Neurodiversity at work: bridging research, practice and policy

This is an independent, evidence-based research paper written by Almuth McDowall, Julia Gawronska, Kevin Teoh and Alexandra Beauregard at Birkbeck, University of London.

The views in this research paper are the authors' own and do not necessarily reflect those of Acas or the Acas Council. Any errors or inaccuracies are the responsibility of the authors alone.

This paper is not intended as guidance from Acas.

If you need this document in a different format, email digital@acas.org.uk

The researchers are grateful to all practitioners who generously volunteered their time to take part in the research and provided case study materials. They also thank 3 sensitivity readers from the Advisory Board for the Centre for Neurodiversity Research at Work (C4NRAW) who generously volunteered their time to review this work from an academic but also lived experience perspective.

This report provides insight into neurodiversity at work from a UK perspective, focusing on what good policy and practice look like for organisations and nationally. Neurodiversity is a broad concept and describes how all humans differ in their thinking and behaviour from each other (Walker, 2021). It encompasses a range of neurodevelopmental conditions, including autism, dyslexia, and Tourette's syndrome. Individuals who identify with or are diagnosed with any of these conditions are considered neurodivergent.

Neurodevelopmental conditions are lifelong and may require environmental adaptations and appropriate healthcare for individuals to thrive both in life and at work. These conditions, when their effects meet the definition of disability, are protected under the UK Equality Act (2010), obligating employers to make reasonable adjustments for employees who disclose prolonged impairments to day-to-day functioning.

How early in life and how accurately people are diagnosed depends on many factors including their gender identity, their race, and their socioeconomic background. Employers thus need to take a holistic perspective to neuroinclusion, which is defined as the conscious and active inclusion of all types of information processing, learning and communication styles at work.

This report emphasises a strengths-based perspective on neurodiversity, which refers to recognising and valuing the unique abilities that neurodivergent individuals bring to the workplace.

The report addresses the following questions:

1. What are the broad trends in academic and practice literature and guidance regarding neurodiversity at work including likely prevalence of conditions? Where does evidence converge and diverge?

Research estimates the prevalence of neurodivergent conditions in adults in the UK at about 15% to 20% when all conditions are considered together. This figure is likely to increase in future because of growing awareness of neurodiversity in the UK.

Academic and practice evidence converge on the need for manager training, personalised workplace adjustments, and the importance of psychological safety in fostering neuroinclusive workplaces. Both highlight that managers are pivotal in supporting neurodivergent employees but often lack the necessary training and confidence to do so effectively. They also agree that neurodiversity intersects with other forms of disadvantage, requiring culturally competent strategies rather than a one-size-fits-all approach. Practical reports and academic studies similarly stress the benefits of clear communication, tailored accommodations, and universal design principles to support both neurodivergent and neurotypical employees.

However, evidence diverges on the strength of empirical support for different types of workplace adjustments. While practice-based reports advocate for flexible schedules and sensory-friendly environments, academic research finds mixed evidence on their effectiveness. This is particularly due to a lack of rigorous studies and a narrow focus on autistic employees. Additionally, larger organisations tend to have structured neuroinclusion policies, whereas smaller businesses often struggle due to resource constraints.

Another key divergence is in the perception of neuroinclusion policies by different groups. While employers and neurotypical employees may view these policies as effective, research shows that neurodivergent employees often find them deficient, indicating a gap between policy intent and lived experience.

2. How can organisations create neurodiverse inclusive workplaces?

Embedding neuroinclusion proactively – rather than reactively – is key to sustainable workplace change. Employers should integrate universal design principles (flexibility, equitability, and simplicity) across the employee lifecycle, alongside visible leadership advocacy to drive progress. Good practices for neuroinclusion include:

• flexible, easily accessible adjustments (for example adaptive technology, flexible working) without requiring a formal diagnosis
• trust-based approaches that recognise lived experience rather than relying solely on medical diagnoses
• recognising that the intersection of neurodivergence with other identities (such as gender or caregiving) can pose additional challenges for workers
• regular awareness campaigns and neurodiversity training for leaders
• supporting staff networks with leadership sponsorship
• incorporating inclusion metrics into manager performance reviews
• universal accommodations, such as sensory-friendly workspaces
• specialist career pathways for workers with specific talents

3. How can line managers best be supported to triage and refer any issues, to have honest and authentic conversations, and to assist with the implementation of any reasonable adjustments?

