Employment of autistic people

, the first person to be diagnosed with formal childhood autism, worked as a bank clerk. The issue of employment is a very recent one in the debates on autism. People diagnosed with infantile autism have long been considered unable to work. they were laughed at by most specialists at the time. At the end of the 20th century the diagnostic criteria for autism were broadened, making it easier and earlier to detect. This led to an increase in the number of diagnoses: autism affects around 1% of the world's population (in 2016), with varying degrees of disability. The DSM-5 criteria allow diagnosis on the basis of difficulties in communication and social interaction, and restricted and repetitive behaviors and interests, with a "clinically significant impact in terms of functioning" in social, academic and occupational terms. These symptoms are present from early childhood, but "may be masked later in life by learned strategies". This variability depends on individual factors such as intelligence, language skills and the presence of co-morbidities, as well as environmental factors such as family support, the provision of appropriate interventions and services, quality of life and various socio-emotional factors. At the end of 2000, researcher Sophie Nesbitt worked with the UK's National Autistic Society (NAS) to study the employability of people diagnosed with Asperger syndrome. The gradual inclusion of autism in the field of disability at international level is reflected in the Council of Europe directive of 27 November 2000, advocating "non-discrimination in employment and occupation", which applies to autistic workers. Its French version is the 2005 Law for Equal Rights and Opportunities, Participation and Citizenship for People with Disabilities, which led to the creation of the departmental homes for the disabled. In 2015 UN Secretary Ban Ki-moon pointed out that the majority of autistic adults worldwide are unemployed. In February 2017, the first French report dedicated to the employment of autistic adults was submitted by Josef Schovanec, PhD in philosophy and social sciences (EHESS), himself autistic, stating that "in France, the employment of autistic people is clearly still in its infancy". In the UK, the National Autistic Society (NAS) handed over a petition to the British government on 21 February 2017, signed by 30,000 people, calling for the employment of autistic adults to be made a priority. The Malakoff-Médéric foundation opens a specialized French site at the end of 2018. Scientific literature followed the evolution of the children he diagnosed in 1943. Leo Kanner, the child psychiatrist who discovered infantile autism, followed the progress of the eleven children (generally from privileged backgrounds) he diagnosed for the publication of his landmark study in 1943. Many went on to obtain decent jobs (in particular "patient 0", Donald Triplett), while those placed in institutions had little or no autonomy in adulthood. she argued for the option of employment support to be made available to all. The following year, an article by French-Canadian researcher and psychiatrist Laurent Mottron appeared in the scientific journal Nature, entitled "Changing perceptions: The power of autism". Testifying to his experience of working with autistic researchers, including Michelle Dawson, as part of his team at the University of Montreal, he hopes that more autistic people will be involved in research teams:[...] They are there because of their intellectual and personal qualities. I believe they contribute to science because of their autism, not in spite of it. Everyone knows stories of autistic people with extraordinary scholarly abilities, such as Stephen Wiltshire, who can exquisitely draw detailed cityscapes from memory after a helicopter ride. None of my lab members are savants. They are 'ordinary' autistic people [...]. – Laurent Mottron, Changing perceptions: The power of autism. In September 2016, Yosheen Pillay and Charlotte Brownlow's review of Predictors of Successful Employment Outcomes for Adolescents with Autism Spectrum Disorders: a Systematic Literature Review, based on 297 articles, was published. In May 2019, a new review of the scientific literature devoted entirely to factors promoting employment for autistic people, by Melissa Scott and her team, was published: it covered 134 studies of inclusion factors, 36 of which evaluated the effectiveness of employment interventions. The vast majority of these studies were carried out in the United States. Targeted hiring experiments , part of the Université de Montréal, regularly employs autistic researchers. The business model of structures specializing in the recruitment of autistic adults is based on the valorization of these skills enabled by neuroatypia. In Germany, Denmark, the United States and India, companies in the IT sector practice positive discrimination. Job coaching is on the increase, particularly in the Czech Republic, Germany, the US and Ireland. Meticulon in Canada, Auticon in Germany, and Asperger Syndrome Training Employment Partnership Entreprise in the USA, use job coaching with a single referent for the autistic employee. In Belgium, the "Passwerk" scheme, created in 2008, is based on intensive individual coaching for autistic employees. In 2008, the AQA (Asperger Quality Assurance) project was launched in the suburbs of Tel Aviv, to enable the professional inclusion of high-performance autistic adults in the software testing field, targeting quality positions in multinational