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A survey of the workplace experiences of police force employees who are autistic and/or have attention deficit hyperactivity disorder
Abstract
Background
There has been little focus on autism and attention-deficit hyperactivity disorder (ADHD) in occupational groups, particularly in high-demand roles such as the police.
Aims
To describe the characteristics and experiences of UK-based police force employees who are autistic and/or have ADHD, including the benefits and challenges their conditions bring to their occupation, their need for reasonable adjustments, and their co-occurring mental illnesses.
Method
An online survey was developed, containing both quantitative and qualitative elements. Survey invitations were disseminated through the National Police Autism Association. The survey was open from 23 April to 23 July 2022.
Results
A total of 117 participants participated in the survey, including 66 who were autistic and 51 with ADHD. Participants who were autistic and/or had ADHD widely reported both benefits and challenges related to their condition(s) in policing work. Both the autistic and ADHD groups widely reported having requested workplace adjustments related to their condition(s), although these were frequently not made. Anxiety (n = 57; 49%) and depression (n = 40; 36%) were both highly prevalent among the participants.
The qualitative findings identified four themes: (a) motivations for taking on this career, (b) rewards of the role, (c) challenges of the job and (d) challenges regarding career progression.
Conclusions
Police force employees who are autistic and/or have ADHD reported that their conditions provided both benefits and challenges with respect to policing work, and that they had requested related workplace adjustments, although such adjustments frequently do not take place. Healthcare professionals need to recognise the importance of workplace considerations and advocacy for people who are autistic and/or have ADHD.
... Workers with ADHD reported not feeling "normal" (Barnett, 2019, p. 103) compared to their colleagues, and shame was also largely reported by the participants (Antshel et al., 2009;Schreuer & Dorot, 2017). Nondisclosure of ADHD diagnosis was common among participants due to their awareness of potential stigma in the workplace (Liebel et al., 2023;Thomas, 2019;Tromans et al., 2023) and their fear of being deemed incompetent (Grossberg, 2004). ...
... Interpersonal relationships at work. Interpersonal relations were raised as the last significant challenge (see Grossberg, 2004;Högstedt et al., 2023;Kent, 2017;Kirino et al., 2015;Liebel et al., 2023;Mather, 2013;Oscarsson et al., 2022;Thomas, 2019;Tromans et al., 2023). ...
... In Kirino et al. (2015), over three quarters of participants agreed or strongly agreed that their ADHD symptoms negatively impacted their relationships at work. Workers with ADHD recounted that their inattentiveness, emotional impulsivity, and failure to notice certain social cues impaired their ability to develop and maintain interpersonal relationships with colleagues and employers (Barkley & Fischer, 2010;Bayne, 2007;Grossberg, 2004;Liebel et al., 2023;Oscarsson et al., 2022;Robello, 2019;Schreuer & Dorot, 2017;Tromans et al., 2023). Individuals with ADHD described how their difficulties with attention and impulsivity may have resulted in a tendency to get distracted, forget details (Robello, 2019), blurt out incoherent thoughts (Button, 2018;Grossberg, 2004), interrupt others (Schreuer & Dorot, 2017), talk excessively (Mather, 2013), and be uncomfortably blunt or straightforward in conversations (Liebel et al., 2023;Oscarsson et al., 2022). ...
Attention-deficit/hyperactivity disorder (ADHD) has a significant impact on psychosocial and occupational functioning. Sixty-five percent of children with ADHD continue to meet full or partial diagnostic criteria for ADHD in adulthood, and an estimated 4% of the workforce has a diagnosis of ADHD. We performed a systematic literature review to understand the experience of ADHD in the workplace. Articles were included in the systematic literature review if they reported results on employment outcomes of adults with ADHD. Methodological quality assessment was evaluated using the Mixed Methods Appraisal Tool. Seventy-nine studies were included in this systematic literature review ( n ADHD = 68,275). Results were synthesized into four categories: challenges, strengths, adaptations, and sex differences. Eight themes were included: ADHD symptoms at work, workplace performance, job satisfaction, maladaptive work thoughts and behaviors, interpersonal relationships at work, personal strengths, embracing ADHD, person-environment fit, and accommodations and support. Workers with ADHD can adapt and thrive in employment with the right person-environment fit, and accommodations and support. Many challenges related to ADHD can be remodeled into assets in a workplace environment that promotes flexible working practices and openness to neurodiversity.
