Autism in the Workplace - Intro to Autism with Dr. Worling
Autism in the Workplace - Intro to Autism with Dr. Worling
(Andrew Pinfold) Okay, let’s start the day. And to begin I’d like to welcome Dr. David Worling to the stage to give us an introduction to autism. Dr. Worling has worked extensively with individuals on the autism spectrum for the past 25 years. In addition to providing diagnostic and running assessments, he’s developed innovative treatment protocols for social confidence, self-coping, depression, and anxiety. He advocates for autism employment issues and develops intervention protocols now offered by Spectrum Works Consulting. Dr. Worling currently supports a number of employees and employment firms navigate the Autism in the Workplace journey. Dr. Worling.
– (Dr. Worling) Lucky me, I get the first spot. The last time I had to give this talk it was in the afternoon at one, so sorry, Dr. Bailey, that’s your turn. Apparently what I’m asked to do is to give you sort of the autism 101. You’re an advanced crowd, so I think we’re gonna go 201. So, I have about 50 minutes to deliver that information, there’s a lot of information. I’ll try and make it somewhat accessible if I can. I like to roam around so, I can see lots of people are avoiding the front seat, that’s probably a good idea ’cause I do pick on people. Thanks, Angela.
So, the plan for today, just to introduce you generally to the topic of autism. The terminology has shifted somewhat, lots of myths and assumptions. We need to talk about the increase in incidence rates, and then of course move into employment. And then look at accommodations for retention and engagement, and then move unto sort of questions at the end. So that’s the plan for the next little while. Stay tuned and let’s move forward. So, for those of you that have been around for a while, autism, the name autism has been around for a long time, but the terminology has shifted considerably over the last few years.
The current terminology autism spectrum, and it’s meant to include all forms of autism, so those that are struggling in the cognitive area, those that are doing well in the cognitive area. What we used to know of Asperger’s Syndrome is now included in there as well. People often talk about high versus low functioning, as you’ll see today as we talk about it, all levels of functioning are somewhat impacted by autism. And the degree to which they’re impacted obviously depends on the individual. And our hope today is to give you a sense of what that might look like in your operations and how that person may fit into your employment.
The term that’s often used is neurotypical, and that’s meant to refer to someone who does not have autism. So, often NT or neurotypicals are meant to include those individuals that don’t have a diagnosis of autism or don’t self-identify as autism. Generally speaking, more recently people have just used the term, neurodiversity. Let’s just be diverse, so there is a huge range of diversity out there. Some of us are great at reading maps, others are really good with memory, so there’s just a huge diversity when it comes to cognitive abilities. So rather than just sort of pigeonholing to one specific area, let’s just call it a neurodiverse world, and how those people would fit into each one of those employment situations. So today I’ll be referring to the term, autism spectrum, and that’s meant to include the entire range both cognitively and other sort of sub areas like Asperger’s, et cetera.
There are a lot of myths and assumptions about autism. Autism is, it’s a neurodevelopmental condition, it isn’t something that you suddenly develop in your 30s, your 20s, or around when you’re 10. It is something that generally you are born with and it moves through your life with you. It’s been around for awhile. We think of it as a relatively new condition, but it’s been around for a very long time. The nomenclature or the name to which we’ve given it has changed considerably, but essentially it’s been around for a very long time. It’s also an extremely diverse description.
So for example, if I tell you that I have a niece with autism, it’s really hard to tell what I mean by that. Is she graduated from university? Is she able to look after herself? What’s her level of ability in terms of functioning, et cetera. It’s not a very descriptive term to be fair, but it is a highly varying continuum with individuals that stereotypically you might see from sort of Sheldon, The Big Bang Theory’s super smart, capable little professors, down to people that are really struggling in the day-to-day, having trouble getting dressed, working their way through the day. And more importantly, for a lot of us it’s a lifelong condition, so people do talk about ways to accommodate, to support and work with individuals on the spectrum, but it is certainly a lifelong condition.
What it’s not, when it comes to myths. It’s not caused by vaccines. It’s not contagious. It isn’t just a fad diagnosis, it’s not going away. In fact, you’ll see shortly it’s on the rise, it’s not on the decrease. It’s not defined as someone who has a special talent, or a savant talent. So we often think of someone, oh, they’ve got autism, they must be able to count matchsticks. They must be able to have a great memory. They can do these wonderful cognitive abilities. Some do for sure. Like the rest of us in a neurodiverse world, some of us are really good at some skills and not so good at others. It’s the same in autism.
And as far as our talk today goes, autism is not confined to childhood.
