Beyond the Diagnosis: How the START Programme is Redefining Support for Neurodivergent Toddlers
A Shift in Perspective
Traditional intervention models for neurodivergent children have historically centered on “behavior reduction”—the effort to minimize traits associated with autism or ADHD to help children appear more neurotypical. However, a growing movement in early childhood development is moving away from these neuro-normative assumptions. We are beginning to recognize that diversity of thought and behavior should be embraced as a societal asset, and that support should focus on improving an individual’s quality of life rather than enforcing compliance with a “standard” mold.
The START programme (Supporting Toddlers with a connection to autism or ADHD to develop strong Attention, Regulation and Thinking skills) represents this shift. Rather than pressuring children to act in a certain way, START adopts a neurodiversity-affirming approach. It is designed for children with a “connection to” autism or ADHD, which includes those with a family history or those showing specific traits, regardless of whether a formal clinical diagnosis has been obtained. Its core mission is to foster the development of executive functions—the mental tools needed to navigate daily life—allowing children to thrive as their authentic selves.
The Science of Executive Function (EF) in Early Childhood
Research indicates that the second year of life is a critical window for cognitive development. This is the period when attentional and executive skills begin to exert a significant influence over behavior. Supporting toddlers during this stage can create a “cascading effect,” where early improvements in attentional control—specifically the ability to focus, shift, and select attention—provide the foundational building blocks for later cognitive and social-emotional success.
The START programme utilizes a hierarchical model of development. It targets basic skills like attentional control and impulse control first, as these are the necessary precursors to more complex, higher-order cognitive skills:
- Inhibitory Control: The ability to resist impulses, ignore distractions, and stay focused on a goal.
- Working Memory: The capacity to hold and manipulate information in the mind over short periods.
- Cognitive Flexibility: The ability to switch between different thoughts or adapt to changing circumstances and rules.
By acting as soon as these skills emerge, we provide the greatest opportunity for positive development across multiple domains.
Introducing the START Programme: A New Framework
START is a 12-week, group-based programme built upon the framework of the Peep Learning Together Programme (LTP), an evidence-based model that values parents as their child’s primary educator. The curriculum is structured like a “pyramid”; it begins with foundational attention and regulation skills and builds toward integrated activities that require complex problem-solving.
The programme operates through a specific logic model defined by three mechanisms of change:
| Mechanism of Change | Description |
|---|---|
| The Child’s Opportunity | Providing play-based activities adapted from research measures to allow children to practice EF skills in a natural, low-pressure setting. |
| Parenting Behaviours | Encouraging “scaffolding,” autonomy support, and contingency to child cues—specific behaviors linked to healthy cognitive development. |
| Environmental Fit | Empowering parents to identify and reduce “EF stressors,” such as sensory overwhelm or excessive demands, to make the environment accessible. |
Why Community Voices Matter: The Co-Production Process
The START programme was developed through an iterative three-stage process involving “experts by experience.” This included a panel of nine parents, many of whom occupied a “double perspective” as neurodivergent adults raising neurodivergent children. By collaborating with these parents alongside psychologists and early years specialists, the programme moved beyond academic theory into lived reality.
Lessons Learned from the Community
Feedback from the neurodivergent community and stakeholder panels led to fundamental design changes:
- Refined Target Age: While pilots included younger infants, the community panel recommended a target starting age of 21–27 months. This ensures that the play-based activities provide an appropriate level of challenge for the child’s motor and cognitive development.
- Identity-First Language: The programme adopted identity-first language (e.g., “autistic person”) by default. However, acknowledging that there is no established identity-first formulation for ADHD, the programme prioritizes respecting individual and family preferences.
- Face-to-Face Delivery: Although online options were discussed, stakeholders unanimously preferred in-person sessions to facilitate the development of supportive peer networks for parents and genuine friendships for children.
- Challenging Stereotypes: Stakeholders expressed concern that traditional “neurotypical” parenting measures can perpetuate harmful stereotypes about neurodivergent parents. In response, the START team initiated the development of new, neurodiversity-affirming measures for parental self-efficacy and responsivity.
From Research to Reality: Evidence of Impact
Initial pilot rounds with 18 families demonstrated that the START framework is both acceptable and effective. Using the Wilcoxon signed ranks test, researchers found a statistically significant increase in the frequency with which parents engaged in EF-related activities at home after attending the sessions.
Rather than a single takeaway, parents identified seven distinct categories of appreciation for the programme:
- Fun and Engagement: High enjoyment of the activities, songs, and stories.
- Theoretical Clarity: Clear explanations of the “why” behind the games.
- Supportive Atmosphere: A relaxed, non-judgmental group environment.
- Tangible Resources: Appreciation for the take-home materials.
- Home Inspiration: Feeling empowered to continue the games outside of sessions.
- Shared Learning: The ability to share new ideas with other family members.
- Individual Insights: Gaining a deeper understanding of their child’s unique needs and strengths.
Practical Takeaways for Parents and Caregivers
The START programme offers actionable strategies that can be integrated into the rhythm of daily life:
- Play as Practice: The “Science of Play” suggests that if a specific task (like a sorting game) is used in a lab to measure attention, it can be adapted into a game to practice that same skill. This transforms “testing” into “playing,” allowing children to build cognitive muscles through joy.
- Adapting the Environment: Success is often a matter of “environmental fit.” By reducing stressors—such as sensory overload, unpredictable routines, or anxiety—parents can lower the “cognitive load” on a child. This makes it easier for the toddler to access and use the executive function skills they are developing.
- Strengths-Based Support: The programme focuses on building self-esteem through a child’s natural interests. For instance, using a child’s creative problem-solving skills during a favorite activity helps build self-efficacy and a positive self-identity from the earliest years.
A Future Focused on Thriving
The START programme demonstrates that early support does not require enforcing neuro-normative standards. By focusing on foundational executive functions and improving environmental fit, we provide toddlers with the tools they need to navigate the world as their authentic selves. Supporting the youngest members of the neurodivergent community to thrive is not just a clinical objective; it is a vital step toward a society that values every mind.