, M., Gottliebsen, V., Hodges, H., Lawrence, J., Leung, V., Levy-Knoll, R., Miklosi, K., Mitchelson, M. R., Nuske, A., Waldie, C.,..., & Jellett, R. (2025). Defining Neurodiversity Affirming Psychology Practice for Autistic Adults: A Delphi Study Integrating Psychologist and Client Perspectives. Autism in Adulthood. https://doi.org/10.1089/aut.2024.0305

Publication date: 2 Jun 2025 Added to AutiHub: 7 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
22
Publication authors identified as autistic
1 / 22 (4.5%)
  1. Rebecca L. Flower
  2. Rebekah Benn
  3. Simon M. Bury
  4. Marie Camin
  5. Joshua Muggleton
  6. Ellen K. Richardson
  7. Erin Bulluss
  8. Bianca Calabria
  1. Amanda Curran
  2. Melanie Giugni
  3. Victoria Gottliebsen
  4. Haylea Hodges
  5. J. Lawrence
  6. Vivien Leung
  7. Red Levy-Knoll
  8. Kathryn Miklosi
  1. Monique R Mitchelson
  2. Alison Nuske
  3. Caitlin Waldie
  4. Courtney Watts *
  5. SA Watts
  6. Rachel Jellett

Abstract

Background: The term “neurodiversity affirming” has been used to describe an inclusive and strengths-based approach to mental health care, aligned with the neurodiversity paradigm and social model of disability. However, there is no known consensus on what neurodiversity affirming practice entails. Methods: We aimed to define neurodiversity affirming support in the context of Australian psychologists working with Autistic adult clients (what we have termed “neurodiversity affirming psychology practice”). Using a classical Delphi design with three rounds, we recruited expert panel members, including Autistic adults who had seen a psychologist, and psychologists (Autistic and non-autistic) who described their approach as neurodiversity affirming. The final panel consisted of 28 experts, aged 24–76 years ( M = 37.29, SD = 11.74). In Round 1, we gathered the panel members’ opinions on essential aspects of neurodiversity affirming support using a series of open-ended questions. In Round 2, the panel members rated key statements for importance, and in Round 3, items that had not met consensus criteria in Round 2 were re-rated. Results: In total, 104 statements reached consensus. We generated a model from the statements, which outlines a set of seven principles characterizing neurodiversity affirming psychology practice for Autistic clients. These principles are as follows: (1) a commitment to continued learning about autism, (2) providing safety to be one’s Autistic self, (3) finding a way to communicate, (4) authenticity and humility in practice, (5) validation of Autistic experiences, (6) Autistic informed person-centered support, and (7) genuine acceptance and appreciation of autism. Conclusion: Our results suggest that neurodiversity affirming support goes beyond a psychologist having knowledge of autism and taking a strengths-based approach. Rather, there are interconnected principles spanning from clear actions to more nuanced and subtle adjustments to the psychologists’ way of working that form the foundation of neurodiversity affirming psychology practice for Autistic adult clients.

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Cited references
59
Total cited references integrated for this publication.
Cited references with an identified autistic author
12 / 59 (20.3%)
Cited author occurrences identified as autistic
22 / 243 (9.1%)
Among occurrences linked to AutiHub author records: 22 / 116 (19.0%). Distinct cited authors identified as autistic: 18 / 221 (8.1%).
Cited author occurrences linked to AutiHub author records
116 / 243 (47.7%)
Distinct linked cited authors: 98 / 221 (44.3%)
Linked cited-author occurrences not identified as autistic
94 / 116 (81.0%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 94 / 243 (38.7%). Distinct linked cited authors not identified as autistic: 80 / 98 (81.6%).
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