companies. The software testing and consulting company Specialisterne, which operates in 16 countries and is headquartered in Denmark, was founded by the father of an autistic child, and employs 70% autistic workers in adapted positions. In 2012, two Mossad agents launched the Ro'im Rachok project, an Israeli army intelligence unit that specifically recruits autistic teenagers to analyze aerial and satellite photographs. In 2013, the German software company SAP announced that it was looking for 650 autistic people for its research and development department, with the aim of having 1% autistic employees. In France, since 2014, the Andros group, supported by the Orange Foundation, has been taking on autistic employees at its Normandy plant. Most are nonverbal, and work part-time. These targeted hirings through positive discrimination remain rare and isolated initiatives. They are not enough to remedy the underemployment of autistic people.Any attempt to tackle the issue of employment for people with autism will have to take into account the fact that very few people with autism have had a linear life course. The dominant, and indeed almost unique, statistical norm in this field is the alternation of phases of greater or lesser inclusion, of various types of precariousness, with multiple interruptions of the pathway and long periods without a solution. – Josef Schovanec, ''Rapport présenté à la Secrétaire d'État chargée des personnes handicapées et de la lutte contre l'exclusion sur le devenir professionnel des personnes autistes''.Structural changes in the job market (increasingly competitive and segmented), recruitment methods and prerequisites (linear careers, formalized recruitment, multiplication of intermediaries, computerized sorting by keywords in curriculum vitae (CVs), etc.) may have led to crowding-out effects, multiplying the difficulties autistic people have in gaining access to employment. It is likely that these difficulties have increased since 2000. Since ca. 2010, the proliferation of tests requiring social skills (such as behavioral interview questions) created yet another obstacle on the path to employment for autistic people. In addition, knowledge of autism among business leaders and employers in general is evolving, and strongly influences employability. In the United States in 2016, most business leaders, especially women, spontaneously associate autism with qualities of concentration and attention at work. of objectifying and valuing skills, making it possible to explore a number of experiments better suited to disabled people, and in particular to the profile of autistic people. For example, telecommuting jobs are likely to become increasingly common in the coming years. According to Tibor N. Farkas and his colleagues, hiring and keeping a job are the main challenges associated with integrating autistic people into the workplace, due to their communication and social skills deficits. == Statistics ==

has studied the employment prospects of autistic people. Autistic adults at all levels of autonomy experience periods of unemployment and underemployment. Overall, they are paid less than their non-autistic peers (whether due to a lower number of hours or a difference in the amount of pay for an equivalent position), These sheltered environments thus play a major role in the issue of autistic employment. (2009) to 77% (2017) Among the Swedish Autism community, two major reactions to employment stand out: one that views autism from a medical angle, as a health problem hindering employability, and which constitutes the slightly dominant view; another that calls for recognition of the particularities of autistic workers in the non-autistic context, and appeals to the social model of autism to demand adaptations to employment conditions. Diploma levels The educational levels of autonomous autistic people outside institutions is much lower to those of the non-autistic population, with a few cases of "over-educated" adults. This is a major root cause of autistic unemployment as autistics drop out of secondary education and higher education at a much higher rate than their non-autistic peers. Diploma level is clearly correlated with employability. Autistic people placed in specialized institutions are very poorly qualified, due to the inaccessibility of training. and British psychology professor Patricia Howlin, among others, have shown that prospects for young autistic school leavers are very limited, both in comparison with the general population and with adults with other developmental disorders. There are no official general (international) statistics on employment rates for autistic adults, only statistics by subgroup. the CNSA estimated (2016), on the basis of the synthesis carried out by the Haute Autorité de santé in 2010, that 56% of autistic adults can work part-time for five hours a week on average, and that between 1% and 10% have full-time work. According to a review of the scientific literature by researchers Alissa Levy and Adrienne Perry, published in 2011, an average of 24% of autistic people find employment during their lifetime, usually on a discontinuous and/or part-time basis. The jobs concerned are low-paid and unrewarding. In the USA, a study of 72 autistic adults over 12 years shows that only just under 25% kept a job for the entire period, while three-quarters found employment over at least a short period. Two phenomena create selection biases. Some people in employment are unaware that they are autistic, particularly women. Others have the