That may sound like an obvious statement to make or an unusual statement to make, but the reality is people in my line of work have forever included autism in the world of childhood diagnoses. Which is great when you have a child who has autism, because the resources are there, supports are there, the information and literature is all there. But for some reason we neglected to consider the fact that most people tend to grow up. By then if you’re lucky, you move into adulthood, and so autism is not restricted to childhood, in fact, there are millions and millions and millions of individuals who are and have autism into adulthood, or are adults now, have autism and don’t know it.
So, we’re gonna focus today on those individuals that are obviously adults and are looking for work. You hear, correctly, that autism is on the rise. It’s absolutely on the rise. So, this is estimated prevalence data coming out of the Center of Disease Control in the States. Approximately one in 59 individuals has a diagnosis, or is expected to have a diagnosis of autism. One in 59. To give you some historical context, 375 years ago when I was in grad school, it was about one in 5,000. So it is significantly increased. I have local data, but I just found out from sources just here, hot off the press, this is actually old data. So it used to be a year ago, one in 57 children in BC currently have a diagnosis of autism. I understand now it’s one in 51. So one in 51 children from the age of six to 18 currently have a diagnosis of autism, about 2%. That’s a change, and I can’t remember the specific number, roughly 350% from the last 10 years.
So there has been a huge increase. Who do we get to blame? Well as I said, we can’t blame vaccines, we can’t blame the water. Who you get to blame are people like myself, those of us who are doing the diagnoses. Right, we have included and broadened the range with which we diagnose individuals, how we’re picking it up, the sensitivity with which we’re using those measurements, and the realities we’ve now realized there are a huge number of individuals that are meeting was what we would consider milder ranges of autism. Hence the increase. So, it is absolutely, if you just take a look at most employee, most work forces, if you do your numbers, 2% or more would be on the spectrum. Mm-hmm?
– (Male Student) What is the ratio among like all people, say 500 years ago, would you expect the same ratio of like autism, if it were diagnosed the same way? Or is it increasing as we go forward?
– (Dr. Worling) So the question is, would the ratio be roughly the same if we looked at this 500 years ago or something to that effect? It’s a great question. The assumption is yes, it should be the same. There was a really interesting study done in the UK a few years back where they just started looking at some random geographical regions in and around London, and they started asking people over 50, just started phoning them randomly and asking them and looking for symptoms and signs.
They had these grad students doing that, and anytime they got somebody who remotely sounded a little bit like they might be on the spectrum, brought them in for a further study, brought them in for their study. By the end of it, what they found is these individuals over 50, who had never been through a diagnostic assessment, the rate was about one in 60. So, the reality is, it’s been there before, we just haven’t seen it. So there are literally millions of people walking around who would probably make the criteria, full criteria for autism spectrum disorder.
So, a couple things. We know that the male to female ratio is roughly, it’s been, you know, people often say it’s been five to one, four to one, I’ll talk about that in a minute ’cause that’s actually changing. It’s gone down recently. Incidence rates have gone up. If you look at IQ as one of the factors, something also is different, is changing. So if we look at IQ, generally speaking 100 is considered to be average. If you have an IQ of less than 70, you’re sort of in the lower 1% of the population, and that’s the marking point when generally it’s considered to be intellectual disabilities below 70. In 1998, to give you some example, about 80% of the population of individuals diagnosed with autism had an IQ of 70 or less. The remaining were sort of above that level.
Fast forward to 2014. Suddenly we only have about 30% of individuals being diagnosed with autism falling in that range. The vast majority are up here. And that’s the shift in the demographics that we’re seeing, is that the vast majority of individuals with autism being diagnosed now, are in the average to above average IQ range. And that’s a shift that is a remarkably different presentation, as you can see from just 20 years ago. So those individuals that are now out there with those diagnoses, have a completely different IQ profile. I’m just gonna touch on this briefly, I don’t wanna go into all the specifics, but here, this is the diagnostic manual that we’re asked to use when we’re diagnosing autism.
As you can see, deficits in social communication, social skills or social interaction, the symptoms must be sort of present early. So again, this isn’t something you can develop later in life or after a car accident, this is something from birth. And most importantly, those symptoms cause clinically significant impairment. People will often refer, so as for example I said oh, I have a niece with autism. The question you ask yourself is, oh, but where’s her level of functioning? Is she high functioning, low functioning? Whatever that means for you, that’s no longer sort of a definition that we’re using in the literature.
