Supporting Neurodiverse and Learning - Difficulty Patients

Neurodiverse patients and those with learning difficulties may process information and communicate differently. Conditions such as autism spectrum disorder, dementia, and intellectual disabilities can affect descriptions of symptoms and responses to the clinical environment.

Effective listening requires patience and attention to non-verbal cues.

Listening to patients with autism

Patients on the autism spectrum may find eye contact uncomfortable, interpret language literally, or be sensitive to sensory input in the consulting room. Helpful strategies include:

• Use clear, concrete language and avoid metaphors or ambiguity.
• Allow extra processing time after questions before repeating or rephrasing.
• Minimise sensory overload by reducing bright lights, noise, or unnecessary movement.

Supporting patients with dementia

Dementia can reduce recall, complicate instructions, and limit descriptions of change. Effective listening may need collateral history while keeping the patient engaged.

Use short, simple, single-issue questions. Observe behaviour and functional cues - navigating the room, handling spectacles - as additional information sources.

Working with patients who have learning difficulties

Spoken explanations may not suffice. Strengthen communication by:

• Providing visual aids, diagrams, or equipment demonstrations.
• Encouraging gestures, pictures, or yes/no prompts where appropriate.
• Checking comprehension regularly by asking patients to show or describe what they understood.

Creating an enabling environment

Longer appointments, consistent staff, and patience with pauses or repetition help patients feel safe to communicate. These adjustments improve history accuracy and uphold the principle of centring every patient in care.

References (numbered in text) Why we include references

1. Standards for optical students — General Optical Council Find (opens in a new tab)
2. Partnership with patients (Communication, partnership and teamwork) — The College of Optometrists Find (opens in a new tab)
3. Accessible Information Standard – implementation guidance — NHS England Find (opens in a new tab)
4. Dementia: assessment, management and support for people living with dementia and their carers — NICE Find (opens in a new tab)
5. Autism spectrum disorder in under 19s: recognition, referral and diagnosis — NICE Find (opens in a new tab)
6. Sensory-friendly resource pack — NHS England Find (opens in a new tab)
7. A systematic review of sensory processing interventions for children with autism spectrum disorders — Jane Case-Smith; Lindy L Weaver; Mary A Fristad. Autism. 2015 Feb;19(2):133-48. Find (opens in a new tab)