🧠 From Rehabilitation to Reconnection: Neurodiversity-Affirming Practice in UK Occupational Therapy (2025)

In 2025, UK occupational therapy is undergoing a quiet but powerful transformation, one that centres neurodivergent voices, reframes traditional goals, and challenges systemic barriers. Neurodiversity-affirming practice is no longer niche; it’s becoming a professional imperative.

What’s Driving the Shift in the UK?

• RCOT & NHS England Workforce Reform (2024–2025):
  NHS England has funded workforce reform programmes that prioritise inclusive, person-centred care across Allied Health Professions.

• NAIT’s Neuro-Affirming Reports Guide (Scotland, 2024):
  The National Autism Implementation Team (NAIT) published guidance co-produced with neurodivergent individuals, advocating for respectful, individualised, and strengths-based reporting practices.

• UK Research Spotlight:
  A 2024 scoping review by Rebecca Twinley (University of Brighton) identified four pillars of neurodivergent-affirming OT:

1. Paradigm shift in therapeutic approaches

2. Advocacy and empowerment

3. Ethical, collaborative practice

4. Addressing systemic and social barriers

   🔍 What Does Neurodiversity-Affirming OT Look Like?

   • Reframing Goals:
     Moving away from “normalisation” and toward co-created, functional outcomes that respect sensory and cognitive diversity.

   • Language Matters:
     Using neuro-affirming language in documentation; avoiding pathologising terms and instead highlighting strengths, preferences, and support needs.

   • Trauma-Informed, Identity-Aware Practice:
     Recognising the intersection of neurodivergence with trauma, marginalisation, and access barriers, and adapting care accordingly.

   • Medico-Legal & Safeguarding Implications:
     Reports must be defensible, but also affirming. The NAIT guide urges practitioners to include communication preferences, sensory needs, and individualised recommendations

💬 Reflection for UK OTs

As this paradigm shift gains momentum, ask yourself:

• How does my documentation reflect neurodivergent identity and autonomy?

• Am I using language that empowers or inadvertently pathologises?

• How can I embed co-production and lived experience into my assessments and service development?