Contextual factors influencing neuro-affirming practice: Identifying what helps or hinders implementation in health and social care.
Anna Gray, Donald Maciver, Eleanor Curnow and 2 others
PMID 40926307WHAT IT FOUND
Practitioners identified rigid eligibility thresholds and single-condition pathways as key barriers to neuro-affirming care.
Transdiagnostic approaches and stable, locally funded multidisciplinary teams were seen as essential enablers. Staff with lived experience improved confidence, but recruitment shortages and short-term third-sector funding hindered consistent support delivery.
Key findings
01Support pathways often rely on rigid diagnostic thresholds and single-condition models, which restrict access for Autistic adults and those with ADHD, particularly post-diagnosis or without formal diagnosis.
02Transdiagnostic approaches and flexible service structures were identified as necessary to address co-occurring needs and reduce barriers, though these were largely viewed as aspirational due to capacity constraints.
03Staff with lived experience of neurodivergence were a significant facilitating context, associated with improved engagement in professional learning and increased confidence in delivering neuro-affirming support.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was limited to Scotland, so findings may not fully transfer to other health systems with different funding or legislative structures. Participants were selected for their strategic or leadership roles, which may have overlooked insights from frontline practitioners without comprehensive knowledge of service structures. Data on participants' age, ethnicity, and socioeconomic status were not collected, limiting the analysis of how cultural backgrounds influence conceptions of neuro-affirming practice. The study focused on staff perspectives; while co-designed with neurodivergent partners, it did not directly incorporate feedback from neurodivergent individuals in the data collection phase.
Declared interests
The research was completed by the National Autism Implementation Team and funded by the Scottish Government.
The easy way to misread this
Do not interpret the identified 'enablers' as proven interventions that improve patient outcomes. This study reports practitioner perceptions of what helps or hinders implementation in a specific Scottish context. It does not provide evidence that transdiagnostic pathways or lived-experience staff roles directly cause better health results for patients.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →