
The field of pediatric occupational therapy is evolving—and so is the way we understand and support neurodivergent children.
More and more therapists are embracing a neuro-affirming approach, which shifts the focus from “fixing” differences to celebrating and supporting each child’s unique way of thinking, feeling, and interacting with the world.
If you’re a pediatric OT, adopting a neuro-affirming lens can transform the way you build relationships, design interventions, and create environments where every child can thrive.
What Does “Neuro-Affirming” Mean?
Being neuro-affirming means acknowledging that neurological differences—such as autism, ADHD, dyslexia, dyspraxia, and others—are part of natural human diversity.
Instead of framing these differences as deficits, we recognize them as variations in brain wiring that come with both strengths and challenges.
This perspective is rooted in the neurodiversity movement, which promotes acceptance, respect, and inclusion for people of all neurotypes.
For pediatric occupational therapists, a neuro-affirming approach means:
- Valuing the child’s perspective and lived experience.
- Avoiding therapy goals that focus solely on making the child appear “more typical.”
- Supporting self-advocacy, autonomy, and sensory needs.

Why Neuro-Affirming OT Matters
Traditional therapy models often placed emphasis on reducing “undesirable” behaviors—such as stimming, avoiding eye contact, or preferring solitary play—without considering whether those behaviors were actually harmful or simply different.
A neuro-affirming approach flips the script by asking:
Is this behavior actually harmful to the child or others?
Is this behavior a form of self-regulation or communication?
How can we support the child’s needs without trying to erase their identity?
By focusing on function, comfort, and confidence rather than conformity, we help children build skills while honoring who they are.
Key Principles of Being a Neuro-Affirming Pediatric OT
1. Listen to the Child’s Voice–this includes non-verbal children
Even very young children can express preferences through their words, body language, or behavior.
Validate their feelings and give them choices in therapy activities.
This builds trust and self-advocacy skills.
Example: Instead of saying, “We’re doing handwriting now,” try, “Would you like to start with handwriting or with a movement activity?”
2. Focus on Strengths First
Neurodivergent children often hear about what they “can’t” do.
Therapy should highlight their abilities and interests to build confidence.
Example: If a child loves dinosaurs, incorporate them into fine motor games, sensory bins, or storytelling activities.
3. Respect Self-Regulation Strategies
Behaviors like rocking, flapping, humming, or pacing—often called “stimming”—can help children regulate their emotions and sensory input.
These should be respected unless they are unsafe.
Example: Instead of stopping a child from fidgeting, provide a fidget tool that meets their sensory needs in a safe way.

4. Adjust the Environment, Not Just the Child
A neuro-affirming OT looks beyond individual skill-building to address environmental barriers.
This may mean recommending sensory-friendly classroom setups, noise-reducing headphones, or predictable schedules.
5. Collaborate with Families as Equal Partners
Parents and caregivers are experts on their children.
Therapy should be a collaborative process where their insights guide intervention planning.
Example: Ask parents, “What’s working for your child at home?” and integrate those strategies into sessions.
6. Use Identity-Affirming Language
Avoid pathologizing terms like “disorder” when talking with families and children.
Many in the neurodivergent community prefer identity-first language (e.g., “autistic child” rather than “child with autism”), but it’s always best to ask the individual or family what they prefer.
7. Prioritize Autonomy and Consent
Even in play-based therapy, children should have the right to say “no” or “not right now” to an activity.
This teaches bodily autonomy and mutual respect.
Practical Steps to Become More Neuro-Affirming

Educate Yourself – Follow neurodivergent voices online, read first-person accounts, and attend continuing education courses focused on neurodiversity-affirming practices.
Reflect on Your Goals – Ask yourself if therapy goals are about helping the child succeed in their own way or about making them “fit in” better.
Reframe Behaviors – Instead of viewing certain actions as “noncompliant” or “problematic,” consider what need the behavior is meeting.
Be Flexible – Let sessions flow naturally based on the child’s energy, mood, and sensory regulation.
Advocate in Your Setting – Share neuro-affirming strategies with teachers, parents, and other professionals.
The Role of Occupational Therapy in Neuro-Affirming Care
Occupational therapists are uniquely positioned to lead the shift toward neuro-affirming care because we focus on function, participation, and quality of life.
We can:
- Design sensory supports that reduce stress and increase comfort.
- Adapt tasks to fit the child’s strengths rather than forcing them into a rigid mold.
- Create environments that support regulation, engagement, and independence.
By adopting a neuro-affirming lens, OTs become not just therapists but advocates for inclusion and acceptance.

Final Thoughts
Being a neuro-affirming pediatric occupational therapist means seeing each child as a whole, capable person—exactly as they are today.
It’s about supporting growth without erasing individuality.
When we shift from “fixing” to empowering, we create therapy spaces where children feel safe, valued, and understood.
And that’s where the most meaningful progress happens.
At SuperKids Pediatric Consultation Services, we believe that every child’s brain is worth celebrating.
My consultations are built on trust, respect, and a deep understanding of each child’s unique sensory and emotional world.
🌐 Learn more about our approach at www.superkidspediatricconsulting.com










































