Neurodivergence

Neurodivergence and Reasonable Adjustments

Autism: 

Autism is a developmental disorder that is characterised by difficulties with social communication, social interaction and social imagination.  It is a spectrum condition, which means that while some people are severely affected, others may be only mildly affected.  Autism is one of a number of conditions which are increasingly being referred to under the umbrella-term Neurodivergence in an attempt to reframe common negative misconceptions of the condition. Sensory processing difficulties are often present in Autism. 

Strengths: 

Autistic people have a number of strengths including in areas such as their focus on a particular passion, their meticulous approach to detail or their ability to spot patterns in data.
In the right role, autistic people can be very successful, but potential difficulties may include:

• Having a narrow focus on one's own work, and lacking interest in other aspects of the department’s work.
• Problems interacting with other people and preferring solitary work.  
• Difficulty carrying out management roles without the appropriate support.
• Additional support may be needed if the individual is in a role requiring interaction with students or members of the public. They may also fail to spot or respond appropriately to other people's distress or concerns. 

People with autism may do well in more technical roles, drawing on possible strengths in meticulous attention to detail, in consistency checking, in pattern spotting or in following set procedures.

Difficulties
They may however struggle with empathising with other people, or knowing what they are thinking. They can find it difficult to read body language, and find it hard to understand and fit in with a society with many unwritten rules. This may lead to anxiety and depression, and also to outbursts of frustration and anger. They can be unusually sensitive to sensory stimuli. They may find the world confusing and unpredictable.

ADHD

Attention Deficit Hyperactivity Disorder. You may find that some individuals use the term ADD (Attention Deficit Disorder) to describe their condition, but this diagnosis was retired and is the same as ADHD. Not everyone has the hyperactivity element, which also explains why some individuals may prefer to continue using ADD. A common misconception is that ADHD refers to an inability to focus; however, it would be more accurate to say that it is difficulty in directing focus, and in fact the ability to hyper-focus is one of the many skills associated with ADHD.

Strengths

Often when we learn about different disabilities and health conditions there is too much emphasis on the difficulties rather than the abilities. Having ADHD can also give individuals valued skills and qualities such as:

• strong 3D visual skills;
• problem solving;
• greater creativity and lateral thinking;
• ability to see the bigger picture;
• ingenuity and diversity of thought, avoiding group think and often highlighting ways in which things can improve;
• communication.

Common difficulties 

People with ADHD most commonly require assistance with:

• Memory
• Organisational skills
• Time Management
• Stress and anxiety
• Concentration
• Listening & Taking Notes
• Executive function – task initiation, planning etc.
• Distractable 
• Emotional dysregulation

Dyslexia 

This may be thought of as a discrepancy between written and verbal language abilities.  It may result in slow and inaccurate reading, untidy handwriting or spelling weaknesses.  Characteristic features of dyslexia are difficulties in phonological awareness, verbal memory and verbal processing speed.  Dyslexia occurs across the full range of intellectual abilities. Dyslexia is best thought of as a continuum, not a distinct category. 

Dyspraxia

This is an impairment in the organisation of movement. Dyspraxia affects the planning of what we do and how we do it.  It is associated with problems of language, perception and thought. Difficulties with dyspraxia may include both gross motor movements such as walking and balance and fine motor movements such as handwriting. There may be heightened sensory sensitivity.  People with dyspraxia may appear clumsy and accident-prone and may easily get lost.

Strengths and weaknesses

If you have dyslexia or dyspraxia you may be good at getting an overview of a situation, in making connections between unrelated areas, in thinking ‘outside the box’.  You may be skilled at spotting a pattern in information. You may be very creative and good at problem-solving.  You may be a fluent verbal communicator. You may have entrepreneurial skills.

However you may struggle in some areas, such as organisation and time management.  Many people have developed coping strategies, but these may fall apart under stress.

Dyscalculia 

This affects a person’s ability to understand, recall or use numerical information. It is a specific learning difficulty with carrying out basic mathematical activities, although the individual may understand complex concepts such as algebra and geometry as this does not directly relate to arithmetic. Extreme difficulties spotting patterns in numbers and making generalisations.

