Adults with attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) often face significant challenges in obtaining and maintaining sustainable employment.
Cognitive difficulties, such as executive function impairments, and sensory sensitivities can make it difficult for them to manage work tasks and adapt to the work environment. Additionally, rigid societal norms and lack of understanding and flexibility in the workplace can create barriers to success.
As a result, individuals with ADHD/ASD are at a higher risk of experiencing chronic stress andautistic burnout/ADHD burnout, which can further impact their ability to sustain long-term employment.
Key Points
Rationale
Adults with attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) often struggle to achieve a sustainable work situation (Högstedt et al., 2023).
Previous research has shown that about 70% of Swedish adults with ADHD and/or ASD rated their ability to work as reduced (Statistics Sweden, 2021), and more than a third receive sickness compensation compared to 2.4% in the general population (The National Board of Health and Welfare, 2019).
While some studies have investigated the challenges and support needs of this population in the workplace (Scott et al., 2019; Anderson et al., 2021; Schreuer & Dorot, 2017), there is a lack of research addressing the needs of individuals with ADHD/ASD concerning their ability to work sustainably over time, especially in those with clinically confirmed diagnoses (Young et al., 2016; Bennett & Goodall, 2021).
Method
This qualitative study used individual in-depth interviews with 20 purposively sampled participants with ADHD/ASD.
The interviews were conducted using a 2×2 matrix covering four areas: the person’s view of their own ability to work, their past, present, and future work situation, experiences of previously received support, and desired support for a sustainable work situation.
Data were analyzed using reflexive thematic analysis with an inductive, latent, constructionist approach.
Sample
Participants were recruited through five psychiatric outpatient clinics in south-eastern Sweden.
Inclusion criteria were being 25-40 years old, having a diagnosis of ADHD and/or ASD according to medical records, and no psychosis, ongoing eating disorders, substance use disorder, or intellectual disability.
The mean age was 32 years, and the mean time since diagnosis was 5.5 years.
Several participants had comorbid psychiatric conditions.
Results
Three main themes were identified:
1. One’s own cognitive abilities and challenges
This included subthemes of having the ability to create structure at work, understanding one’s own support needs, and hypersensitivity to sensory impressions.
One participant described: “I have a weekly schedule … the problem is I don’t follow it.” (Participant 14)
This came with subthemes of being seen, understood, and accepted, having clearly defined tasks and instructions, and permission to choose when, where, and how to work.
“Most important for me is to work from home, given that it costs me so much energy just to transport myself to work and be there physically … open office plans, many people … they want everyone on-site.” (Participant 9)
3. Accumulated stress makes the work situation unsustainable over time
This encompassed subthemes of battling with the system over time and juggling everyday life in a sustainable way.
“It is like it’s designed to keep me stressed and tired, and then it continues when I pick up the kids, and when I get home, and then I go to bed and feel that I am still stressed, and then I know that there’s a new day and it just keeps going like that … ” (Participant 4)
Insight and Depth
This study is particularly informative because it captures the complex interplay between individual challenges, environmental factors, and the accumulation of stress over time that affects the ability of adults with ADHD/ASD to find and maintain sustainable employment.
The findings highlight the importance of individually tailored, flexible, and long-term support measures that consider both work-related and non-work-related factors.
The study also sheds light on the detrimental effects of rigid systems and lack of continuity in support, which can exacerbate stress and lead to burnout in this population.
Strengths
The study had several methodological strengths, including:
Limitations
The study had some limitations, including:
These limitations may affect the transferability of the findings to the broader population of adults with ADHD/ASD.
Implications
The results of this study have significant implications for supporting adults with ADHD/ASD in the workplace.
The findings suggest that occupational therapists, healthcare providers, employers, and support agencies should focus on providing individually tailored, flexible, and long-term support measures that address both work-related and non-work-related factors.
The study also highlights the need for greater understanding and acceptance of neurodiversity in the workplace and the importance of challenging rigid systems and norms that can create barriers for individuals with ADHD/ASD.
By implementing these changes, we can promote more inclusive employment practices and improve the well-being of adults with ADHD/ASD.
Conclusion
This study underscores the importance of understanding the complex challenges and support needs of adults with ADHD/ASD in the workplace.
The findings reveal the intricate interplay between individual factors, environmental factors, and the accumulation of stress over time that can make it difficult for this population to find and maintain sustainable employment.
While the study provides valuable insights, further research is needed to explore effective interventions and support strategies that can promote long-term success and well-being for adults with ADHD/ASD in the workplace.
It is crucial to acknowledge the sensitivity and complexity of this topic and to approach it with empathy, understanding, and a commitment to creating inclusive and supportive environments for all individuals.
References
Primary reference
Högstedt, E., Igelström, K., Korhonen, L., Käcker, P., Marteinsdottir, I., & Björk, M. (2023). ‘It’s like it is designed to keep me stressed’—Working sustainably with ADHD or autism.Scandinavian Journal of Occupational Therapy,30(8), 1280-1291.https://doi.org/10.1080/11038128.2022.2143420
Other references
Anderson, C., Butt, C., & Sarsony, C. (2021). Young adults on the autism spectrum and early employment-related experiences: Aspirations and obstacles.Journal of autism and developmental disorders,51(1), 88-105.https://doi.org/10.1007/s10803-020-04513-4
Bennett, M., & Goodall, E. (2021). Employment of Persons with Autism: A Scoping Review.
Schreuer, N., & Dorot, R. (2017). Experiences of employed women with attention deficit hyperactive disorder: A phenomenological study.Work,56(3), 429-441.
Scott, M., Milbourn, B., Falkmer, M., Black, M., Bolte, S., Halladay, A., Lerner, M., Taylor, J. L., & Girdler, S. (2019). Factors impacting employment for people with autism spectrum disorder: A scoping review.Autism,23(4), 869-901.https://doi.org/10.1177/13623613187877
Statistics Sweden. (2021). The labour market situation for people with disabilities 2020. Information about education and labour market (IAM), 2.
The National Board of Health and Welfare. (2019). Konsekvenser för vuxna med diagnosen ADHD: En kartläggning och analys.
Young, S., Adamou, M., Asherson, P., Coghill, D., Colley, B., Gudjonsson, G., Hollis, C., McCarthy, J., Muller, U., Paul, M., Pitts, M., & Arif, M. (2016). Recommendations for the transition of patients with ADHD from child to adult healthcare services: a consensus statement from the UK adult ADHD network.BMC psychiatry,16, 1-10.https://doi.org/10.1186/s12888-016-1013-4
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Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