... Further, a UK-based survey of autism and ADHD in the police force found that individuals with these conditions reported significant problems within the workplace, at least in part because reasonable and supportive adjustments to the environment were often not made (Tromans et al., 2023). To date, there has been no examination of the prevalence or experience of neurodiversity among staff working within secure psychiatric care. ...
Background. Whilst there is increasing recognition and interest in how staff who have neurodivergence are represented and contribute to industry, to date, there has been very little exploration of neurodivergence among healthcare staff and none with those working in forensic psychiatric services.
Aims. To estimate the prevalence of neurodivergence among staff working in a UK high-secure psychiatric hospital and explore their experiences.
Methods. All staff were invited to complete a confidential online self-report questionnaire consisting of both closed and open questions.
Results. A fifth of the staff responded (n = 124), but two did not report their neurodivergent status, so were excluded. Nearly 40% of responders reported having some form of neurodivergence, with Attention Deficit Hyperactivity Disorder (ADHD) being the most common, followed by dyslexia, autism and dyspraxia. Over a third (36%) of those reporting neurodivergence said that they had chosen not to disclose this to the organisation and around a quarter (23%) reported not feeling valued or supported by the organisation. Of the staff cohort who responded, most expressed the view that neurodiversity in the workforce is beneficial to patient care, despite the majority being unsure whether neurodivergence is an advantage or a barrier for the individual themselves. Over half of staff completing the survey felt there was not enough awareness of neurodiversity among staff and that more training on the subject would be beneficial.
Conclusion. This survey suggests gaps in our recognition and understanding of neurodivergence among hospital staff. Although the prevalence figure should be treated with caution, given the low response rate, in this first survey of neurodivergence among staff in a secure hospital, our findings suggest substantial numbers of staff with neurodivergence and the likelihood that neither they nor the organisation are optimising this situation. The further steps should include the development and evaluation of strategies exploring ways of improving recognition and relevant support for staff, as well as discovering ways in which neurodivergence in staff might inform and optimise care and treatment for patients
... Moreover, little is known about how Autistic persons who wish to be social workers view entry to their profession and the experiences of those who do train, at university and whilst on training placements (Long 2023), reflecting a broader, limited knowledge regarding autism and employment (e.g. Tromans et al. 2023). In endeavouring for sustainable recruitment and retention of the workforce (Edwards et al. 2022), the involvement of the Autistic community within social work needs to be supported. ...
Social work has a vital role to play in supporting Autistic people of all ages. Whether in facilitating access to other services, such as housing, enhancing quality of life, or in a safeguarding capacity, social workers have a legal and moral responsibility to ensure their practice ensures full, equitable involvement of Autistic people. Regrettably, research evidence indicates practice is not always inclusive and can fall short in responding effectively to Autistic people’s needs. This article adds to recent UK practice guidance and social work scholarship concerning social work and autism. It does so by introducing a framework developed by Autistic doctors for meeting Autistic people’s needs in medical settings known as ‘Autistic SPACE’ and exploring how it could be used for social work contexts. The five core autistic needs recognised in the SPACE framework are addressed, i.e. Sensory, Predictability, Acceptance, Communication and Empathy. How a practice-near social work perspective may aid in developing the framework further is also considered, extending the acronym from SPACE to SPACES to highlight the significance of Social Safety and Support.
Health-related conditions often difer qualitatively or quantitatively
between individuals of diferent birth-assigned sexes and gender
identities, and/or with diferent gendered experiences, requiring
tailored care. Studying the moderating and mediating efects of sexrelated and gender-related factors on impairment, disability, wellbeing
and health is of paramount importance especially for neurodivergent
individuals, who are diagnosed with neurodevelopmental conditions
with uneven sex/gender distributions. Researchers have become aware
of the myriad infuences that sex-related and gender-related variables
have on the manifestations of neurodevelopmental conditions, and
contemporary work has begun to investigate the mechanisms through
which these efects are mediated. Here we describe topical concepts
of sex and gender science, summarize current knowledge, and discuss
research and clinical challenges related to autism, attention-defcit/
hyperactivity disorder and other neurodevelopmental conditions.
We consider sex and gender in the context of epidemiology, behavioural
phenotypes, neurobiology, genetics, endocrinology and neighbouring
disciplines. The available evidence supports the view that sex and
gender are important contributors to the biological and behavioural
variability in neurodevelopmental conditions. Methodological caveats
such as frequent confation of sex and gender constructs, inappropriate
measurement of these constructs and under-representation of specifc
demographic groups (for example, female and gender minority individuals
and people with intellectual disabilities) limit the translational potential
of research so far. Future research and clinical implementation should
integrate sex and gender into next-generation diagnostics, mechanistic
investigations and support practices.