wrong diagnosis (infantile psychosis...), or have a diagnosis but refuse to communicate it, and/or hide their behavioral particularities from their colleagues and employers: 9% of the 99 people in employment interviewed for a Malakoff Médéric survey in 2015 said they told no one that they were autistic; only 26% informed their superiors and colleagues. The review by Scott et al. (2019) cites the following summary figures: An American study of 254 autistic adults showed that those who disclosed their diagnosis to their employer were three times more likely to be hired than those who did not. However, a more recent study (2018) based on the follow-up of a Utah cohort since the 1980s, tends to invalidate the relationship between IQ score and employment rate, and to conclude that lack of mastery of social skills is the main factor in unemployment. Similarly, according to Laurent Mottron, in North America (2011), around 10% of autistic people cannot speak and 90% have no regular employment, 80% of autistic adults remain dependent on their parents; yet only a minority have an associated neurological disorder that diminishes intelligence (e.g. fragile X syndrome). == Accessibility and employment benefits ==

Like non-autistic people, autistic adults feel the need to be useful to society, and to experience a sense of comfort. However, there are differences in expectations between autistic and non-autistic people: the absence of a circle of friends may be experienced as problematic by a non-autistic person, but not by an autistic person. especially as the difficulties encountered are unique and specific to ASD. The transition to adulthood is often a difficult period, a source of anxiety and uncertainty. The financial compensation granted to disabled people, depending on the rules of the country concerned and the type of benefit, may require that a ceiling of resources not be exceeded: as a result, a number of autistic adults work in voluntary jobs. In October 2015, Australian researcher Melissa Scott and her team published in PLOS One a study of 40 autistic adults in the context of their work, and 35 employers: according to them, the majority of autistic adults are able to hold down a job. These jobs can be in mainstream or sheltered settings, in competitive or non-competitive sectors. Temple Grandin cites three common characteristics of successful autistic people: • Having had the opportunity to develop their strengths, with support to do so • Being helped during adolescence and early adulthood to work on social skills, including understanding human relationships in employment • Taking medication or adapting eating and exercise habits to manage sensory problems, and associated disorders such as depression and anxiety Selective advantages The disability status of autistic adults is accompanied by selective advantages in the performance of specific tasks, particularly those involving visual skills, resulting in higher performance. There is an "ample level of evidence" in favor of the potential benefit to companies of hiring autistic people on tasks that mobilize their strengths, such as problem-solving, attention to detail, precision, memory, technical skills, or factual and detailed knowledge of specialized fields. However, in employers, the dominant view is based on the medical model of autism, which sees it as a sum of deficits:This predominance of the medical model, or one based on interventions aimed solely at compensating for deficiencies, leads to an unbalanced vision of autism as a sum of deficits that must be compensated for in order to gain access to employment. This paradigm prevents us from seeing the skills developed by people with autism. – Melissa Scott et al. Autistic adults often develop an intense and enduring interest in a specialized field. These interests can be varied, and knowledge is most often acquired by self-teaching. Autistic adults make, and have made, many contributions to the economy, but these contributions are not very visible, as they are usually made discreetly and anonymously. although they are invaluable on the job market. In fact, autistic people from affluent families, who have benefited from counseling and support, are statistically the most likely to access rewarding employment. Temple Grandin and Stephen Shore Josef Schovanec qualifies this observation, as some autistic people have no apparent interests, or change their interests over the course of their lives. The HAS and ANESM recommend relying on centers of interest for employment support, unless they are too invasive. Companionship can be adapted, but often poses the problem of living in a community. Finally, there are some notable cases of successful careers following a geographical move away from the person's place of origin. Fields of activity The idea that only a restricted range of occupations is possible for autistic people is a widespread prejudice. The jobs that can be performed are varied, from "basic" to highly technical Cultural factors create differences in the way professions are practised in different countries. In the Anglo-Saxon world, for example, autistic people are well known to work in the stock market and in accounting, but this is not the case in France. Misrepresentations associated with certain professions, such as diplomacy, perpetuate the idea that careers are inaccessible to autistic people. and in which the tasks to be accomplished are clearly defined. According to Josef Schovanec, most autistic people are not interested in IT, or struggle to make a living from it when it is