EMBRACING NEURODIVERSITY

Cosmetic Vault founder and self-care advocate Claire Campbell-Adams explores how to make your clinic more inclusive for neurodiverse patients and staff

2023 was the year we saw influencers and celebrities highlight their ADHD/Autism diagnosis and subsequently share the impact it has on their lives, leading to an influx of people, in particular women, seeking a diagnosis. NHS trusts such as the Aneurin Bevan University Health Board in South Wales have a waitlist of eight years and Psychiatry UK had to close its books to patients seeking ADHD assessments. This increase in awareness allows clinics to make small changes to be accessible for both neurodiverse clients and staff. To achieve this, it’s important to understand what neurodiversity is and the everyday challenges neurodiverse people face.

Christine Flintoft-Smith, head of Autism Accreditation at the National Autistic Society, says: “Autistic people represent a huge part of our society - at least one in 100 people are autistic. Autistic people must have the opportunity to go to beauty salons and aesthetic clinics just like anyone else if they wish to, but many find the sensory aspects of these environments, like bright lights, the noise of equipment and the smell of products overwhelming. Small changes can make a huge difference.”

Simply put, neurodiversity is an umbrella term used to describe the differences in how people’s brains work. It includes conditions like autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), dyslexia, dyspraxia, dyscalculia, Tourette’s syndrome, and, in some circles, there is a call to include obsessive compulsive disorder (OCD). The ADHD Foundation reported that one in five people are neurodiverse, with the National Autistic Society stating that over 700,000 adults and children in the UK have been diagnosed with autism.

Neurodiverse conditions are on a spectrum meaning no two people present in the same way. For example, the definition of autism is evolving and, with that, there are conflicting opinions, with some saying that you cannot compare an autistic person who requires 24/7 care with those who can live independently. However, a core set of behaviours are always present for diagnosis. The idea of a spectrum often conjures up a linear profile, with high to low functioning examples bookending it. However, a spiky profile is more accurate!

Autism is a lifelong developmental disability which affects how people communicate and interact with the world, which manifests in a range of behaviours, including difficulty with social communication and interaction, repetitive and restrictive behaviours, over or under-sensitivity to light, sound, taste or touch, highly focused interests or hobbies, extreme anxiety, meltdowns, and shutdowns.

The ADHD iceberg diagram shows the internal challenges that people with ADHD face. It is not just the stereotypical naughty boy running around the classroom. Often hyperactivity can appear as racing thoughts and struggles with attention can manifest in both lack of attention and hyperfocus to the point that people forget basic self-care, such as eating and going to the toilet. There are three types of ADHD: hyperactive, inattentive, and combined.

Autism and ADHD share challenges in sensory and information processing, so while there are numerous facets to both these conditions, focusing on these areas can aid in accessibility and client experience.

Autism and ADHD are invisible disabilities, so one of the easiest things you can do as a clinic is to train your team on the ‘hidden disability sunflower lanyard’, a project designed to let others know that the wearer has a hidden disability (https://hdsunflower.com/uk/shop.html ). You can download digital logos to use on your website, download a poster for your waiting room, and share posts on your social media highlighting your understanding and support of the sunflower.

THE NEURODIVERSE TOOL KIT

• Provide a video showing the clinic to help the patient know what to expect, which helps plan and reduce anxiety

• Provide a text service where the patient can wait in the car or outside until their appointment is ready helping reduce the anxiety and overwhelm of sitting in a waiting room

• Ask if the patient would like a text/call before to remind them of the appointment as planning can be difficult

• Train staff on how to use the sunflower lanyard

• Train staff on neurodiversity and how it manifests differently in people. Explain that neurodiverse people may need extra time to process questions and information

• If there is a last-minute change to what the client is expecting, let them know as soon as possible and understand the change may make it difficult for them still to attend their appointment, so offer alternatives. For example, if the therapist they were expecting has been replaced by someone else, sudden unexpected change can be difficult to process

• Bright lights can be uncomfortable, so offer the use of an eye mask during treatment or, if safe, dim the lights

• Allow use of ear pods during treatment to help dull background noise

• Allow time for questions, some people like to know every step and ask lots of questions. It may be helpful to have an FAQ available or an opportunity to submit any questions in advance, to make your clinic more accessible. For example, if they are having laser hair removal, you could ask them if they would like to see a photo of the machine and a step-by-step guide of the treatment, so they know what to expect.

HOW TO MAKE YOUR CLINIC MORE INVITING TO NEURODIVERSE PATIENTS

• On your patient information form, include a question about neurodiversity and any reasonable adjustments you can make to enhance their visit

• Offer alternative methods of communication e.g. help filling out the form, instead of just asking them to fill it in

• If you have a neurodiverse tool kit, include a tick box where they can indicate what ‘tool’ they would like to access

• Amend your patient feedback form to ask specific questions. People with autism find it easier to answer questions when specific details are required. For example, replace ‘How was your visit?’ with ‘Did you enjoy your visit today?’

HOW TO IMPROVE YOUR CLINIC FOR NEURODIVERSE EMPLOYEES

• Ask if any reasonable adjustments need to be made at the interview stage

• Allow movement breaks

• Place doodle pads beside phones, which help ADHD employees concentrate

• Explore alternative ways to communicate

• Allow extra time to complete written tasks, for example, students in exams get 25% extra time

• The most important thing is to ask what you can do and open the dialogue.

“It could be as simple as staff learning more about autism and making simple adjustments, like keeping movement to a minimum, dimming bright lights and offering visits in advance so autistic people feel comfortable and reassured,” concludes Flintoft-Smith. “It’s so important that beauty salons and aesthetics clinics consider autistic people and find out how they can help to open up the salon experience to everyone.”