And the newest, in 2013 the DSM came out with three ways to sort of decide on levels of functioning. Level one, requiring support. Someone who speaks simple sentences, and was engaging in communication. But there are some definite social difficulties, conversations are challenging and might be some unusual presentations. So that’s considered autism spectrum level one. Level two, requiring substantial support. Again, some language, but a little more rudimentary. And definitely some unusual communication forms. Down to level three, requiring significant or very substantial support. Someone may be unable to speak or not use much language, and requiring considerable support.
What you’ll notice is none of these are requiring no support. So individuals with autism will all require some level of support, and I’ll get into that more specifically when it comes to the workplace, and what’s required. I talked earlier about gender. The assumption has always been it’s a boy thing, right? If you have autism it’s kind of a guy thing and all guys have a little bit of smattering of autism. We’ll come back to that later, guys. ‘Cause definitely may be true. When it comes to gender however, so it’s five to one, right? So is it always more boys than girls? It really depends on the age at which you take that measurement. So what you’ll see, the ratio is about five to one if you’re looking at sort of kids up to about 10 years of age. So that’s true.
What you’ll notice as the age along the bottom increases, that ratio decreases. So, as people getting older and coming in for assessments, what we’re finding, certainly in my practice and I know Dr. Bailey would echo this, is that increasing more and more women are coming in looking for diagnoses of autism. And more and more women are getting a diagnosis of autism. It’s always been assumed it’s a male thing. The reality is there are a significant number of women out there, so it’s almost a one to one ratio when it comes to sort of people coming in for assessment into the adult range. So again, myths and assumptions, it’s not just a guy thing.
This is why we’re here, so we should get into this section. If you just look at the numbers, it doesn’t look like a lot. But this is relatively the percentage of autism that we’d be looking for in the workforce in Canada, give or take. You start doing the math though, worldwide we’re looking at 50 to 60 to 70 million people, adults that would likely meet criteria for autism. We know there aren’t that many out there with a diagnosis. So the reality is you have individuals in your workforce now who are probably on the spectrum. They don’t know it, you don’t know it, they may know it. But the reality is most people over the age of 30 have not been through the diagnostic system that we have now in place.
So there are a large number of adults currently walking around that would likely meet criteria. So if we just look at sort of the issues that was raised in the introduction that individuals on the autism spectrum struggle in the workplace. Let’s look at the data. So if we just take a neurotypical population, how many of those individuals are employed, generally speaking it’s about 83%. So most people without a diagnosis of autism who are looking for work, are able to work, that’s great. If you take, in 2015, when they look at anyone with any form of disability, physical disability, cerebral palsy, autism, intellectual disability for example, what’s the participation rate in the labor force? It drops down to about 54%. So considerably less. And then we look at the world of autism and say okay, how many individuals with a diagnosis of autism are working? It’s about 34%. A significant decrease in the number of individuals with autism who are currently employed.
This is just one study, there are a number of studies out there and they all tend to have comparable data. So it’s really anywhere from sort of 20 to 30 to 40% of individuals with autism are employed, the rest are not. It’s a huge issue. If you look at people with that other, just the disability category, this one study tracked a series of individuals who went through the United States system of special education, and then asked them and then sort of followed them afterwards and said, okay, how many people are working?
You’ve been through special ed, so maybe it’s for intellectual disability or maybe speech and language or emotional or learning disability. What they found was, for example, if you had a learning disability you were 12 times more likely to be employed than someone with autism. If you’re an emotional disturbance, you were seven times more likely to be employed than someone with autism. If you had an intellectual disability and an IQ less than 70 you were four times more likely to be employed than someone with a diagnosis of autism. So traditionally, there has been something about autism that has been challenging in the workforce. I say traditionally because you are here, so I’m preaching to the converted.
The reality is people are looking for differences and we now are able to support individuals on the spectrum in the workplace, in a way that will allow these numbers to change significantly. So I’m hopeful, if I’m still around to give this talk 10 years from now, these are gonna be very different slides that I’ll be showing. So what is it that gets in the way? Why is it that autism is so challenging in the workforce? This is a busy slide and I’m not gonna go in, I’m gonna cover a bit of it a bit later, so I just wanted to make a note here. Some of the internal barriers we have difficulties often with, and again, because it’s such a wide range of individuals that meet criteria for autism, some of these apply, some don’t. So, I wanna just give a sense of it.