This article examines 181 autistic adults’ views toward, and experiences of, requesting and receiving workplace adjustments in the UK. Using an online survey, we collected both qualitative and quantitative data relating to individuals’ experiences. While the majority of participants perceived workplace adjustments to be important, many were not receiving them. Analysis of open-ended text responses highlighted specific challenges that autistic people face in requesting and receiving adjustments. Specifically, participants felt the onus fell on them to (1) identify their need for adjustments; (2) establish the specific adjustments that would be beneficial and (3) request adjustments from their employer. Yet, they reported struggling with this process. Participants also highlighted a range of social and organisational barriers to the successful implementation of workplace adjustments. Unsurprisingly, the lack of successfully implemented adjustments had far-reaching impacts on participants’ wellbeing as well as the choices they made about their future employment. These findings highlight the need for employers to take a more active role in the identification and implementation of workplace adjustments, as well as a need for more understanding and inclusive working environments that truly allow autistic employees to thrive in the workplace.
Autistic adults are inadequately supported in the workplace. This study sought a definition of ‘reasonable’ and explored facilitators and barriers to employers making reasonable adjustments. 98 employers and employees across a UK city completed a survey; 15% identified as being autistic. Qualitative data were analysed using framework analysis. Reasonable adjustments were defined as having a positive impact on autistic employees’ wellbeing and work outputs without being detrimental to non-autistic employees or the organisation; they were low cost and easily implemented. Recommendations were for autism awareness training, low-stimulus work spaces, clear instructions and flexible working hours. A definition of reasonable is added to the literature, with suggestions of where to invest support efforts. Recommendations mostly apply to the education sector.
Background:
Adult attention-deficit hyperactivity disorder (ADHD) has recently attracted much attention, however, an up-to-date estimation on the prevalence of adult ADHD is lacking. In this study, we aimed to assess the global prevalence of adult ADHD in the general population through a systematic review and meta-analysis.
Methods:
PubMed, Medline, Embase and PsycINFO were searched to identify relevant articles published from January 2000 onwards. Population-based studies that were conducted in the general adult population and quantified the prevalence of adult ADHD were included.
Results:
The prevalence of persistent adult ADHD (with a childhood onset) and symptomatic adult ADHD (regardless of a childhood onset) both decreased with advancing age. By adjusting for the global demographic structure in 2020, the prevalence of persistent adult ADHD was 2.58% and that of symptomatic adult ADHD was 6.76%, translating to 139.84 million and 366.33 million affected adults in 2020 globally.
Conclusions:
This study provides an up-to-date estimation of the global prevalence of both persistent and symptomatic adult ADHD. A well-defined strategy for diagnosing adult ADHD and large-scale investigations on the epidemiology of adult ADHD are needed.
Adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) commonly experience impairments in multiple domains of daily living. Work has a central role in daily life and is susceptible to ADHD due to its cognitive demands. The present study seeks to examine the nature of work-related problems and impairments of adults with ADHD, and explores the association to ADHD symptoms and neuropsychological test performance. A community sample of 1231 individuals took part in this study and completed a set of questionnaires assessing ADHD symptoms and work-related problems. Furthermore, a clinical sample of 134 adults diagnosed with ADHD were recruited from an ADHD outpatient clinic, who completed the same set of questionnaires. A subsample of 51 patients with ADHD additionally performed a neuropsychological assessment using tests of attention and executive functions. Work-related problems were found both in individuals of the community sample with symptoms of ADHD and individuals diagnosed with ADHD. Individuals with ADHD reported work related problems particularly in not meeting their own standards and perceived potential, yet it less commonly manifests in negative performance evaluations at work or job loss. ADHD symptoms, in particular symptoms of inattention, were found to be strongly associated with work-related problems, whereas neuropsychological test performance was no meaningful predictor of functioning at work. This study emphasizes the susceptibility of individuals’ functioning at work to ADHD symptoms and impairments associated with ADHD. ADHD related difficulties at work should be considered in the clinical evaluation and targeted screening at the work place to provide support when indicated.
Background:
Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose.
Methods:
The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD+ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group.
Results:
At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025).
Conclusions:
Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.
Introduction:
At present, very few autistic people are employed, even though many want to be. It is important that their strengths are identified and valued to help them to find jobs that they enjoy, and that make good use of their skills. The aim of this study was to investigate what strengths autistic people have in the workplace, self-reported by autistic people themselves.