Line managers play a crucial role in neuroinclusion, serving as the first point of contact for identifying and implementing reasonable adjustments. Their support impacts workplace inclusion and worker perceptions of psychological safety. Managing performance in neurodiverse teams is complex, requiring tailored communication strategies and structured policies to address diverse needs effectively. Employers should therefore formally recognise this as part of managers' job responsibilities and workload. Key recommendations for supporting line managers are:

• formalise their role in neuroinclusion within job descriptions and performance reviews
• provide dedicated time for managing neurodiversity and sharing responsibilities with HR and specialists
• ensure ongoing training for line managers on effective communication, managing emotional demands, and implementing reasonable adjustments
• centralise resources (for example guidance on adjustments) to ease the burden on line managers
• encourage leadership advocacy, where senior leaders share their neurodivergent experiences to foster an open culture

4. How can line managers' (and other relevant stakeholders' such as equality and diversity practitioners) organisational knowledge about neurodiversity and positive attitudes to neurodivergent workers (whether disclosed, diagnosed or not) best be supported?

Mandatory and regularly refreshed neurodiversity training is essential for fostering an inclusive workplace. Training should cover more than just specific conditions and include communication, conflict resolution, team dynamics, and reasonable adjustments. Smaller organisations may struggle with training quality due to limited access to in-house specialists, so best practices include:

• co-creating training with neurodivergent individuals while ensuring an evidence-based approach
• providing broad, inclusive training that is not condition-specific and considers intersecting identities
• covering key topics, including adjustments as tools for productivity, pre-approved adjustment catalogues, and positive communication
• using a structured evaluation framework
• applying best practices from other successful training initiatives

5. What does 'good' look like for proactive reasonable adjustment processes?

A proactive approach to reasonable adjustments should not require a diagnosis or formal disclosure, with 75% of expert stakeholders consulted for this report stating neither is necessary. Instead, adjustments should focus on how employees work best and be discussed early in the recruitment and onboarding process. Key elements of an effective adjustment process include:

• quick wins – fast access to software and low-cost equipment without lengthy approvals
• standardised systems – 'access' or 'health' passports to ensure continuity of support across roles
• universal accommodations – low-cost and cost-neutral options such as flexible work hours, inclusive meeting formats, and streamlined communication
• performance-focused approach – rebrand adjustments as productivity tools rather than remedial support to counteract stigma
• consistent processes – avoid reliance on line managers alone to create or drive processes, as this leads to inconsistency across the organisation, instead, centralise budgets and approvals with clear guidance
• psychological safety – employees must feel safe discussing needs without fear, and managers need training to lead sensitive conversations

More specialised adjustments may require HR and workplace assessments to balance individual and organisational needs. Small businesses with greater resource limitations can make use of external support programs like Access to Work to help implement adjustments.

The research took a 3-step approach combining a rapid review of prevalence trends and research, surveys and interviews with expert stakeholders and guidance for best practices, and in-depth case studies from organisations with a strong interest in neuroinclusion.

The report concludes with recommendations for national policy around:

• supporting neurodivergent people through government initiatives such as the Connect to Work framework described in chapter 1 
• realising the benefits to neurodivergent people from the wider 'Making Work Pay' agenda
• considering all forms of neurodivergence in an inclusive group instead of in a condition-specific way, such as just autism or just dyslexia
• collecting good quality data on neurodiversity and employment
• promoting the principles of the Equality Act 2010

The report also makes recommendations around best practices, emphasising the importance of training managers, creating neuroinclusive environments, and implementing personalised and barrier-free adjustments to support neurodivergent employees. The role of line managers is crucial so that they can triage and refer, have supportive and clear conversations, and know where to turn to for advice for more complex cases. The report recommends that neuroinclusion be embedded into existing human resources policies, such as those regarding equality, diversity and wellbeing, and that centralised and transparent practices and guidance be provided to reduce the burden on line managers.

