34th Annual Scientific Meeting proceedings

Don’t confuse neurodiversity & neurodivergent
Neurodiversity refers to the range of behavioural types and patterns in the whole human population. This includes neurodivergent (ND) individuals with specific neuro-developmental conditions. These include autism (autistic spectrum/AS or autistic spectrum disorder/ASD), attention deficit/hyperactivity disorder (ADHD), dyslexia, dyscalculia, dyspraxia, Tourette’s syndrome etc. Multiple diagnoses are common – for example, I’m autistic and mildly dyspraxic with have some ADHD traits.

Relate the diagnosis to the person – and respect it
This is important – I don’t “have” autism, I am autistic. The former relegates me to a diagnosis, suggests I’m abnormal, and implies I can be treated and cured. The latter respects me as a whole person and recognises the strengths that I have while helping me navigate the challenges that will I face in a neurotypical (NT) world.

Similarly, while many NT people exhibit ND traits that is not the same as being ND. While often meant well, using this to relate to ND individuals actually belittles them and their lives. For example, don’t tell me “not to worry because we’re all on the spectrum” and don’t say to a dyslexic person that “my spelling sucks too”. This fails to acknowledge to totality of the impact of ND conditions.

Neurodiversity in the veterinary profession
ND conditions are frequent in the veterinary profession. It’s estimated that 15-20% of people are ND in one or more areas – therefore towards 50% of veterinarians could be ND (whether they have a diagnosis or not). There are various reasons for this. In my case, I could not make connections and bond with other children. This led to isolation and bullying, and I sought and found solace in animals and nature. Like many ND people, these were my earliest emotional connections. Couple this with intelligence, an ability to focus and work hard, and amazing teachers – and it's no surprise that I’m a vet. However, I’ve also been lucky (see below).  

Neurodiversity – ability versus disability
This can be nuanced. In the UK, with a diagnosis of autism I am legally disabled. This has some benefits in terms of a free bus pass, legal protections, and access to support (see below). However, the term “disability” is generally pejorative and focuses on the negative rather than the strengths that ND people have. For example, many ND individuals are observant and empathetic, autistic people are hardworking, focused, and show great attention to detail, and ADHD brains are creative and good at multi-tasking. These are great traits in veterinary practice.

Challenges for neurodiverse individuals in a neurotypical world
ND conditions are not pathologies by themselves – it is the associated mental health issues that cause the problems. I suffer from chronic anxiety and imposter syndrome - some of this is inherent and some arises from the problems I have living and working in an NT world. In many ways, I’ve been lucky though - ND people are much more likely to be unemployed and/or in non-secure employment, vulnerably housed, have mental health or addiction problems, and/or be in prison. In addition, 9/10 ND women have experienced sexual assault - think about that statistic. 

Masking is essentially the act we put on to interact with other people. Everyone masks to some extent – I’ll behave differently with my family, friends and clients for example. Masking can be tiring and is one reason why teaching or clinics are exhausting. Many ND people mask frantically all day just to appear “normal” in NT work, study and social environments. This is particularly common for women, where there is greater pressure to conform to expected stereotypes and where “geeky” behaviours and interests are less tolerated than in men. This can also be a problem for ethnic minorities if there is pressure to conform (e.g. Asian societies) or where ND behaviours are regarded as threatening (e.g. for Afro-Caribbean individuals). Masking to this extent is draining and inevitably leads to burn out. However, letting the mask slip can result in the “uncanny valley” experience – an NT person might feel something is wrong and make (all the wrong) intuitive deductions (e.g. shifty, untrustworthy, not interested etc.).

To the outside world, an ND person may appear gifted, hard-working, compliant and/or eager to please. What isn’t seen is the sensory overload, anxiety, imposter syndrome, communication problems, feelings of being different and isolated, being misunderstood, social confusion, and sheer exhaustion. When this become too much, the emotional overload results in meltdowns or shutdowns. While there is often great sympathy for someone declaring their ND condition, there is usually little to no sympathy for stress-associated ND behaviours.

Moving to inclusive study, work and social environments

Diagnosis
Getting a diagnosis transformed everything. Up to that point navigating through life had been like trying to assemble flat pack furniture without the instructions in a dark room. I now have the instruction manual to my brain – I know my strengths, understand why and when I will have challenges, and how better to manage these (i.e. I know where the cliff edge is and can start mitigation before I fall off into a meltdown or shutdown). I also know my rights, and where, when and how I can expect appropriate adjustments, help and support (including employment protection). However, challenges to getting a diagnosis include access (especially if it’s perceived that there is no impact), waiting lists and costs (if private). In addition, there can be feelings of loss, grief and confusion over having an ND future or (conversely) time wasted before the diagnosis.

Respecting diversity and neurodiversity
Humans are diverse, whether ND or NT. We need to respect and celebrate our differences. The confident and extrovert (and male) vet stereotype encourages masking and leads to burnout. Diverse teams are happier and more effective.

Demand free adjustments
These are easy wins with little to no resource, infection control or health & safety implications that help everyone. Examples can include accepting personal appearance (what does a vet look like anyway?), fidget spinners or other distortion tools, safe spaces, ear loops, coloured lenses, filters & papers etc., fonts, spell & grammar checkers, transcribing software, and non-aversive uniforms etc. We’re only by our imaginations!

Ask and be open
Foster an open and inclusive environment that encourages openness rather than masking. Ask ND individuals what would help and don’t take this as a challenge or not being part of the team. Finally, establishing how to avoid or manage meltdowns and shutdowns ahead of time is essential for everyone.