Celebrating Neurodiversity in the Workplace

To recap some big topics from my previous Neurodiversity Celebration Month articles:

#1 - I am a woman in tech with ADHD (10 min read)

• Attention-Deficit Hyperactivity Disorder (ADHD) is a neurological condition, qualifying as a cognitive "disability." It has a biological basis and is not a mentally conjured ailment.
• Despite ADHD stereotypes and rampant "ADHD-like" symptoms permeating the workforce, symptoms are a lot more severe for people who have been diagnosed with ADHD (the disorder), and it can be debilitating at times.

#2 - The Key to Succeeding with Neurodivergence: Embracing It (12 min read)

• The terms neurotypical and neurodivergent are specifically chosen to destigmatize differences in neurological composition and celebrate the unique perspectives (and strengths) that come with cognitive and neurological conditions.
• For employees (and empathetic managers/employers): the first step to actually improving productivity in the workplace is to accept that you are neurodivergent, and therefore, will occasionally need divergent strategies as opposed to typical ones. There are plenty of strategies that I've tried over the years which you are welcome to try (and I am still learning as I go).

As I've said in previous articles, neurodivergent employee strategies will only be as successful as the supports in place to pursue those strategies. Therefore, success of employees hinges on the success of active efforts in the workplace. So, in this article I'm going to share:

• what is legally required by employers;
• how organizational trust plays a major role in disability disclosure and the ability to create an effective accommodation plan;
• 3 (or 5?) P's to build competency and foster a culture of inclusivity and accessibility

Neurodivergent, Disabled... Potayto, Potahto... but what is actually *legal* to talk about in the workforce?

The short answer: A person may choose to disclose their disability, but they are not legally required to do so. In the US, there are laws in place to protect the rights of those with disabilities during and after hiring (assuming that person is capable of doing the job's necessary functions, with or without reasonable accommodations). In fact, it is illegal to ask people about several different topics during job interviews, including race, religion, marital/family status, national origin, or disability.

While not everyone is in the process of hiring this exact moment (though it certainly can feel like it these days), I bring up this particular fact because there are millions of people in the workforce who were already hired, and chose not to disclose their disability in an effort to avoid the effects of unconscious/implicit bias in the hiring process (even if it is illegal to discriminate on the basis of disability, bias still exists).

Employees may choose to disclose their disability later, but even then, employers may be prohibited from asking whether an accommodation is needed, unless they have a reasonable belief that an employee’s known disability is contributing to a workplace issue that warrants accommodation. This prevents bias and assumptions that a disability will cause an issue when there is currently no cause for that.

The corollary, though, is that employers must consider reasonable accommodations if the need for accommodations is known. Ultimately, it is the employee's responsibility to disclose information about their disability in order to request specific accommodations (thus, an employer may ask for documentation in those specific cases).

What is required when someone discloses their disability?

Here is a summary of Title I of the Americans with Disabilities Act of 1990 (ADA) according to US Equal Employment Opportunity Commision (EEOC):

"This law makes it illegal to discriminate against a qualified person with a disability in the private sector and in state and local governments. The law also makes it illegal to retaliate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit. The law also requires that employers reasonably accommodate the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or employee, unless doing so would impose an undue hardship on the operation of the employer's business."

If you're wondering about that last, bolded sentence... there are some specific "reasonable accommodations" mentioned in the full legal text:

• making existing facilities used by employees readily accessible to and usable by individuals with disabilities; and
• job restructuring, part-time or modified work schedules, reassignment to a vacant position, acquisition or modification of equipment or devices, appropriate adjustment or modifications of examinations, training materials or policies, the provision of qualified readers or interpreters, and other similar accommodations for individuals with disabilities.

Does this mean you will have to restructure a person's job or schedule when your business cannot do it without drastically changing business model? No, because the "undue hardship" clause protects businesses from financial ruin by noting specific factors for undue hardship, including financial resources, size of the company, and business functions (though these can still be up for legal interpretation).

The "undue hardship" clause does mean two things, though:

• unscrupulous employers can often find legal loop-holes to avoid hiring or keeping disabled people on staff, and
• even well-meaning employers cannot always accommodate if they are small, have limited financial resources, or require employees to perform very specific functions.

