‘Beyond the Stereotype’: Neurodivergent Students’ Experience and Peer and Teacher Understanding of Neurodiversity in a Mainstream Girls’ School

School Setting

At the inception of the study, the authors were contacted by a teacher at a highly academically competitive and selective private single-sex girls’ school for girls aged 11–18 years old in the United Kingdom. The authors were approached to conduct a study exploring the experiences of neurodivergent students at the school, motivated by the school's wish to implement effective change and improve support for such students. The school and students involved in this collaboration for this study have asked to remain anonymous.

Participants

All teachers and students in the school were invited to take part in this study. Sixty-eight teachers completed the study, however, 38 were removed due to being aged 18 years old or under, and it was suspected that they were students who had been sent an incorrect link. As the links were only shared with staff or students within the school, these 38 participants were subsequently added to the student sample, but as there was only a crossover for two questions their data is only partially included. Due to this, the final teacher sample was 30, of whom 5 (16.7%) reported a neurodivergent identity, 22 (73.3%) reported a neurotypical identity and 3 (10%) were not sure. The teacher sample was aged 25–61 years, mean age of 46.27 years (SD = 10.45). The majority of the sample was female (n = 27, 90%) and three (10%) were male.

In total, 171 students accessed the student survey, however, those who had only completed the demographic questions (n = 58) were removed from the sample due to incomplete data. A further two were removed due to lack of recorded consent, and one participant from the student survey was removed for age above 45 years (suggesting that the form was completed by a staff member by accident). With the addition of the 38 students who accidentally completed the teacher survey, the final student sample size n = 148.

When asked about neurodivergent identity, 32 (21.6%) students identified as neurodivergent, 101 (68.2%) identified as neurotypical, 14 students (9.5%) selected that they were not sure and one (0.7%) selected they preferred not to say. The students were aged 11–18 years old, mean age of 15.6 (SD = 1.77). The mean age of the neurodivergent students was 15.63 years (SD = 1. 79) and 15.6 years (SD = 1.77) for neurotypical students. The majority of students identified as female (n = 135, 91.2%), one student identified as male (0.7%), seven identified as non-binary (4.7%; 4 = neurodivergent, 2 = not sure and 1 = neurotypical) and five selected ‘prefer not to say’ when asked about gender (3.4%; 1 = neurodivergent, 2 = not sure and 2 = neurotypical).

In the neurodivergent or “not sure” group (n = 46), four participants (8.7%) had a formal diagnosis of autism, 8 (17.4%) had a diagnosis of ADHD, 8 (17.4%) had a diagnosis of dyslexia, 4 (8.7%) had a diagnosis of dyspraxia and 10 (21.7%) had another formal diagnosis of neurodiversity such as a tic disorder. When asked about self-identification (without a formal diagnosis), 8 (17.4%) identified as autistic, 15 (32.6%) identified as having ADHD, 2 (4.3%) identified as having dyslexia and 6 (13%) identified as having another neurodivergence.

Participatory Approach

The initial focus of this study was conceptualised by a group of neurodivergent students (n = 10), a class teacher and the school SEN co-ordinator (SENCO). The class teacher subsequently approached the first and last authors, who are researchers, to further develop the study concept, aims and design. When considering what measures to implement in the study, the steering group of neurodivergent students provided insight into suitability and accessibility. The students, along with the class teacher, also developed the items included in a novel measure of camouflaging ADHD traits which is outlined below. The steering group (including the class teacher and SENCO) was also crucial in designing the study procedure to ensure we reached as many students as possible. This involved designing the recruitment materials (e.g. videos presented during school assemblies) to encourage survey uptake and reduce barriers to participation. Following data analysis, the results were fed back to the steering group along with three neurotypical students to gather their interpretation and reaction – this is outlined in the result section below.

Measures

Procedure

Ethical approval was granted from King's College London PNM Research Ethics Subcommittee, ethics reference number: HR-20/21-19437.

Participants were approached by the SENCO at the school via email and the school's online portal. The information sheet informed participants that the purpose of the study was to ‘learn more about the schooling experiences of neurodiverse students and how teachers and peers understand neurodiversity’. For students under the age of 16 years, parents were asked to provide online consent before a link to the survey was provided. Teachers and students above the age of 16 were given direct access to the online survey. Surveys were hosted by Qualtrics and initially presented participants with a study information sheet and consent form. Measures were then presented in the order stated above.