Some difficulties with emotional regulation, something often with individuals on the spectrum have a hard time with. Executive functioning, organizing, planning, et cetera. Some mental health issues which we cover later today. Dr. Bailey. Sensory sensitivities or sensory reactions or issues. Social skills, challenges, and possible some language challenges. So that’s what the individual with autism may bring to the workplace that makes it a bit of a barrier for employment. Likewise, the employers also provide some barriers or have traditionally in the past. Things like just attitudes towards disability in the workplace. Is it an environment that is accepting of that? What are the management styles, is there training involved? Do other individuals in the workplace understand autism? Are they supportive of it or are they sensitive to it? Just what’s the structure of the workplace, what are the expectations? Is there any shift or availability or accommodation that can be made? And the last point is just a combination, just the willingness of the employer to make some, what I hope to present to you, would be some fairly low-level accommodations that can really make a huge difference for those individuals on the spectrum. First of all, general assumptions.
Quality of life for an individual on that spectrum is exactly the same as for anyone else. Meaning work is important, it provides a great deal of self-esteem, a great deal of focus, it makes a huge difference to the individual, it’s no different. If you’re happy in your job, it correlates to a lot of things in life, right? And happy in your life, you’re happy in your job, so it’s no different in the world of autism. You’re doing what you do and it works well. Exactly, that’s okay for me, by the way, I’m happy with that, ’cause I’m assuming that she’s listening, right? Well, yeah, okay.
– (Woman) Thank you.
– (Dr. Worling) Individuals on the spectrum are quite capable of employment, in fact, are desperate to work and would love to work. So, there are some super powers to autism, absolutely. Honesty, sometimes to a fault, but it’s important. Right, so, you know you ask someone within the autism spectrum, hey, do you like this plan, is this a good idea? You’ll probably get a very direct answer, which in the world of business is sometimes appropriate and helpful and refreshing. Integrity, right, lots of integrity. Rule-abiding, stick-to-itiveness, routine, thinking outside the box, thick-skinned, these are a lot of traits that I’m sure a lot of you wish a lot of your employees had and brought to your employment on a regular basis.
The reality is these, again, are just some samples and there’s a lot more that we can talk about. This was lifted from a journal looking at autism employment in Australia. And what they asked the employers was, after you’ve hired individuals with autism, what difference did it make to your employment facility? So if I were lasering this right here you would see, probably it’ll turn up, increased awareness regarding people with autism, yeah about 60% of employers said, yeah, made a huge difference. People understood autism, they didn’t before. Positive adaptation, new creative and style differences brought to the workplace. Improvements in the workplace moral. 32% of those reviewed said that was important. I’d like you to draw your eye down to decreased productivity by the team, 0%.
So not a single employer said having someone on our team with autism made a difference to our bottom line, period. This is from the same publication looking at specifics. Okay, so what they did is they asked, they followed these employees and looked at different traits and looked at what are the percentage that, the top percentage that met those traits?
So you can see the sort of purplish line would be the NTs or neurotypical employees, and the blue line would be individuals with autism who are employed. And essentially, these are the differences between the two groups after working there for a few years. So, you’ll see there’s more of the neurotypicals who are considered to be flexible in their workplace. Makes sense, right? So just a little less in the autism world. Attention to detail. In fact, in the individuals with autism had more attention to detail than neurotypical employees. Comparable with completes work on time, following instructions, work ethic, as I said earlier, strong integrity. Productivity, and quality of work. All extremely comparable. So no difference, really between those who had autism and those who did not, based on a fairly large sample of individuals working in Australia.
So, I often get asked the question, so what kind of work should someone with autism do? That’s kind of like saying, what kind of work should a boy do, right? Or what kind of work should a left-handed person be doing, right? The reality is the assumption is one of the myths is, oh, I understand, people with autism should be doing computer programming. Some of them do, sorry Carol, I know they do, but not everyone. In fact there was a study done looking at individuals in the UK again, where would you like to work? And working in the computing world was about 17% of those individuals.
So most like computers, most use a lot of computers, that doesn’t mean that you should actually work with computers. So, you can see it’s fairly diverse. So it’s every commercial, to business, to healthcare, the variety is wide open. So I would really to, if I can dispel that myth, if you’re concerned that you just only have a spot in IT for individuals that are on the spectrum, that’s not the case. Again, looking at a separate study in 2014, where were these individuals working? You can see clerical, administrative, laborers, professionals, trades, all over the map. So I know from my own practice I work with individuals that are lawyers, physicians, IT, pet groomers, a huge range.
So the assumption is, please do not assume it’s only IT. There are those individuals however who are excellent IT, and you can ask Carol about that later. The reality is that not all individuals on the spectrum are good programmers. So again, why work, why are we even going down this road? And as you can see, the reality is these were individuals who had autism, or high functioning autism or Asperger’s back in the day, and were asked, so why do you wanna work? What is it that you like about working? 65% said, well, really it makes me feel more important. Makes me feel I can kind of, you know, contribute, I get some independence, I have freedom. It’s super important. Only 28% were in it for the money. The rest were all in it for more just, let me get out there and let me be part of that community, I really wanna do things, I wanna be part of what’s going on. So I talked about those internal versus external challenges. So there can be some internal challenges.
