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Asperger's Syndrome at work: what EA professionals need to know.

"April is National Autism Awareness Month, yet few understand the challenges that adults face in the workplace."

Certain employees are enigmas to their colleagues and supervisors. Consider "Allan" a brilliant programmer who forgets to make eye contact and to smile. He irritates coworkers with painfully blunt, but usually accurate, assessments of their ideas, "That's dumb and won't work!" Doreen has lost more than a dozen technical writing jobs for asking too many questions and being "rude." Notoriously, she tried to empathize with a colleague by observing, "I can tell that your diet isn't working because you're still fat." Mark's supervisor laments, "He can be an incredibly creative, out-of-the-box thinker, but he gets so caught up in the details that he loses sight of what we're trying to accomplish. How do I get him to stay on track?"

What all of these employees have in common is Asperger's Syndrome (AS), a mild form of autism. Although awareness of Asperger's Syndrome has grown dramatically, little attention is given to the challenges that adults face in the workplace--particularly those earning high salaries in white-collar jobs. Many of them do not disclose their AS to their employers, while others entered the workforce before this disorder was recognized by the medical community. Many of these individuals aren't even aware that they have autism.

Asperger's Syndrome is estimated to affect 1 in every 250 people in the U.S. As a result, chances are that EA professionals are likely to come into contact with employees with this disorder. For instance, they may receive a call from a supervisor about an employee who is smart but doesn't "fit in." The employee in question usually has no idea that something is wrong. Interventions that do not match the unique way that these individuals process information will not work. In many cases, there are low-cost and even free accommodations that will enable an employee to meet performance requirements.

What is Asperger's Syndrome?

An Austrian physician named Hans Asperger, who wrote about a group of unusual children that had difficulty making friends, first described Asperger's Syndrome in 1944. Their pedantic speech was accented by odd vocal tones and rhythms. Their interest in a topic, no matter how arcane, often became an all-consuming passion. Writing in his native German, Asperger's work remained largely unknown in the English-speaking world until the 1980s, when British researcher Dr. Uta Frith translated it.

It wasn't until 1994 that Asperger's Syndrome was included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). It is classified as one of five Pervasive Developmental Disorders that include autism. The diagnostic criteria for Asperger's Syndrome (299.80) includes "qualitative impairment of social interaction" (e.g. nonverbal communication, development of reciprocal social relationships), and "restricted repetitive and stereotyped patterns of behavior, interests, and activities" (e.g. inflexible adherence to routines). There is no clinically significant delay in language or cognitive development (DSM-IV-tr 2000). (1) The cause is unknown.

Individuals with Asperger's Syndrome vary widely in their abilities, challenges, and need of support. Not every person experiences every symptom. For some, holding on to any job is a challenge. Others are able to establish careers, although they usually face significant struggles with communication throughout their working lives.

Individuals with AS in the workforce are typically bright and college educated. Although represented in all types of careers, the areas of high technology, technical writing, scientific and academic research, library science, and engineering make good use of their logic and analytical skills, excellent memory for facts, attention to detail, vast knowledge in specialized fields, and tolerance of routine.

Persons with Asperger's Syndrome process information differently than individuals who do not have autism. Problems with social skills and communication can cause them to behave in ways that seem willfully rude or insubordinate. They may offend others with candid remarks, which they consider to be honest and factual. The literal interpretation of language can lead to serious, sometimes comical, misunderstandings: "How come you're not using the new scheduling software?" asks Tim's manager, "I told you to take a look at it two weeks ago." "I did look at it," replies Tim, "and didn't think it was useful, so I deleted it off my system."

A reduced Theory of Mind that is characteristic of people with Asperger's Syndrome further complicates communication. Theory of Mind is the concept that other people have thoughts, desires, knowledge and motives that differ from one's own. This theory acknowledges that not only are our bodies separate physical entities--but our minds (e.g. our thoughts, feelings, and emotions) are separate from others as well.

An individual with a strong Theory of Mind can predict how someone will likely react to a situation, and how he or she should respond. For most people, this understanding develops intuitively in childhood. However, persons with AS often assume that others around them are thinking and feeling the same things that they are. The weaker a person's Theory of Mind, the more random and confusing interpersonal interactions become.

Moreover, non-verbal communication, such as body language, facial expression, and tone and volume of voice, may not be recognized or interpreted correctly by individuals with Asperger's. As a result, they may not be aware that other people are upset with them, or understand an implied request from a supervisor. Jokes and sarcasm elude them. The individual may have no awareness of a non-verbal message that he or she is sending by not making eye contact, standing too close to others or speaking in a monotone.

In addition, deficits in executive functioning, which govern the ability to plan and organize, can impact productivity. An employee with Asperger's may have trouble prioritizing, multi-tasking or working quickly enough to meet productivity requirements. He or she may not see how tasks fit into the larger whole unless they are explicitly explained. A tendency toward black-and-white-thinking makes it hard for those with AS to perceive options. Other workers, who see the AS individual's talent and intellect, brush aside appeals for help with comments like, "You should know what to do; it's obvious!" or, "At your level you should know what the priorities are." Chances are they don't know!

Severe photo, olfactory, auditory, and tactile sensitivities may also interfere with job performance. An employee with AS may see the cycling of fluorescent lights, or hear the sound of a co-worker's typing as harsh, utterly distracting noise. The smell of tobacco smoke on a colleague's clothing made one of my clients so ill that she had to quit her job. Others have reported that they are unable to look someone in the eye and listen to what they are saying at the same time.

