We don't ususally think of the stress in our lives as a...
Autism Spectrum Disorders in the Workplace
Boston University and other colleges and universities have increased the accessibility of higher education to students with autism spectrum disorders (ASDs), but few have focused attention on adapting their workplaces to employees with ASDs. Advocates for neurodiversity, or greater inclusiveness of people with neurological differences such as ASDs and Attention Deficit Disorder, argue that society would benefit from opening workplaces to people whose brains work differently. One renowned advocate, Dr. Stephen Shore, received his doctoral degree in education here at BU in 2008. Now an assistant professor at Adelphi University, Dr. Shore writes and speaks widely about the obstacles he and others with ASDs struggle with to achieve their potential. This article is an invitation for us to reduce the barriers and create workplaces in which employees with ASDs can thrive.
According to the most recent findings from the Centers for Disease Control, one in 88 children in the US has an ASD, a 78% increase since 2002. For boys, it’s 5 times higher: 1 in 54. There is disagreement about the possible explanations for this. Some attribute the increase to greater awareness and identification. Others argue that broadening the diagnostic criteria in the 1990′s to include those who are more mildly impaired has cast too wide a net. Many researchers and clinicians in the field believe the actual prevalence has increased and that environmental toxins play a role. While experts debate, most of us now know someone who has been diagnosed with an ASD, often the child of a family member or friend.
The autism spectrum is wide. The most severely affected may be non-verbal, intellectually disabled, and prone to self-injury. On the milder end are people who are highly intelligent, some of whom possess unique talents and abilities; they are often diagnosed with the ASD subtypes of Asperger Syndrome or Pervasive Developmental Disorder, Not Otherwise Specified (PDD, NOS). The attributes which span the spectrum include difficulty with communication and social interactions, along with some type of restriction and repetition in interests and behaviors.
Recognizing Autism Spectrum Disorders
Employees with an ASD are likely to be seen by coworkers as “different” or “quirky.” They might avoid eye contact, talk too loudly, ask too many questions. They’ll come across as socially awkward, possibly even rude. Their tendency to say the “wrong thing” sometimes leads to the perception that they are insensitive or uncaring about others’ feelings. They may be unusually focused on circumscribed, often eccentric, topics and talk on and on about these, not recognizing when others have lost interest. Flexibility is not their strength; change may trigger anxiety, making it difficult for them to transition from one activity or train of thought to another. They may be rather literal and have difficulty understanding idioms and certain humor, particularly sarcasm. Colleagues would probably describe them as intense and recognize that they struggle with high levels of anxiety.
These are not just differences in personality or social upbringing: individuals with ASDs have unique brains. Their behavioral and perceptual characteristics stem from underlying neurological anomalies which result in their having a significantly different experience of the world. Sensory sensitivities are common. They may include extreme discomfort with loud noises, the buzz or flicker of fluorescent lights, or the stimulation of physical contact. Difficulties with motor skills and coordination often hinder proficiency in athletics and handwriting. Impairment in the ability to decode non-verbal communication such as tone of voice, facial expression, and body language can significantly interfere with understanding others and developing relationships. Executive functioning challenges impede initiating, prioritizing, and completing tasks.
Then there are the gifts: the ability to focus for hours, weeks, or years on a personal interest, though often at the expense of other domains in life such as social relationships and recreation. There’s the uncanny attention to details and the ability to categorize and retain vast amounts of information on a subject of interest. Unconventional thinking sometimes leads to creative, even brilliant, insights and discoveries. The historical record strongly suggests that Albert Einstein, Thomas Jefferson, Emily Dickenson and Andy Warhol all had an ASD. Dr. Temple Grandin, a contemporary who is a professor of animal sciences at Colorado State University, revolutionized the field of livestock handling. One of Time magazine’s 100 most influential people in 2010, Dr. Grandin credits her autism with giving her unique insights into the perspective of cattle and other animals. She has used these insights to design corrals and walkways that provide more humane treatment to animals processed in the livestock industry.