Let’s be direct. Social difficulties. If you think about it, individuals on the autism spectrum, one of the key components to a diagnostic description is just difficulty with social communication and social interaction. We would expect, therefore, that there would be some difficulties in those things into adulthood as well. So, I said to you before that sometimes being direct is a good skill, and sometimes it isn’t. So some individual in the spectrum will tell you exactly what they think of what you’re wearing, what you’re doing, what their work is. And some points, as I said that’s helpful, other times a bit not. Difficulties with things like reading between the lines, sarcasm, right.
So, you know, I used to do lots of social skills and we worked with kids, and I’d have parents sitting on the couch, I’d have an adolescent on the couch and I said, okay, so if someone comes up to you at school and says, nice jacket, do they like your jacket or not? Most people I work with on the spectrum might say, yeah, they like the jacket, right. ‘Cause they just heard the words. They missed the sarcasm and missed the rest of the context that goes with it. For those of you that don’t have autism and you’re able to sort of, you consider yourself socially strong, those are skills that you don’t even think about. It’s like driving here today, you didn’t really think about it, you just got here, right? Dealing with someone socially, you’re taking in everything from eye contact to facial gestures, the whole sarcasm, the tone, the context of the conversation, all of that you’re processing at a rapid rate. Easy peasy. Some individuals on the spectrum that’s not so easy, in fact it’s quite challenging. So, yes, you can run into some social difficulties. Failure to understand complex instructions, or often implied instructions.
So I’ve worked with an individual who at the last count had worked for about 32 jobs, all construction. And been fired from them all. Super strong, strapping young man, quite capable, university degree. But he couldn’t hold down a construction job. And the number one reason was failure to understand what were seen to be complex instructions. So he’d arrive at the site, the foreman would say, okay I want you to take all this crap here, and I want you to get rid of it for me over there and then he’d walk away. And our guy would look at this stuff, see the guy walking away and have no idea what’s exactly expected. Should he use a wheelbarrow, should he use a broom, how does he do that, what’s the best way? Oh, and while he’s at it, he’s gonna start to calculate the most efficient way to get it from there to there. Next thing you know the foreman comes back an hour later, nothing’s moved, right. They don’t tolerate that very well on the first day in some of those jobs, so he would just rotated through these things.
Eventually we did very low-level intervention and said, hey, why don’t you just ask for some direct instruction? Get it written down. Made a huge difference.
Sometimes hygiene can be an issue sometimes. And that’s the same with all individuals by the way, not just the individuals on autism, I’m sure. I’m getting some laughter so you must have to deal with that. The difference is presumably, if you’re a neurotypical and you haven’t showered for three days, and you show up to your place of employment, someone’s gonna walk over and sort of start to nudge you a little bit, give you some subtle things like, I’m just gonna throw the window open here for a little while. Or, you know I hear Shoppers has got a sale on soap today or you’d start throwing out something subtle in the hopes they would pick it up. Rarely would you walk up and say, you know, it smells a bit strong here, I wonder if you got a shower in the last few days, would you mind? Right, you’re not gonna do that.
So, the problem is in the world of autism, whether you know it or not you work all around the edges of subtlety. Most of what we do is subtle and it’s inferential. So you’ll make little comments here, you’ll do this, you’ll raise an eyebrow, you’ll titch, you’ll do something. Make something that the person will say, oh I get it, I need to do this. Often, unfortunately, some individuals on the autism spectrum are missing those cues. And if you miss those cues you really lose a chance for sort of social correction or social change, right. So, that can be a problem.
Job interviews. How many people here, for a living, do job interviews? ‘Kay, a few of you, excellent. So, you know what it’s like. Your job is to find the best candidate, so you’re gonna screen all these people on these sheets of paper, whatever you do, they come in and then you’re gonna make your decision. Presumably you’re gonna make your decision as a very social creature, and you’re gonna try and hire the other person as a social creature.
So you have rules in your head or guidelines that you’re gonna follow to hire that person, whether you have them articulated or not, they’re just there. So you wanna make sure the individual is gonna fit into your environment. The problem often in the world of autism is the number one block. First of all, if they can get themselves organized to get the paperwork in, get the resume together, get the cover letter in and get to the appointment, they sit down in your office and they do the interview. And this is where I often see or hear from a lot of individuals where they really struggle. So, the number one thing as we expect is eye contact, right? You spend 45 minutes with somebody interviewing and they don’t look you in the eye, if I asked you, how do you feel? You might say, mm, not sure, right? People use the word, I’m suspicious. That person was really, you know, were low self-esteem, they weren’t very confident. Not who I want in my organization.
