Navigating Healthcare: The Unique Challenges and Needs of Neurodivergent Patients
As medical students, seeing patients is routine. But we run the risk of becoming procedural, catching ourselves becoming desensitized to the fears and anxieties many patients experience when visiting doctors. For neurodivergent individuals, these encounters can be particularly daunting, as they may perceive the sensory and social dynamics of healthcare spaces in ways that differ significantly from neurotypical individuals. As future healthcare professionals and leaders in Alberta, we need to strengthen our understanding of how diverse populations engage with our healthcare system to foster more inclusive, accessible care.
Annika Hanson, a registered Speech-Language Pathologist (SLP) based in Edmonton, brings a wealth of experience working with neurodivergent populations. Her journey into neurodiversity began at age 15, when she volunteered for a community social skills program called Chatter. She is now the program coordinator for Chatter and a key member of a multidisciplinary autism assessment team. Annika provides a range of services to children aged 5-18, with a specialized focus on neurodiversity-affirming autism assessment and intervention.
I had the privilege of speaking with Annika to gain insights into the unique challenges neurodivergent individuals face within healthcare settings.
Annika describes neurodiversity as a concept that aligns with the "social model of disability," offering a framework that views differences in thinking and perceiving the world as natural variations of human experience, rather than deficits to be fixed or cured. While neurodiversity is often associated with autism, it encompasses a broad spectrum of conditions, including ADHD, OCD, and others, all of which may be identified by individuals as part of the neurodivergent community.
A common theme in Annika’s experience is that many neurodivergent individuals encounter environments that are not inclusive or conducive to their success. She notes, for example, that traditional educational assessments—such as essays and written tests—are often ill-suited for children with learning disabilities related to reading and writing. Despite these challenges, she believes that societal barriers can be mitigated through thoughtful accommodations and adaptations.
Healthcare, like education, is an area where neurodivergent individuals often face significant challenges. Although recent years have seen increased awareness of neurodiversity in healthcare spaces, Annika asserts that much work remains to be done. She highlights that healthcare environments are particularly challenging for individuals with communication disorders, sensory sensitivities, and executive functioning difficulties.
Effective communication is a cornerstone of patient-centered care. However, many traditional methods of medical history-taking and patient interviews do not align well with the needs of neurodivergent individuals. Annika explains:
“Healthcare practitioners are often trained to ask open-ended questions during patient interviews (e.g., 'How would you describe your pain?'). While this approach works well with neurotypical individuals, many people with communication disorders respond better to closed-ended questions, or those offering specific choices, such as 'Yes' or 'No.' Many autistic individuals, for example, struggle with abstract medical terminology (such as rating pain on a scale of 1-10). Additionally, individuals who have difficulty processing language may not fully grasp explanations of diagnoses or treatment plans, especially when these are delivered quickly or with complex medical jargon. Some patients, while seemingly able to communicate verbally, may still require extra time to process verbal information. Those who are minimally verbal face even more significant challenges, as they may not be able to express medical concerns, leading to missed diagnoses. For many neurodivergent individuals, communication difficulties are amplified in overwhelming or stressful environments.”
Differences in sensory processing also complicate healthcare interactions. Many neurodivergent individuals are either hyper-sensitive or hypo-sensitive to sensory stimuli, which can deeply affect their experience in medical settings. For those who are hypo-sensitive, identifying and articulating the intensity of pain can be challenging, often leading to underreporting of symptoms and delayed diagnosis. Conversely, individuals with hypersensitivity may find even the most routine procedures—such as the use of a tongue depressor—painful or distressing. The sensory overload often experienced in environments like emergency departments can also be overwhelming, making even simple visits to healthcare facilities a source of significant anxiety.
As my peers and I prepare to step into roles as future healthcare providers, we will soon be responsible for managing our own clinics, wards, and emergency departments. Annika’s insights into the experiences of neurodivergent individuals in healthcare are invaluable in shaping our understanding of how to create environments that are not only more accessible but genuinely inclusive for all patients. By embracing these perspectives, we can ensure that our future practices will be better equipped to meet the diverse needs of the populations we serve, fostering both comfort and equity in the care we provide.