The world in which we exist now has shifted rapidly in recent years. Those shifts ripple along our interconnected webs through our nervous systems, our workplaces, and the people we serve. Neurodivergent individuals often feel these vibrations most acutely.
The profession of Speech and Language Therapy has also been deeply affected by these changes, particularly with the growing neurodiversity movement. This is why Sam Simpson and Emily Lees’ new course has landed at the right time, giving a space to pause and take stock.
Neurodivergence can potentially permeate many areas of our lives: personal, professional, and at a wider community and systemic level. When supervising clinicians these layers can interact in complex ways e.g clients and clinicians who may be neurodivergent (diagnosed or not), navigating systems that are not designed with them in mind.
As a late-diagnosed neurodivergent woman with years of both lived experience and of that working with a neurodivergent caseload, this day was a perfect opportunity to sit with these different elements and see what surfaced.
Early on we were asked to consider what we brought with us on that day, one aspect to consider was our current regulatory or emotional state. A small question perhaps, but at a time when a recent RCSLT survey revealed that 68% of SLT’s report unsustainable caseloads leading to burnout, there might not be a more important question to ask with any supervisee, regardless of their neurodiversity ‘status’.
As the day unfolded I found myself reflecting and connecting so many loose threads that had been sitting in the back of my mind. For instance, many qualities within individuals who are naturally drawn to speech therapy – curiosity, problem solving, sensitivity, love of learning, creativity – are common in neurodivergent people. Independent practice, too, can offer environments where these strengths flourish further: autonomy, flexibility, space for deep dives, and fewer layers of bureaucracy.
It raises an interesting question: perhaps there are more neurodivergent therapists among us than we once assumed? And if so, our supervision practices must evolve to meet their needs.
This becomes even more relevant in a female-dominated profession, where broader socio-political issues intersect. Women’s health, including neurodivergent identification, remains chronically under-researched and under-supported. Many supervisors will meet colleagues who arrive already carrying an invisible load – work demands, household and financial responsibilities, uneven childcare and so on. For some late-identified or undiagnosed adults, any coping strategies used may start to reach their limits, particularly at a time when we may be asked or expected to deliver more with less.
Therefore, it seems more pertinent now that supervision must be a place where honesty about how we are, is not only permitted but welcomed.
Effective supervision relies on awareness – of ourselves, of our supervisees, and of the systems shaping us. Neurodivergent-affirming supervision requires nuance, flexibility, openness about communication preferences, and a willingness to explore how trauma, masking, or internalised ableism may influence how someone presents and interacts with others. A supervisee may meet us at many different points in their journey, and we must be sensitive to what sits beneath the surface.
A well-trained, empathic supervisor providing the right support at the right time can be transformational – especially for someone who has experienced years of rejection sensitivity or feeling like they are ‘too much’ or conversely ‘not good enough’ in professional spaces.
Whilst being aware and ready for discussions around the challenges we face as individuals and a profession during this time, we must also highlight the inherent strengths our neurodivergent colleagues bring. In supervision we hold up our figurative mirrors and shine our metaphorical torches to highlight and nurture what is already there – strengths that may have been overlooked or undervalued in neurodivergent clinicians.
Discussions within supervision may be big or small; neurodivergence may sit quietly in the background, or roar loudly in the foreground. These reflections can influence how a clinician understands themselves, how they show up with clients, and how we collectively dismantle the ableism embedded in our systems and professional culture. Speech therapy is, inevitably, political.
In increasingly difficult financial and political times – with services stretched, funding unstable, and systemic pressures mounting – we cannot overlook the impact of this on the individuals within our profession. If we want sensitive, empathic, creative, innovative, ethical, deeply committed clinicians who advocate strongly for their clients to remain in the field, they must be cared for. These are the clinicians who can make the greatest difference to their caseloads. It is not enough to offer neurodivergent clinicians a seat at the table; we must support them well once they are there. Good-quality supervision is a protective factor for anyone feeling vulnerable or overstretched, and it is especially vital for neurodivergent clinicians navigating additional emotional, sensory, and systemic layers.
As supervisors this can feel like a weighty responsibility. My lasting thought from this day was that the kindness, compassion, and curiosity that we warmly give to those we support must extend back to ourselves as we embark on these journeys.
We don’t need to have all the answers, but lets keep asking the questions, providing safe spaces, and offering the steady presence required for growth – both our supervisees and our own.
By Melody Dalligan
Independent Speech and Language Therapist and Supervisor based in Medway, Kent
You can find me at:
melodydspeechtherapy@outlook.com