Neurodiversity prevalence rates are already high (15 to 20%) and likely to increase as awareness and support grows. Employers need to be aware that at least a fifth of the working age population will identify as neurodivergent, that co-occurrence (more than 1 condition) is common, and that employees may not have had fair access to diagnosis and support early in life.

Neurodiversity has received increased attention as a key focus for equality, diversity and inclusion (EDI) activities at work (Silver, Nittrouer and Hebl, 2023). Neurodiversity describes the breadth of human neurocognitive functioning – that people think, feel and act in different ways.

Differences in human functioning include neurodevelopmental conditions such as autism, dyslexia or Tourette's syndrome. Most relevant conditions are lifelong. People may require environmental adaptations and appropriate healthcare to thrive at work and in wider life. The neurodiversity movement brings a strengths-based perspective to the forefront of the conversation, which highlights the unique abilities that neurodivergent individuals bring to the workplace. While neurodivergence may be considered a disability, many neurodivergent employees do not identify as disabled and may not meet that definition under the Equality Act (2010).

Neurodivergent conditions may be a protected characteristic in law under the UK Equality Act (2010) if difficulties are prolonged and have a substantial impact on day-to-day functioning. Employers may be required to make reasonable adjustments, but what these adjustments are and whether they are reasonable is a nuanced area of law. Context is key – for example, small businesses would not be expected to make the same level of investment in adjustments as large businesses, while safety-critical environments would not be required to make the same level of adjustments as office environments.

In parallel, there are growing efforts to actively support and recruit neurodivergent talent, particularly autistic people. Such efforts are supported by charities such as the National Autistic Society. UK-wide professional bodies, such as the Chartered Institute for Personnel and Development (CIPD, 2024) and charities, such as Neurodiversity in Business, are also raising awareness of the need for neuroinclusion. There is no unifying definition of neuroinclusion in law or policy. Broadly, this refers to an approach where everyone is valued for their talents, and where the organisation makes proactive efforts to recognise and support different neurotypes as part of a supportive, inclusive and flexible culture. How organisations can work to be neuroinclusive is discussed in chapter 3, and in all 4 of the case studies.

Yet, employment outcomes for neurodivergent workers remain bleak as labour force participation is far lower than for any other disability. For example, according to self-identification data in the Labour Force Survey, only 1 in 3 autistic people is in gainful employment (ONS, 2022). This report presents the existing evidence on how different stakeholders are addressing neuroinclusion at work in the UK, what good practice is, what gaps in understanding are and the implications for wider policy and organisational practice and strategy. It also expands on existing evidence, adding to the evidence base.

Recent government policy has acknowledged the inequalities that neurodivergent people may face both securing and sustaining employment, as well as targeting inequalities faced by neurodivergent people already in employment.

The government that came to power in the summer of 2024 introduced a wide ranging 'Make Work Pay' agenda. This includes reforms aiming to support people considered to be disabled under the Equality Act 2010 (including neurodivergent people who meet those criteria) into sustainable work to ensure a more inclusive labour market. 'Connect to Work', for example, proposes a supported employment framework for local authorities to support people with disabilities, health conditions, or complex employment barriers into sustained employment. The 'Supported employment quality framework' element of this was initially designed and developed to support neurodivergent people into employment and provides up to 12 months of intensive support for those out of work, and up to 4 months for those at risk of losing their job.

There are also more specific neurodiversity reforms and policy proposals. In January 2025, the government announced the launch of a Neurodiversity panel, an independent panel of academics who specialise in neurodiversity that will advise the government and make recommendations on improving job opportunities for neurodivergent people.

