Episode 6: Autism & Employment - part 2
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This podcast explores recently published research on a number of different neurodivergent types. This season I am talking about autism, and in this episode I will go over some recent research on autism in the workplace, and occupational factors for autistic people. This episode is split into two parts because of the amount of recent research I found on this topic, and this is part 2. Unless otherwise specified, the research I have done for this and all episodes do not include those with intellectual challenges in conjunction with autism characteristics. While I will describe autistic characteristics in this episode, I also recognise that every autistic person will experience autism differently, and these are not specific to every person who identifies as autistic.
Fong and others (2021) found in their research that individuals without severe disabilities are eight times more likely to be employed than individuals with very severe disabilities. Individuals with autism are among those least likely to be employed and only 14%–15% of individuals assessed for autism in the United States gained employment. Several studies they sourced in their work have indicated that autistic individuals are more likely to lose their employment for behavioural and social interaction reasons, rather than their inability to perform work tasks. In an Italian study (Brighenti, et al.. 2023), researchers noted that 31.3% of people with disabilities, including autism, aged between 15 and 64 are employed compared to 57.8% of people in the same age range without disabilities. Furthermore, females with disabilities are more disadvantaged: only 26.7% of women with disabilities are employed compared to the males’ rate of 36.3%. Martin and others (2023) in their study recognised that adults from this population may possess fewer resources to cope with interpersonal relations in the workplace and behave in ways that do not match employer expectations. Individuals having additional physical or mental health issues experience further barriers, and common co-occurring disabilities are intellectual disability, attention deficit/hyperactivity disorder (ADHD), mood disorders, anxiety disorders, gastrointestinal problems or sleep disorders (ibid).
Autism is a neurodivergence that will always be present in a person’s life, with some autists needing lifelong support and care in ways that are individual to their specific needs (Bertilsdotter Rosqvist, Hultman, and Hallqvist, 2023). Researchers Bertilsdotter Rosqvist, Hultman, and Hallqvist (2023) write that support and services are foremost aimed at children with autism, and their families and caretakers, and more understanding in research should go into the experiences of autistic adults. By viewing lived experiences through the lens of the neurodiversity approach rather than the medical model, that describes deficits to be filled by services and supports, the focus changes to broader concerns of human rights, social inclusion and quality of life, as well as an alternative autistic way of functioning - to be different neurologically (ibid). They reviewed research regarding the barriers that autistic people faced in the employment market, and found two particular areas of interest: first, autistic traits such as interest characteristics, including overcommitment; and secondly, barriers in the work environment. The problem areas were identified as social and communication characteristics in the workplace, occupational social demands, distracting or disruptive sensory environments, and lack of flexibility in work hours. Work tasks and occupation characteristics such as a disconnect between interests and job tasks could become problematic (Bertilsdotter Rosqvist, Hultman, and Hallqvist, 2023). We heard in part 1 about the dangers of stigma and discrimination that may occur from being neurodivergent in the workplace, of putting demands on autistic people to ‘camouflage’ or ‘mask’ aspects of their autism in order to conceal or compensate for their differences. Thus, the autistic individuals might appear to cope and, consequently, their needs for support or adjustments at work might be overlooked (ibid).
Martin and others (2023) write that despite there being many benefits of employing autistic people, autistic adults continue to face obstacles related to stigma, lack of autism awareness, lack of flexibility and employer understanding toward possible adaptations, or unsupportive colleagues and bullying.
Fong and others (2021) asked in their research if interventions such as specialised internships for autistic people would help them find and keep employment, and the answer was positive. They found that social skills and behavioural interventions for autists, designed specifically for workplace settings, have received increased attention in the research literature as a means of addressing this barrier to employment. As autistic individuals may possess varying levels of social competencies, interventions that enhance social skills can be particularly effective for job‐related activities such as interviewing and interpersonal interactions with other employees (Fong et al., 2021). It needs to be mentioned that workplace interventions should not try to teach an autistic individual how to be more ‘normal’ or ‘neurotypical’, but to allow understanding between employer and employee in order to avoid needless barriers of understanding that could result in job loss, isolation, and other negative outcomes. Fong and others (2021) found that another set of interventions often targets work‐related skills such as specific job training tasks that may help autistic individuals maintain their employment through on‐the‐job training and long‐term support. In the last episode we heard that researchers hypothesise that matching autistic people in jobs that relate to their specific special interest could help them with maintaining employment. Project SEARCH is a 9‐month internship model where youth with developmental disabilities like autism in their last year of high school are embedded in a large community business. Fong and others (2021) noted that vocation focused programs like Project SEARCH may have positive impacts on the employment outcomes for autistic individuals. They identified other researchers who found that virtual reality job interview training was able to enhance the acceptance of job offers for [autistic] participants compared to [non-autistic] control participants as well (ibid). These findings also support previous correlational studies showing that individualised work experiences predict better outcomes in competitive, integrated employment (Fong et al, 2021). While other studies they reviewed measured virtual reality for gaining interviewing skills, Fong and others (2021) contributed to a more general body of research supporting the use of technology to teach skills and promote independence in a variety of employment and school settings. They saw an urgent need for greater funding for high‐quality research and technical assistance to support the employment of autistic individuals. It should be noted that to address this lack of research in the employment of youth with disabilities, several U.S. federal agencies, led by the Social Security Administration have launched two large scale demonstration projects: the Promoting the Readiness of Minors in Supplemental Security Income (PROMISE) Initiative, and Youth Transition Demonstration (YTD) Projects.