their focus. despite its mismatch with expressed career wishes. It is possible that some past Russian army programs have been conducted with autistic people, although this remains speculative. Translation-editing jobs, which are often in demand, Careers in contact with nature, plants and animals (horticulture, equestrianism, etc.) are among the most common interests, with individual examples of autistic farmers and breeders in the media. The best-known example is that of a zootechnician and doctor in animal science, Temple Grandin. The arts and crafts professions, which "have in common the need for high precision of gesture and great patience in often solitary work", also attract a significant proportion of autistic people, without requiring "advanced social or verbal skills". A significant proportion of autistic people want to work in libraries, but this desire is rarely in line with the reality of the profession and the number of positions available. There are career opportunities in the autism sector itself, both in France and in the English-speaking world, among other things to ensure that autistic people are represented before public authorities. For some highly qualified autistic adults, higher education and research are sometimes the only career options. Solitary occupations and lifestyle choices have historically provided refuge for autistic adults, such as shepherding, monasticism and asceticism, a lifestyle with no social contacts and many routines. Certain sectors are notoriously unsuitable for autistic profiles. Grandin, for example, advises against jobs in political science, commerce and positions involving regular use of the telephone, because of the problems of sensory overload and over-solicitation of social skills. == Explanations for difficulties ==

The difficulties encountered by autistic people on the job market have multiple explanations, linked among other things to communication and social interactions with employers and colleagues, to their sensory hypersensitivities, The unemployment rate does not seem reducible without taking this social aspect into account on the employer's side. The level of qualification is less often cited as a limiting factor than problems of communication and organization in the workplace, in particular the unsuitability of the environment and equipment. task-planning difficulties due to working memory functioning in autism, The profile of autistic adults is often destabilizing for their colleagues and employers. The argument commonly used to justify the underemployment of disabled people – lack of skills – does not always apply to the employment of autistic people. A review of the scientific literature shows that the autistic adults most rejected from employment are in fact those with the most behavioural problems. The curricula followed by autistic people are often linked to their interests, which are not very compatible with the reality of the job market. The results of the study by Scott and his team (2015) show that, although both groups (employees and employers) appear to be engaged in an employment process, there is a difference in understanding of the type of workplace support required, expectations and productivity requirements, which hinders the autistic person's success in employment. According to the authors, "these findings highlight the need to facilitate communication between employees and employers to ensure a clear understanding of the needs of both groups". Similar findings were reported in earlier studies by other researchers. Furthermore, around 46% of those, who are employed, are over-qualified for their current role. and negative perception of autistic candidates by non-autistic interviewers is frequently cited as a major barrier to gaining employment for autistic adults. According to the Malakoff Médéric survey, job interview "appears to be a highly discriminating barrier for an autistic person who does not play well the social comedy attached to this rite of passage. They fail the psychological tests, whose pitfalls they rarely avoid". More specifically, autistic candidates are "perceived as having a more monotonous tone of voice, being less composed and focused, and displaying less natural eye contact and gestures than their non-autistic counterparts, and received lower ratings for likelihood of social approach". According to Josef Schovanec, job interviews are difficult, if not impossible, to pass for autistic people, because the judgement is based not on the possession of the skills required for the job, but on the respect of social codes (politeness, dress, hairstyle...) during the interview, which is a point of difficulty common to all autistic people. Prior training helps to prepare for the questions asked at this type of interview, and improves the chances of success. Social skills Among the major challenges posed by autism are the management of social skills and friendships, communication difficulties (particularly in holding and managing conversations), and difficulties in guessing the desires and thoughts of others (theory of mind). An autistic person may unintentionally come across as rude to colleagues or lack diplomacy. as is the lack of understanding of relationships between employees, particularly when it comes to competition. and detrimental, as it often includes the need to supervise or manage work groups, skills that are notoriously among the weak points of autistic workers. In the worst case, autistic workers may attempt to kill themselves after a promotion that leads to a change in their type of