Initiatives begun by the previous government are also continuing, though these generally focus more on single conditions. The ADHD taskforce, launched by NHS England, for example, continues to work to better understand the barriers and challenges of people with ADHD, including around employment. The taskforce recommendations will be published in summer 2025 with the intention of leading to further improvements in support for neurodivergent people facing barriers to employment.

The research aims

This research takes an evidence-based approach to guide relevant Human Resource Management (HRM) and Human Resource Development (HRD) strategies and activities and to document recommendations for neuroinclusive policy and practice.

The language and terminology used in this report are outlined in Appendix A.

The research questions

These research questions guided the approach:

1. What are broad trends in the academic and practice literature and guidance regarding neurodiversity at work, including likely prevalence of conditions? Where does evidence converge and diverge? (chapter 2)
2. How can organisations create neurodiverse inclusive workplaces? (chapter 3)
3. How can line managers best be supported to triage and refer any issues, to have honest and authentic conversations, and to assist with the implementation of any reasonable adjustments? (chapter 4)
4. How can line managers' (and other relevant stakeholders' such as equality and diversity practitioners) organisational knowledge about neurodiversity and positive attitudes to neurodivergent workers (whether disclosed, diagnosed or not) best be supported? (chapter 5)
5. What does 'good' look like for proactive reasonable adjustment processes? (chapter 6)

These questions were answered through a rapid assessment of evidence, surveys, interviews and workshops with stakeholders, and 4 in-depth case studies for neuroinclusion. The full approach and methods are described in Appendix B. The report begins with the broad trends in academic and practice literature, moves through each research question in turn, and concludes with recommendations for national and organisational policy and practice and a short conclusion. Table 1 below gives a brief summary of the main good practice topics covered in each case study.

This chapter addresses the research question: What are broad trends in academic and practice literature and guidance regarding neurodiversity at work, including likely prevalence of conditions? Where does evidence converge and diverge (covered in Appendix D)? Specifically, the chapter looks at the prevalence of neurodivergent conditions, the likelihood of co-occurrence, and employment rates for neurodivergent people.

Prevalence

Academic and practitioner sources agree that the likely prevalence of neurodivergence in adults is about 15 to 20% (for example, Branicki et al, 2024; Doyle and McDowall, 2021; McDowall, Doyle, and Srinivasan, 2024; Michelini et al, 2024; Silver, Nittrouer, and Hebl, 2023) when all conditions are considered together. Considering prevalence both in adult populations and across all neurodivergent conditions is relatively new practice, so it's uncertain if this has been static over time or not. However, there is no suggestion in the academic literature that prevalence will decrease, with the caveat that most research has focused on children and young adults for distinct conditions at a time (rather than co-occurrence of conditions). Both the levels of diagnosis and the numbers of people seeking diagnosis are increasing, likely linked to the strong genetic component for all neurodevelopmental conditions (Agnes-Blais et al, 2022; Roman-Urrestarazu et al, 2021; O'Rourke et al, 2009; Warrier et al, 2022).

Population prevalence varies considerably between conditions and also varies between geographical locations. For example, the UK prevalence estimation is about 1% for autism (NICE, 2020) and 10% for dyslexia (NHS, 2022) although globally autism prevalence rates vary greatly (Zeidan et al, 2022). There are large gender differences in prevalence. Autism, attention deficit disorder and Tourette's syndrome conditions are far more prevalent among boys and men, with estimates ranging from 2 to 4 times more common (Adak et al, 2017; Faheem et al, 2022; Levine et al, 2019).

There is a far higher prevalence of neurodiversity in some industry sectors, for example construction, where 1 in 4 identifies as neurodivergent compared to about 1 in 5 in most industries (Neurodiversity in Construction, 2023). This could be due to the task-oriented, hands-on environment, which suits strengths often found in some neurodivergent individuals, like spatial awareness or attention to detail. A complementary explanation is that some neurodivergent conditions, such as autism or Tourette's syndrome, are more likely to be diagnosed in men, who are also disproportionately likely to be represented in the construction sector. Case study 2 looks at how an engineering and construction firm supports neurodivergent workers.