Because people with ASDs appear on the surface to be typical and highly capable, their struggles with ASD-related difficulties may be unrecognized or misconstrued by others. Family members, teachers, and supervisors may have high expectations of them based on their intelligence and excellent rote memory and verbal skills. Their disability is not as evident; consequently they may be blamed for behaviors they cannot control. They may even blame themselves: many adults with ASDs were never diagnosed and may have grown up viewing their challenges as indications of inadequacy and inferiority.
While the strengths associated with ASDs can mask the disability, they can also be useful in managing it. The website for the Asperger Association of New England (AANE) notes:
Asperger Syndrome affects people lifelong, but many can use their cognitive and intellectual abilities to compensate for some of the challenges they face, so as people grow, Asperger Syndrome can be managed. At AANE, we have seen countless people with Asperger Syndrome who, given the proper supports, have used their Asperger Syndrome to their advantage to accomplish feats beyond what the “typical” mind could muster.
Adulthood and Employment
Our education systems have gotten better at providing supports that enable people with ASDs to succeed academically. Success in school, however, has not translated to adult independence for many. Unemployment and underemployment are high among adults with ASDs. As New York Times reporter Amy Harmon wrote in her excellent article on the topic, people with ASDs “typically disappear from public view after they leave school. As few as one in 10 hold even part-time jobs. Some live in state-supported group homes; even those who attend college often end up unemployed and isolated, living with parents.”
Approximately 200,000 teenagers with ASDs will reach young adulthood in the next five years. If we don’t find ways to integrate these individuals into society, we’ll miss out on the contributions they have the potential to make. Amy Harmon notes, “Opening the workplace to people with autism could harness their sometimes-unusual talents … while decreasing costs to families and taxpayers for daytime aides and health care and housing subsidies, estimated at more than $1 million over an adult lifetime.” The expense of state support could be enormous; it will benefit all of us to help those with ASDs become productive members of society.
Creating workplaces which welcome neurodiversity requires us to move out of our comfort zone. It’s easy being around people who are socially adept and confident; it’s more challenging interacting with someone who is socially awkward and doesn’t adhere to social norms. We need to be more accepting and tolerant of the odd behaviors and social missteps of those with ASDs. Managers need to establish and maintain high standards of sensitivity and respect for others to create a safe social environment. Many employed adults with ASDs report feeling excluded by their coworkers; some have even been ridiculed and bullied. They may not be able to distinguish between playful teasing and malicious abuse, so managers need to watch for mistreatment and intervene. Training for staff on disabilities in general, or ASDs specifically, may promote understanding and support.
Employees with ASDs will generally qualify for legal protection from discrimination under the Americans with Disabilities Act. This requires employers to make reasonable accommodations to enable the employee to perform her or his job. Most employees will require few if any formal accommodations. The types of adaptations which might be useful include the following, drawn largely from a list by the National Autistic Society of England.
- When evaluating job candidates, recognize that they may not give a good indication of their skills in a job interview. People on the spectrum often do not interview well due to their difficulty with social interaction. Consider other means of evaluating candidates’ abilities.
- Make sure instructions are concise and specific. Try to give the person clear instructions right from the start about exactly how to carry out each task, from start to finish. Don’t assume the person will infer your meaning from informal directions. Provide instructions in writing, not just orally. It can be helpful to ask the person to repeat back instructions so you are sure they have understood.
- Create a work environment which is well-structured. Assist with prioritizing activities, organizing tasks into a timetable for daily, weekly, and monthly activities, and breaking larger tasks into small steps. Some employees will appreciate precise information about start and finish times, and help getting into a routine with breaks and lunches.
- Clarify expectations of the job. You may need to be more explicit about your expectations for a staff member with an ASD. In addition to the job description, you may need to explain the etiquette and unwritten rules of the workplace.
- Provide sensitive but direct feedback. Make sure it is honest, constructive, and consistent. If the person completes a task incorrectly, don’t allude to or imply any problems – instead, explain tactfully but clearly why it is wrong, check that they have understood, and set out exactly what they should do instead. Be aware that the person is likely to have been bullied in the past, so be sensitive in giving criticism and give positive feedback wherever appropriate.