By the way, a lack of eye contact is just one symptom of autism, it isn’t the symptom of autism. There is no such thing as a single, number one symptom of autism. So you will find individuals with autism who have fantastic eye contact. Some with overly intense eye contact that’s right there, you can’t move. And some with very little eye contact at all. So, in the job interview, it’s challenging. And I apologize to those of you who have heard this story before. This is the part where I swear.
I have a client who’s now in his early 30s, who told me an interview story that he did. He has been working and has been working as a server in restaurants for years. He isn’t sort of what you’d imagine as a stereotypical individual with autism. He’s really super like GQ good-looking guy. He pays full attention to, he’d, you know, proudly use the term metrosexual before I even knew what it was. You know, fortunately for him he comes from some financial support, so he dresses beautifully, he’s a good-looking guy, he’s actually quite social. But at 30 he has zero friendships. Hasn’t had a friend ever, actually, and prefers his own company to those of others. But he likes to work, and he wants to work.
So he went off to a job interview in another city, and he was being interviewed at a place, doesn’t matter what it was, he was in a restaurant, fairly high-end, busy, sort of highly social kind of place. So he went in for the interview and the woman who was doing the interview liked what she saw, clearly so, come on in, have a seat, let’s talk. So they’re in the restaurant and they’re having this conversation. And she starts with the usual questions, oh I see you’ve worked at so and so, what was that experience like? You know, I see you went to school here, tell me about that. Oh, and why do you wanna work as a server? And so she did all the standard questions that many of you would ask. And then she dropped it, she said, so, if you were gonna be a kind of sandwich ingredient, what ingredient would you be? So my guy says, pardon? She says, you know, if you’re gonna be like a sandwich ingredient, what would you be? And he says, pardon me, what the fuck kind of question is that? He stands up and he storms out.
I saw him two days later and he said, what kind of question is that, and I’m still struggling, maybe you guys can help me in the HR departments, right? So we went over it, maybe you know, she wanted you to be like lettuce, kinda bland, not really sort of stand out. Or maybe you want a jalapeno and be spicy or maybe you’re like the bread, like you know, there’s solid foundation. I don’t know. He had no idea what it meant, to this day he doesn’t know what it meant, and he lost the job. Now, and you’re all thinking, I think I would be watercress or you know, ooh. You guys can do your own projective and we can talk later. And the point is, he lost the job.
He would have been excellent in the job. He had everything he needed, but he couldn’t answer the sandwich question. So, we talked about it and to this day, like he said, he’s still frustrated. Most of us probably would have sat through that saying, well that’s a really weird question, okay. And then you would just kinda make something up on the spot. For him, he just wasn’t capable of doing that.
So, the job interview is one of those things, I’m not sure if we’ll be talking about this specifically today, but it’s one of those things that can shift and change. And with those shifts and change you can introduce a whole realm of individuals that struggled in that traditional job interview.
Executive function can be challenging for sure. As you’ll hear a bit later there’s often some co-existing mental health condition, the anxiety, depression, things like that. And then some sensory issues as well. I worked with a woman who was fantastic at her job. In fact, she was so good at her job that she has been asked to be promoted three times. Turned them all down. In fact, too many times and the union came in and said you can’t turn down four promotions, and there was a huge issue and we figured it out. She turned the job down, the promotion down because she was really good at what she did, and what she did was just working on the phone with customers, customer service. She loved it. They wanted to promote her to management, which meant she was gonna be less with customers and more with the team members, and she didn’t wanna do that.
The other issue for her was that she was arguing with the union because she wanted a separate lunch area. So all she was asking for, can I just not eat in the same area as everyone else? Because she had a number of sensory issues that were so strong, she couldn’t be in when people were popping up in with tuna salad, or they’re eating their eggplant, or what they were doing. Which just doesn’t work. So for some individuals that sensitivity is it’s visceral, it’s real, we all have things that we don’t like, so nails down a chalkboard. For me it’s balloons. So if you take a balloon and you rub a balloon, it just gets me, right? Yeah, a few people here.