Co-occurring neurodivergent conditions

For all neurodivergent conditions, there is a high likelihood of co-occurrence, namely that people at work report more than one neurodivergent condition and also have a mental health condition or physical health condition (see Brown and Fisher, 2023; Doyle, 2020 for an overview). Recent practice research on neurodiversity at work documents that two-thirds of UK neurodivergent workers identify with more than one neurodivergent condition or mental health condition (McDowall, Doyle and Kiseleva, 2023). Employers, managers and policy makers need to understand this overlap because neurodivergent people, on average, have additional vulnerabilities that have not been recognised. This should be addressed through job design, such as ensuring that job duties harness the strengths of neurodivergent people while also being aware of the need to manage workload and expectations. One study highlighted that active support for physical and mental health through good job design is important to address pressure and workload for dyslexic workers, in part due to the common overlap between neurodivergent conditions and mental health conditions (De Beer et al, 2022). Supporting workers' individual needs is discussed in chapter 3.

Transdiagnostic approaches that examine underlying mechanisms and common traits across multiple diagnostic categories are a significant trend in research into neurodevelopmental conditions (Apperly et al, 2024; Astle et al, 2022; Michelini et al, 2024). This line of research shows that there are not only shared genetic origins among conditions but also overlapping challenges and strengths – for example, regarding memory or how people regulate emotions. This means that focusing on supporting functions and maximising strengths through a tailored approach is likely to be more helpful to supporting neurodivergent workers than diagnostic labels.

The biopsychosocial model of health (for example, De Beer et al, 2022; Doyle, 2020) is a useful perspective for neurodiversity and neuroinclusion. This acknowledges that different neurotypes have varied and complementary strengths and that the aim of any accommodations is to support these and address any challenges. The goal is to harness diversity to benefit not only organisations, but also wider society.

Employment rates

Much academic research remains condition-specific, and somewhat autism-focused. This literature also tends to concern itself with distinct topics such as selection practices or job design practices rather than evidence for holistic neuroinclusion approaches. For example, job coaching and modified performance reviews have been recommended for autistic employees (Ezerins et al, 2023). A recent study considered whether people are likely to refer an autistic colleague for a job if they disclose their condition - this is far more likely for autistic men than for women (Lup and Canonico, 2024). Such findings document the influence of intersectional experience, as autistic women are more disadvantaged.

A large study based on UK Labour Force Survey data found that neurodivergent people are more likely than neurotypical individuals to be out of work and in precarious employment, and that neurodivergent women earn less and have shorter job tenures than neurodivergent men (Branicki et al, 2024). However, the Labour Force Survey collects data only on autism and specific or severe learning difficulties. This limits the generalisability of its findings, as many neurodivergent conditions are not relevant to either category. Still, these data show us that legal protection for neurodivergent workers, which is more advanced in the UK than in many other countries, is not sufficient because unequal employment outcomes prevail. To reduce inequality, human resource organisations need to invest in proactively developing a range of integrated practices to support a range of neurodivergence. Chapter 4 discusses reasonable adjustments for neurodivergent workers, as do case studies 1, 3 and 4.

Key messages from chapter 2: broad trends in academic and practitioner literature

The key messages from academic and practitioner literature are:

• around 15 to 20% of adults are neurodivergent, with prevalence varying by condition, gender, and industry
• co-occurrence of neurodivergent and mental health conditions is common, requiring holistic workplace support
• research favours transdiagnostic approaches that focus on shared traits rather than diagnostic labels, aligning with the biopsychosocial model to maximise strengths
• despite legal protections, neurodivergent individuals – especially women – face higher unemployment and precarious work
• existing literature is often condition-specific and autism-focused, highlighting the need for integrated, inclusive employment practices

Drawing on findings from the literature review, surveys, focus groups with stakeholders and case studies, this chapter outlines the key components of a neuroinclusive workplace. These include:

