Neurodivergence in Radiography: Why Language Affects Patient Safety and Physical Health
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Neurodivergence is not a rare presentation in radiography. Around one in seven people are neurodivergent, meaning imaging departments regularly support patients whose sensory processing, communication, pain perception, and physical health needs may differ from neurotypical expectations. Despite this, clinical language has not always reflected the impact this has on patient safety and diagnostic quality.
This matters because communication in radiography is not neutral. It directly influences whether patients disclose symptoms, tolerate procedures, and access timely diagnosis. It also interacts with significant physical health inequalities, including chronic pain, joint hypermobility, autonomic dysfunction and fatigue. When language is deficit-based or unclear, these needs are more likely to be missed or minimised, increasing clinical risk.
Around one in seven people are neurodivergent.
Autism is part of neurodivergence, an umbrella term signifying a different neurocognitive experience from what has been considered ‘typical’. About 1 in 7 people are neurodivergent (and about 1 in 50 are autistic), and this impacts the way they perceive the world, communicate and process environmental stimuli
In any busy imaging department, that is not a niche consideration: it is a routine clinical reality. Yet the language that healthcare professionals, including radiographers, use to describe and address neurodivergent patients has often reinforced stigma, discouraged disclosure and made an already anxious environment more difficult to navigate. This editorial argues that changing that language is not a matter of political sensitivity. It is a matter of patient safety and care quality.
The paper's central argument is that language and communication are inseparable from clinical outcomes. When neurodivergent patients encounter deficit-based framing, whether through terms like "disorder," "challenging behaviour," or functioning labels such as "high-" and "low-functioning," they are more likely to mask or camouflage their needs. Patients may not disclose communication, sensory, or physical health needs if they do not feel understood or believed. In a radiography context, where procedures require cooperation and where the imaging environment is often sensory-intensive and unpredictable, a patient who cannot safely disclose their needs is a patient at risk. Non-attendance, incomplete procedures, and delayed diagnosis follow.
The authors draw on a substantial evidence base to show that autistic people face a life expectancy gap of 16 to 30 years compared to non-autistic counterparts, a figure shaped not only by mental health disparities but by systemic failures in physical healthcare access.
Health inequalities are physical, not abstract:
One of the most important contributions of the paper is the framing of neurodivergence as tightly linked to physical health inequalities, not just communication differences.
Neurodivergent populations, including autistic people, experience:
Higher rates of chronic pain conditions
Greater prevalence of joint hypermobility and connective tissue differences
Autonomic dysfunction affecting heart rate, blood pressure, digestion, and temperature regulation
Fatigue and energy regulation difficulties
Interoceptive differences affecting perception of internal bodily signals
These are not secondary features. They are often the very reasons people attend imaging services in the first place.
When these physical conditions are combined with communication barriers or dismissive language, clinical risk increases. Pain may be minimised, symptoms misunderstood, and underlying conditions missed.
This is not a communication issue alone. It is a diagnostic equity issue.
The Double Empathy Problem :
The Paper draws on the Double Empathy Problem, the idea that communication breakdowns between autistic and non-autistic people are not the result of a deficit in the autistic person, but a mutual mismatch.
It means:
Communication difficulty is not located solely in the autistic person
Clinicians are not “neutral communicators” by default
Adaptation is a clinical responsibility, not a patient burden
For radiographers, this requires recognising that standard communication styles may not be universally accessible in high-sensory, high-stress environments such as MRI, CT, or fluoroscopy suites.
Applied to radiography, this translates into concrete changes:
Using literal, unambiguous instructions (“remain still for five seconds” rather than idioms or vague reassurance)
Providing written or visual explanations of procedures in advance
Offering non-phone-based booking or communication options
Reducing unpredictability through step-by-step explanations
Actively asking patients how they communicate best
Language and Practical Adjustments :
The paper also addresses identity-first versus person-first language.
Research shows many autistic adults prefer identity-first language (“autistic person”), as autism is not experienced as separable from identity. Person-first language (“person with autism”) is often associated with deficit framing.
However, the key clinical point is not enforcing one approach over another.
It is: Ask the patient
Language preference is part of informed, respectful care, not stylistic convention.
Applied to radiography, this translates into concrete changes:
practical adjustments to sensory needs, predictability, communication, acceptance and empathy.
Workforce issue:
Importantly, the paper does not limit its focus to patients.
Neurodivergent radiographers and healthcare staff work within the same systems of language and expectation. Deficit-based framing affects:
psychological safety
disclosure at work
career progression
retention in clinical roles
Inclusive language therefore functions as workforce safety as well as patient safety.
A shift toward inclusive, affirming communication creates psychological safety in the workforce too.
Conclusion:
This paper reframes language as a clinical intervention. For radiographers, the implications are direct. Every phrase used in a scan room carries clinical weight: it can either increase disclosure and safety or increase masking and risk.
Changing language is not about preference. It is about diagnostic accuracy, patient safety, and equitable access to physical healthcare.
In imaging environments, where precision is everything, communication should be treated with the same clinical rigour as equipment calibration. Words are not separate from care. They are part of it.
Disclosure: Jane Green MBE is a co-author of the paper reviewed in this blog. The paper cites research and resources from SEDSConnective regarding neurodivergence, hypermobility and physical health.
REF: Potts, B., Parish, C.J., Ukaji, N.F., Pavlopoulou, G., Karaminis, T., Lane, M., McStravick, J., O'Brien, M., Harvey-Lloyd, J., Shephard, S., Green, J., Collis, A., Stogiannos, N., Skelton, E. and Malamateniou, C. (2026), The Role of Language in Shaping Cultural Perceptions Within Healthcare and Supporting Neurodivergent People's Well-being and Access to Care: Focus on Autistic Experiences. J Med Radiat Sci. https://doi.org/10.1002/jmrs.70096