The 16th – 22nd March marks Neurodiversity Celebration Week 2026, a global initiative which tackles challenging stereotypes and misconceptions around neurodiversity. This year’s theme is “Working together to create a world that understands it takes all kinds of different minds”. As well as awareness, Neurodiversity Celebration Week asks us to action structural changes to remove barriers, whilst embedding these skills within our everyday lives.
What is neurodiversity/neurodivergence?
(Reference: RCN)
Neurodiversity describes the natural diversity of the brain.
Neurodivergence is when someone’s brain processes, learns, and/or behaves differently from what is considered “typical” (e.g. Dyslexia, dyspraxia, attention deficit hyperactivity disorder etc.)
Our team asked Elizabeth Herrieven and Paul Robinson about neurodiversity within the emergency department (ED) and what can we do to create a safer space for our neurodiverse patients and clinicians.
Paul Robinson is a post CCT clinician and Co-Lead for Neurodiversity on the College Equity Committee and has previously shared his story about being diagnosed as an adult with ADHD.
What changes would you make in the Emergency Department (ED) to make it more accessible yourself and neurodiverse patients?
The first key adjustment is “Radical Acceptance” – the recognition that all neurodivergent conditions are here, are real, and deserve empathy and adjustment. Neurodivergent conditions are damaging afflictions with implications for lifespan, liberty, earnings, even happiness, and are in fact under – not over – diagnosed. Radical acceptance is the first step, and no one needs to understand the conditions ‘perfectly’ to start there. ND individuals are your colleagues, friends, people you know. We don’t need distraction toys – we need to be recognised.
The next step is asking how we can adjust. Adjusting for your colleagues and understanding what’s needed can teach you very quickly to adjust for your patients; don’t underestimate how exhausting masking and processing for a neurotypical world can be. Our processes are often rigid and learning to align yourself with someone’s needs can be a huge contribution. This can be a simple as flexible deadlines, pre-agreed feedback metrics for learners, combating executive dysfunction, or just having their adjustment be that they can come to work pre-changed into their scrubs, or take an extra break. Tiny things give way to huge relief for neurodivergent people.
Have you observed any harmful stereotypes within the ED?
Identifying ND conditions as “superpowers” can be extremely dangerous – as it shifts blame from the institution (which would have to adjust) to the individual (who has ‘not learned to use their gift properly’).
Any other tips you’d like to share for Neurodiversity Celebration Week? What should clinicians start doing?
Try getting assessed. Be it locally or through a support service (be ready to push back if those wheels don’t turn, and if your referral is ignored). If there isn’t a local support network, it could be pivotal in helping to establish one.
If your colleagues are learning averse then be ready to challenge micro-aggressions, reticence – and be ready to say to those struggling with burnout “have you ever considered neurodivergence might be involved?”.
Ask if these conditions may be involved in those you work with who attract labels like “difficult” or “problematic”. Challenging the origin of those difficulties at every stage is hugely important – you may not know what your colleagues, undiagnosed or diagnosed, are living with. Time to speak up.
Elizabeth Herrieven is a consultant in paediatric emergency medicine at Sheffield Children’s Hospital and is the author of the Royal College of Emergency Medicine Disability toolkit which we urge all emergency clinicians to use when caring for disabled patients.
What changes would you make in the Emergency Department (ED) to make it more accessible yourself and neurodiverse patients?
The biggest thing that needs changing, and this isn’t just in emergency medicine, but all of healthcare, is that we need to see people as individuals, with their own strengths and challenges, and deserving of our time and attention, rather than making assumptions.
Neurodiversity means that we are all different – our brains work in diverse ways. Neurodivergent people may have brains that work in ways that seem unusual to others, but that just means we need to try to find out how best to support them whilst they’re in the ED, whether they are a colleague or a patient.
No two autistic people are the same. By assuming we know what someone may or may not be able to tolerate, or that we won’t be able to communicate with them, we make life more difficult for everyone.
Have you observed any harmful stereotypes within the ED?
Sadly yes. Things like “refusing obs”, “refusing treatment”, “not cooperating with examination” are written all the time in patient notes, usually without any consideration for the reasonable adjustments that are required by law to enable people with disabilities (autism is included in this) to access healthcare. If someone is not cooperating with examination, then it’s up to us, as clinicians, to find a way to help them to cooperate. That might mean thinking about taking more time, chunking explanations, involving carers or family members, using communication tools, modifying the environment, minimising sensory overload, etc.
Saying that an autistic person is uncooperative is a dangerous stereotype which contributes to health inequalities. In a similar way, if behaviours such as shouting, throwing, hitting, running off, etc are down to “badness”, or poor parenting, for example, risks missing important causes of distress. All behaviour is communication and behaviours of distress are a way of expressing pain, discomfort, fear, and many more distressing feelings.
Any other tips you’d like to share for Neurodiversity Celebration Week? What should clinicians start doing?
Loads!
Listen to family or carers – if they say something is different, believe them.
Almost everything is more common in Down syndrome, especially infections. If something is different, look for a cause other than Down syndrome.
Some neurodivergent people may need particular sensory stimulation to help them tolerate being in ED (stimming, music, movement, for example). Others will be more comfortable in a low stimulus environment. You won’t know which will help your patient if you don’t ask.
Same goes for colleagues – neurodivergent colleagues may need movement breaks or breaks from the sensory overload.
Eye contact can be difficult for some people. Don’t assume someone is ignoring you or disrespecting you if they can’t maintain eye contact.
Believe an autistic person when they say they are in pain – they may not use the non-verbal parts of communication that we’re used to, but that doesn’t mean they are lying.
What can you do in the Emergency Department (ED) right now with RCEM/RCEMLearning?
Elizabeth Herrieven has created a Disability Toolkit for our clinicians can utilise to help transform the ED for those with learning disabilities and improve their healthcare.
Join us at the RCEM study day on “caring for autistic patients and those with learning disability or complex needs in the ED” online on May 19th, to find out more about how to reduce health inequalities for patients and how to support neurodivergent colleagues.
We have several RCEMLearning modules available which are a great resource to learn about the patient experience of how they navigate the ED.
Autism and the ED – RCEMLearning
Behaviours that Challenge – RCEMLearning
Public Health in the Emergency Department Series #3 – RCEMLearning