Neurodiversity-affirming care — communication OSCE

Objectives

1. Use preferred language and reduce sensory load in the encounter. [4] [2]
2. Reframe "behaviour" as possible person-environment mismatch. [1] [2]
3. Co-produce a short affirming plan with school adjustments and review ownership. [6]
4. Screen for camouflage cost, burnout and medical red flags without lecture. [3] [5]

Candidate brief

12-minute station. Child and caregivers present. School letter request on the table. Child not in acute danger. [1]

Expected actions

• Open with name, pronouns if relevant, and language preference (identity-first vs person-first). [4]
• Reduce load: one question at a time; offer headphones/movement break; avoid forced eye contact as a test. [2]
• Ask what works at home versus fails at school; map noise, wait, instructions, bullying. [1]
• Elicit child goals and caregiver goals separately. [1]
• Name camouflage/after-school collapse if present; do not praise masking as success. [3]
• Quick medical screen: sleep, gut, pain, seizures, mood, self-injury, safeguarding. [5]
• Write 2-4 concrete adjustments plus medical-home/school owners and review date; offer hospital passport language. [6]
• Teach-back of next steps. [6]

Marking

Pass: preferred language asked; environment-fit framing; few co-owned goals; concrete school adjustments; owner/review; medical red-flag screen. [1] [4] [6]
Fail: forced eye-contact goals only; dismisses identity language; no medical vigilance; open-loop vague "please support"; blames family for meltdowns. [3] [5]