Tourette’s Syndrome 

This is a neurological condition characterised by a combination of involuntary and repeated movements and sounds – referred to as tics. It usually starts during childhood and for over half of those affected symptoms will continue into adulthood. A large proportion of people with Tourette’s syndrome will also have other conditions, the most common of which are Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD).

There are 4 main categories of tics

Simple Motor Tics

• Eye blinking, head jerking, shoulder shrugging, nose twitching, teeth grinding, eye rolling, and facial grimacing.

Simple Sound tics

• Throat clearing, yelping, grunting, squeaking, sniffing, coughing and tongue clicking.

Complex Motor Tics

• Jumping, touching other people or things, copying other people, smelling, twirling and sometimes hitting or biting oneself.

Complex Sound Tics

• Uttering words or phrases out of context, swearing loudly or shouting inappropriate words and phrases, repeating a sound, word or phrase just heard.

Most people diagnosed with Tourette’s syndrome have a combination of all types of tic, which may change over time. The tics can also vary depending on how they are feeling; perhaps worse when stressed, anxious, ill or excited and perhaps better if enjoying or concentrating on a task.

The tics are involuntary, meaning that they are not deliberate and people cannot help letting them out. Most people can suppress their tics for a short time, but this can be very draining. Eventually the tics will come out, and are likely to be even stronger or come in a big “release”. Most people with Tourette’s experience premonitory sensations, which are uncomfortable or unusual feelings before having a tic. The tics are unlikely to cause long-term health issues but people can experience pain from a sudden movement and have disturbed sleep. However, many people with Tourette’s experience social and emotional effects such as low self-esteem, bullying and isolation.

Auditory processing disorder (APD) 

This affects people’s ability to understand auditory information. It is not impaired hearing but the inability of the brain to process sounds in the normal way. It is quite common for people with dyslexia, dyspraxia, ADHD or autism to experience auditory processing difficulties.

Potential difficulties

• Hearing speech clearly against a background of noise;
• Hearing poor quality sounds (e.g. mobile phone, echoey room);
• Picking out one voice from others;
• Identifying where a voice or sound is coming from;
• Hearing speakers clearly from a distance;
• Listening selectively to one side or the other;
• Distinguishing similar sounds e.g. “seventy” and “seventeen”;
• Following spoken and / or multiple step instructions;
• Understanding information given verbally;
• Remembering instructions or messages told verbally;
• Maintaining attention to speakers and concentrating;
• Reading, spelling or other academic activity may also be affected.

Points to consider if you have APD

• Focus on the person speaking to you if you are in a crowded room; 
• Give them your full attention and concentrate on key words;
• Watch gestures and facial movements very closely;
• Position yourself directly in front of the person speaking to you;
• If you are talking, position yourself so that the person you are talking to is closer to any noise source than you;
• Aim to arrive early for meetings / training and position yourself close to the chair/speaker/trainer;
• On the telephone hold the receiver as close to your ear as possible – it should be tight enough so that it covers the ear and keeps out other sounds.

Advice for managers and colleagues of someone with APD

Ask colleagues / visitors to:

• Get the person’s attention before they start talking and face them when speaking;
• Speak clearly and a little slowly – avoiding complex grammar and vocabulary;
• Not cover their mouths when they are speaking;
• Allow time for processing the information – only rephrase, or explain information in a different way when needed;
• Emphasise their speech to highlight the key points;
• Write down information that is extremely important such as directions, phone numbers or schedules;
• Break it down – presenting information in small, manageable chunks.

Suitable Environment

• Choose a room with good acoustics for meetings;
• Rooms with carpets, soft furniture and cushions, heavy curtains and acoustic ceiling tiles are best for your hearing;
• Choose the quietest room and minimise background noise;
• Switch off air con, shut doors and windows, ask colleagues to keep noise to a minimum.