Data Analysis

Students’ Self-Reported Autistic Traits and Camouflaging

An independent sample t-test revealed that participants who selected they were ‘not sure’ (n = 12) were not significantly different to those who identified as neurodivergent on the AQ-10 (M (SD) = 5.85 (2.54), 5.25 (2.14), respectively; t(36) = 0.71, p = 0.486), therefore, these participants were combined for the following analysis. Descriptive statistics from the AQ-10, CAT-Q and the ADHD-CAT-Q can be found in Table 1.

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Table 1.

Mean (SD) Scores Split by Student Group.

	Neurodivergent (n=31)	Neurotypical (n=60)	t-value	Effect size (Cohen's d)
AQ-10 (max = 10)	5.66 (2.41)	3.18 (1.86)	5.59***	1.21
CAT-Q (max = 175)	108.28 (21.85)	86.13 (20.57)	5.49***	1.06
ADHD-CAT-Q (max = 91)	64.52 (18.42)	46.03 (11.89)	5.82***	1.28

Note: n < total sample as not all participants completed these optional measures. The participant who selected to ‘prefer not to say’ on the neurodivergent question was not included. AQ-10: autism quotient; CAT-Q: Camouflaging Autistic Traits Questionnaire; ADHD-CAT-Q: adapted CAT-Q for attention-deficit/hyperactivity disorder traits developed by the authors (see Methods section). *** p< 0.001.

An independent samples t-test revealed that neurodivergent students reported significantly higher CAT-Q scores than neurotypical students with a mean difference of 22.14, 95% CI [14.16, 30.12], t(112) = 5.49, p < 0.001. Neurodivergent students also reported significantly higher ADHD-CAT-Q scores than neurotypical students with a mean difference of 18.48, 95% CI [11.14, 25.83], t(43.08) = 5.08, p < 0.001 (Levene's test for equality of variance, F = 4.6, p = 0.035).

A further independent samples t-test revealed that neurodivergent students reported significantly higher autistic traits than neurotypical students with a mean difference of 2.48, 95% CI [1.59, 3.37], t (59.16) = 5.59, p< 0.001 (Levene's test for equality of variance, F = 4.32, p = 0.040).

Within the whole sample, there was a statistically significant moderate non-parametric correlation between AQ-10 scores and CAT-Q, r(89) = 0.47, p < 0.001, AQ-10 and ADHD-CAT-Q, r(89) = 0.45, p < 0.001 and CAT-Q and ADHD-CAT-Q, r(90) = 0.62, p < 0.001.

Thematic Analysis

A summary of themes and subthemes can be found in Table 2 and are discussed below.

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Table 2.

Themes and Subthemes Summarised from Open Text Responses.

Themes	Subtheme
1: Challenging assumptions: What is neurodiversity?	1.1. Neurodivergence beyond autism and attention-deficit/hyperactivity disorder
	1.2. Difference not deficit
2. ‘It marks them out as different’.	2.1. Stigma
	2.2. Scrutiny
	2.3. Sharing a diagnosis
3. Living in a neurotypical world.	3.1. Viewing the world differently
	3.2. Meeting expectations
	3.3. Lack of accommodations
4. Steps towards a neuroaffirmative approach	4.1. A desire to learn
	4.2. Intentional effort
	4.3. Pastoral care
5. ‘Breaking the ice on discussions around neurodiversity’.	5.1. Championing neurodivergent voices
	5.2. Bringing people together

Theme 1: Challenging assumptions: what is neurodiversity? Throughout the data, participants provided various definitions of what is meant by ‘neurodiversity’. A majority of responses called for the understanding to be broadened beyond just autism and ADHD, and to include other conditions when discussing neurodivergence. A difference and not deficit definition was the predominant narrative, conceptualising neurodivergence as a different way of viewing the world and variation from the ‘norm’.

I would understand neurodiversity to be a term that encompasses all those who feel they process information, the world or relationships in a different manner from the majority due to a diagnosed condition that affects their brain functions. (Neurotypical student)

Several assumptions and myths were challenged in the responses collected, emphasising the heterogeneity of neurodivergence. However, many neurodivergent students expressed challenges faced when others did not fully understand their experience. In particular, one student noted ‘if I excel at something it's an excuse for them to renounce my struggles in other areas’, reflecting a limited understanding of the nuances and variation of neurodivergence, and a lack of strengths-based approach from those around them student.