• the role of senior leaders in embedding neuroinclusion, particularly in policies and through universal design
• embedding neuroinclusion through the organisation via strategies, policies and practice, driven by senior leaders and universal design
• psychological safety for neurodivergent workers to discuss their needs
• line managers and employers being aware of how other aspects of a person's identity can impact their experiences
• specialist career pathways, including for neurodivergent people
• monitoring and evaluation of progress

Senior leaders as advocates for neuroinclusion

Senior leaders can embed neurodiversity most effectively by being proactive rather than reactive. This includes strategic priorities around policies, processes, practices and signposting. This should cover holistic policies and practices which take account of multiple identities, such as neurodiversity, gender and caregiving responsibilities, rather than one policy on each – policies should allow for flexible tailoring to needs. Case study 4 gives an example of how this can be done.

Many employers, particularly smaller ones who do not have dedicated in-house support, may be new to this topic so working toward neuroinclusion will involve a gradual transition. The application of three overarching universal design principles regarding flexibility, equitability and simplicity (among other aspects) is a good starting point. Universal design is a framework of 7 principles: equitable use, flexibility in use, simple and intuitive use, perceptible information, tolerance for error, low physical effort, and size and space for approach and use. Application of universal design ensures that consideration for and support of neurodivergence and indeed other disabilities is embedded through the employee lifecycle. This needs to be paired with visible leadership advocacy to drive and maintain change and momentum.

Leadership advocacy could include sponsorship for employee resource group activities to enable them to develop practical tools and resources and to contribute to wider inclusion and diversity events. Additionally, performance metrics for managers should include measures of success for inclusion and adjustment success, such as retention statistics and data from employee surveys.

To address organisational culture, it is important that dialogue and language about neurodiversity shift to focus on equity, practicality and harnessing talent, rather than on special treatment. This should be organisation wide, encompassing both policy and practice and how neurodiversity is spoken about more informally. Clear communication and consistent policies counter misconceptions, for example, that adjustments are individual 'favours', and thus improve acceptance for different ways of working effectively. Case study 4 focuses on the value of clear communication and how this can be implemented across an organisation.

How to embed neuroinclusion into strategy, policies and practice

Experts responding to the survey concurred that to embed neuroinclusion into strategy, policies and practices it is vital to do the following:

• regularly raise awareness of neurodiversity in the workforce (64%) – noting that this is important to ensure the topic remains current, but that this alone is not enough (chapters 1 and 3)
• have a barrier-free process for reasonable adjustments (64%) through simple and centralised processes (chapter 4, case study 2)
• train everyone in the organisation and refresh training at regular intervals (46%) – awareness raising without knowledge is insufficient (chapter 4, case study 3)
• check in with line managers regularly (46%) to ensure that they actively support neurodiversity and have someone to talk to (chapter 4)
• sponsor employee resource groups (41%) to support grassroots activity (chapter 3, case study 2)
• consult external experts as necessary (30%) (chapter 6)

As multiple responses to this question were possible the total does not add up to 100% – the percentage agreement is shown in parentheses.

Interviews and workshops with stakeholders and the case studies show that 3 key elements are required for an organisation to move towards being neuroinclusive:

• training for baseline knowledge
• supporting line managers
• dedicated budgets and resources

It is important that neurodiversity initiatives are linked to organisational strategy and a holistic approach as documented in case study 1.

Case study 1: how to support neuroinclusion at all levels of the organisation

About the organisation

This case study is with a modern outsourcer operating across 8 countries with 41,000 colleagues, supporting primarily UK and European clients with people-based services, underpinned by market-leading technology. The organisation is responsible for delivering important government contracts that involve supporting people with a disability, long-term health conditions and neurodiversity, and it intentionally recruits people who bring a lived experience lens to deliver these services.

A key challenge for the organisation: supporting neurodivergent employees across a large organisation

Neuroinclusion is a key part of the diversity, equality and inclusion action plan. The organisation's commitment to neuroinclusion is driven by its wish to support existing employees to thrive at work and recognition that a significant proportion of prospective job applicants will potentially be neurodivergent.

The solutions in this case study are ordered broadly in the order of the employee lifecycle, with some additional solutions focused specifically on support for line managers.