Bertilsdotter Rosqvist, Hultman, and Hallqvist (2023) stated that a holistic approach is key in the support to autistic people in the employment market. This includes strong and consistent supportive systems including broader community resources, family support, workplace capacity building (e.g. between an employer and co-workers) and policy configuration (ibid). They stress the importance of ‘matching’: employers and employees, the workplace and the employee, and special interests and job opportunities (ibid). I mentioned in the last episode that I recognise these workplace adjustments would not only benefit neurodivergent people, but neurotypical also, and that perhaps some of the issues facing autistic people don’t lie entirely with their neurodivergent characteristics, but with the way we work in society as a whole. As I read the recommended supports for autists in the workplace, and how difficult their neurotypical peers can find watching a supervisor supporting them, I would like to see future research discover whether new ways of working could support every employee regardless of neurotype. In our post-COVID world where we learned how to work remotely, for example, a hybrid system may create a supportive environment for all, as well as a shorter 4-day working week, for example. I am describing a system based on Universal Design, which is described in Gemma North’s (2021) research on autistic women in the workplace from the last episode, a system that accommodates all needs of all people, without categorising people by disability or ability. To continue with the research from Bertilsdotter Rosqvist, Hultman, and Hallqvist (2023), they write that a holistic approach also calls for a different mindset in relation to autism and autistic people in line with a neurodiversity approach, which could be referred to as an autistic-centred approach to support. First, this includes a strength-based support, where support is provided based on the strengths and abilities of autistic people in order to increase self-empowerment, and develop work-related skills in a supportive environment. Secondly, this stresses the importance of increased self-awareness and self-reflexivity amongst autistic people, which may support increased empowerment, and an ability to make clear plans for the future. Thirdly, this means to question the one-sided idea of non-autistic people as support providers and autistic people as benefiters of support. The researchers (ibid) stress the importance of autistic coaching; supporting autistic people to be role models for other autistic people. In their study (Bertilsdotter Rosqvist, Hultman, and Hallqvist, 2023), young autistic men were asked to identify areas in work that were difficult, and one area was in setting up boundaries between their private and working life. Without these boundaries in place, the young autistic men would lack enough energy to either keep their job or to perform their work tasks at a level which they were content with. The need to separate private life from working life is not necessarily a need unique to autistic people (ibid). However, they tended to express that this separation was more crucial to autistic people than to neurotypicals due to autistic people’s challenges to maintain and rebuild their energy levels. Autistic people have smaller margins than neurotypicals, in which difficulties in time perception and energy budgeting may mean that there is no time and energy left for self-care activities (ibid). Help with balancing private life from work life becomes more important for them than for neurotypicals (ibid).
An Italian study from Brighenti and others (2023) also used technology and training with their autistic participants, using the Individual Placement and Support model, or IPS – a targeted placement system designed to help someone find a job relatively fast. Rather than a preliminary training model, a joint support to the company and the worker through a series of specific adaptations for the person and support actions is given both inside and outside the company (ibid). Their (Brighenti et al, 2023) research project represents an innovative model of intervention because it combines a rehabilitation and treatment approach alongside with job placement. It was based on the eight Individual Placement and Support principles: eligibility based on client choice, focus on competitive employment, integration of mental health and employment services, attention to client preferences, work incentives planning, rapid job search, systematic job development, and individualised job supports. Additionally, the innovative perspective is not to try to change individuals’ skills through a pre-work training to better fit with work environment, but to find a good match between personal interests and skills and a good workplace wherein the right amount of support can be given. And so, their project considers both the enhancement of social skills and the cognitive abilities to support the employment of autistic people (ibid).