I was working with a woman who was in university, super bright, she’s sitting in lecture and the woman behind her starts to eat a banana. What? Okay, it’s a little weird eating a banana in a lecture but she was doing it. And so my client was getting increasingly agitated by the sound of this woman eating a banana. If you think about it, it’s got a bit of a mushy sound to it, right? So she’s trying hard to focus on the lecture and she can’t, so finally she just stood up, turned around, and she just let this woman have it in the middle of the lecture. So, whatever you think you deal with on a sensory issue, what smells you don’t like or tastes, or certain cloth or textures you don’t like, you can sometimes magnify that significantly for some individuals on the spectrum.
So again, you can make shifts and changes to the environment, pretty straightforward. So what about the employers? Well, it’s all in the attitude, we hear. So in one study they looked at, what was also one of the significant barriers, and that was the employer. So just not really understanding the issues that are involved in autism. So as I said, if you meet a coworker and that co-worker avoids your eye contact, says things in a very blunt kinda way, that’s someone you may start to, if you didn’t know the context, you didn’t understand the rationale behind it, you might start to move away from or avoid and/or that person may not be in line for promotion because of that. But within the context that suddenly changes when it comes to autism. Workplace adjustments, accommodations, right.
Often individuals I work with on the autism spectrum are really looking for what I would consider to be really low-level accommodations. You know a change in seating arrangement, maybe changing the lighting, just a change in some of the sensory issues. Someone to relate to in a different way. We’re not looking at significant changes, structural or any other way. This is actually two bullet points, not one. Reluctance involved with third-party support, so things like job coaches, you’ll hear today or getting other supporters, getting people to come in and support your employment setting. Really again, a fairly low-level thing to do, and as I’ll show you shortly, makes a huge difference for the likelihood of retention in particular. Then there’s all those rules, right? Those rules in your place of employment. I don’t mean the ones that are on paper, I mean the ones that aren’t said.
Right, so I had one poor guy who was getting a lot of pushback from the place he worked because he was working way too hard. He didn’t quite realize that everyone kinda finishes at four and that’s when you stop, everyone takes their break. He wanted to work through his lunch, didn’t really wanna sit and talk to people, he just wanted to work, right. But he was working way too hard, he was making the other people look a little bit less productive, so he was getting a lot of pushback from his peers.
The other reality is, and I just say this ’cause this was an important thing, one of the clients I worked for, and comes back to honesty, so I had a young man, he’s now probably, I guess he’s about 35. He was working in a factory, forklift driver. He was, by definition of his employer, the best forklifter they’ve ever had. He’s the only guy who came in and actually followed the safety rules. He’s the only guy that actually read the safety rules. And he’s the only guy that did those repeatedly, every single day. Never missed a day, followed every single rule, worked through his lunch. And that was an agreement because he could leave early, ’cause he wanted to go home and do his stuff. He was into plants and science and nature and he wanted to just go back and research, he didn’t wanna do what he was doing. So, great, no problem.
He gets sick, gets a cold, calls in, as he’s supposed to. Protocol says, if you’re sick you call in to your work and tell them that you’re not gonna be there. No problem, he did that. But it was a nasty cold, lasted about six days. What he failed to do was then call back the second day, ’cause that’s what you’re supposed to do. In his mind, that’s stupid, I told you I was sick, why would I need to call in again? This happened repeatedly, he was called in, went off to occupational health and safety, they started asking questions. So you know, how you and oh, do you drink alcohol? Yes, tick. Remember honesty and integrity? Have you ever had more than two drinks in one evening? Tick. I know what you’re thinking. And have you ever had three drinks in one evening? Yes, have you ever lost memory because of drinking? The word is ever, not while you’re in employment, ever. So he says to himself, yeah when I was like 16 or 17, you know, yeah, so he ticks yes.
Suddenly you’ve moved into the drug alcohol problem, addictions, and he had to go through a whole series of things. He doesn’t drink, by the way. He doesn’t drink anymore, but he did, and so he answered the question honestly. So sometimes the rules we put in place, we know they’re just sort of guidelines, but from some individuals that can be significantly impaired.
I’m going through until 12:30 today, right? No, what time I’m going to? Tell me. 10, 11? 10. 10ish, okay, alright.
Supports. So what would it take? So far, hopefully I’ve outlined for you that we’re looking at a wide range of individuals. Individuals that have traditionally been either underemployed, or unemployed. And by underemployed I mean I work with a number of individuals who have advanced degrees that are doing jobs that are clearly not related to it. So a few individuals that have advanced degrees in statistics, engineering law, medicine, that aren’t working in their field. So, and I’ve now hopefully given you some indication of what some of those barriers traditionally have been. Now let’s talk about what we can do about it.