Solution: job design based on individual needs

Job design has been addressed proactively considering individual needs and preferences. For example, some workers prefer great routine and simplicity and thus have streamlined job duties (rather than multi-tasking routinely). This allows people to work to their strengths.

Solution: simplified recruitment processes

The organisation has partnered with local education providers to support disadvantaged communities into work, many of whose members are neurodivergent and have mental health needs. The organisation has made recruitment processes simpler so they are neuroinclusive.

Solution: immediate reasonable adjustments

Crucially, adjustments are offered proactively in response to workers identifying a need, without waiting for any formal health reports or diagnoses, thus employees do not need to disclose neurodivergence to access support. Assistive technologies including specialist software and noise-cancelling headphones are available to everyone on request.

Solution: learning resources

More widely, the organisation has a dedicated neuroinclusion employee network group (ENG) and accessible resources including dedicated wellbeing pages, team chats, and knowledge banks for employees and managers to learn about and support neurodiversity. There are also dedicated employee-led discussion groups to share experiences, signpost resources and offer support.

Solution: celebrating neurodiversity

To promote a climate of inclusion, events like neurodiversity month celebrations are harnessed to educate the workforce, promote inclusion, and foster a culture of trust and openness. These opportunities help to emphasise how important individual experience is, so that employees feel safe to share stories of success and celebrate neurodivergent strengths while not negating any struggles. Such honest exchanges help to address stigma and prejudice. Senior leaders are an important part of such conversations when they act as role models by sharing their own experience, and they also offer direct sponsorship for grassroots activities.

Solution: survey analysis looking at neurodivergent employees experiences

To understand workforce sentiment and progress, the organisation uses its annual employee survey data through a disability lens to identify priorities, including looking at the data broken out by disability –  but also acknowledges the challenge to draw out neurodiversity implications from broader disability metrics, given concerns about disclosure and potential loss of anonymity. To address this, the organisation is planning to separate neurodiversity data from general disability metrics, ensuring a more accurate and meaningful representation while maintaining employee confidentiality.

Solution: practical training for line managers

To support line managers, in addition to digital training about neuroinclusion, live mock meetings paired with direct feedback are particularly effective for preparing managers for neurodiversity-related conversations. Challenges include scaling such efforts across a global organisation, meaning that line manager training can be ad hoc and self-initiated. Managing these challenges effectively is still a 'work in progress' at the organisation.

Examples of good practice

The organisation recommends to others wanting to improve neuroinclusion: 

• recruitment – personalised onboarding processes with additional human touch points to ease transitions for neurodivergent employees
• training – use of a body-doubling support strategy, where people who struggle with motivation intentionally work together, and accountability workshops to support neurodivergent employees
• role play practice – include live mock meetings for line managers
• mentorship – support programmes (could be upward) for senior managers to improve their understanding of neurodiversity
• wellbeing – ensure that organisational policies to support mental health and wellbeing are neurodiversity sensitive
• the physical environment – even in an organisation where most employees have hybrid or homeworking arrangements, do not underestimate the importance of making physical spaces neuroinclusive, for example, by giving people control over light and noise levels

Ensuring psychological safety for neurodivergent workers

The organisational climate (the meaning and behaviour attached to policies, practices and procedures employees experience) needs to emphasise psychological safety, meaning an environment in which neurodivergent workers can voice concerns without fear of negative consequences, everyone feels acknowledged, risks are managed, and organisational learning is encouraged (McDowall, Doyle and Kiseleva, 2023; McDowall, Doyle and Srinivasan, 2024; Pearn Kandola, 2024). For example, disclosure of an autism diagnosis can improve job referrals, particularly for men, indicating the importance of creating a safe environment for disclosure (Lup and Canonico, 2024).

As part of ensuring psychological safety, organisations need clear neuroinclusion policies, senior level sponsorship and regular root and branch reviews of job design and adjustment provision (CIPD, 2024). A large-scale UK report (with over 1,200 neurodivergent participants) shows that neurodivergent workers see neuroinclusion, disability and wellbeing policies as less effective than neurotypical peers or employer representatives do (McDowall, Doyle and Srinivasan, 2024). Ensuring psychological safety is also discussed in more depth in case study 4.