activity, if they find themselves distanced from the task they used to enjoy. The evolution of certain economic sectors has been to their detriment, including IT, which increasingly requires more advanced social skills. Recruiters are often surprised by the profile of highly qualified autistic people, since companies also expect them to have good social and managerial skills. She also believes it is important to make colleagues and superiors aware of the social difficulties faced by autistic people. Emotional dysregulation Difficulties in managing emotions such as anger, anxiety and depression are frequently linked to autism. Socializing with non-autistic peers is also a source of stress. Sensitivity to the unexpected often translates into strong reactions to interruptions during a task requiring concentration, in around half of autistic workers. The Malakoff Médéric Foundation survey emphasizes (2015) that "sensory aspects are essential to take into account for the success and sustainability of inclusion in employment": three-quarters of the 99 autistic workers surveyed said they had hypersensitivities to noises, smells, taste or touch. Autistic people may also be disturbed by certain visual perceptions. These hypersensitivities lead to significant fatigue at work, Most autistic workers say they cannot work properly in an open-plan layout, mainly because of the ambient noise in these workspaces, and would prefer an individual office. On the other hand, some autistic people have hyposensitivities, associated with self-regulatory behaviours, or present both hyper- and hyposensitivities, which can result, in the same person, in a refusal of tactile contact and a need for physical movement. The drudgery of work may be experienced differently than by non-autistic peers: in France, night work and repetitive work, which come under the legal definition of "arduous work", may be experienced as less arduous for an autistic worker than other situations that do not fall under this definition, such as unpredictability in employment and working in a socially-charged environment. Autistic adults generally prefer jobs that include a certain amount of routine. == Discrimination and injustice in employment ==

According to Autisme Europe, stigmatization and discrimination are the biggest difficulties to overcome. The latter may, however, arouse the jealousy of their colleagues. An analysis of employment discrimination complaints from disabled people in the United States shows that complaints from autistic adults are most numerous against the retail sector, and more often emanate from men, particularly from Native American ethnic backgrounds. According to NAS data published in 2016, 43% of UK autistic people who are or have been in employment say they have lost a job due to autism-related discrimination. A further 81% say they have experienced harassment, injustice or lack of support in the workplace. "And, if one of them, gifted with better communication and interpersonal skills, manages to complete his or her studies, get a diploma or a degree, he or she won't find a lasting job because no one will bother to recognize his or her characteristics and make, possibly, a small modification – in schedule or work setting – that makes life less difficult for such a fragile person in terms of interaction". In the UK, if there is a suspicion of discrimination, it is advisable to ask precisely why a job was refused or lost. In the event of a trial, a judge will be able to assess whether these reasons are valid for the position in question, or whether the treatment of the autistic person amounts to discrimination. Specific adaptations for autistic people are often refused, Furthermore, little attention is paid to the fatigue of autistic people in workplaces ill-suited to their disability, despite the fact that some 80% of workers questioned for the Malakoff Médéric survey reported greater fatigue than non-autistic people. More than half of the autistic workers surveyed would like to work staggered hours, to avoid the presence of a large number of colleagues and crowded public transport. Non-remuneration or exploitation There have been reports of autistic workers being exploited by malicious colleagues or employers, as a result of their frequent naivety when it comes to human relations, particularly in the early years of adulthood. Josef Schovanec's report gives an estimate of around a third of unpaid work, in defiance of legal obligations, with autistic people notoriously reluctant to complain or threaten the companies in question. Rather, it is the absence of oral language skills that severely compromises the chances of professional success. As an example, he cites the recruitment experience of the Andros group, which mainly recruited non-speaking autistic young adults, who were labelled "Asperger" as soon as they were hired. Potential employers tend to ask only for "Asperger" profiles, despite the fact that no research has shown any link between this former medical category and greater professional competence. == Measures ==

