Many neurodivergent individuals and their families know the feeling of leaving a doctor’s appointment sensing that something important wasn’t quite understood. For them, general medical care can feel like translating between two very different languages. A neurodiversity-informed approach means a GP has learned to speak both.
But what does that actually mean in practice?
The Gap That Too Many People Fall Through
Neurodivergent individuals experience their bodies, their environments, and their healthcare encounters differently. They may describe symptoms in ways that differ from what clinicians expect. They may have heightened or muted pain responses. They may find a standard consultation genuinely overwhelming before it has even begun.
For children, this can mean being seen as uncooperative rather than overwhelmed. For adults, it can mean being read as vague or inconsistent rather than as communicating differently. For parents, it can mean walking away with reassurances that don’t reflect the child you know and love.
This gap often goes largely unaddressed in traditional medical training, which has not historically prioritised neurodevelopmental differences. Over a lifetime, the cumulative cost of that gap is significant.
What Makes a GP “Neurodiversity-Informed”?
A neurodiversity-informed approach means not simply knowing that autism and ADHD exist; it involves understanding how neurodevelopmental differences shape the entire patient experience and adapting practice accordingly.
This means person-centred, evidence-based, collaborative care. It is good medicine applied with greater precision.
In practical terms, this might look like:
- A different kind of consultation. More time. Fewer assumptions. Concrete, specific questions rather than open-ended ones. An awareness that “how are you feeling?” may not yield useful information for someone with differences in interoceptive awareness (the ability to notice and name internal bodily sensations). For children, it may mean directing questions to the child first, at their level, before turning to the parent.
- Recognising what’s easily missed. Anxiety presenting as persistent stomach aches. Burnout presenting as chronic fatigue. Sensory sensitivities flagged as “behavioural problems”.
- Understanding masking and its medical cost. Masking involves suppressing, hiding or adapting natural traits and behaviours, often in response to social expectations or pressure to appear neurotypical. Many neurodivergent individuals, particularly autistic girls, women, and later-identified adults, invest significant energy in appearing “fine”. They may present calmly while experiencing significant internal distress.
- Genuine collaboration. A neurodiversity-informed approach does not work in isolation. In line with Health Professions Council of South Africa (HPCSA) guidelines on multidisciplinary care, they liaise with psychologists, occupational therapists, speech-language therapists, psychiatrists, neurologists, and other professionals to build a picture that no single consultation can provide. Referrals are purposeful, well-communicated, and timely.
Common Health Concerns in Neurodivergent Individuals
Neurodivergent individuals are not simply “different thinkers”. They frequently experience higher rates of co-occurring physical and mental health conditions that are often under-recognised or misattributed. A neurodiversity-informed approach means being alert to these patterns.
Sleep Difficulties
Sleep problems are among the most prevalent and under-addressed concerns in neurodivergent individuals. Research consistently shows that autistic individuals and those with ADHD experience higher rates of insomnia, delayed sleep phase (a body clock that runs late), frequent night waking, and unrefreshing sleep than the general population. These are not simply habits or parenting challenges. They often have neurological and physiological underpinnings, including differences in melatonin production and the body’s internal clock (the circadian rhythm).
A neurodiversity-informed approach means taking a thorough sleep history, considering whether sleep difficulties contribute to daytime behaviour or learning challenges, and exploring evidence-based options before recommending an intervention.
Gastrointestinal (Gut) Issues
GI difficulties, including constipation, abdominal pain, reflux, and food selectivity, are significantly more common in autistic individuals. The relationship between gut function, chronic anxiety, and sensory sensitivities is complex and runs in both directions. GI discomfort can drive behaviour that is often misread in other contexts, and distress can, in turn, worsen GI symptoms.
Allergies and Immune-Related Conditions
Research consistently points to higher rates of allergic conditions, including hay fever (allergic rhinitis), asthma, eczema, and food allergies, in neurodivergent individuals compared to the general population, with the link being particularly well-established for ADHD. Large population studies have found these conditions more common in children with neurodevelopmental differences than in their peers, and the relationship appears to run both ways, with each raising the risk of the other. However, researchers are still investigating the reasons.
A neurodiversity-informed approach means remaining alert to possible allergic or immune-related conditions and investigating them when clinically indicated, rather than automatically attributing related symptoms to a person’s neurodevelopmental profile. Unmanaged allergies can significantly worsen day-to-day life for a neurodivergent person, driving sensory overload, disrupting sleep, increasing anxiety, and adding to attention difficulties in ways that are easily mistaken for features of the neurodevelopmental profile itself.
Identifying and treating an underlying allergy can, in some cases, produce meaningful improvements in functioning and wellbeing that no amount of behavioural or psychological support alone would achieve.
Anxiety and Its Physical Presentations
Anxiety is one of the most common co-occurring conditions in both autism and ADHD, and it frequently shows up as physical symptoms (headaches, nausea, chest tightness, fatigue, or recurrent unexplained pain). In neurodivergent individuals, the relationship between anxiety and physical symptoms can be particularly complex, partly because interoceptive differences may mean that emotional distress is felt and reported primarily as physical sensation.