Theme 2: ‘It marks them out as different’. Throughout the responses, stigma was highlighted as a key barrier to disclosing a diagnosis and accessing support. Furthermore, stigma was implicitly and explicitly present throughout the data, including negative perceptions of what it means to be neurodivergent and the notion that it is associated with weakness. Neurodivergent participants expressed being seen as outsiders, as being different from their peers, which impacted their sense of fitting in with others. There were concerns about being seen as a label. Additionally, beliefs that disclosure may lead to increased vulnerability to bullying were shared by neurodivergent students.

I think my biggest fear about telling others I'm neurodiverse is I think it has previously been associated with weakness, being unable to handle what neurotypical brains can. It sometimes feels uncomfortable knowing that many people I know think like this subconsciously and are making judgements about me, but I feel it is important for people with whom I spend a lot of time to know about it as it is a significant facet of my character. (Neurodivergent student)

Many responses echoed a sense of scrutiny from peers, with statements suggesting that only a formal label would allow for understanding and compassion towards a person's behaviour. Some participants expressed concerns about ‘not being believed’ due to preconceptions about what neurodivergence ‘should’ look like. Students shared experiences of ‘being forced to prove it’ and being ‘held to’ fixed assumptions about neurodivergence. There was a sense that neurodivergent labels are perceived as an ‘excuse’. Some participants reported being ostracised by peers, sharing experiences of being singled out or isolated. Sharing a diagnosis was thought to reduce scrutiny from others, as peers would understand why teachers respond differently.

…I feel like sometimes it is interpreted as an excuse for certain behaviours such as disorganisation, messiness, or lack of attention. This can feel incredibly distressing because neurodiversity isn't an excuse and when teachers react in this way it becomes harder to learn. (Neurodivergent Student)

There was a strong narrative that ‘neurodivergence is not an excuse or an embarrassment’. Neurodivergent participants discussed being treated or perceived differently or feeling embarrassed about differences which arise from their neurodivergence. Teachers and neurotypical students brought in the idea that disclosing a diagnosis may be an ‘invasion of privacy’, which may reflect their biases that neurodivergence is something shameful to share.

It was noted that participants were concerned about the possible negative consequences of disclosing a diagnosis. Others felt that they did not wish to disclose a diagnosis due to the belief that disclosure would not change anything for the better. Teachers shared that, without a neurodivergence disclosure, they would likely perceive a child as ‘misbehaving’ and ‘naughty’ and would subsequently use punitive measures. There was a sense that adaptations could not be made without understanding the underlying reasons why a person may experience difficulties or act differently from the norm. Teachers also noted concerns that knowing a person is neurodivergent might result in other teachers responding negatively or in a patronising manner towards the student. Teachers were hesitant to ‘overcompensate’ or show a bias towards or against neurodivergent students. Similarly, some participants expressed problems with teachers underestimating neurodivergent students if a diagnosis is disclosed. In contrast, comments from neurotypical students suggested that disclosure is required to avoid or reduce judgements or assumptions. These responses led to many neurodivergent students feeling as though disclosure is a ‘lose, lose’ situation, as they might face prejudice from peers if a disclosure is not made, or from teachers if they are open about their diagnosis.

It marks them out as different which could mean that a teacher reacts differently to them or makes assumptions about [what] they can and can't do. (Teacher)

Theme 3: Living in a neurotypical world. Neurodiversity was conceptualised as reflecting different ways of viewing the world by several participants. It was acknowledged that many challenges faced by neurodivergent students were a consequence of living in a world not designed for them. It was noted that there is a ‘misconception that being neurodiverse, people aren't as capable as neurotypical people, but that is not the case’.

Neurodivergent participants shared feeling ‘stupid’ when speaking with peers, especially in group settings as they faced challenges with initiating and ending conversations. They also reflected on challenges with ‘understanding verbal and non-verbal rules’, for instance using eye contact to demonstrate attention, and uncertainty around how much to share with others.

Specifically for this school setting, many students shared experiences of not keeping up with the pace or demanding workloads in lessons and feeling pressure to perform well in a highly academic environment; these difficulties were amplified for neurodivergent participants, with one neurodivergent student noting ‘everyone else's brains work different to mine, and it's very evident in school. This makes me feel really dumb’.