Meetings and Training

• Write down key words and instructions;
• Use visual clues such as pictures and gestures and utilise mind maps;
• Make sure you are looking at the individual when speaking to them;
• Check understanding of tasks – ask questions and encourage them to indicate if anything is not clear;
• Encourage them to indicate when they have not understood and ask questions;
• Explain what is going to happen;
• Be clear in your communication;
• Provide a break ideally with an opportunity for physical activity;
• Be supportive and encouraging;
• Give instructions before not during an activity and when it is quiet;
• Choose pairs for exercises rather than individual work.

Irlen Syndrome

Irlen® Syndrome is also known as Visual Stress, Scotopic Sensitivity Syndrome or Meares Irlen Syndrome. It involves visual perception or eye problems – caused by the way in which the brain interprets the visual information that is being sent through the eyes. It can make reading effectively and efficiently very difficult and people also perceive their environment differently. Those with Irlen Syndrome have to constantly make adaptations or compensate for their eye problems, which involves exerting extra energy and effort.

Potential difficulties

• Poor comprehension or misreading words;
• Problems tracking from line to line when reading either print or onscreen;
• Preference for reading in dim light;
• Loses place in text or skips words or lines;
• Words distort, blur or move;
• Reads slowly or hesitantly;
• Tires easily when reading – needs regular breaks;
• Avoids reading altogether;
• Reacts badly to white paper / high contrast;
• Squints, rubs eyes, is wide-eyed or blinks a lot.

Writing and IT

• Trouble copying;
• Unequal spacing or letter size;
• Difficulty writing on a line;
• Inconsistent spelling;
• Mathematical errors;
• Misaligned numbers in columns;
• Strain or fatigue from PC use.

Physical symptoms

• Sensitivity to / glare from bright light objects;
• Strain and fatigue;
• Headaches or nausea;
• Eye strain – eyes hurt or become watery;
• Mood changes – anxious, or irritable.

Other effects

• Poor concentration / attention;
• Ineffective use of time;
• Lack of motivation;
• Working hard but not getting results;
• Clumsy / accident prone;
• Difficulty judging distances;
• Poor hand – eye coordination.

It is thought that up to 20% of us are affected to some degree by visual stress. Some experts believe that nearly half of people with dyslexia and a third of those with attention disorders may have Irlen Syndrome. It is also thought that it may be a factor in the sensory overload or distortion that some autistic people experience.

Points to consider

• The most common and most effective way to help improve visual processing is the use of coloured overlays (using sheets of transparent coloured plastic) and tinted lenses.
• Coloured overlays are most effective if the difficulties are mainly with reading and they can make the print clearer and more stable. They can improve reading speed, accuracy and comprehension as well as help you track and keep your place when reading. For many people they should reduce eye strain, tiredness and headaches and increase concentration.
• Coloured filters or lenses are more suitable if people have difficulties with copying, depth perception or light sensitivity.

Other solutions include:

• Coloured paper – for both reading and writing;
• Use of a ruler to keep track of text;
• Larger, clearer print;
• Changing background colours on computer screens;
• Avoiding fluorescent or over-bright lights;
• Frequent breaks or changes of task;
• Avoiding bright colours or busy patterns.

Neurodiversity and the Disability Disabilities Act

Being neurodivergent will often amount to a disability under the Equality Act 2010, even if the person does not consider themselves to be disabled. This is because it impacts the individual on a daily basis with functional tasks and will impact for over 12 months and is a long term disability.  For more information about how to determine whether a person has a disability under the disability please see: 

https://www.gov.uk/definition-of-disability-under-equality-act-2010

Accommodating Employees with Neurodivergent conditions

Some specific accommodations have been detailed above but there are often overlapping challenges. Some people may have some of the limitations discussed below but seldom all of them. Also, the degree of limitation will vary from person to person. Be aware that not all people with a neurodivergent condition will need accommodations to perform their jobs and many may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

Questions to Consider:

1. What limitations is the employee experiencing?
2. How do these limitations affect the employee and job performance
3. What specific job tasks are problematic as a result of these limitations?
4. What accommodations are available to reduce or eliminate these problems. See below for accommodations.
5. Once accommodations are in place, agree how often to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations may be needed?
6. Do supervisory personnel or other employees need training?

This can all be documented in the Wellbeing at Work Action Plan. This plan should be completed with the staff member and regular 1:1s should be in place. 