A neurodiversity-informed approach means holding both possibilities (medical and psychological) simultaneously, rather than rushing to reassure or to refer. It also means being alert to the fact that anxiety in autistic individuals may not present in textbook ways and that standard anxiety screening tools may not be adequately calibrated for this population.
Fatigue and Burnout
Autistic burnout, a state of profound physical and mental exhaustion resulting from sustained masking, sensory overload, and the cumulative demands of living in a neurotypical world, is increasingly recognised as a clinically meaningful phenomenon. Research suggests it has features that differ meaningfully from depression, though the two can co-occur and are not always straightforward to distinguish. When burnout is missed or misidentified, interventions intended to help may be poorly matched to what the person actually needs.
In ADHD, fatigue related to sustained cognitive effort, poor sleep, and difficulty regulating emotions is similarly common and similarly overlooked. A neurodiversity-informed approach means taking a history that explores functioning over time, not just current symptoms, and considering burnout as a possible explanation where appropriate.
Sensory Processing and Pain
Neurodivergent individuals may experience pain and sensory input very differently from the general population. Some have heightened pain sensitivity; others have significantly reduced pain responses and may not report injuries or illness that would be obvious in others. This has direct clinical implications: for anaesthesia, for post-operative care, and for understanding why a child who is clearly unwell may not be complaining.
An informed GP will ask explicitly about sensory sensitivities as part of routine history-taking and document them clearly to inform future medical encounters.
Mental Health
Neurodivergent people experience higher rates of depression, anxiety disorders, OCD and trauma responses. This reflects a complex interaction of factors, including neurobiological differences and experiences such as misunderstanding, masking, social exclusion, and inadequate support. In South Africa, where access to mental health care is limited, the GP is often the first and most consistent point of contact for mental health concerns.
ADHD and Autism: What a Neurodiversity-Informed Approach Means
For individuals with ADHD or autism (and for the many people who live with both), the GP plays a central and ongoing role in coordinating care. This does not mean working in isolation; a neurodiversity-informed approach allows for consultation, referral, and collaboration with neurologists, paediatricians, psychiatrists, psychologists, and allied health professionals. It means families have a consistent, knowledgeable point of contact who holds the whole picture.
In practice, this includes:
Medication management and ongoing monitoring.
Routine care includes ongoing monitoring (weight, growth, blood pressure, heart rate, appetite, sleep, and mood), ensuring families have clear support between appointments. Where medication forms part of a person’s care, the GP will also be alert to heightened sensitivity to side effects, potential difficulty reporting adverse reactions, and the need to adjust doses gradually and review more closely.
Recognising co-occurring conditions.
Neurodevelopmental conditions commonly co-occur with other health, developmental and mental health conditions. Anxiety, difficulty regulating mood, sleep difficulties, learning differences, motor coordination challenges, GI issues, feeding difficulties, and epilepsy are all commonly co-occurring conditions or differences. A neurodiversity-informed approach holds this complexity, tracks patterns over time, and avoids treating each presentation as a separate, unrelated complaint.
Pre- and post-diagnostic support.
Registered psychologists, psychiatrists, and medical specialists within multidisciplinary teams can conduct formal diagnostic assessments for autism or ADHD. However, the GP is often the first person a family approaches with their concerns, and how that conversation goes matters enormously. A neurodiversity-informed approach helps the GP listen carefully, validate what families are observing, make timely and appropriate referrals, and support the diagnostic process with a medically informed perspective.
Sensory-aware and adapted care.
Medical procedures (blood draws, physical examinations, etc.) can be genuinely distressing for neurodivergent individuals with sensory sensitivities or procedural anxiety. A neurodiversity-informed approach means preparing patients in advance, building in additional time, offering sensory accommodations where possible, and prioritising trust rather than simply expecting compliance.
Information and family support.
For families navigating a new diagnosis, a GP who can explain what a condition means and what evidence-based support looks like can provide significant support.
Supporting transitions
Adolescence, the move to adult services, starting university, and entering the workplace can bring significant changes in expectations, environments, and support needs. A GP who knows their patient well, stays in touch with the wider support network, and advocates where needed can provide the continuity that makes a real difference at these critical junctures.
Why It Matters
Neurodivergent individuals deserve healthcare that understands them, not just their diagnosis, but also how they experience the world, communicate distress, and respond to clinical environments. When that understanding is present in a GP, the benefits are felt more widely: families aren’t starting from scratch at every appointment, physical health concerns are taken as seriously as cognitive and psychological ones, and the different professionals involved in someone’s care are working from the same page rather than in parallel silos.
For parents, this can mean finally feeling heard in a medical setting. For educators, it can mean having a medical perspective that complements rather than contradicts what is being observed in the classroom. For allied health professionals, it can mean referrals that land well and communication that genuinely informs care.
Neurodiversity-informed approaches to general medical care continue to develop, and the growing interest is encouraging. Good, whole-person healthcare for neurodivergent individuals is both possible and worth working towards.