Employees with AS often experience heightened levels of anxiety. This can lead to magnification of workplace situations. This individual may become panicked over making a minor mistake, or over an insignificant conflict with a co-worker. My clients frequently report the need for continual hyper-vigilance to avoid saying or doing the wrong thing, which leaves them exhausted by the end of the day.

Asperger's Syndrome and the ADA

The Americans with Disabilities Act (ADA) says that employers must provide equal opportunities to qualified individuals with disabilities. A qualified individual is someone who meets the employer's requirements for education, skills, experience, and job performance. The ADA does not contain a list of specific disabilities. Instead, "disability" is defined as a physical or mental impairment "that substantially limits one or more major life activities" which can include "walking, seeing, speaking, breathing, learning, performing manual tasks, caring for oneself and working [etc.]." (2) Depending on the nature of the impairments, a person with Asperger's Syndrome may--or may not--be considered disabled under the ADA.

The Americans with Disabilities Amendments Act of 2008 (ADAAA) lowered the threshold of "substantial limits," and stated that mitigating measures (e.g. medications to control symptoms) can no longer be used to determine if a person has a substantially limiting impairment. This increases the number of people who qualify as disabled. The Amendments Act shifts the focus from whether an employee is disabled to whether the employer meets its obligation to reasonably accommodate a disabled individual. And under the ADA, employers are protected from having to make accommodations that would pose an undue hardship on the organization.

Workplace Accommodations

As a result of the ADAAA, employers are more willing to work with employees to make accommodations that enable them to perform the essential job functions. Discussions between employers and employees about accommodations need not be adversarial. On the contrary, I have had a number of cases where relatively simple adjustments have resulted in the retention of skilled and loyal workers. The following are a few of them:

* To accommodate a receptionist with Asperger's Syndrome, her employer agreed to turn off the lobby television during her shift, eliminating a distraction that led to errors.

* A sales manager's auditory processing problems made it impossible to follow the rapid conversations in meetings. She was given an agenda in advance; along with the questions she would be expected to answer.

* Common accommodations for AS employees include: access to meeting notes taken by a colleague; weekly meetings with a supervisor to clarify expectations and identify priorities; written instructions for tasks; permission to wear noise-canceling headphones; and/or relocation to a quieter workspace.

Disclose--or Not Disclose?

The decision to disclose a disability is solely that of the employee. Whether it is the fight option depends on the individual, the job, and his/her performance. Disclosing is not without risks, and it can be difficult, time consuming, and expensive to prove discrimination.

Employers are within their rights to request proof of diagnosis from a qualified medical professional, along with specific information about how the disability impacts job performance and what accommodations will be needed. Adults who have not had formal evaluations may need referrals to neuropsychologists experienced with autism spectrum disorders. They may also need assistance clarifying the specific accommodations that are needed, and explaining challenges to their supervisors.

Unfortunately, there are times when an individual is unable to meet performance requirements. If the clinician is able to mediate with a supervisor, the feedback can help the person with AS understand what went wrong on the job:

* Communication skills may need to be improved;

* The individual may need to better manage anxiety, learn how to ask for help; and/or

* Be taught systems for managing time and tasks.

The individual may be in a job that emphasizes areas of weakness, and not areas of strength. I had a client who was able to switch from a management role to one that utilized his outstanding technical ability.

Summary

Understanding Asperger's Syndrome enables an EA professional to bridge the gap between individuals with AS and others in the workplace. "One reason I was successful as a Peace Corps volunteer," explains a 47-year-old IT specialist with AS, "is because they train everyone on how to act in the foreign culture. If I could have lessons on how to act in the U.S., it wouldn't be so bad for me here."

Resources

Job Accommodation Network (JAN) offers free information for individuals and employers on workplace accommodations and disability employment issues: www.askjan.org.

Online Asperger Syndrome Information and Support (OASIS) provides resources for individuals and medical professionals: www. aspergersyndrome.org.

U.S. Equal Employment Opportunity Commission (EEOC) investigates charges of discrimination against employers: www.eeoc.gov.

Yale School of Medicine Child Study Center lists clinics, support groups and professionals nationwide (including adult resources): http://medicine.yale.edu/childstudy/autism/resource/index.aspx.

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision). Washington, DC.

Attwood, Tony (2007). The Complete Guide to Asperger's Syndrome, London, Jessica Kingsley Publishers.

Gaus, Valerie L. (2007). Cognitive-Behavioral Therapy for Adult Asperger Syndrome, New York, The Guilford Press.

Job Accommodation Network, the U.S. Department of Labor's Office of Disability Employment Policy, www.askjan.org.

Meltzer, Lynn, Editor (2007). Executive Function in Education, from Theory to Practice, New York, The Guilford Press.

(1) Among the proposed changes to the DSM-5 (to be published in 2013) is elimination of the Asperger's Syndrome diagnosis and incorporation into the category of Autism Spectrum Disorder.

(2) Job Accommodation Network, www.askjan.org.

Barbara Bissonnette is the Principal of Forward Motion Coaching. She specializes in career development coaching and workplace advocacy for adults with Asperger's Syndrome, and consults with professionals and employers. She is the author of the Asperger's Syndrome Workplace Survival Guide, available at www.forwardmotion.info.
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Author:Bissonnette, Barbara
Publication:The Journal of Employee Assistance
Geographic Code:1USA
Date:May 1, 2011
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