Bringing Autism to Work

As another aspect of my firm, I do motivational and public speaking, but I like to share some insights from that world here, as well, since workplace abilities and challenges for autistic people are an important topic affecting attorneys in corporate and employment law, as well as disability law and other areas. 

I recently had the privilege of presenting to the National Association of Disability Examiners on bringing autism to the workplace, this was at their annual conference, which was in Detroit this year. I want to share a couple of highlights from this talk.

On the one hand, there is great evidence that, at least in some cases, autism can be an advantage. A small percentage of autistic people have remarkable gifts, and a smaller percentage, still, are able to translate these gifts into remarkable careers. Temple Grandin, a world-famous Professor of Animal Sciences and public speaker, is an extremely well-known example. Another is Stephen Wiltshire, shown below, an architectural artist with exceptional, even surreal skill.

Stephen Wiltshire, pictured when he became a Member of the British Empire (source: Wikimedia)

The data, unfortunately, says that this is not the most common outcome for autistic people, whose employment outcomes are poor, even compared to a range of other potentially disabling conditions.

There are a handful of relevant empirical studies, and I reviewed three of them. A Howlin et al. (2013) study in the UK followed 70 adults with non-verbal IQ > 70, an average of 37 years after they were first diagnosed. They found only 28% of their sample was competitively employed, and 55% had never worked or were experiencing long-term unemployment. While Dr. Grandin and Mr. Wiltshire are visible faces of highly skilled autistic people, only two of 70 participants worked in high skill, professional capacities. Of note, only one woman in the study was employed, whereas almost half the men were.

A U.S. study, Taylor & Mailick (2014) found similar results in 161 adults age 18-52 at baseline and followed for 10 years, in Wisconsin and Massachusetts. They again found low employment outcomes, with the vast majority of their sample not maintaining competitive employment, but interestingly, they found that, over 10 years, the employment trajectory of autistic women actually worsened, while it stayed stable for men. When Taylor followed in 2015 with a study looking at a subset of 73 autistic adults, now including only those with normal or better IQ, and now following them for 12 years, she found that only 59% had work experience, and only 25% had consistent participation in competitive employment. While those with post-secondary education had much higher rates of employment, this did not translate to skilled work related to their degrees. In fact, only three participants (4%) had achieved this.

Two more things are notable about this 2015 study. First, while 25% achieved consistent, competitive employment, this was mostly at a low number of hours, and mostly in unskilled work. Less than 10% of the sample achieved sustained, competitive employment that was at a full-time level of 30+ hours per week.

Screen Shot 2017-08-20 at 12.18.04 PM
Taylor (2015) found that few autistic adults in her US sample sustained competitive employment, and that fewer still sustained competitive employment at a full-time level of >30 hours per week.

The second important finding was that, again, there were significant, poorly understood gender disparities. 31% of the men (18/58) in the study were consistently, competitively employed or in post-secondary education at every study time point, but of 15 women in the study, none achieved this.

powerful girl reality vs ambition wishful thinking concept. Sad woman looking down
Employment outcome studies in the autistic adult population seem to consistently find poorer outcomes for women, a finding replicated across all three studies described above. (Source: Fotolia)

On the bright side, an increasing number of companies, including SAP, Microsoft, and recently, Ford Motor Company, are innovating to improve autistic employment outcomes and also deliver on their core organizational missions.

From a forensic standpoint, neuropsychologists can be helpful on several fronts. Beyond a thorough historical review that vets information supporting an early, credible autism diagnosis (since the CDC estimates median age, even for more subtle forms of ASD, such as what has traditionally been called Asperger’s Disorder, to be around six years of age), a thorough review of academic records, and validated, empirically supported cognitive testing, including a special focus on neuropsychological areas of particular interest in this population. Problem solving, sustained attention, social and emotional processing, and current emotional functioning / personality assessment are all important considerations, and can be helpful in a wide variety of referral questions, such as issues related to the need for guardianship or conservatorship, functional capacity for employment, and more.

Thank you for reading this article. My next open-to-the-public speaking engagement will be Wednesday, Oct 18th, 2017, at the Ann Arbor District Library, in downtown Ann Arbor, and this will be part of the University of Michigan Investing in Ability Series. My talk will be entitled, From Stigma to Strength: Rethinking How We Do Diversity. More to come on that! 

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