Both of these ultimately result in fewer employment opportunities for disabled people, the former by malicious intent, the latter by necessity (...perceived or otherwise).

What do we do about it?

It's important to acknowledge that many of the social constructs and norms around professional life are established by expectations of neurotypical behavior and, for many years, purposefully excluded or denounced divergent behavior. In many ways, accessibility is still a "new frontier," particularly as it relates to neurological conditions, despite the past 30 years of ADA protection (society often progresses at a glacial pace).

While all of us would love to have the ability to create a Diversity, Equity & Inclusion office, not all companies have the people or resources to have a dedicated office or department. Very small businesses often only have a few employees; and those in rural communities would be lucky to have more than five.

To be clear, I am not making excuses for "ableist structures" around us, and neither am I maligning small companies that are barely staying afloat. I am, however, proposing a third option, inspired by the often-quoted "Serenity Prayer" (Note: I promise it is a secular suggestion, despite its origins.)

Grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference;

All this to say... I'm of the school of thought that iterative 1% improvements over time with realistic goals will consistently yield better outcomes than trying to find, refine, and implement a 100% perfect solution all at once.

The key, though, is to figure out which 1% improvements are going to be prioritized to yield the maximum benefits. Based on the time I've spent observing people in workplace settings, here's where I think 1% improvements would make a very big difference:

Improving Trust

In order for an employer to be able to support a neurodivergent employee, the employees need a sense of safety to be vulnerable enough to admit that they have a "disability." The way to create that sense of safety is to establish a climate of trust (which is easier said than done). Trust, however, can sometimes be either poorly established or poorly maintained between employees and employers. It is also not granted overnight, nor will it be fixed with a public missive about how much the organization cares about inclusivity. Trust is fostered by consistently making commitments and following through on them. (This goes for both the employee and the organization.)

Questions to answer:

• What organizational priorities or values are established?
• How are those upheld (as in, incentivized or penalized)?

If there is a discrepancy between what is prioritized and what is rewarded, trust in the organization will erode.

For example, let's say there's some organization which states that it "values quality," but most employees are actually focusing on speed to delivery, there is likely an incentive or penalty which is swaying behavior. If an employee achieves high quality (a stated priority), but see that another is penalized or fired for lack of speed to delivery (not a stated priority), this will further reinforce the expectation that speed is the true priority, despite stated objectives. This mismatch in commitment and outcome can diminish employee confidence rather quickly.

Maybe "quality" is a poorly worded priority then. If I were to guess the true priority in this hypothetical case, "speed to delivery without jeopardizing quality" is far more specific and accurate. Finding and addressing these discrepancies is critical to ameliorating organizational trust issues.

Trust is also a direct contributor to whether people feel comfort expressing dissenting assessments or opinions (in other words, comfort in asking for an accommodation or stating when a timeline is unrealistic). This is critical for neurodivergent people because people with cognitive disabilities are highly cognizant about the perception of laziness or "slowness." Requests for extended deadlines in school were rarely rewarded with friendly or accommodating responses, and score penalties were often awarded to late submissions. So, if there is a proposed project timeline, many neurodivergent people are highly unlikely to challenge it in an effort to be a good team player, unless they have reasonable suspicion many other people will also struggle achieving that deadline.

Obviously, deadline extensions are not always possible, but earlier start times and deadlines are. Or, if earlier start times are not possible, consider what is the minimum viable output? What is really possible and needed vs. what would be nice to have? Discuss deadlines early, before resources are allocated, in order to better manage project scope and scale.

Systematizing Support

Many organizations do not have a formalized strategy or system in place to handle neurodiversity, and to be frank, achieving inclusivity and accessibility takes a lot more work than simply having a Diversity, Equity, Inclusion, and Accessibility (DEI&A) officer as part of your staff, or asking a "token" disabled person on your team to train your organization. If inclusivity was that easy, we all would've done it already! Even having fully-staffed offices for HR and DEI&A doesn't guarantee you'll have an inclusive workplace (though it'll certainly help).

Questions to answer:

• What systematized supports do you have in place (3P's: policies/protocols, programs/perks, processes)?
• Who is responsible for this "workplace design?"

