BEST PRACTICES
"Neurodiversity in the Veterinary Profession"
By Elycia Degenhardt, BA, CVT
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ost of you have likely heard of neurodiversity, but you may not know what it is referring to and how it impacts your veterinary team. While neurodiversity is a very broad topic with evolving research and education, there are widely applicable steps you can take in the workplace to better support neurological variety.

*note* I use identify-first language (autistic rather than person with autism) at times in this article. Individuals may have personal preferences as to the use of identify-first or person-first language regarding themselves. I am autistic and use identify-first language when it applies.
Pink cartoon brainWhat Is Neurodiversity?
Neurodiversity is the understanding that there is an extensive range of how human brains work. This diversity is a natural part of human variation. The term “neurodiversity” was coined by sociologist Judy Singer in 1998 as a way to reframe society’s attitude toward people with neurological differences. She wanted to help society see these differences as natural and accepted human variety rather than illnesses to be cured. She became internationally known when she published a chapter in a book titled “Why can’t you be normal for once in your life?”, a refrain she heard many times growing up and, sadly, one many with neurological differences are all too familiar with.

Neurodiversity includes people who are neurotypical (brains function in the most widely accepted way) and neurodivergent (brains function in a way that is not currently accepted as “normal” in society). Neurodivergence includes, but is not limited to, neurodevelopmental and mental health conditions such as ADHD, ASD, Dyscalculia, Dysgraphia, Dyslexia, Dyspraxia, OCD, Tourette Syndrome, Bipolar Disorder and PTSD.

The terms “neurodivergent” and “neurotypical” are not medical terms. While there are developmental disorders and diagnoses categorized under the term neurodivergent, it is not a diagnosis in itself, nor do all people with these diagnoses choose to identify as neurodivergent. The term neurotypical is potentially controversial, as there is no scientific body of evidence to support one typical way of brain functioning. It is a sociological term referring to what society accepts as “baseline” or “normal.”

I would also like to acknowledge that many individuals with conditions commonly recognized as neurodivergent experience struggles that make life difficult. Just because this variety exists naturally doesn’t mean people don’t experience challenges directly related to their differences. The goal of many in the neurodivergent community is to help make changes in society, rather than forcing individuals to attempt to conform in a way that is extremely uncomfortable, exhausting and often impossible.

Cartoon image of a brain on fire
One of the most important things you can do to support all staff is to stop relying on observational learning. Many autistic and ADHD individuals are not able to learn well this way, especially in a distracting environment.
Pink cartoon brainSupportive, Inclusive Workplaces
Building a workplace that is respectful of a neurodiverse population benefits all employees. First, it is possible there are staff members who have not disclosed a neurodevelopmental or mental health condition. While there is movement in society to destigmatize these differences, individuals have different levels of comfort sharing their personal information and have a right to privacy. Additionally, barriers to diagnosis and differing life experiences mean that people have varying degrees of self-awareness and resources available regarding any possible neurological differences. Finally, many individuals who would consider themselves neurotypical share at least some of the challenges typically associated with neurodivergent conditions.

For these reasons and others, it is best to create an inclusive environment from the start rather than waiting for someone to request accommodations. The following are some best practices for a workplace designed to help a neurodiverse population achieve individual and team success.

Pink cartoon brainExplicit Instruction
One of the most important things you can do to support all staff is to stop relying on observational learning. Many autistic and ADHD individuals are not able to learn well this way, especially in a distracting environment. This can be due to differences or challenges associated with sensory processing, information discrimination/prioritization, working memory and/or neurological processing speed. Observational learning makes a number of assumptions that are not universally guaranteed, including:

  • Observer can discern what is important.
  • Observer can filter out non-important information and distractions.
  • Observer can determine acceptable deviation for individual style.
  • Observer can form an effective working memory while receiving/processing information in a busy environment.
  • Communication between the two individuals is compatible and clear.

While having a mentor in a clinic can be very useful, explicit instruction is an essential component of workplace learning. Using explicit instruction increases the likelihood of the desired outcome, reduces the mental burden of the learner and provides specific reference points for feedback. Explicit instruction should include clear, written instructions in a procedural format such as standard operating procedures. Using a sans-serif typeface, avoiding underlining and increasing inter-word spacing improves readability. Keep instructions short (bullet-point or list format rather than paragraph) and supplement written instructions with visuals. Explicit instruction should be supported with demonstrations, but any demonstrations intended as part of employee training should be done in a low-pressure, low-distraction setting outside of daily clinic operations.