Below is some advice for the staff member based on challenges they may experience in the workplace: 

General health promotion advice is available on the Health and Wellbeing pages. Completing a stress risk assessment may also be beneficial to understand and minimise work stresses. 

Challenge: 

Concentration and focus, Easily distracted, Procrastination, Fatigue:

• Take short breaks throughout the day. Negotiate taking 10-15 minute breaks regularly away from your desk.  
• Focus on one job at a time rather than multi-tasking when you may be distracted often. Set a regular timer on phone or PC to bring you back to focus should you tend to go off track – can be visual or auditory. This needs to be intrusive enough for you to notice it.  
• Use a “do not disturb” sign/function on your telephone and email, when specific tasks require intense concentration.  Ask your employer to encourage co-workers not to disturb you unless absolutely necessary. 
• Ask your employer if you can work somewhere that is quiet and away from distractions, for example away from doors, busy phones, loud machinery.
• Understanding any sensory issues, e.g. open plan offices have lots of noise and lights, which may be minimised by the use of desk partitions, telephones that light up when ringing, noise-cancelling headphones, desk low-lights etc.  
• Ask about the possibility of working from home occasionally or coming in early or staying late, to reduce distraction, stress and fatigue.  
• Relaxation techniques can help with concentration. 

Challenge: 

Hyperactivity: 

• If you need to move a lot, perhaps a chair that has a wide range of movement (balance chair) or a rise and fall desk allowing you to stand to work when you need to.  
• Movement breaks can help control this – using stairs rather than lift, walking in office rather than internal phone/email  
• Stress ball / fidget toy. 
• Be aware that your need to move may be someone else’s distraction. If you need to pace up and down while thinking at work try to do it in a corridor rather than a shared office. 

Challenge: 

Social interaction and communication. 

• Ask for an office mentor-maybe line manager, colleague, buddy arrangement. Someone who can help you build awareness of how you communicate and any other issues with social cues. They can help defuse difficult social situations before they become too large. Workplace coaches are available. 
• Workplace passports and one-page profiles can help me to build relationships and communication with others.
• Asking for breaks from the office can help control heightened emotion and avoid outbursts.  
• Understanding that your eye contact, speech, and body language may not be the same as other co-workers.  Ask for clear and specific information and instructions about what is expected of you e.g. when going for meetings, completing work tasks etc. This could include travel directions, photographs of people you will be meeting, when activities will start and end.  
• Understanding that you may find hypothetical or abstract questions difficult and that you may also interpret language quite literally.  Ask if your employer can avoid asking questions that are too open e.g. “Tell me a bit about yourself”.  
• Let employers know if you have a tendency to talk too much or focus on one particular topic at length, and that it is okay for them to let you know when you are doing this.  
• Let the employer know that they may need to prompt you and ask supplementary questions in order to get the information from you that they need.  
• Adjustments can be available for job interviews. Please see supportive interview adjustments. 

Challenge: 

Arithmetic 

• Ask for a handheld or talking calculator, or use the calculator function on TextHelp software.  
• Say the numbers out loud or write them down  
• Allow (and ask for) more time than usual for any tasks that involve arithmetic
• Ask for written rather than verbal instructions  
• If possible, ask for mathematical data to be represented in a visual way e.g. graphs, charts and infographics  
• Ask for facilities for speed dialling of telephone numbers  
• Appropriate reasonable adjustment for using security codes for doors and computer log in etc. 

Challenge: 

Reading and writing 

• Understanding that some tasks such as taking the minutes of meetings or reading a page of text may be difficult for you, and that you may need extra time to complete them.  
• Allow (and ask for) plenty of time to read and complete tasks.  
• Ask if the employer can use other ways of giving the same information that avoids reading.  
• Alternative formats such as audio or videotape, drawings, diagrams and flowcharts.  
• Ask for mind-mapping software, such as Inspiration, Mind Genius.  Digital recorders and speech to text software.

Challenge: 

Spelling 

• Assistive text software such as ClaroRead or TextHelp.  
• Allow (and ask for) time for proofreading work. 

