Learning from the Experiences of Autistic Professionals Working in Health and Education

This study aimed to explore the experiences of autistic professionals working in the public sector in Scotland and investigate the factors that supported them in achieving employment in their chosen career.

We interviewed 34 autistic adults employed in professional roles in the health and education sectors in Scotland about their successes and challenges during training, recruitment, and employment. Interview conversations of 60-90-minute duration were transcribed verbatim. The research team, which included autistic and non-autistic researchers, conducted inductive thematic analysis.

Resultant themes included complexity of disclosure; navigating differences in social communication and across employment stages; and control of the environment. Autistic professionals face inequalities and unsupportive environments. Participants described multifaceted decision-making processes behind choices to disclose or withhold their autism diagnosis, which could determine their right to workplace accommodations or provoke unfavorable treatment. The styles of communication preferred by colleagues could engender misunderstanding and lead to challenges negotiating social situations, recruitment processes, and organizational culture. Participants' needs and preferences for predictability and routine required them to use strategies to overcome the negative impacts of suboptimal social and physical environments.

Findings confirm the importance of acceptance and inclusion and demonstrate that there is a need for culture change within public sector education and health workplaces to improve accessibility. Applying minor changes to the environment and individual communication styles can enhance workplace conditions for autistic employees.

Why is this an important issue?: Fewer autistic people are employed in skilled jobs than we would expect, and autistic graduates are less likely to be employed than graduates with any other disability. We need research to understand what helps autistic people in skilled work and career development, for example, through promotion. It is important that autistic people can follow their chosen career paths without risk to their health.What was the purpose of this study?: We wanted to know more about the experiences of autistic people employed in public sector professional roles in Scotland. We wanted to find out about work, training, and recruitment from their point-of-view. We wanted to understand what worked well, and what employers can improve.What did the researchers do?: We interviewed 34 autistic people working in professional roles in health or education in Scotland (including nurses, doctors, teachers, occupational therapists, clinical scientists, and radiographers). We thought about what people told us to help us understand their experiences.What were the results of the study?: Autistic professionals said that the decision to share their autism diagnosis at work was complicated. Before deciding to share this information, they thought about the risk of discrimination or stigma. They thought about how this might affect their access to support at work, and their wish to raise awareness of autism by acting as a role model. Sometimes colleagues communicated in ways which led to misunderstandings. Autistic employees told us that the habits and ways of working at their workplace did not suit them. They reported that work environments did not support their needs. This caused them stress and meant that they needed to find ways to stay in employment and look after their health.What do these findings add to what is already known?: We already know that autistic employees face discrimination and stress in the workplace. Our research confirms that there is a need for changes to support autistic professionals. The untrue or unfair views that colleagues have about autism (and other distinctions such as age, ethnicity, race, sex, social and economic status, or gender) create discrimination and prevent people receiving support at work or progressing in their career.What are the potential weaknesses in the study?: People who took part in this research were all professionals working in Scotland and were mainly White, female graduates. They had all been working for at least 2 years. This means that the training and recruitment they talked about may have happened some years ago.How will these findings help autistic adults now or in the future?: Participants highlighted challenges and difficulties they face at work that affect their health and limit career progression. Findings show that employers and colleagues need better understanding of autism to reduce discrimination and help autistic professionals feel supported and safe to talk about their needs. This would help employers work with autistic professionals to identify changes to workplace habits and ways of working, which can support the well-being and career progression of autistic professionals.