What Educational Psychologists Need to Know About Writing Neuro-Affirming Reports

If you work with neurodivergent children and young people, the language you use in your reports matters more than you might think.

The National Autism Implementation Team (NAIT) in Scotland published its Neuro-Affirming Reports: Guidance for Health Practitioners a couple of years ago. It is a thorough, thoughtfully constructed guide that draws on published research, practice experience, and direct feedback from neurodivergent individuals and their families. While it has been developed in Scotland and references some Scotland-specific frameworks and guidelines, the principles it sets out are directly relevant to EP practice across the UK, and it is well worth the time of any professional involved in assessment and report writing.

Our Senior Educational Psychologist Melanie Adkins and Education Department Manager Katie Séverin have reviewed the guide and shared their reflections. This blog draws on those thoughts alongside the key messages from the document itself.

What is a neuro-affirming approach?

NAIT explain that a neuro-affirming approach prioritises listening to neurodivergent people in service planning, collaboration with colleagues, and when working directly with patients or service users. It is rooted in a strengths-based, rights-based perspective that respects the diverse ways individuals think, learn, process, and experience the world.

Language Is Not a Small Thing

The NAIT guidance clearly demonstrates that the language used in psychological reports has a real emotional impact on the people who receive them. Neurodivergent individuals and their families shared both positive and negative experiences of reading their reports, with some likening them to a character assassination. That is a significant finding, and a significant responsibility.

Educational psychologists do not set out to write anything damaging. The issue is often not intention but habit, and that the frameworks we have been trained to use are themselves rooted in deficit-based language. Diagnostic manuals still use terms like “disorder” and “deficit.” It takes active effort to translate that clinical language into something that describes a person’s experiences accurately and respectfully.

The guidance includes a reframing grid that Melanie considers one of the most immediately practical tools in the document. It sets out common phrases still used in professional reports alongside neuro-affirming alternatives. Language goes in and out of use, and even well-intentioned professionals can find themselves relying on terminology that has fallen out of step with current thinking. The grid is a useful resource to return to regularly.

A few examples from the guide for considering reframing language in a neuro-affirming way.

Instead of	Use
Person with autism.	Autistic person. Identity first language is preferred by most autistic people (Hartman et al., 2023).
Terms such as ‘mild’, ‘moderate’ or ‘severe’ or ‘high’ or ‘low’ functioning.	Describe individual experiences, variation and support needs. Descriptive terms such as these continue to medicalise autism and may also lead to the false belief that some individuals may not experience difficulties and require support at certain points in their life.
Deficit, disorder, or symptoms.	Differences, characteristics, preferences, features.
Poor eye contact.	Prefers reduced levels of eye contact. May look around the room when talking.
Easily distracted, poor attention.	Can get distracted by sensory stimuli which may be distressing and can impact on attention, communication and learning.
Refuses to wear school uniform, shoes, eat certain foods etc.	Finds certain textures difficult to tolerate, prefers softer fabrics, prefers to be barefoot.
Can refuse to communicate.	May experience ‘shutdown’ or situational mutism when overwhelmed or uncertain. This is the difficulty or inability to process and use language when overwhelmed. It can appear like a ‘freeze’ response to a stressful situation. Some people may identify as ‘semi-speaking’. This means they can use speech at times but not at others.
Challenging behaviour or tantrums.	Non judgmental language. Distress, actions, responses, meltdowns or overwhelm. Response to disrupted expectations. Actions that indicate distress, that needs are misunderstood or not met. Actions or responses that can be a form of communication or that can communicate reactions, needs and preferences directly or indirectly to those around them.
Self-stimulatory behaviour, repetitive movements.	Stimming, self-expression, body language.
Lack of empathy or blindness to recognising others’ feelings and intentions.	Breakdown in mutual understanding with non-autistic people. Non-autistic people can find it equally difficult to empathise/understand/relate to/communicate with autistic people; the breakdown can happen on both parts, not because of a deficit in the autistic person. This is commonly known as ‘The Double Empathy Problem’.  There is a developmental progression in the ways children and young people learn to notice, recognise and infer other people’s thoughts, beliefs, feelings and experiences, even when these are not directly stated. In the report you may be able to identify in what way it is helpful for others to share and express such information.

