Imagine being an eight-year-old who knows they experience the world differently but has no words to explain why. School feels overwhelming, friendships are confusing, and everyday tasks seem harder than they do for everyone else. A parent notices these struggles and seeks help, only to discover they have to wait years for an assessment (NHS England, 2025).
Many of the children at the centre of this issue may be experiencing traits associated with attention deficit hyperactivity disorder (ADHD) or autism, including differences in attention, activity levels, social communication and interaction, sensory processing, and patterns of interests or behaviours (APA, 2022).
While the Equality Act (2010) states that reasonable adjustments should be provided regardless of whether a child has a formal diagnosis or not, this legal entitlement is not consistently implemented (Ward & Powell, 2026). As a result, many children remain unable to access the understanding and accommodations they need (Autistica, 2024). As children wait, their difficulties do not pause. Delayed recognition has been linked to lower self-esteem, school disengagement, and a greater likelihood of anxiety and depression (French et al., 2023).
Psychoeducational resources have been shown to improve understanding, coping, and quality of life for diagnosed neurodivergent children (Powell et al., 2025). However, many existing resources are written using clinical, deficit-focused language and are designed for children who have a diagnosis. This leaves an important question: what support is available for children who are still waiting or may never receive a diagnosis? Shore and Powell’s (2026) qualitative study explores whether co-produced, neurodiversity-affirming resources can bridge this gap.
Methods
The authors wanted to explore how neurodiversity-affirming psychoeducational resources were perceived by children aged 7-11 without a formal diagnosis of autism or ADHD, their families, and professional stakeholders. Twenty-four families were recruited through schools and community networks, and seven stakeholders were recruited by convenience sampling. Child participants attended mainstream schools and included those on diagnostic waitlists or with suspected autistic or ADHD traits. Stakeholders included teachers, educational psychologists, clinicians and advocacy representatives.
Families received one of two interactive booklets adapted from existing ADHD- and autism-focused resources. Using strengths-based, non-clinical language, the booklets support child-led learning through interactive activities, open-ended prompts, visual elements, and practical strategies that could be personalised to individual experiences.
Families used the resources for at least two weeks before taking part in a semi-structured interview exploring their relevance, acceptability, usefulness and accessibility, alongside suggestions for improvement. Stakeholders reviewed the prototype booklets and gave written feedback. Family interviews and stakeholder feedback were analysed together using Braun and Clarke’s (2021) reflexive thematic analysis to identify patterns and themes across the data.
Results
Analysis identified one overarching theme, supported by six themes:
- Active participation and the power of engaging design highlighted how participants felt the colourful design, interactive activities and personalised tasks encouraged children to engage with the resources. Participants described the activities as motivating, accessible and confidence-building, and valued the engaging, child-friendly format compared with traditional, text-heavy psychoeducational materials.
- Harnessing words as a foundational principle showed that participants valued the use of clear, non-pathologising language. Rather than focusing on “disorders” or “symptoms”, the resources used strengths-based terms such as “traits” and “superpowers”. Families felt this reduced stigma and helped children view their differences more positively, and stakeholders believed the accessible language made resources more suitable for use in schools.
- Personal resonance as a mechanism for self-acceptance demonstrated that children recognised their own experiences in the resources, which participants felt supported self-understanding and a more positive view of their neurodivergent traits.
- Communication as a first-line support tool highlighted how participants felt the resources created a shared, non-clinical language that helped children communicate their needs and supported more collaborative discussions between children, families and professionals.
- Tailoring for growth in a universal design emphasised the importance of flexible, child-led design, with participants valuing multiple ways of engaging that helped children access the resources in ways that suited their individual needs and preferences.
- Strategies for challenges to enhance well-being demonstrated that participants felt the resources supported planning, emotional regulation and coping, while also supporting self-esteem, confidence and self-acceptance.
Empowering individualised engagement was identified as the overarching theme, because all themes highlighted how participants felt the resources enabled children to actively explore their experiences in an individualised and affirming way. The co-produced, non-clinical design allowed children to engage with their cognitive profiles without requiring a formal diagnosis, while strengths-based language and personal resonance supported children to develop a more positive understanding of themselves. Stakeholders viewed the individualised approach as particularly valuable for inclusion and support while children awaited assessment.
Conclusion
Perhaps the most important message from this study is that children should not have to wait for a diagnosis before they can access support, recognise their strengths, communicate their needs and develop practical coping strategies. Neurodiversity-affirming psychoeducation could help bridge this gap, with participants particularly valuing resources that were co-produced, engaging, flexible and grounded in strengths-based, non-clinical language. Although further research is needed to establish their effectiveness, this study offers an important reminder that support should be guided by children’s needs, rather than waiting for a diagnostic label.
Strengths and limitations
This study has several notable strengths:
- The qualitative design using semi-structured interviews enabled participants to provide detailed accounts of their experiences and perspectives that may not have been captured through quantitative measures alone.
- Including children, parents/caregivers and professional stakeholders captured perspectives from different groups involved in supporting neurodivergent children and helped identify themes across participant groups.
- Families engaged with the resources for at least two weeks before providing feedback, giving them time to explore their usefulness and relevance to everyday experiences rather than relying on initial impressions.
- The researchers demonstrated explicit reflexivity by acknowledging how their neurodivergent identities could have influenced the research process. Reflexive journals and discussions around coding decisions increased the transparency of the analysis. However, their close involvement may also have shaped how interviews were conducted and findings interpreted, which should be considered when interpreting the findings.