Methods:
In this study, autistic participants (n = 66) completed an online questionnaire that asked their views about employment-related strengths that they experienced. We analyzed these data using thematic analysis to identify commonalities across participants' experiences, and areas where they felt that they could perform better than their nonautistic colleagues.
Results:
The main strengths identified from these data revealed cognitive advantages such as superior creativity, focus, and memory; increased efficiency and personal qualities such as honesty and dedication; and the ability to offer a unique autism-specific perspective.
Conclusions:
Overall, this study suggests that autistic people have many employment-related strengths that should be recognized and valued by autistic people and employers alike. By understanding the strengths that could be associated with autism in the workplace, autistic people may be better able to identify their own strengths in the workplace (with the help of support workers, where necessary). The results should also encourage employers to make an effort to recruit and retain autistic employees, making appropriate adjustments to interview processes and working conditions, and seeking out training when needed.
Purpose
The purpose of this paper is to give autistic employees a voice, evaluate their work-based experiences and to disseminate the relevant recommendations of the Westminster AchieveAbility Commission report.
Design/methodology/approach
These experiences were identified through a questionnaire answered by 600 neurodivergent employees, including 95 autistic respondents. This allowed us to compare experiences across neurodivergent categories.
Findings
The overwhelmingly negative work-place experience is consistent at every stage unless managers had a good understanding of neurodivergence. This deteriorated further the more categories of neurodivergence identified with, and minority ethnicity. Few reasonable adjustments were made. Psychometric tests are experienced as disabling. No statistically significant differences were found between genders.
Research limitations/implications
The target group are not representative of the wider autistic population and the sample is relatively small. Further research could look at how managers come to understand neurodivergence, the utilisation of reasonable adjustments and how to promote neurodivergence awareness.
Practical implications
There need to be wholesale changes in recruitment and reasonable adjustments in the workplace, which will require substantial changes in attitudes.
Social implications
The experience of neurodivergent people in the work-place, including autistic employees, was more consistently negative than expected. It was difficult to find any autistic employees without disabling experiences. This paper hopes this will alert wider society to the issues and may serve to support more solidarity amongst neurodivergent people in relation to employment. The findings have already influenced The Advisory, Conciliation and Arbitration Service.
Originality/value
There is very little detailed research focussed on the work-place experience and voices of autistic employees and less research that considers the implications of neurodivergent overlaps in the workplace.
Attention deficit/hyperactivity disorder (ADHD) is a debilitating disorder and most research therefore focuses on its deficits and its treatment. Research on the potential positive sides of ADHD is limited, and although a comprehensive overview of empirical studies on this subject is missing, it has been suggested that ADHD is associated with enhanced creativity. To identify important relations, trends and gaps in the literature, we review 31 behavioral studies on creativity and ADHD, distinguishing different research designs, age groups, creativity measurements and effects of psychostimulants, as well as reflecting the potential underlying neural mechanisms of creativity and ADHD. Most studies find evidence for increased divergent thinking for those with high ADHD scores (subclinical) but not for those with the disorder (clinical). The rates of creative abilities/achievements were high among both clinical and subclinical groups. We found no evidence for increased convergent thinking abilities in ADHD, nor did we find an overall negative effect of psychostimulants on creativity. Neuroscientific findings suggest candidate regions as well as mechanisms that should be studied further to increase our understanding of the relationship between creativity and ADHD. We propose research opportunities to boost the knowledge needed to better understand the potential positive side of ADHD.
Background
Occupational demands are well documented for the general population. Social relationships are one such demand, according to job demands-resources theory. When demands exceed an individual’s available resources, stress results; in turn impacting well-being. Little research has investigated the potential differences between social demands, the impact of demands and relationships that buffer these comparing autistic and non-autistic (i.e., neuro-typical; NT) individuals.
Method
Using an online survey, the present exploratory study gathered 140 responses. Thematic analysis was applied.
Results
Different facets of social relationships were described by autistic (n = 81) and NT individuals (n = 31) as an occupational demand. Together, demands appear to have a greater impact on well-being for autistic, compared to NT, employees. To buffer demands, both autistic and NT individuals expressed relationships with management as important. Yet, autistic employees favoured non-organisational supports, compared to NT individuals who favoured collegial support.
Conclusions
By understanding individual needs and providing flexible work practices, supportive management processes can assist autistic individuals in managing workplace demands, particularly improving social interactions in the work environment. Employers might also consider adapting job roles and organisational diversity policies to better suit individual needs. As well, providing additional external supports, e.g., via employee assistance programs.