A decade ago, the only time occupational health would potentially see a neurodivergent employee would typically be a case that was “getting to the point of a disciplinary scenario” where the employee had only
just declared that they had a neurodivergent condition, says Karen Phillpotts, Head of Clinical Standards, Optima Health.
Now, however, employees are much more “empowered” to come forward.
“They’ll say something to their manager like ‘look, I’ve got this underlying condition and I’m struggling, potentially because of this, and I need some support,” says Phillpotts.
Many more adults being diagnosed
Doubtless, this newfound empowerment is partly related to the fact that many, many more adults are being diagnosed than ever before, giving people a feeling of strength in numbers. With regard to ADHD, for example, there was a 200-fold increase in diagnoses between 2000 and 2018 in the UK, according to IQVIA Medical Research Data.
But it’s not only the ‘diagnosed’ that are coming forward. According to Phillpotts, Optima Health is also seeing a “huge increase in people in their 40s and 50s without a diagnostic, but recognising they may have traits consistent with a particular diagnosis because of their children, or people they know”.
Diagnosis or not, it doesn’t matter, say most experts (and certainly those consulted for this piece). What does matter is how the traits are impacting the individual’s ability to do their work well.
You don’t need a label
“For occupational therapists, it doesn’t necessarily matter that a person has a diagnosis. It can help individuals having a label. But within Occupational Health, what we’re looking at is the person’s functioning. The emphasis should be on the individual and the job they’re doing, marrying up those job demands with their strengths and weaknesses,” says Phillpott.
Kirsty Cook, Global Director Neuroinclusion Services at auticon agrees: “You don’t need a label to talk about traits common to neurodivergent people like perfectionism and anxiety.” She even suggests not putting a label on a conversation may make it more approachable (see this feature).
A common story, which both Cook and Phillpotts say they hear often from neurodivergent workers, is that they work at home, in the evenings and weekends, to accommodate for the way their underlying condition gets in the way of their productivity.
Sense of meaning
Psychological Safety and Neurodiversity Advocate Richard Peachey, Co-Founder of ND Directed CIC, and Principal Consultant at Lemonade, coaches neurodivergent workers and says he hears stories of people “throwing everything at their work because that sense of purpose is so meaningful to them”:
“One coachee said they wake up at two o’clock in the morning to work because it’s quiet but then they really struggle with sleep disruption! When I ask them why, they say it’s because they can’t work effectively at the pace of the rest of the team during the day because of all the distractions.”
These stories should be an instant alarm bell to any line manager because working this way is unsustainable and will lead to burnout. It also could imply that the person is not well enough supported by adjustments to do their job well.
Inflexiblity leads to burnout
Peachey believes that a workplace that is not flexible enough to the needs of their workers directly leads to burnout, and is the reason why so many neurodivergent people are out of work, or unhappy in their jobs, with only 15% of autistic people and 50% of ADHD people in work.
More than half of neurodivergent workers apparently want to quit their jobs, or already have, because they don’t feel valued or supported by their employer, according to a recent survey by global tech firm Alludo.
So, while we’ve made great strides in understanding, there is still much work to do on neurodiversity. In fact, an evolution similar to what has happened in the mental health world needs to occur in terms of recognising that it’s a spectrum that we’re all on.
Neurodiversity includes everyone
“The first shift in thinking that needs to happen is that neurodiversity includes everyone. Just like everyone has mental health. A lot of the ways that we support neurodivergent people should be ubiquitous and available to everybody,” says Peachey. “Once we stop labelling, and sub categorising, and we start dealing with everyone, looking at how we get the best out of each person, then we’re going to end up with more productive, engaged workforces.”
In this new way of thinking, a conversation about adjustments would happen with every new employee, covering aids and adaptions available, regardless of whether they have a diagnosis or an underlying condition at all. The conversation would be ongoing throughout the employee lifecycle and different life events.
“The conversation is the same: what do you really struggle with? What do you enjoy doing?”
Marginalised by perceptions of others
That said, according to Peachey, it’s also useful in some cases to understand the nuances of different conditions because they can “butt up against each other”.
“Take two people with oppositional defiance,” says Peachey. “They can get into an argument, not because they want to, but because they’re trying to show empathy and see it from a different perspective. And, because of their challenging social skills, it can look like an argument.”
This kind of behaviour, which doesn’t go down well particularly in open plan offices, leaves neurodivergent colleagues marginalised. And, as Peachey says: “We’re all neurodiverse, but we’re not all marginalised by it. And sometimes we’re even marginalised by it because of the perception of others, rather than our actual ability.”
Treating people as individuals, not diagnoses
A good example of this is the stereotype that someone who is autistic is not going to be a good people manager. “That’s just rubbish!” says Cook.
This comes down to people being open minded, tolerant of difference and able to be willing to approach each neurodivergent person as an individual, not a diagnosis. As the saying goes, “when you’ve met one autistic person, you’ve met one autistic person”. Which is why, while it’s helpful to be aware of general traits, it’s crucial not to make assumptions.
One particularly thorny issue on this front is language. This, too, is experiencing an evolution, just like mental health has done. Some words which were used a decade ago, are now frowned on. Some neurodivergent people still frown on words used to describe them. The best advice when choosing words? Ask the individual for their preference.
Taking comments personally
“I don’t like to compare neurodiversity to gender but I keep finding myself being drawn that way,” says Peachey. “Every individual has a right to freedom of expression and, as organisations, we need to be as inclusive as reasonably possible to that difference. Be led by the speaker, it is their identity afterall!”
Another issue he sees, which he believes is a problem, is when someone questions the descriptor another person is using. Or questions an opinion in general, but particularly of the more personal nature pertaining to identity.
“When someone questions us we have to ask – are they questioning for clarity? If you’re perceiving their questioning as argumentative, maybe that’s a perception you need to work on [whether you’re neurodivergent or not] because some people don’t have the social intelligence to be tactful or delicate, or precise in how they ask clarifying questions.”
Being more comfortable with conflict
Peachey has definitely, as a neurodivergent person himself, had the situation when someone has misperceived him due to his line of questioning. “Just because someone says ‘I don’t know what you mean’ doesn’t mean they are saying they think it’s rubbish. We’re just using the words we have available to us to try to be clearer. So what’s needed is tolerance and compassion.”
Perhaps what’s also needed – which we’ve covered before in articles on diversity – is a thicker skin when it comes to conflict, and not being quite so British about it all. Head of Culture at Lloyds of London Mark Lomas talked about this in this article when he said that “as a generalisation, conflict is seen as a bad thing, to be avoided, in British business. The problem with this is that speaking up necessitates a level of conflict.”
Conflict – a precursor to innovation?
We all happily trott off the truism that ‘diversity leads to innovation’ but what we don’t truly live by is the truth that the path to this innovation will undoubtedly be paved with potholes. After all, to follow on from Lomas’s point, if you have several different people in a room expressing different ideas there will inevitably be a level of conflict.
And, perhaps, if some of those people are neurodivergent, they won’t shy away from conflict, but rather go headlong into it, maybe not even entirely realising the impact of their words. But that shouldn’t detract from their ideas being heard. If we want to unlock the potential of our neurodivergent colleagues, we need to get past this personalisation and see it as a precursor to innovation, not a barrier to it.
Not only that, perhaps we could all even learn something from some of our neurodivergent colleagues when it comes to speaking up for what we believe in. Why? Because speaking up and feeling heard is not only good for idea generation, but it’s also good for our wellbeing and engagement, too. If you want to talk about productivity and performance, that’s three birds with one stone.