"Being mindful of clarity helps all communication partners stay aligned, especially in a goal- or performance-oriented work setting"
Pink cartoon brainClear Communication
Good communication is a key component of any well-functioning team. While a wide variety of preferences and styles exist, some individuals with neurodevelopmental differences may have communication needs that lie outside of the general population’s experience. Being mindful of clarity helps all communication partners stay aligned, especially in a goal- or performance-oriented work setting.

Whether using verbal or written communication, it is best to avoid figures of speech, sarcasm, rhetorical questions or exaggerations, as these can be confusing or misleading. When delivering important information, keep things to the point and highlight the information you would like the listener to retain with phrases such as, “This is important” or “Please remember this.” Any additional anecdotes or flourishes can distract a listener from the main point or may be mistaken as the intended purpose of the interaction.

Before you deliver important information, ask if the person you are communicating with is ready to receive information. Several neurodevelopmental conditions correlate with task-switching difficulties. If you try to communicate something critical while the listener is in the middle of something, the likelihood of that information being processed, understood and retained is decreased. The listener may need to complete what they are working on before they receive new or important information. They may also need to move to a different location if the one they are currently in is too distracting. Some listeners may require note-taking tools or technologies. If someone informs you they are unable to receive information at this moment, set up an appropriate time and location that works for both partners.

Here is a basic example of what this might look like for the large task of setting up for surgery:
Smaller Task
  • Select and prepare IV catheter supplies including IV catheter, connector, tape, scrub, and flush
Desired Outcome
  • Place IV catheter
  • Choose endotracheal tube and laryngoscope
  • Intubate patient
  • Prepare and label all drugs associated with procedure
  • Premedicate and induce patient
  • Deliver gas anesthesia safely and effectively
  • Set up anesthesia machine
  • Respond quickly to an anesthetic emergency
  • Ensure emergency supplies are prepared
Smaller Task
  • Select and prepare IV catheter supplies including IV catheter, connector, tape, scrub, and flush
Desired Outcome
  • Place IV catheter
Smaller Task
  • Choose endotracheal tube and laryngoscope
Desired Outcome
  • Intubate patient
Smaller Task
  • Prepare and label all drugs associated with procedure
Desired Outcome
  • Premedicate and induce patient
Smaller Task
  • Deliver gas anesthesia safely and effectively
Desired Outcome
  • Set up anesthesia machine
Smaller Task
  • Respond quickly to an anesthetic emergency
Desired Outcome
  • Ensure emergency supplies are prepared
Pink cartoon brainWorkplace Organization
In veterinary medicine, we are often asked to fulfill multiple roles in the workplace during the day, frequently at the same time. This reduces effectiveness of most employees and is very difficult or nearly impossible for some with neurological differences.

Whenever possible, create specific roles within your team, such as appointment, surgical or laboratory technician, client service representative, etc. Within these roles, establish clear responsibilities and guidelines. While these roles may shift from day to day or even from morning to afternoon, allow the person in that role to remain dedicated for the duration of a set time period or to completion of a predetermined task. This creates an opportunity to focus and gives structure to the day which helps with executive functioning (an area of difficulty for some neurodivergent individuals). This also allows someone to more accurately anticipate the workload of any particular day. People who have neurodevelopmental, mental health or physical health challenges may need to carefully plan their day to account for flagging energy reserves.

Another way to support all staff members is to break large tasks into several smaller, shorter tasks with clear outcomes. It is often helpful to create a checklist so the person assigned to the task can track their progress. This reduces reliance on memory and likelihood of errors.

Using explicit instruction, clear communication and strong workplace organization helps create an environment that supports the broadest population of employees; however, it is also important to remain responsive to individual needs. The main lesson we learn from exploring neurodiversity is that no two people are exactly alike. Difference is natural. By combining a foundation of best practices with flexibility and understanding, we can shape a veterinary profession where more people thrive.

Resources:
Elycia Degenhardt
Elycia Degenhardt is a certified veterinary technician in Wisconsin. She joined the veterinary profession after four years as a high school teacher and remains passionate about education. Elycia earned degrees from the University of Wisconsin-Madison and Madison College and continues to learn new things every day through her career and life experiences. Elycia currently works in a general practice and as an instructor in the Veterinary Technician program at Madison College.
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