Several methodological limitations should also be considered:
- Potential selection bias: The sample was mostly White British and concentrated in a few regions of England, and recruitment through schools, community networks and convenience sampling may have attracted families already interested in neurodiversity-affirming approaches. The study was also explicitly framed around the neurodiversity paradigm, with parents identifying their children as experiencing challenges associated with attention, activity levels or social-sensory processing. Families who understand their child’s experiences differently may therefore have responded differently to the resources, potentially limiting the transferability of the findings.
- Reliance on adult support: For younger children or those with greater support needs, the usefulness of the resources may depend on active involvement from parents or school staff. Families or schools with limited time, capacity or engagement may therefore experience different outcomes, limiting the transferability of the findings.
- Mainstream school setting: All the children attended mainstream schools, meaning the findings may not transfer to children in specialised educational settings. Children with greater learning, communication or sensory needs may require further adaptations to the resources or how they are implemented.
- Short evaluation period: The resources were evaluated over a relatively short period, so it remains unclear whether the perceived benefits would be sustained over time or translate into meaningful improvements in children’s wellbeing.
Implications for practice
This study highlights that support for neurodivergent children does not have to wait until after a diagnosis. Instead, neurodiversity-affirming psychoeducational resources could provide valuable first-line support by giving children the language and strategies to better understand themselves.
Although the Equality Act 2010 states that reasonable adjustments should not depend on formal diagnosis, many families continue to report a lack of support until one is obtained. Neurodiversity-affirming resources could potentially be embedded within whole-school approaches, pastoral support or SEND (special educational needs and disabilities) provision to encourage self-understanding and communication between children, families and staff. However, further research is needed to establish how effectively these resources can be implemented within schools.
The findings may also have implications for health services. With increasing waiting times for autism and ADHD assessments across the UK, GPs, clinicians and early intervention services could consider how evidence-informed psychoeducational resources might support children and families while they wait. Although not a substitute for comprehensive assessment, participants felt the resources helped children better understand their experiences and encouraged collaborative problem-solving within families. This strengths-based approach is supported by wider autism research, with greater strengths use associated with better quality of life, wellbeing and mental health (Taylor et al., 2023). Importantly, because Shore and Powell’s (2026) resources do not assume a diagnosis, they may be relevant to children who identify with the experiences described, regardless of whether they ultimately receive an autism or ADHD diagnosis.
Future research should now move beyond acceptability and explore effectiveness. Larger and more diverse studies are needed to determine whether these resources improve outcomes such as emotional wellbeing, self-esteem and school engagement. Research should also explore how they can be implemented within educational settings. Providing resources in schools could increase access for families with less time, capacity or knowledge to engage at home, while school staff may be well placed to facilitate engagement. Exploring their integration into existing SEND support, pastoral provision and whole-school approaches could therefore help establish their feasibility in everyday practice.
As an Education Mental Health Practitioner working in schools for the SEND Mental Health Support Team, I found these findings particularly encouraging. I frequently work with children who are on long waiting lists to receive an assessment. During this time, families often feel that they are left alone and unsure how best to support their child. These findings suggest that simple, evidence-informed resources could be embedded within schools and NHS pathways to support children and families while they wait for assessment. Future research is now needed to establish whether this approach is effective and feasible to implement at scale.
Statement of interests
Jess Stace works as an Education Mental Health Practitioner within a SEND Mental Health Support Team and regularly supports the mental health of children with a neurodevelopmental diagnosis or awaiting an assessment. This experience has influenced her interest in early intervention and psychoeducational approaches. She has no other conflicting interests to declare. AI tools were used for proof reading and in the editing process.
Edited by
Dr Nina Higson-Sweeney.
Links
Primary paper
Evie Shore, & Lauren Powell. (2026). Bridging the gap: Co-produced neurodiversity-affirming resources for undiagnosed children aged 7–11: Insights from children, families and stakeholders. Journal of Research in Special Educational Needs, 26, e70077. https://doi.org/10.1111/1471-3802.70077
Other references
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425787
Autistica. (2024) ‘Not a priority’ highlights crisis in autism assessment and support. https://www.autistica.org.uk/blog/no-a-prority
Braun, V., & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis?. Qualitative Research in Psychology, 18(3), 328-352. https://doi.org/10.1080/14780887.2020.1769238
French, B., Daley, D., Groom, M., & Cassidy, S. (2023). Risks associated with undiagnosed ADHD and/or autism: a mixed-method systematic review. Journal of Attention Disorders, 27(12), 1393-1410. https://doi.org/10.1177/10870547231176862
NHS England. (2025). Report of the independent ADHD Taskforce: Part 1. https://www.england.nhs.uk/long-read/report-of-the-independent-adhd-taskforce-part-1/
Powell, L., Parker, J., Stott, J., & Colbert, E. J. (2025). The impact of psychoeducation interventions on social skills in autistic 5–12-year-olds: A narrative systematic review. Neurodiversity, 3, 27546330251356718. https://doi.org/10.1177/27546330251356718
Taylor, E. C., Livingston, L. A., Clutterbuck, R. A., Callan, M. J., & Shah, P. (2023). Psychological strengths and well-being: Strengths use predicts quality of life, well-being and mental health in autism. Autism, 27(6), 1826-1839. https://doi.org/10.1177/13623613221146440
Ward, M., & Powell, L. (2026). The lived experiences of primary and secondary education for autistic university students. International Journal of Inclusive Education, 30(4), 732-748. https://doi.org/10.1080/13603116.2025.2490596