Neurons Gone Rogue: Counseling Beyond the Neurotypical Script
My name is Kayla Birkeland, and I am a licensed therapist in Washington and Oregon. I worked in a school setting for 8 years, predominantly with students with learning disabilities and emotional behavioral disorders (i.e., trauma).
In September of 2024, I transitioned to a group practice in Vancouver, WA, where I currently work with youth, ages 11 and up, and adults. I operate largely from an existential, CBT, and Neurodiversity Paradigm lens, and my areas of (clinical) special interest are neurodivergence (ADHD/Autism/trauma) and identity. In my free time, I love spending time with my pets, friends, and family, and boxing. When I need to recharge my battery in solitude, I love spending time in nature, reading, writing, and doing art.
My passion for working with neurodivergent individuals started back in 2016 when, for my graduate school internship, I was assigned to a Special Education school in the Forest Grove school district. It was my first time working with any population in the therapist role, and those kids radically changed the trajectory of my professional life. After graduation, I spent the next seven years working in schools (three years general education and four years in an alternative Special Education program). That time and all those kids solidified my love for working with those who march to the beat of their own drums. They were funny, creative, direct, strong-willed, and resilient…working with them was equal parts challenging and refreshing, and helped me grow in ways I’m not sure I would have otherwise.
My love for and ability to relate to the outsiders and misfits come from a lifetime of learning how to navigate a world not made for my nervous system. It was just about a year ago, at the age of 35, that I received my first formal diagnosis of ADHD - combined type, with suspected autism. Having this new framework and language for understanding why I am the way I am has been more helpful than words can describe.
The unfortunate thing is that late diagnosis, such as I experienced, is not the exception but the norm. On average, women get diagnosed and treated for ADHD 4-5 years later than men. Some studies suggest the gap is even broader, though. It is a diagnosis that has been widely overlooked in females due to vast differences in presentation and outdated misconceptions about what it “looks” like. Similarly, autism diagnoses for women and gender-nonconforming individuals also have a higher likelihood of occurring later in life, if at all.
The consequences of these missed and late diagnoses can be significant, from feeling chronically misunderstood (even by providers who are trying to help) to suicide rates up to 11 times more likely than those of neurotypical folks. There has been growing research and understanding of this population, and we still have a long way to go. Particularly, understanding and awareness have started to expand in the area of autism. In her book Is This Autism: A Guide for Clinicians and Everyone Else, Donna Henderson notes, “The first estimate of the prevalence of autism was about 1 in every 2,222 children in 1966. That number has steadily increased through the following decades: 1 in 667 in 1979, 1 in 150 in 2000, 1 in 59 in 2014, 1 in 54 in 2016, and the most recent survey from 2018 found 1 in 44! And other research suggests that even this may be an underestimate (Henderson, Wayland, & White, 2023). Additionally, “Undiagnosed autism is even more prevalent in clinical populations. Recent research shows that the prevalence of autism in clinical populations (especially those with mental health conditions) is higher than in the general population, often about 20% or more (Henderson, Wayland, & White, 2023). And according to CHADD, in the United States, “The current combined estimate of adults and children with ADHD is 22 million.” These numbers are not the result of a growing epidemic, but rather a growing understanding of how neurodivergence presents in different people and populations, and shows us that neurodivergence is a lot more common than what has been previously understood.
One’s neurodivergent experience and identity shape everything. How one experiences their world and how the world experiences them - communication, emotional experience and expression, nervous system activity, socializing, sensory experiences, and so much more. I have found that not many professionals in the mental health and healthcare settings understand this world, which leads to a lack of access to adequate care, misdiagnosis, misunderstandings, and a further sense of feeling broken or beyond help. I hope that through sharing my experiences personally and professionally, I can help others in the field deepen their curiosity, understanding, and awareness of the neurodivergent experience and how to engage and support within the context of the neurodiversity paradigm.
Gasparini, D. (2024, April 12). Is ADHD different in women? Here’s what the data says. Charlie Health. https://www.charliehealth.com/research/adhd-and-women-statistics.
Henderson, D, Wayland, S, & White, J. (2023). Is this autism: A guide for clinicians and everyone else. Routledge.
Littman, E.B. (2021, August). Gender myths and ADHD. CHADD. https://chadd.org/adhd-news/adhd-news-educators/gender-myths-adhd/.