Improving Procedure Completion and Engagement of Neurodivergent Patients in Medical Imaging: A Systematic Review

Introduction: Neurodivergent conditions such as autism and attention deficit hyperactivity disorder (ADHD) are increasingly recognised in clinical and societal contexts. However, neurodivergent individuals continue to face barriers in accessing healthcare services, including medical imaging. Their complex sensory, communication and emotional needs often go unmet, contributing to reduced rates of completed medical imaging examinations. This systematic review aimed to identify strategies reported in the literature to improve imaging procedure completion among neurodivergent patients. Methods: A systematic search of medical databases was conducted using relevant keywords related to neurodivergence and medical imaging. After screening titles and abstracts and reviewing full texts, studies that investigated interventions or strategies to support neurodivergent individuals during imaging procedures were included and analysed. Results: The search yielded 1789 peer-reviewed articles. After applying inclusion and exclusion criteria, 40 articles underwent full-text review, with 11 meeting eligibility for inclusion. Thematic analysis identified that both pre-examination and examination strategies are necessary to improve procedure completion. These included preparatory interventions, such as mock imaging sessions, environmental adaptations, involvement of carers and flexibility in imaging techniques and scheduling. Conclusion: Improving access to imaging for neurodivergent individuals requires adjustments across all phases of the examination. Despite the existence of supportive strategies, no formal guidelines currently exist to assist medical imaging professionals (radiographers, sonographers and nuclear medicine technologists) in delivering accessible, neurodivergent-inclusive imaging care. Further research and guideline development are needed to ensure equitable access for this patient population.