A messy moment in history

We’re living through a genuinely messy time for neurodiverse children and their families. Messy, because for decades, autism was understood as an illness, something broken, something to be managed. All the systems and institutions built around that understanding share the same basic premise: diagnose, then train the child to be acceptable in society. Train them to mask. Make allowances. Fit them in.

Then, over the last twenty years, the concept of neurodivergence arrived. Autism, ADHD, OCD, PDA and plenty of other presentations began to be understood not as illnesses, not as problems to fix, but as different ways the brain can function. Different ways of thinking, different ways of experiencing the world. The argument shifted: we should accommodate these children, not make them feel like outsiders.

The messiness comes from the fact that the people and institutions working with neurodiverse children are often still soaked through with the older medical model. A child might attend a school, trying hard to secure accommodations, only to step into a CAMHS assessment still rooted in diagnosis and compliance. Individual teachers, psychologists, and psychiatrists: some work from a neurodivergent framework; others still work from a medical one. The child and the parent are left trying to work out which lifeline to grab.

The medical model focuses on behaviour and fitting in. The neurodivergent model focuses on identity, authenticity, and accommodation. These are not minor differences in approach. They lead somewhere quite different.

What masking actually costs a child

The practical outcome of the medical model, for a neurodiverse child at school, is that they spend the day masking. They walk into a noisy form room where the social dynamics are chaotic and unpredictable. They’re overwhelmed within minutes. They don’t understand the social banter, the shifting roles, the unspoken rules that neurotypical children navigate without thinking. They’re looking for clarity and predictability, and all they get is noise.

But they’ve learned to hold it together. To sit there. To get through. And then they come home.

At home, they can’t mask anymore. The exhaustion tips over. Something as simple as sitting at the table for a meal is too much. The meltdown happens here, with the people who love them most. And parents are understandably confused: how can this be the same child who held it together all day at school?

Over time, the costs run deeper. A child who has to perform constantly, who is never simply allowed to be, begins to internalise the message that something is wrong with them. That they are the problem. They may start to withdraw, to isolate, to disengage from the world. And who could blame them?

Something I know from the inside

I understand something of this from my own experience. At ten, I was the annoying child who was top of the class but couldn’t sit still. In the earlier years of primary school, there had been art, movement, creative work, and I’d been fine. But by the final year, it was pencils and desks all day. I still carry a small mark on the palm of my hand from where I stabbed myself with a pencil out of sheer restlessness. I can see it as I write this.

The teachers didn’t know what to do with me. I was put on a very strong sedative as I moved into grammar school. This was the mid-sixties; ADHD wasn’t yet a concept. But the diagnosis of anxiety led to heavy medication, and the medication suited the school rather better than it suited me. I went from a restless, engaged, bright spark to a daydreamer staring out of the window. Compliant. Invisible. Easy to manage.

When I came off the medication, I’d already learned the lesson. On the few occasions I allowed my real self into the classroom, it didn’t go well: too loud, too much, too cocky. So I daydreamed my way through secondary school. That was masking. And it cost me my education, more or less. I wasn’t interested in what they were putting in front of me; I was interested in music, drama, art, and poetry. My mother understood this, and I’m grateful to her for protecting those interests and allowing me to follow them. They became my life.

I’m not claiming a diagnosis. I’m saying it feels familiar. And that familiarity matters to how I work now.

Forty years of watching the same mistake

Forty years ago, I worked in an extraordinary therapeutic educational environment where the curriculum followed each child’s special interests and emotional needs. That approach was gradually lost to UK education for children we’d now describe as neurodiverse, squeezed out by behavioural frameworks driven by cost and accountability. I struggled to work in mainstream education, where compliance was consistently held above the individual needs of the child.

For the last eight years, I’ve been in private practice as a psychotherapist. It’s a genuine relief to work again in a way that puts the child’s needs first.

What a relational space actually offers

What I offer is not strategies. It’s not tools for managing behaviour, techniques for fitting in, or new ways of masking what’s going on. It’s a relational space. A space where a child doesn’t have to conform to any particular way of being.

There’s no diagnosis required, and no diagnostic category changes how I meet a child in the room. I meet the person, not the label.

What it looks like in the room

One child spends most of the session blowing bubbles while we talk. Another’s eyes light up the moment they spot the spinny office chair: they can have it, and they know it. Children bring their favourite soft toy, or a precious object from home. One liked to stand on their head in the corner before settling. Another bounced a ball around the room throughout every session.

In the therapy room, a child learns that they have agency. They can affect the space they’re in. They can decide whether the light is on or off. They can get up and walk about whenever they want. They can make noise, hide under the table, lie stretched out across all the cushions. And whatever they do, I’m still there, listening, giving them space in the way they want to use it.

For some children, it takes time to get used to that. Some never quite manage it; they’re so conditioned to compliance and controlled spaces that the freedom itself is overwhelming. But when a child really is being themselves in the room, it’s a remarkable place to be. I’m seeing a side of them that many other people don’t. And just by allowing them to be fully themselves in that space, something changes. I don’t know what that is, and they don’t know what that is. But we both know that it’s giving them something.

Children who arrive in crisis, who’ve been suspended, excluded, and had the riot act read to them, often end up in a completely different place after a sustained period of this kind of work. I haven’t taught them any skills. I’ve just allowed them to work out for themselves what overwhelms them, what helps them feel connected, and what safety actually feels like.

Why parents are part of the work

The room alone doesn’t do it. What happens in the therapy space needs to connect with what happens at home. At a minimum, parents need to understand that I’m not working towards compliance. I’m not reinforcing the institutional approach. I’m working in a different direction entirely, and home needs to be on board with that.

The main thing I work on with parents is regulation and co-regulation. A child comes home from school having masked for most of the day. They’re exhausted. They need demand reduction. They need to be allowed to be messy, noisy, and a bit uncontrolled, within boundaries. If you can give them that, and you can stay calm while you do it, you’re giving them what they need. They need you to be calm so they can be calm. They need you to be warm so they can feel safe. That’s co-regulation, and it’s one of the most powerful things a parent can offer.

If you’re reading this as a parent

Whatever stage you’re at, whether you’re trying to keep your child in school, trying to get them back into school, or simply exhausted from the sheer energy of keeping going with something that doesn’t seem to be working, this kind of relational support exists.

I work with a small handful of children in person in Bude, North Cornwall. If that’s within reach, I’d be glad to talk. If it isn’t, the thing to look for is a therapist who is neurodivergence-aware and comfortable with unmasking: someone who isn’t going to teach your child to perform differently, but is willing to sit with them as they are, and trust that to be enough.

That kind of space is rare. But it exists, and it’s worth finding.