Integrating Polyvagal Theory and the Neurodiversity Paradigm for Inclusive Practice

Introduction: The aim of this clinical focus article is to advance equitable and affirming outcomes for neurodivergent individuals across diverse contexts by developing strategies that manage sensory overload, promote self-regulation, and create supportive environments. The primary author is autistic and experiences heightened sensory sensitivities, often leading to sensory overload in environments with bright lights, loud noises, strong smells, or crowded spaces. The second author, an acquired neurodivergent following a subarachnoid hemorrhage, has also experienced shifts in sensory processing and nervous system deregulation with lights, noises, smells, and spaces. Autistics and neurodivergents may experience heightened environmental sensitivities. Polyvagal theory (PVT) emphasizes the role of the autonomic nervous system in mediating nervous system deregulation. The SIGNAL Framework: Informed by PVT and their own experiences, the authors propose the application of the SIGNAL framework: Securing safety (i.e., meeting sensory needs and reducing signals of threat), Identifying autonomic nervous system states (i.e., understanding how individuals process information respond to the environment), Guiding co-regulation (i.e., managing one's actions and behaviors through integration of functions such as motivation, perception, emotion, and goal-directed behavior), Neuroception awareness (i.e., understanding how autonomic nervous system states shape behavior and internal physiological states), Applying neurodivergent-affirming PVT principles (i.e., engaging the ventral vagal complex and promoting a regulated internal state), and Leading a paradigm shift (i.e., shifting to the neurodiversity paradigm and neurodivergent-affirming support). Discussion: SIGNAL integrates principles from PVT in creating inclusive, safe, and neuro-affirming environments. It also provides actionable steps for speech-language pathologists and other professionals working with neurodivergent populations.