Participants highlighted the day-to-day impact of living in a world designed for and by neurotypicals, emphasising the need for adaptations and/or accommodations to be put in place. One student noted ‘it's not just a sort of arbitrary label […] it makes everyday tasks a lot more difficult than it might for most people’. Living in an environment without acceptance, understanding and adaptations led to an effortful attempt to fit in, with some students feeling as though they were required to ‘perform’. This additional effort to fit in at school was reported to lead to exhaustion, and for some, feelings of embarrassment.

I would like people to understand that neurodiversity isn't an excuse for being unable to think/process information/act like neurotypical people. I wish people understood that certain mechanisms have to be put in place in order to help neurodiverse people vs forcing neurodiverse people to fit an education system that wasn't designed accounting for neurodiversity. (Neurodivergent Student)

Theme 4: Steps towards a neuroaffirmative approach. Many students expressed a good understanding of neurodivergence, which was developed by meeting and spending time with neurodivergent students. It was felt that this engagement with others led to an understanding of difference that was met with empathy and acceptance, rather than negative attitudes. Throughout the data, there was a sense of curiosity from neurotypical participants to understand neurodivergent experiences, and a desire from neurodivergent participants for others to understand their genuine differences in thinking style and/or social interactions.

Several teachers reported a desire to protect neurodivergent students’ wellbeing and self-esteem, however, they felt that in order to do this, awareness of a diagnosis was required to facilitate understanding. Several teachers commented that they made intentional efforts to adapt their approach to neurodivergent students. Examples included attempts to improve communication, such as adjusting and clarifying expectations, and changing the language used when explaining tasks or giving instructions. Teachers noted that they strived to be ‘more patient and compassionate’ in response to neurodivergent students, stating that awareness of a diagnosis facilitates their ability to do this.

In addition to these adaptations, students called for ‘better pastoral care’, including suggestions about having someone to speak to, a support group, and safe spaces for neurodivergent students to go when overwhelmed.

I hope (but doubt that I can say I do this really effectively) that it might deliberately alter how I respond for positive reasons – to facilitate their needs in the classroom. I question whether I do that really because I think [name of school] has a narrow academic ability and attainment band and we are very used to not having to teach a classroom to varied ability levels. I think that might make us particularly bad at accommodating needs. (Teacher)

Theme 5: ‘Breaking the ice on discussions around neurodiversity’. A call for improved awareness and understanding was a thread throughout the responses. Several participants indicated that the best way to do so was to embed neurodiversity as an ‘openly discussed subject so that everyone has the same basic understanding’. An open discussion was suggested to reduce misconceptions and reduce the likelihood of offending others as appropriate language is explored in a safe way. It was felt that an increased understanding of neurodivergence would improve relationships for everyone, as there would be mutual understanding.

Within this, it was considered essential to champion the voices of and amplify the perspectives of neurodivergent students themselves. Several participants noted the importance of taking ‘neurodivergent students seriously’ to demonstrate respect and consideration of their needs. Opening conversations about neurodivergence was also thought to bring together people with similar experiences and create a sense of community. However, it was also noted that the responsibility to educate others should not be solely placed on the neurodivergent students.

Create an environment whereby stigma surrounding neurodiversity at school is broken down by talking about it. Encourage those who identify as neurodiverse to talk about their conditions + help others to understand what that means. Will create an environment where people can talk freely and removes misconception that neurodiversity is something to be frowned upon. (Neurotypical student)

Feedback From Students

On completion of the data analysis, the first and second authors met via online meeting with a group of neurodivergent and neurotypical students from the school, as well as the school's SENCO (total n=15, neurodivergent status was not formally recorded by the researchers but was indicated by the SENCO). The purpose of the meeting was to feedback on the results to the students and to discuss their reactions and opinions about what was found. The students were not surprised that stigma was common across many of the themes, as this was their daily experience. However, the neurodivergent students were surprised that their neurotypical peers were aware of the stigma that they face at school, including the discomfort that students may face when disclosing a diagnosis. It was noted that often the burden is placed on the neurodivergent student to draw attention to their needs and to be noticed by others. Many commented that neurotypical students' and teachers’ motivation and interest in learning more about neurodivergence felt superficial and more needed to be done in practice. All of the students agreed that the results highlighted the need for change in their school, to look ‘beyond the stereotype’, and improve provision and support for all.