Who doesn't love good alliteration? Some of these 3 (or 5?) P's can be found in other management frameworks and disciplines but let's discuss them in order of level of influence you may have as a mid-level manager vs. something more transformative (...and potentially expensive).

Policies & Protocols

Again, to align on some definitions... policies are long-standing, universally applicable standards or rules which serve to inform when certain protocols are used. Protocols are contextually-dependent standard processes which are often triggered by some event. I define these specifically, because many organizations will have a loose policy regarding accommodating disabilities, but very few have meaningful, tactical protocols. This partially has to do with the highly individualized nature of each disability, which can make protocol planning difficult. However, these protocols are still necessary because they serve to provide guardrails and avoid inconsistently applied policies.

I list these first, because these are the quickest and "easiest" things to discuss and prepare. Obviously it's not "easy" but it is certainly going to require less organizational overhaul than finding a new insurance company or benefits provider for the whole organization, or changing the whole business model.

Consider: What policies do we have in place around accessibility? Do these policies account for cognitive disabilities as well as physical ones? What training do we give to managers to ensure they have the knowledge and resources to create an accommodation plan? What does an accommodation plan look like? Is there a format or template to make sure we're hitting all the necessary talking points? What specific benchmarks can we use to make sure the accommodation plan is working?

Programs & Perks

These are listed second, because they often require the orchestration of both management, HR, and third-party benefits providers, which is a lot harder to do than create some documentation on how to address accommodation plans. However, there are certain specific employee benefits which could drastically help neurodivergent people. You may already have some or all these as part of your benefits packages (and if so, great!) but if not, these could be a great step to help both neurodivergent and neurotypical employees.

• Health insurance which covers behavioral health, including inpatient and outpatient care and medication. Behavioral health is considered one of the 10 essential health benefits in the US (meaning, all plans in the insurance marketplace must cover each of these). However, there are often exclusions or reasons insurance may deny someone treatment, including when medication is not deemed "medically necessary," or if hospitalization falls under certain "specialty psychiatric" criteria. Outside the US, there are a number of ADHD medications which are not approved or banned, and thus those afflicted need to turn to other medication used "off-label" for ADHD (such as antidepressants or anti-anxiety medication) - which could muddy the waters when considering what is deemed "medically necessary."
• Health Savings Accounts (HSA) to help pay for healthcare expenses (like medication, vitamins/supplements, and other cognitive aids). As I've mentioned in a previous article, ADHD comes with a "tax" - often in the form of additional expenses like medication, vitamins, or other aids. HSA accounts can help offset the cost (and sales tax burden) on these expenses.
• Employee Assistance Program (EAP). These programs are employer-sponsored, work-based intervention programs which employees resolve personal problems that may be adversely affecting their performance at work, such as marital, financial or emotional problems; family issues; or substance or alcohol misuse. My husband and I often lament that ADHD affects more than the afflicted, it affects the whole family, since forgetfulness, executive dysfunction, emotional dysregulation, and many other unfortunate symptoms often impact others. In lieu of medically necessary psychiatric help or even in lieu of cognitive-behavioral therapy* (CBT), EAPs can give employees personal and marital counseling, life coaching, and financial advising. So, whether or not the company's health insurance plan offers psychiatric services or medically necessary therapy, EAPs can more holistcally support the beneficiary and the family members in their ability to navigate personal challenges (even legal ones, at times). *Note - Not all "talk therapy" is cognitive behavioral therapy. CBT addresses specific behavioral problems and uses behavioral strategies in addition to adjustments in mental narratives.
• Stipends for wellness (such as sponsoring fitness expenses up to a certain amount, or reimbursement for wellness specific investments like the ones I mentioned in my previous article). While this is a physical health strategy, it's a behavioral health one as well, since these two are inextricably linked. Regular exercise and physical activity can help neurodivergent employees better manage their stress levels and, for those with ADHD, diffuse the restless energy that often comes with the condition. It also can indirectly help build social relationships outside of work which can help combat isolation.

