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., 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
4 / 22 (18.2%)
  1. Rebecca L. Flower
  2. Rebekah Benn
  3. Simon 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.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 13:58.

Cited references
59
With a DOI
51
Without a DOI, from raw bibliography text
8
13 / 59 (22.0%) cited references include at least one author identified as autistic.
References with data to complete
5 / 59 (8.5%)
References with detected author names
54 / 59 (91.5%)
Without detected author names
5
Without a structured title
5
Without a stable identifier
8
References with raw author names still to review
5
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
243
From DOI or external metadata
243
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
9
128 / 243 (52.7%) names are linked to an author already present in AutiHub. 115 / 243 (47.3%) names are not yet linked.
Names linked to a person identified as autistic
28 / 243 (11.5%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 28 / 128 (21.9%). Distinct people identified as autistic: 24 / 223 (10.8%).
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