Strengths and Limitations

Our findings elucidated the experience of neurodivergent girls and young women, who have historically been overlooked in research. However, the sample used in this study is unique in many ways, and unlikely to be representative of the wider population. The highly academically selective nature of the school means that these participants are intellectually extremely able, and we cannot presume the results will generalise to neurodivergent individuals with average or below-average intellectual ability. No data regarding ethnicity or ancestry were collected, however, the demographics of the school population is predominantly white, therefore we cannot assume that the experiences reported here reflect those of non-white neurodivergent individuals. We also focused on students at a girls’ school and cannot infer that their views would be reflected in a boys’ school sample; future work is needed to see what may be the same or different for boys in a single-sex school, or indeed for all genders in a mixed-sex educational setting.

We used the CAT-Q (Hull et al., 2019) and an adapted novel version addressing camouflaging in ADHD. Recent evidence has suggested lower construct validity when implementing the CAT-Q with individuals younger than 15 years of age (Lundin Remnelius & Bolte, 2024). Additionally, as the ADHD adaptation is novel to this context, we are yet to determine its psychometric properties. Results should be interpreted with these possible limitations in mind. The AQ-10 was used in this study, however, the Cronbach Alpha was 0.68 which indicates questionable internal consistency of the measure. The low number of items measuring a widely heterogeneous condition might explain this value; low internal consistency has also been found by Bertrams (2021) and was explained as the low correlation between different diagnostic dimensions (e.g. imagination vs. attention to detail).

A major strength of this study was the collaboration with key stakeholders and neurodivergent young people throughout each stage of the project, from inception to interpretation of findings. It is imperative that neurodivergent individuals are involved in research that addresses their experiences to ensure that their voices are represented and contribute to appropriate recommendations for the future.

Recommendations

Our results call for improved whole-school education about neurodiversity that includes practical suggestions on how to create an inclusive and supportive environment. This may take the form of workshops incorporated into existing lessons, specialised lessons or assemblies, whole school projects evaluating the needs of the students, adaptation to school ethos and values, and greater connection with specialist services. All steps towards improving understanding and support should be conducted in collaboration with neurodivergent students to ensure that the strategies used accommodate their needs and are not biased by a neurotypical lens (Fletcher-Watson et al., 2021).

Schools should create and dedicate safe and non-judgemental spaces to facilitate conversations about neurodivergence with all students and staff. Our study shows that both students and staff are motivated to participate in these conversations. The benefits of these conversations are manifold, with both short- and long-term consequences for all (Gillespie-Lynch et al., 2015, 2017; Muniroh et al., 2017). These include reducing stigma and improvements in peer cohesion, which may improve mental wellbeing, academic achievement and the overall school environment.

The findings of this study suggest that there is a relationship between camouflaging strategies and autistic traits across the clinical and subclinical range. It is important to consider that, within the context of an academically selective school, neurodivergent differences may be overlooked due to high academic performance and the rigid structure of the education setting. It is likely that putting in practices such as ensuring instructions and expectations are clear and explicit, a quiet space to go to recharge, or management of sensory stimuli, may be beneficial for all students – regardless of neurodivergent status. An additional benefit to the general application of these strategies is that it might alleviate the fear of judgement or stigma felt by neurodivergent students following or leading up to a neurodivergent disclosure. If support is offered regardless of diagnostic status, this may remove concerns around the need to disclose in order to receive support in school. However, it is important that students feel that they have a safe and trusted environment where they can share their diagnosis without negative consequences. It is therefore imperative that staff are trained to sensitively support and protect these students, should they choose to disclose. Our ultimate aim should be that students can own their neurodivergent identity, build self-esteem and self-understanding, and be confident that their differences will not be a source of discrimination.

Amongst the teachers taking part in our study, a small number identified or were diagnosed as neurodivergent. It was not possible to systematically compare their responses to those of the neurotypical teachers, but this would be an interesting focus for future research with larger samples. Recent research has begun to highlight the strengths that autistic teachers bring to their job, as well as the aspects of school life and environment that are most challenging for this group (Wood & Happé, 2021; Wood et al., 2022). These studies have shown that some neurodivergent teachers, just like some of the neurodivergent students in our study, are reluctant to disclose their diagnostic status. Therefore, having more inclusive environments might support teachers with their own disclosure, which might in turn help students feel able to be more open about their neurodivergence.