In research from Martin and others (2023), they found some managers expressed positive attitudes regarding employees on the autism spectrum even when they needed continuous support to function in the workplace. Autistic adults have many employable strengths that include, but are not limited to, attention to detail, task focus, ability to adhere to routine, ability to tolerate monotonous tasks, expertise in certain areas, good memory, passion, creativity, open-mindedness, loyalty, trustworthiness, and dependability. Some companies have decided to capitalise on these strengths to achieve business benefits. For example, most employees at Specialisterne, an international company that provides consulting services in software testing, programming, and data entry, are autistic. Similarly, large international enterprises in different sectors, such as SAP, Microsoft, Ford, JP Morgan Chase & Company, and EY have created specific programs employing autistic individuals and regularly tout the benefits of doing so for outcomes ranging from innovation to productivity. Martin and others (2023) found literature that explored how neurotypical managers supervised autistic employees, which unsurprisingly discovered that autistic individuals had different needs and preferences that required clarity and customisation. As such, authentic leaders that displayed honesty, respect, and individualised consideration were associated with job satisfaction and lower turnover intentions (Martin et al, 2023). Leader-member exchange theory (LMX) describes how the supervisor (or leader) develops different relationships with each of their subordinates, and how the quality of this relationship is a determinant of each subordinate’s workplace experience (ibid). Leader-member exchange theory is derived from social exchange theory, which posits that social exchanges are based on reciprocity and negotiated rules (ibid). The quality of this relationship is indicated by a leader’s use of behaviours like providing feedback, rewards and recognition, clarifying task requirements, and customising work design to fit the individual (e.g., their skills and interests). Employees that have a good relationship with their supervisor will be more likely to seek feedback on performance, embrace a learning orientation to the feedback that allows them to make necessary adjustments and corrections to their work, and improve job performance (Martin et al, 2023). Supervisors may have less positive affect toward employees with disabilities, and view the relationship as lower quality, because they perceive them as different from themselves (ibid). Employees with disabilities also receive less feedback, and the feedback provided is less forthright and developmental, in part, coming from a belief that it is not “nice” to critique disabled people. Given the centrality of this relationship, it is critical to develop a richer process understanding of how leaders perceive their autistic employees, and the conditions under which their relationships are of higher or lower quality (ibid). Martin and others (2023) found that a supported employment approach is effective in assisting people with autism gain and maintain employment, with or without additional disabilities. In this approach, a job coach facilitates finding a job, teaches the individual how to apply and interview for a position, liaises between their client and co-workers or supervisor, and manages crisis situations. Managers who had general open-mindedness about autistic employees valued the improved team climate, their improvement as a manager, their pride and the recognition they got from their organisation or from external sources, which incited them to continue investing in the relationship (ibid). In contrast, when efforts for their autistic employee led to results that they considered disappointing, the quality of relationship was low, consistent with research on neurotypical employee-manager relationships. This suggests that the manager’s emotional experience of the interaction and work with the employee plays a key role in employment outcomes beyond the quality of task performance (ibid). Autistic employees tended to describe specific, often discrete, work tasks and expressed less awareness of their interpersonal relationship with their manager (ibid). Neurotypical managers placed greater emphasis on interpersonal relationships, sometimes conflating their autistic employee’s interpersonal style with task performance (e.g., an employee’s apparent disinterest, but actual high performance) (ibid). This suggests that leader membership exchange, and relationships that cross neurotypes, necessitate more deliberate and systematic intervention to clarify expectations and guide behaviour and interactions than previously conceptualised (ibid). When these deliberate steps were done well, Martin and others (2023) found evidence of benefits for the employee and the manager.
I’ll end this episode with this beautifully written and empowering paragraph from Marie Djela (2021), the Chair of the Neuro Diverse Self Advocacy Forum:
“From realisation, disclosure to employment tribunals and implosion into a mental health crisis, the common underlying themes are invalidation, bullying and managerial practices that fail neurodivergent people at all levels before, during and after their employment. Autism employment gap is unlikely to be reduced significantly without a complete overhaul of managerial provisions, criteria and practices concerning neurodivergent talent. Most importantly, the narrative has to change, by involving and hearing autistic people reasserting and articulating their talents and strengths, speaking for themselves. That requires redefining autistic people as an integral and crucial part of human diversity and treating them as essential talent fully able to pursue their chosen career paths. We have to coach and develop autistic leaders, and for neurodivergent talent to ‘come out’ and be the role models for autistic and other neurodivergent people. To make neurodivergent people feel empowered to do so, a transformation of attitudes in society is needed” (Djela, 2021, p.1).
Thank you for listening. Join me next episode where I will talk about autism and pregnancy. I will be posting these episodes every fortnight from now on to allow more time for my own research and college studies. Please review the podcast on the platform you listen from and share it with someone you think might be interested. The research I have used in this episode can be found cited in the show notes. I am Alexa and this has been The Neurogender podcast.
Show notes:
Neuro Diverse Self Advocacy Forum
Bertilsdotter Rosqvist, H., Hultman, L. and Hallqvist, J. (2023) 'Managing Vocational Work, Achieving and Sustaining Work Performance: Support and Self-management amongst Young Autistic Adults in the Context of Vocational Support Interventions in Sweden', The British journal of social work, 53(1), pp. 258-275.
Brighenti, S. et al. (2023) 'Social Skills and Cognitive Training to Support Work-Related Skills and Job Placement in a Group of Autistic Adults: Effectiveness of a Neuropsychological and Social Skills Intervention: A Case Series Study on a Pilot Program', Community mental health journal, 59(8), pp. 1610-1618.
Djela, M. (2021) 'Change of autism narrative is required to improve employment of autistic people', Advances in autism, 7(1), pp. 86-100.
Fong, C. J. et al. (2021) 'Interventions for improving employment outcomes for persons with autism spectrum disorders: A systematic review update', Campbell systematic review, 17(3), pp. e1185-n/a.
Martin, V. et al. (2023) 'Sustainable employment depends on quality relationships between supervisors and their employees on the autism spectrum', Disability and rehabilitation, 45(11), pp. 1784-1795.