Challenge: 

Written communication 

• Ask for verbal as well as written instructions.  
• Use alternatives to written information such as voice mail.  
• Use/ask for screen reading software and scanners.  
• A Reading Pen may be useful for unfamiliar words.  
• Ask for information on coloured paper and set up a computer screen with a coloured background.  
• Keep operating instructions next to office equipment such as photocopiers and scanners. 

Challenge: 

Spoken communication  

• Ask for instructions to be given one at a time, slowly and clearly, and in a quiet location.  
• Ask for certain tasks to be demonstrated and/or supervised.  
• Use a digital recorder.  
• Back up verbal instructions and information with notes or diagrams. 

Challenge: 

Organisation and planning 

• Ask for a workspace that is quiet and free from distractions such as doors, phones and loud machinery. 
• Ask if it is possible to work from home occasionally.  
• Ask for a workspace that is well lit, neat and tidy.  
• Ask for a wall planner to visually highlight appointments, deadlines and tasks.  
• Ask for reminders of important deadlines, priorities & projects.  
• Ask for timetables, mnemonics and mind maps if these help with prioritising 
• Colour code items in your workspace.   
• Use computer features such as calendars, alerts and alarms.  
• Create a daily “To Do” list.  
• Ask for work to be broken up into manageable chunks.  
• Build planning time into each day.  
• Allow extra time for tasks and projects, for unforeseen circumstances.  
• Ask for templates for detailed work, such as reports. 

Challenge: 

Memory:  

• Use mnemonic devices and acronyms.  
• Use diagrams and flowcharts to organise information.  
• Use multi-sensory learning techniques such as reading material onto a tape machine and then playing it back whilst re-reading.  
• Use appropriate computer software such as program menus and help features.  
• Ask for incoming telephone calls to be kept to a minimum.  
• Before making a telephone call, jot down the key points you want to cover. 

Challenge: 

Sense of direction  

• Try to use the same route each time  
• Ask for a visual representation of a route, and visible landmarks.  
• Ask for detailed maps and/or GPS system.

Challenge: 

Working at a computer:  

• Change the background colour of the screen. 
• Use/ask for an anti-glare screen filter.  
• Take frequent breaks, at least every hour to move and complete sensory diet activities is required
• Ask if you can avoid working on a computer all day and alternate computer work with other tasks.  
• Change or slow down the mouse.
• Keyboard shortcuts can also be used as an alternative to the mouse. 

 

Useful apps:

These are just some suggestions of useful apps. 

• HabitRPG: Habit building and productivity app that uses gamification to motivate. Collect points for completing good habits and avoiding bad habits.
• Routinely: Set goals for each of the tasks and habits that make up your day, and then track your completion of those goals. Can send you notifications to remind you to complete your goals, and provides a history view to review past 
• Todoist: Acts as a checklist, organiser, calendar, reminder and habit-forming app. Can be shared with others for joint projects, integrated with other apps such as Dropbox and Alexa.
• Work Autonomy: Designed to assist with person-generated communication with co-workers and supervisors regardless of linguistic or cognitive skill, tracking task analysis and work schedules independently, and allowing access to information about work expectations, production etc.
• Time Timer: A simple visual timer using a clock face & a countdown bar to show the time left. Colour changes to orange & red when time is running out.
• MoodPanda: Track your moods using graphs and calendars. Community aspect to offer support and advice
• Miracle Modus: Designed to help with sensory overload, by providing strong visual stimuli that move in predictable patterns.
• Anti-Social: Set the app for your chosen time frame and it will block distracting social media websites. Currently only for Mac users.  
• SelfControl: This will block access to the websites that distract you the most for a set period that you determine. Until the timer expires, you will be unable to access those sites—even if you restart your computer or delete the application.  
• StayFocusd: This is a free Chrome extension that will help you to stay more focused on your writing by restricting the amount of time you spend on distracting websites. You set a certain amount of time for social media for a day, after you have used your allotted time you will be blocked for the rest of the day.  
• Freedom app to block internet, messages and social media leaving you free to focus on your work 
• Sensory App: Range of sensory apps to help with relaxation and overstimulation. www.sensoryapphouse.com