Processes

Sad fact: most workplaces are designed for the "average" workers when they need to be designed for the extremes. Those in the UX field might be familiar with the expression "design for the extremes." This relates to the philosophy of focusing design efforts on people at the "fringe" or "edges" of your population. This great article by UX Collective details how this principle works, but essentially, designing for averages often creates a less than ideal solution which only serves a few people who happen to be average (if any). So, by serving those with the greatest dependence on support and greatest independence from support, you will increase the probability that you'll serve the needs of everyone that falls in between.

I mentioned policies and protocols earlier, which can certainly identify moments of high dependence or independence of support, but those relate to specific, contextual moments, and often do not permeate the very business model or workflow we have established. Processes, however, do that, which is why I list this last, as the most difficult (in time and sometimes in money) but also the most impactful and transformative.

Consider: What flexibility can we consider to be the "default"? I take great pride in where I work, Nielsen Norman Group, because of the flexibility baked into our business model. NN/g has been a 100% remote company since I started working here, and I can work whatever hours I see fit. However, I don't just "goof off," I do have some structure, such as meetings within reasonable business hours (which we only schedule when absolutely necessary), facilitating research during reasonable hours for my participants, write my articles, record podcast episodes, and teach the courses I'm assigned at the hours in which they're scheduled. But, I do have a lot of autonomy to get my work done when and how I work best.

I realize not every organization or role can be structured in this way. So, another question to consider: what is the "minimum viable structure" required to deliver the quality necessary? And what is a truly necessary job requirement? What is "nice to have"? Of course, we want to do our best to maximize productivity and achieve All The Things?. But, if we know for a fact productivity and attention is finite, then we have to make sure we're prioritizing it effectively (and, as stated earlier, rewarding the behavior we really wish to see without negatively impacting the emotional wellbeing of our employees).

Evaluate: where do employees as a whole (neurotypical and neurodivergent) need the most support? Where is the least support needed? Identifying painful experiences for your most vulnerable employees will often shed a light on experiences that are painful or annoying to everyone else as well. See if you can diagram some of the key business processes your organization conducts... perhaps a service blueprint to identify areas of pain so that you can better address the needs of every employee in the organization while you're at it.

(This might be an unsurprising suggestion from someone who cares deeply about service design and mapping out processes to make them better for everyone involved!)

Finally, just to clarify: I am not an expert on starting or improving DE&I initiatives (and definitely do not claim to be). I know many people who are much better suited to talking about this than I am. That said, if you need somewhere to start, the Society for Human Resources Management (SHRM) is an excellent resource, and this article goes in great detail about ideas to create or improve a DE&I initiative at your organization.

Ultimately, it is on business owners, executives, and managers to sponsor systemic changes which will systematize inclusivity and accessibility. If you're reading this last sentence, and you're one of them, then that certainly bodes well for us all, and I have good reason to be optimistic about the future!

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Thanks for reading this installment of my Neurodiversity Celebration Month article series! I'm publishing an article for every week of April. So far I've written this article plus two others:

• #1 - I am a woman in tech with ADHD?(Apr 1, 2022 - 10 min read) - Cognitive and neurological conditions often lack external physiological symptoms or forms, and thus, can go unnoticed, undiagnosed, and untreated for years at a time. Some of your colleagues may be living with one of these invisible disabilities, and there are things you can do to help support them. I share the story closest to home: mine.
• #2 - The Key to Succeeding with Neurodivergence: Embracing It?(Apr 10, 2022 - 12 min read)?- This installment covers language, mindsets, and specific strategies that may help neurodivergent people bring their best selves to the workplace (and, as it turns out, will probably help other people too)
• #4 - The Neurodivergent Prospect: Tackling the Hiring Process (Apr 30, 2022 - 13 min read) - In this article, I cover some observations and advice on personal branding and professional networking. It's just a representation of my own personal experiences, but I hope it sparks more discussion on how to make the hiring process better for all, ND and otherwise.

It means a lot to have the support I've been given over the last month, and I am sincerely grateful for your attention (especially if you have ADHD, that attention is precious). I would love to pay forward the kindness I've received, so if you or someone you know is a neurodivergent person in the UX/tech space, please don't hesitate to connect with me. I would love to keep the conversation and momentum going.