Successful integration into the workplace depends both on learning on the part of autistic workers, and on adaptations to their working conditions. Various measures are being tested, taking into account difficulties such as job interviews, autonomy and workstation adaptation. Employers in the UK are being encouraged to take autistic profiles into account, for example by not asking for communication skills if the job does not require them, and by avoiding assessing candidates on their social interactions during the job interview, to encourage integration into the job. In Germany (2012), a website exists to put employers in touch with each other who are looking for particular skills or profiles to which autistic people can respond. Josef Schovanec believes that autistic people need job coaching and training in the difficulties of working life. The passive medical focus on the deficits of autistic people often leads to blaming the individual for what he or she is, rather than adapting the environment and social organization to the disability.Interventions for adults with autism should instead focus on identifying barriers and facilitators to job acquisition and mitigating their weaknesses by promoting and enhancing their strengths. – Melissa Scott et al. Specific measures for autistic people are more effective than general measures. The Australian survey of 59 employers also shows that these measures are beneficial for companies, and do not generate additional costs. States' commitment to the employment of autistic adults has an economic interest, by reducing recourse to social benefits, and increasing revenue from contributions and taxes. Employment support To encourage hiring and the retention of autistic people in employment, according to a Swiss Social Security survey (2015), the main lever is the creation of vocational guidance and training measures tailored to their specific needs. In particular, the study recommends the use of job coaching and case management schemes; the French CNSA also recommends job coaching. Job coaching programs generally target positions with very low levels of responsibility. There are few, if any, initiatives aimed at positions considered more prestigious. Individual Placement and Support (IPS), Autism: Building Links to Employment (ABLE) in Northern Ireland, American SEARCH projects42 and other programs66) generally prove their effectiveness, with success rates of up to 90%, The effectiveness of this support is generally judged more positively by the employer than by the autistic people themselves and their families. They could be differentiated according to gender, as they seem to be more effective with men than with women; overall, there is less research on women than on men. Increasing autonomy through occupational therapy appears to be highly beneficial. Peer emulation (discussion groups between autistic adults or between autistic and non-autistic adults) can also provide effective support. The role of the coach is to teach the autistic employee how to adapt to the rules and culture of the company. A social worker or workplace mentor may also be called in. On-the-job training is more effective than simulation. However, virtual job interview training (with computer support) seems to be effective; the use of video models to learn how to answer the phone can also be explored. Numerous testimonies report the damaging use of pseudoscientific methods or vectors of sectarian aberrations in the field of business coaching, such as divinatory tarot, neuro-linguistic programming and transactional analysis. On 11 November 2012, the NGO Autism Rights Watch alerted MIVILUDES to the development of coaching in the healthcare field, and the persistence of unverified psychoanalytical theories targeting autistic people in France. In France in 2015, the family circle and public organizations such as Pôle emploi and Cap emploi are the main "de facto" coaches for autistic adults engaged in a job search. Feedback from the latter two organizations is generally negative (2015), particularly with regard to the requirement for regular appointments, which generates stress and breaks in entitlements. Feedback from parallel systems specializing in autism, both in France and in England and Israel, is more positive. Adapting working conditions According to Temple Grandin, adapting a workstation to sensory hypersensitivity often requires little in the way of adaptations. It's possible to use noise-cancelling headphones, do away with shrill bells and neon lights, and use more written communication. The Malakoff Médéric foundation cites raising team awareness, adapting working hours and taking sensory aspects into account as three elements necessary for successful integration. For visual sensitivities, tinted glasses seem to be effective. Anxiety and hypersensitivity are often linked. Managing emotions can be a challenge, particularly anger. On the other hand, many employment difficulties are solved by a good quality of sleep. Adaptations to working conditions can have a positive bilateral effect. For example, unlike the majority of non-autistic people, some autistic people prefer to work at night, and are therefore more productive. == Media coverage ==

Hiring initiatives specifically targeting autistic people are very recent and generally generate enthusiasm and spontaneous support. In the 2016 film The Accountant, the autistic main character (played by Ben Affleck) works as a forensic accountant. The Korean series Good Doctor (2013) and the American series The Good Doctor (2017) feature a young autistic surgeon (played by Joo Won in the Korean series and Freddie Highmore in the US series) who faces stigmatization and prejudice in his professional environment. The French-Belgian series AstraZeneca (2008) features a young autistic surgeon who has a very low self-esteem. The Franco-Belgian series Astrid et Raphaëlle (2019) has an autistic archivist (played by Sara Mortensen) working for the criminal investigation department as one of its two main characters. ==See also==