For more reframing language visit the NAIT Guide here. 

Differences, Not Deficits

A thread running through the guide is the move away from pathologising language towards something that recognises difference as exactly that: difference, not disorder.

This matters because how a person is described in a report shapes how they understand themselves. Neurodivergent people face a higher risk of mental health difficulties, compared to the general population. The research cited in the NAIT guidance points to the role that internalised stigma, self-acceptance, and everyday discrimination play in those outcomes. A report that frames everything through deficit contributes to how a person sees themselves and how others see them.

Every person presents differently. Neurodivergent people may find their differences more challenging, others may not. Good report writing holds that individuality clearly and validates a person’s own understanding of their experience and agency.

Masking

In Katie’s words, masking is ultimately the suppression of someone’s authentic identity to conform to neurotypical norms, and is an exhausting survival strategy driven by the pressure to adjust to a neuro-normative environment. 

Katie stressed the importance of recognising masking as it can mean a child appears to be coping in school when they are not, or that an assessment captures a performance rather than an authentic picture. It’s important that we don’t celebrate “surface compliance” that leads directly to burnout and distress.

This has direct implications for report writing, a report that describes only what was observed in an assessment setting, without considering the possibility of masking, risks being both inaccurate and harmful. The guidance encourages practitioners to think carefully about how environment and context shape presentation, and to reflect that nuance in how they write.

Katie further added that the way we phrase our thinking and our questions is just as important as the language we use when discussing neurodivergence, and that we cannot just use neuro-affirming words in isolation. The structure of our questions reveals our underlying assumptions. When we frame an assessment around a young person’s “deficits” we are signalling to educators and families that the child is the problem to be solved. Neuro-affirming practice isn’t just about replacing outdated words with preferred terms, we need to reflect on our thinking, our biases and our practice so that we are not trying to “fix” a child so that they fit the system, but that we are changing the system so that it supports the child. A student shouldn’t need to mask their identity to earn a sense of safety in an educational space. 

Intersectionality and Environment

The guidance also asks practitioners to look beyond the individual to the systems and environments surrounding them. An Environment First approach means asking what adaptations can be made to a setting to support participation, rather than suggesting that a neurodivergent person should adapt their behaviour and skills to meet others’ needs/wishes.

Related to this is the concept of intersectionality, Katie highlighted a point to remember, a person’s neurodivergent experiences do not exist in isolation from their cultural background, family context, language, socioeconomic situation, or other aspects of their identity. 

Rather we cannot accurately assess a child’s barriers to learning if we fail to see how systemic processes and expectations compound the pressure on them to perform or hide their neurodivergence, or that they are treated differently when they are unable to do so.

A Note on Provisions

Melanie raised an important point – some provisions that have historically been presented as evidence-based do not fit with a neuro-affirming stance.

The honest challenge is that the field has not yet produced a comprehensive set of alternatives to replace them. The most defensible position for EPs at this point is not to name specific programmes at all, but to describe clearly what a neuro-affirming approach should look like: adapting the environment, building on the individual’s strengths, validating their identity, and supporting their access to appropriate adjustments and communities rather than asking them to change who they are.

This is an area where practice is actively evolving, and honesty about that is more useful to families and colleagues than false certainty in either direction.

A Resource Worth Sharing

The NAIT guidance is a well-evidenced, practically useful document. It was developed through co-production with neurodivergent people and their families, which is reflected in both the quality of the content and the specificity of the recommendations it makes.

If you are an EP, psychologist, or other practitioner involved in assessment and report writing, we would encourage you to read it. The reframing grid alone is worth bookmarking. You can access the full document and references here.

At Psychology Direct, neuro-affirming practice is something we take seriously across our educational psychology and assessment work. If you have questions or would like to join us as an associate please get in touch.