So this graph followed individuals with autism in the workplace for a year and a half. And then looked at the level of support that they required to stay in the job. So how much work was required to keep them working for a year and a half? Minimum intervention was defined as four hours or less per month. Not per week, not per day, per month. Intense was more closer to sort of 10 hours per month or more. So what they found is after 18 months, again if I had my pointer, you would see that were, right off the bat, only about 60% of those individuals required a little bit of help. By the end of that term, most of those individuals, most of all the whole entire set, and there’s 104 adults with autism, by the end of that 18 months, most 104 required less than four hours of support per month.
So it isn’t a huge ask, and that level of support can, as you can see, hugely varies.
So, and Dr. Bailey will talk more about this when it comes to mental health piece, is that really, I hate that a fact this one arrow just floats up there. It’s one of those PowerPoint errors, you know, and just kinda like, aw, really? Should have fixed it last night, but I got my slides in really early, like on Sunday night at 11.
So some of those individuals are really basic. So, let’s just say, and this by the way, can apply for most individuals in your workplace. So you have some kind of behavior, someone who’s breaking down, who’s upset, who leaves early, who has a bit of a tantrum on the job. Okay, so what are we looking at? If the individual has autism, the first thing we need to look for, okay, are their autism needs being met? So for example, is it a sensory issue? Is it maybe the fact that they’re, you know, requiring different lighting, or there’s some reaction that’s basically specific to autism? If they’re not being met, obviously you fix it. If the behavior stops, we’re done. That’s the simplest, lowest-level thing.
So what is it we need to shift, is it specific to autism? Okay, let’s go in and fix it, done. If you go in and you look and well, actually we’ve looked at the lighting, we’ve talked the sensory issues, everything seems to be okay, we can’t track it down. And the next thing you wanna go to is, okay, let’s look at mental health. What are some other things out there? And again, that will be covered by Dr. Bailey later this afternoon. Anxiety, depression, other kinds of things. We address those, the behavior stops, great, we’re done. It isn’t always this clean, by the way, I wish life was exactly like this. Doesn’t work. So you can place yourself into this frame any way you’d like, your family members or your employees. If it doesn’t stop, you go back, and we’re just gonna start to circle that loop back and forth until we find it. But the reality is you’ll find it, it’s out there, right? And it just takes, like everything else with a specialized population, you just have to ask the right questions.
So if you’re not asking the right questions, you’re not gonna find it. But once you have, it makes this system much easier for the employee and the employer. So where’s some specific combinations we might wanna make? Direct, clear feedback. Remember my shower comment before? Right so, instead of just throwing a window open, making a comment hoping it’s gonna work, I can’t count the number of times I’ve had people sit on my couch, yes I have a couch ’cause that’s supposed to by stereotype, aren’t I? Right, no patches on the elbow yet though. So, sit on my couch and say, I wish, I wish, I wish the world would just be straightforward and direct. Why is there all this fluff? What’s all this about, right? Why can’t I just say you’re an idiot, or I don’t like this, or please don’t do this, right? Imagine, I’d love to see a day, if we could just like, you know there’s always movies like The Purge, you get 24 hours to do this stuff. What if there was 24 hours in a day where we could all be direct? That’d be kind of fun, right?
So, and we try to be subtle because we’re trying not to hurt feelings, right? We don’t wanna be nice. You don’t wanna say, look, you know what? Yeah, could you just please maybe have a shower today? And you’re afraid of being embarrassing. But in the world of autism, often what they’re missing is direct feedback, and that direct feedback is really helpful, right? So if you walk up and say, hey I just gotta let you know, feels like you haven’t had a shower in a couple days, would you mind doing that for tomorrow? Thanks. Done. Right, and so that direct feedback is really important.
Attention to sensory issues, you know getting that separate lunchroom for that woman I talked about, or different kinds of lighting, things that are generally fairly specific that to most of us aren’t noticeable. Again, it’s the balloon thing. So when I did that with the balloon thing, about a third of you went, And the other are going like, what’s he talking about? Balloons are fine. Right, so, if you’re a non-balloon person you wouldn’t think about accommodation.
Job coaching, so there’s an entire industry out there of individuals who make a living and are trained in the world of autism and helping individuals work on the job. Occupational fit, so it is the job that you’re asking this individual to fill, is it really what they’re good at? Is it really what they are capable of doing? Is there a way to shift that in a way that would allow that individual into your organization in a way that would be more productive for them and for you? So maybe there’s a shift there.
Supporting mental health. The assumption is often that individuals in the spectrum would require just the same sort of extended health package as other people, maybe, that you might wanna make that a specific to autism kind of package. Or you might wanna do something different.
Alright, well I appreciate your attention this morning, and I’ll be around for the day if you guys have any other further questions.