Mental health challenges are significantly elevated in adolescents with autism and/or ADHD. While emotional regulation difficulties (ERD) are often cited as a core driver of these problems, such accounts are typically based on adult, neurotypical interpretations of behaviour and fail to account for the lived experiences of neurodivergent youth. This keynote integrates findings from the RE-STAR programme, which challenges deficit-based models by exploring how emotional distress emerges not simply from internal dysregulation, but from the emotional burden of navigating socially invalidating, controlling, or alienating environments.
Drawing on two studies coproduced with a neurodiverse team of academic and youth researchers, the talk centres the voices of neurodivergent young people themselves. The first is a qualitative study based on interviews with 57 adolescents (aged 11–15) diagnosed with autism, ADHD, or both. Using a co-designed, semi-structured approach, the research explored how they experience and make sense of emotionally upsetting triggers. Four key themes emerged: social dislocation and conflict; the need to mask authentic emotional responses; internalised self-doubt and shame; and sensory mismatch and overwhelm. Diagnosis-specific nuances were also evident: autistic participants often described alienation and the burden of ‘not belonging’, while those with ADHD highlighted feelings of injustice and being controlled. Dual-diagnosis participants described a combination of these experiences, often with greater emotional intensity. The talk will also cover what was reported as helpful from a youth perspective to prevent triggers and manage emotional responses during periods of upset. Autonomy in choosing self-regulation strategies, co-regulation and expressing distress without stigma were considered key for emotional wellbeing.
Complementing these findings, the keynote also presents the development and application of the My Emotions in School Inventory (MESI), a co-produced self-report tool that quantifies emotional burden in school environments. Completed by over 700 secondary school students across neurodivergent and neurotypical groups, MESI findings showed that autistic and ADHD youth not only experienced upsetting school-related events more frequently but also responded to them with significantly greater emotional intensity. Importantly, emotional burden predicted symptoms of depression and anxiety independently of traditional ERD measures, highlighting its relevance as a distinct and impactful pathway to poor mental health.
Together, these findings argue for a paradigm shift: from focusing on individual deficits to understanding the social and emotional costs of navigating unsupportive, invalidating systems. Attendees will leave with a deeper understanding of how to support neurodivergent adolescents by creating emotionally safe, affirming environments, and why centring their voices is essential in this work.

By the end of this session, participants will be able to:
1. Identify key emotional triggers experienced by autistic and ADHD youth, including those with a dual diagnosis.
2. Understand how neurodivergent adolescents conceptualise and cope with school induced emotional burden.
3. Recognise the role of environmental and relational factors in supporting emotional wellbeing and resilience.
4. Apply insights from the RESTAR study to develop more inclusive, youth-informed practices across clinical, educational, and care settings.