- Regularly review performance. As with any employee, managers should have regular one-to-one meetings with the person to discuss and review performance and give overall comments and suggestions. When managing a person with an ASD, brief, frequent reviews may be better than longer sessions at less frequent intervals.
- Provide training and monitoring. When a person with an ASD starts a job or takes on new responsibilities, clear and structured training is invaluable. This can be provided informally on the job, by a manager, colleagues or a mentor, or may take the form of more formal training.
- Provide a mentor or buddy in the workplace – an empathetic colleague who is willing to provide support, advice, and assistance with integrating socially into the workplace.
- Offer reassurance in stressful situations. People with an ASD can be quite meticulous, and may become anxious if their performance is not perfect. Let them know you expect they will make mistakes and that it’s not a problem if they occasionally arrive late due to transport problems or other unpreventable factors.
- Appreciate the employee’s sensory sensitivities and allow her or him to make adjustments such as wearing earphones, changing the type of light bulb, or taking breaks from situations of high sensory input such as loud noises or strong odors.
- Be aware that eye contact can overload the employee’s sensory system and do not misinterpret a lack of eye contact as disrespect or inattention.
- Accommodate to the employee’s need for predictability and routine. When possible, provide forewarning of any changes and allow the employee time to adjust and transition.
- Give clear and direct feedback to the employee if he or she behaves in ways that seem disrespectful or are inappropriate to the situation (such as interrupting others, publically “correcting” a manager, or making a distasteful joke).
In an often repeated quote, Dr. Stephen Shore once said, “When you meet one person with Asperger Syndrome, you’ve met one person with Asperger Syndrome.” There is more variability than similarity among people with ASDs. Their difficulties emerge from a common cluster of traits, but the intensity of each trait lies along a continuum. Hence the accommodations which benefit one employee may be completely unnecessary for another.
People with ASDs often struggle with questions regarding when and to whom they should disclose their diagnosis. An employee may choose not to disclose to anybody in their workplace including their immediate supervisor. Managers suspecting that an applicant or employee has an ASD can make the applicable accommodations without formal acknowledgement of a diagnosis. When an employee does disclose, it’s often helpful if the manager assists the employee in determining who else in the workplace needs to know.
Our society has made tremendous gains in identifying and educating individuals with ASDs. The next challenge is to provide the supports and accommodations necessary for people with ASDs to reach their full potential and to thrive in the workplace.
A number of resources exist which can help both the employer and the employee identify ways to facilitate success for a particular employee on the spectrum. A few of them are listed below.
Local support and consultation for employees and employers:
- The BU Faculty and Staff Assistance Office : www.bu.edu/fsao
- The Asperger Association of New England: www.aane.org
Additional suggestions on integrating those with ASDs into the workplace:
- “ Employer Factsheet: Managing Someone with an ASD,” National Autistic Society of England
- “Employees with Asperger Syndrome,” Melanie Whetzel, M.A., Job Accommodation Network
- “Employment and Asperger Syndrome, ” Ashleigh Hillier, Ph.D., Assistant Professor of Psychology, University of Massachusetts Lowell, Asperger Association of New England,
Employment guidance for employees with ASDs:
- “Autistic and Seeking a Place in the Adult World”, Amy Harmon, New York Times, Sept. 17th, 2011.
Books Written by People with an ASD:
- Beyond the Wall: Personal Experiences with Autism and Asperger Syndrome, Second Edition by Stephen M. Shore and Temple Grandin (Jan 31, 2003)
- Thinking in Pictures, Expanded Edition: My Life with Autism (Vintage) by Temple Grandin (Jan 26, 2010)
- The Way I See It, Revised and Expanded 2nd Edition: A Personal Look at Autism and Asperger’s by Temple Grandin (Mar 15, 2011)
- Look Me in the Eye: My Life with Asperger’s by John Elder Robison (Sept 25, 2007)
By Karen Brouhard, LICSW