Timothy Frawley

Introduction: Evidence indicates that the number of neurodivergent students in higher education is increasing. Yet, these students often experience poorer academic outcomes than their peers. Thus, the need to understand how to best support neurodivergent students’ engagement in higher education is evident. Objective: The objective of this scoping review is to identify, describe and synthesise approaches to supporting engagement of neurodivergent students in higher education. Inclusion criteria: English-language articles published globally between January 2000 and August 2022 which recruited higher education students or staff aged 18 years or over were included. Research articles that examined neurodiversity as a main outcome and included an approach that aimed to develop students’ engagement in higher education were considered, excluding meta-analyses, systematic reviews, correlational and case study designs. All other quantitative, qualitative and mixed methods designs were considered according to the eligibility criteria. Method: The scoping review was conducted between June and August 2022. Six databases were searched: Scopus, CENTRAL, EBSCOhost, CINAHL, PubMed and Web of Science, using a patient or population, intervention, comparison, and outcomes question: In neurodivergent higher education students (P), what targeted approaches (I) support their engagement in higher education (O) MeSH and related search terms were used and combined using Boolean connectors. Search terms were: Neurodivers* OR Autism* OR Dyslexia* or Dyspraxia* or Dyscalculia* or Dysgraphia* or ADHD*) AND (student* OR staff OR academic* OR faculty*) AND (university* OR campus*). Articles were imported from Endnote™ into Covidence, where titles and abstracts were subject to exclusion according to the criteria. Full-text review of the remaining articles was conducted by two reviewers independently, with a third reviewer available for resolution. Data were extracted using a template uploaded into Covidence. Results: 59 articles were included in this scoping review: 25 quantitative, 25 qualitative and nine mixed methods in design. The majority of the articles were published in America, with autism most frequently studied. Students were the most studied population, with sample sizes ranging from three to 27, 643. The heterogeneity of study designs and the diverse nature of the identified interventions made synthesis difficult. Overall, the review identified a number of potentially useful approaches including: peer mentoring and support, attention-deficit/hyperactivity disorder coaching, specific skills training and strategy instruction, and therapeutic and computerised interventions. The role of accommodations, staff awareness training and potential benefits of problem-based learning were also identified. Conclusions: The outcome of this review suggests that while a number of approaches to engaging neurodivergent students in higher education are identified, considerable work is required to develop an evidence base strong enough to influence policy and practice. More rigorous research designs are required to better evaluate the effectiveness of these interventions. Future research should also seek to address the geographic and demographic gaps identified in this review. This includes more consistent inclusion of non-binary gender(s), and inclusion of the wider student body beyond those registered with disability services.

Chapter 4 explores the intersection of neurodiversity and mental health, highlighting the importance of understanding and addressing the co-occurrence of neurodivergence and mental health conditions. The author outlines the significance of this understanding, particularly in the context of mental health services, where neurodivergent individuals often experience under-recognition and mischaracterisation of their needs. As such, the chapter reveals the complex relationships between these neurodivergent experiences and mental health illnesses. The author stresses the need for greater awareness of the higher prevalence of mental health issues within neurodivergent populations and advocates for tailored support and services. Additionally, the chapter discusses the structural and institutional challenges within mental health services, including diagnostic overshadowing and the lack of specialised care. It also highlights positive developments in mental health service provision, such as neurodiversity-affirming practices and inclusive service designs. The chapter concludes by emphasising the need for collaborative efforts between healthcare providers, policymakers, and academics to improve mental health care for neurodivergent individuals, suggesting that despite current challenges, there is hope for a more inclusive and supportive future.

Neurodiversity and Mental Health presents an evidenced-based and theoretically informed guide on effective, impactful strategies for collaborative advancement in the area of neurodiversity and mental health in terms of health care services and other social and political institutions. Moving beyond generic approaches and assumptions about neurodivergence the contributors demonstrate strategic priorities that optimise outcomes for co-occurring mental health challenges and neurodivergence. The book synthesises the prevailing ideas, sets the cultural and scientific context and provides a useful resource for individuals and services to signpost necessary changes. Drawing together the international literature on co-occurring mental illness and neurodivergence, it pinpoints exemplars of best practice and provides a roadmap for further research and service innovation. Neurodiversity and Mental Health will be essential reading for any practitioner, student, or scholar seeking to understand how mental health challenges and neurodiversity co-occur, and how to ensure optimal outcomes for patients.

