Who We Are and How We Show Up in Our Work With Neurodivergent Individuals

About the Author

A developmental and clinical psychologist, Dr. Pinderhughes studies contextual influences on and cultural processes in parenting among families facing different challenges. These circumstances include adoption, living in high-risk, low resource communities, and raising children as a sexual minority parent. She has thirty-plus years of experience in the adoption field as a researcher and clinician, focusing first on readjustment processes among families adopting children from foster care.

While we each navigate the world as someone who is neurodivergent or neurotypical, we all have other social identities that also shape how we experience our world and interact with others. Our social identities are linked to how we view ourselves as a member of different cultural groups (Tajfel & Turner, 1986). We each have a range of social identities  – for example, our racial or ethnic identity, our sexual/romantic orientation, gender identity, religious identity, identity as an immigrant in or citizen of this country where we reside, our perceived social status, as neurodivergent or neurotypical, identity linked to where we live/grew up, and more. Depending on the situation or experience, certain social identities become more salient than others.

As professionals, we have an ethical obligation (see, for example, APA Multicultural Guidelines, 2017, NASW Code of Ethics, 2021) to ensure that when we work with others who are culturally different from ourselves, we support them and all of their identities, and don’t just focus on their neurodivergent identity. What does this obligation look like or mean? It means that we must consider/understand ourselves as cultural beings who support others who also are cultural beings.  In this piece, we focus on ourselves, because of the power and impact we have as professionals on others.

Our goal should be to understand our own social identities and how they impact our work with neurodivergent individuals, especially clients or colleagues who are culturally different from us. I suggest three important steps: 

• Identify, acknowledge and examine beliefs, attitudes and values that may be problematic in working with others
• Hold ourselves accountable for those beliefs, etc.
• Decide what steps to take and take action

As we consider this deeply personal and individual work, it’s important that we have a shared understanding of key concepts. Here are some definitions:

• Culture is shared norms, beliefs/values, practices/behaviors/rituals, communication styles that ensure that a group can sustain itself in the world. Importantly, culture provides guidelines for how children are raised, how one functions as a successful adult, and how communities function well (E.B. Pinderhughes, 1989). While many tasks are universal (e.g., raising children and helping them learn, ensuring safety, providing nurturance, etc.) HOW those tasks are performed can vary across cultures. For example, we each have been socialized to have certain values about how children or persons with differing abilities should be viewed or supported. When we work with others, we need to be aware that they may have different values or views, which may help or challenge the working relationship.
• Social stratification is a system of ranking people/cultural groups based on certain social/economic characteristics (Keister & Southgate, 2012). Stratification operates to provide advantage or disadvantage in power, prestige and privilege to different cultural groups. Folks can experience stratification linked to different social identities. Those of us who have experienced privilege, whether economically, racially/ethnically, due to gender, or religion, etc. can be less aware of how stratification can undermine others who are different.
• Intersectionality – a word that we see used a lot these days – is the nexus of two or more marginalized identities (where one is a member of a group that the system disadvantages through stratification). Some examples of intersectionality are: being neurodivergent and gay, being Latino/a and trans, being Asian, female and neurodivergent, being a Black trans male who is an immigrant. 

As we consider our ethical obligation to engage in self-examination of our own social identities, this process involves querying ourselves about our experiences, and values/beliefs that are linked to specific social identities. Elaine Pinderhughes (1989) offered some valuable questions that professionals should self-examine.  Here are some questions that we can systematically explore:

• What was your first experience with difference? How did you feel? What happened? How did that experience with difference shape what it means to you to feel different from others? How comfortable are you with feeling different and helping others who feel different?
• What is your ethnic background and what does it mean to be a member of that group? What do you like about your ethnic group? What do you dislike about your ethnic group? What messages did you receive about others who are ethnically different?
• What are your earliest or most salient images of race or skin color? What information were you given about how to deal with racial issues? How did those messages shape your comfort level with talking about race, racial differences, racial issues, etc.? How might your comfort/discomfort level impact how you work with clients or colleagues who are neurodivergent and a different race than you?
• We can ask ourselves questions like the above about each of our social identities (e.g., religious, nationality, gender identity, as one with abilities/disability), focusing particularly on how our beliefs/values would impact our work with others.  

We might find that we hold certain beliefs, values, or assumptions about groups, cultures, communities, and other identities we now realize may be problematic for supporting certain individuals who are different from us. When we have such a realization, we must own and acknowledge that we have those beliefs/values and hold ourselves accountable for having those beliefs/values.  The next step is to carefully decide what to do – work to change those beliefs/values, or to acknowledge their danger and consider whether and how we can manage/contain those beliefs/values so that we don’t injure or harm others when we work with them. 

This can be emotionally difficult work – examining and holding ourselves accountable for beliefs and values that may be problematic in our work with culturally diverse neurodivergent individuals.  When we step into this challenge, we step toward honoring our ethical obligation to support neurodivergent individuals and their various social identities.