A Neuroinclusive School Model: Focus on the School, Not on the Child

Figures & data

Table 1. Design-based research process followed in cycle 1 and its effects on the model’s design.

Phase	Actions and people involved	Main findings and effects on the design of the model
Analysis and exploration	Exploration of scientific literature and key references: on effective practices in schools with autistic students (reference works, ERIC, Education Source, and MEDLINE databases with keywords associated with school inclusion, autism, and intervention). Two focus groups with school practitioners: to better understand concerns about school participation for autistic students, the potential reasons for the challenges (Grandisson et al., 2020). Fourteen school staff members from regular elementary schools from the region of (location blinded for review) participated. Seven were involved in regular classrooms only, five in special classrooms only and two in both. Six participants were teachers, three were support professionals (speech and language pathologists and psychoeducator), three were special education technicians and one was a daycare educator.	Identification of good practices in the field of autism (e.g. visual supports, structured environment) that can be used with all students. Provision of empirical support to justify the choice of the preliminary characteristics of the model. Identification of universal design for learning as a good practice in schools to help all students learn by highlighting how learning should be motivating and how different means of representation, action and expression should be used (CAST, 2018). Identification of the need for changes to occupations and environments that are applicable to many students to support their use by school personnel. Synthesis of the features of environments and occupations affecting students’ participation, including the difficulty of tasks, group requirements, limited time, lack of structure and stability, overload of the physical environment, lack of training and resources, lack of cooperation, variable peer acceptance and tolerance. Necessity to start by evaluating the need for support in activities throughout the school day (e.g. transitions, play, meals, educational).
Design and construction	Initial drafts of the model by the design team of three occupational therapists (initials removed for blinding), keeping in mind the need to reduce barriers not only for autistic students, but also for their peers as in Universal Design for Learning. Consultations with practitioners: from an elementary school (one school administrator, one professional, one daycare representative), an educational services coordinator, an occupational therapist from a specialized school, and researchers and student-researchers in occupational therapy, speech and language pathology, and education	Approaches aimed at developing the skills of autistic people were rejected. Modification, clarification, or grouping. Choice of positive terms. Decision to use accessible terms (e.g. activity instead of occupation).
Evaluation and reflection	Evaluation with school practitioners: pilot project in which an occupational therapist accompanied a team of nine school practitioners from one mainstream school in (location blinded for review) to facilitate meaningful participation of autistic students and their peers through helping them modify the environment and activities (Rajotte et al., 2022). Four generalist teachers, one specialist teacher, three special education technicians, and one daycare educator were involved. Only 6 days of occupational therapy were provided over 2 months due to extended school closure (COVID-19 pandemic). They provided feedback through interviews and questionnaires. Evaluation with occupational therapists: training and communities of practice offered as part of a research project to 12 occupational therapists working in school settings (n = 11) and in a private clinic (n = 1) (Grandisson et al., 2024). They provided feedback through interviews.	Model helps occupational therapists and school teams change their perspectives on how to facilitate the participation of autistic students, focusing on strengths and on changes to environments and occupations. Model helps them focus on strategies that are concrete, simple, and applicable to many. Modifications are perceived to be beneficial for autistic students and also for others. Occupational therapists and school teams would be more likely to invest time and energy into creating more inclusive environments and occupations if the needs of other neurodivergent students (i.e., those with neurological profiles that differ from the current norm) were encompassed and if other professionals shared the same vision.

Table 2. The design-based research process followed in cycle 2 and its effects on the model’s design.

Phase	Actions and people involved	Main findings and effects on the design of the model
Analysis and exploration	Exploration of scientific literature and key references: on neurodiversity and inclusive education, focusing on the perspectives of neurodivergent people and their families concerning barriers and facilitators to the participation of neurodivergent students (ERIC, Education Source, and CINAHL databases).	Clarification of how the features can help meet the needs of neurodivergent students. Provision of empirical support to justify the choice of the final characteristics of the model. Inclusion of more examples from research using the perspective of neurodivergent students.
Design and construction	Modifications to the previous model by a design team composed of two occupational therapists (initials removed for blinding), applying a neuroaffirmative lens. Consultations with people with lived experience, i.e. three parents of neurodivergent students, two of whom self-identified as neurodivergent.	Modification of terms and removal of features inconsistent with a neuroaffirmative lens (e.g. peer modeling). Additional efforts were made to ensure that the model does not implies that neurodivergent people should change their way of participating, but rather emphasizes the need to reduce the barriers they encounter in schools. Clarification that participation should be meaningful to neurodivergent students and foster well-being. Terms that were more meaningful to neurodivergent people were chosen (e.g., neuroinclusive school). Central positioning of the social environment to emphasize its critical importance and modification of its features to emphasize caring and valuing neurodiversity. Making explicit the need for students’ and families’ involvement, for leadership from school administration, and for recognizing the uniqueness of each student and context.

Figure 1. A neuroinclusive school model supporting meaningful participation and well-being for neurodivergent students and their peers.

Grandisson, M., Rajotte, E. M., Godin, J., Chrétien-Vincent, M., Milot, E. L., & Desmarais, C. (2020). Autism spectrum disorder: How can occupational therapists support schools? Canadian Journal of Occupational Therapy, 87(1), 30–41. https://doi.org/10.1177/0008417419838904

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CAST. (2018). Universal design for learning guidelines version 2.2. https://udlguidelines.cast.org

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Rajotte, É., Grandisson, M., Hamel, C., Couture, M. M., Desmarais, C., Gravel, M., & Chrétien-Vincent, M. (2022). Inclusion of autistic students: Promising modalities for supporting a school team. Disability and Rehabilitation, 45(7), 1258–1268. https://doi.org/10.1080/09638288.2022.2057598

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Grandisson, M., Chabot, L., Hamel, C., Couture, M. M., Chrétien-Vincent, M., Bussières, E. L. (2024). Building occupational therapists’ capacity to support school personnel involved with autistic students. Journal of Occupational Therapy, Schools & Early Intervention.

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