This book is the first in a pioneering series on neurodiversity, originating from an international conference co-hosted by University College Dublin, Maynooth University, Stanford University, ADHD Ireland, and the Neurodiversity Hub in 2020. Emerging from rich dialogue and master classes, the book advances a community-led, neuroaffirmative framework that centres lived experience, inclusivity, and epistemic diversity. It explores the complex intersection between neurodiversity and mental health, highlighting how systemic exclusion, across education, healthcare, employment, and social life, contributes significantly to poor mental health outcomes for neurodivergent individuals. Contributions from neurodivergent scholars and colleagues offer an evidence-based and theoretically guided critique, pushing against entrenched narrow biomedical and deficit-based models. The book challenges the pathologisation of difference, embraces diverse scholarly voices, and maintains rigour through empirical grounding. The work underscores the urgent need for systemic reform and inclusive policy informed by the democratisation of epistemic injustice. The book offers a space for authentic, respectful, and dialogical engagement that disrupts echo chambers and opens new areas of thought. Ultimately, the book advocates for a shift towards a more just, inclusive, and affirming society, where neuro-differences are understood, not as a problem to be solved, but as a valuable dimension of human variation.

Background Depression is highly prevalent among older adults in nursing homes and living in nursing homes has been reported to be associated with depression. While depression can be attributable to many causes, it may be associated with organisational culture and quality of care in nursing homes. Person-centredness is espoused in the regulatory standards of many nursing homes and has informed cultures. However, systematic reviews of the impact of person-centred practices on depression have yielded mixed results and the prevalence of depression among older adults in nursing homes remains high. This realist review protocol gives details about the background to this study and how the authors intend to carry out a realist review. The review aims to gather evidence as to whether person-centred cultures contribute to the aetiology and management of depression among older adults in nursing homes, how, why, for whom and in what contexts? Method This protocol details a theory-driven realist review. The review will follow the four-step design as follows: define the scope of the review, search for and appraise evidence, extract and synthesize findings and develop narrative. Evidence will be gathered in the form of context, mechanisms and outcomes (CMOs) from both published and unpublished sources and grey literature to test and refine initial programme theories with the collaboration of an expert panel. Findings will be reported according to RAMESES publication guidelines and will be shared with stakeholders. Conclusion It is anticipated that the review detailed in this protocol will outline theories and give insight that can explain whether or not, in what way, how and why person-centred cultures contribute to the aetiology and management of depression among older adults in nursing homes and provide guidance for the embedding of person-centred cultures in nursing homes. The review was registered with PROSPERO in July 2024 (CRD4202456825).

Aim: To understand the extent and type of evidence that exists related to nurses' and midwives' experiences of participating in clinical supervision and ascertain how clinical supervision is defined in the literature.Design: A scoping review of peer reviewed research.Data Sources: CINAHL Complete (EBSCOhost), MEDLINE (Ovid), PsycINFO (EBSCO), Embase (Elsevier) and the Cochrane Library were searched for relevant articles published between 2010 and 2024.Review Methods: The scoping review followed the JBI methodology.Reporting Method: PRISMA‐ScR.Results: Forty‐three articles were included, qualitative, quantitative, mixed methods studies and three reviews were found describing nurses' and midwives' experiences of clinical supervision. The studies identified were carried out across 15 countries and reported on experiences of group clinical supervision, one to one clinical supervision or both, more recent studies included a focus on group clinical supervision. All definitions found are reported, and although these varied, there were frequently used terms common in many.Conclusion: Although some evidence exists on how nurses and midwives experience clinical supervision gaps in evidence and detail of supervision practices remain. Inconsistencies of approach to this practice remain and specific detail relating to clinical supervision explored in existing research is frequently lacking. The lack of a universally accepted definition highlighted may influence inconsistences in clinical supervision, key terms identified in this review may assist in the development of a definition. Further research into this support is required to establish its value in practice.Impact: This scoping review progresses the ongoing debate that clinical supervision is a valuable support for nurses' and midwives' but the absence of evidence is an indication that clinical supervision is not fully understood nor is visible in practice. To this end, this review highlights that the lack of consensus on a clinical supervision definition causes ambiguity thus reducing the use of this support for nurses and midwives.Patient or Public Contribution: There was no patient or public contribution to this paper as it is a review paper that seeks information on research available on a professional support.Protocol registration@ Open science Framework: identifier 10.17605/OSF.IO/QNKUR