Moving Beyond the “Fix It” Model in Adult Therapy

For many neurodivergent adults, therapy has historically meant the following:

• Change yourself.

• Mask more effectively.

• Speak more typically.

• Reduce the behaviours that make others uncomfortable.

This is the “fix it” model. It assumes that difference is a deficit and centres on normalisation.

The Problem With “Fixing”

When therapy focuses on fixing communication, it often targets:

• Eye contact

• Tone of voice

• Small talk

• Reducing directness

• Increasing “social appropriateness”

• Suppressing stimming

The underlying message can become: “You are acceptable when you look and sound more typical.”

For many neurodivergent adults, this has resulted in years of masking. However, masking comes at a cost. It can contribute to heightened anxiety, chronic exhaustion, burnout, and a diminished sense of identity. Therapy should not reinforce patterns that require someone to suppress who they are in order to be accepted.

Communication Is Not One-Size-Fits-All

Communication is culturally shaped, context-dependent, and neurologically diverse. Some people communicate directly, while others prefer written expression. Some process information more slowly and need additional time to respond. Some find small talk difficult but thrive in structured or interest-based discussions. Others may experience verbal shutdown under sensory overload. These are differences, not defects.

Unlearning the “fix it” model means pausing to ask: Is this truly a barrier to participation, or is it a difference that others can learn to understand and accommodate?

From Compliance to Capacity Building

Instead of asking, “How do we make this person appear more typical?”, we should be asking, “How do we build skills that support autonomy, authenticity, and reduce distress?”

This might include:

• Self-advocacy skills

• Workplace communication strategies

• Scripts for navigating unclear social expectations

• Sensory regulation to support verbal expression

• Planning and organisational supports

• Repair strategies for communication breakdowns

• Energy management

• Environmental adjustments

Final Thoughts

Unlearning the “fix it” model means recognising that neurodivergent communication styles are valid.

Speech pathology is not about reshaping someone into a more socially “acceptable” version of themselves. It is about building life skills, functional communication strategies, and autonomy in a world that is not always designed with neurodiversity in mind.

Therapy should feel empowering, not corrective.