Neurodiversity Affirming Standards: What Can the US Learn?

When Australia published its National Guideline for Learning, Participation, and Wellbeing of Autistic Children and their Families (Trembath et al., 2022), I took note. The title included wellbeing, which Australia has integrated into its educational system for many years (White & Kern, 2018). Last year, the Australian government released Measuring What Matters: Australia’s First Wellbeing Framework, to measure and understand how Australians are faring beyond traditional large-scale governmental metrics such as Gross Domestic Product.

The United States has produced some standards of care for autistic children in youth, including the American Academy of Pediatrics Identification, Evaluation, and Management of Children With Autism Spectrum Disorder (Hyman et al., 2022) and the Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder (Steinbrenner et al., 2020). However, wellbeing is not named or well-represented in these reports. Indeed, searching for the term “wellbeing” comes up blank for both reports developed in the US. The Australian guidelines reference “wellbeing” 134 times in the 146-page report. Frequency of word usage is not an ideal evaluation method, of course, and arguably, the effective services and support to autistic individuals outlined in the two US documents do contribute to wellbeing. Still, as the Australian Government stated with their Wellbeing Framework, we need to begin measuring—ergo addressing—what matters.

Wellbeing matters.

Almost 10 years ago, researcher Peter Vermeulen (2014) stated: “It is remarkable that emotional wellbeing and its pursuit, although highly valued by every human being, have received so little attention in research on the autism spectrum.” Wellbeing continues to be under-researched in the autism community, and the current well-established wellbeing practices (e.g. gratitude, mindfulness) are not widely applied to autistic individuals or the autism community.

The Australian National Guidelines include 17 guiding principles. These principles are based on human rights guidelines and provide a supportive framework for supporting autistic children. Principle 3 states that “support should build on each child’s and family’s strengths and interests.” Historically, intervention in autism has been deficit-based. Interventions are developed to remediate the autistic individual's perceived deficits. A strengths-based approach is pivotal to promoting wellbeing.

In the field of positive psychology, "strengths-based" typically refers to the use of character strengths (Peterson & Seligman, 2004). Character strengths, as classified by positive psychology, are positive traits (e.g., honesty, kindness, and bravery) expressed through a person’s thoughts, feelings, and behaviors and are recognized as strengths by individuals and communities. Character strengths are emerging in autism intervention (Kircher et al., 2016; Niemic et al., 2017 ). Assessing character strengths and implementing evidence-informed interventions such as strengths spotting (naming and noticing strengths in others) is one strategy to implement wellbeing systematically through a strength-based approach in autism intervention.

I hope the United States can look at the work being done in Australia and incorporate wellbeing more strongly into our practice guidelines. Given the prevalence of autism, every pediatrician and educator will at some point be called upon to support an autistic child. The professional guidelines and standards guiding the work of these professionals should explicitly address the wellbeing of the children we’ve been invited to serve.