Large organisations are more likely to have referral and support mechanisms in place, whereas smaller organisations find themselves inadequately resourced. This indicates a need for widely accessible guidance, training, and application of universal design principles in the workplace to all employees, neurodivergent and neurotypical alike (Silver, Nittrouer and Hebl, 2023). Universal design as applied to work means that a set of 7 principles, including equitability and flexibility, are applied across the employee lifecycle from recruitment and onboarding through to performance management and wellbeing (Doyle and McDowall, 2021).

Meeting the individual needs of neurodivergent employees

Academic literature and interviews and workshops with expert stakeholders agree it is important that workplace adjustments take account of nuanced needs. Any conversation between employees and line managers about this should not focus solely on neurodiversity but consider the possibility of other needs and characteristics. It is therefore important that neurodiversity policies and practices are part of broader diversity policies. Streamlined policies and 'one stop shops' are also simpler for smaller organisations and easier for line managers to learn and embed.

Neurodiversity intersects with other forms of disadvantage and marginalisation, with factors such as social disadvantage, race, gender, and socioeconomic status influencing prevalence, diagnosis, and support for neurodivergence (Roman-Urrestarazu et al., 2021; Nair, Farah, and Boveda, 2024). Both the literature and findings from interviews and workshops with expert stakeholders emphasise the need for employers to recognise these intersecting identities to foster true neuroinclusion. This includes ensuring that neurodivergent employees from marginalised backgrounds receive appropriate support and that workplace policies go beyond a one-size-fits-all approach.

Organisational awareness must be raised to promote equitable treatment in recruitment, particularly between neurodivergent men and women, and to address identity-specific needs such as those related to menstruation and menopause. Furthermore, expert stakeholders highlighted that neurodivergent carers, who often support neurodivergent children, face unique challenges. Some organisations have begun to acknowledge this by establishing dedicated employee resource groups or staff networks, underscoring the importance of culturally competent strategies and middle manager training in implementing inclusive policies.

Creating specialist career pathways

Inclusive career management practices are an important element of workplace inclusion to foster talented neurodivergent employees who may not thrive in generalist roles and are discussed in more detail in case study 1. Some organisations have distinct progression routes for specialist roles (for example, technical experts) while others endeavour to identify distinct talent during onboarding and regular work conversations. This can help people job craft – where they shape a job role to suit their needs and talents. Organisations can support specialist pathways through the following (percentages of survey respondents' agreement stated in parentheses):

• local line manager support to encourage organisational consideration of specialist job roles (61%, 29 respondents)
• signposting of opportunities to apply specific talents throughout the employee lifecycle (39%, 17 respondents)
• dedicated specialist progression and promotion pathways (36%, 16 respondents)

Stakeholder views collected in interviews and workshops varied on types of proactive adjustments in recruitment and onboarding such as dedicated mentoring schemes to support neurodivergent talent right from the start. There was no unanimous agreement on this, as other expert stakeholders cautioned that targeted hiring policies rely on applicants declaring their neurodivergence. One mechanism for counteracting stigma and prejudice is educational campaigns which transparently show how aggregated data are used to improve organisational practice and support (case studies 1, 3 and 4 discuss different ways organisations have used data effectively). Other effective mechanisms are personalised support for progression (for example, through coaching and psychological support) and self-directed learning and resources, which need to be well signposted.

Strengths-based approaches, which focus on the skills and strengths the person brings rather than their additional needs, are important to encourage employees to leverage their specialist talents rather than focusing on managing challenges. Case study 1 gives an example of how this can be done, through job design focusing on individual strengths. Yet even senior experts noted how strategic organisational support for specialist talent development can be lacking. There is still a wide assumption that a 'good worker' equals a generalist. Organisations need to promote different routes to personal and organisational success by ensuring that people in specialist roles have equal access to development, progression and promotion opportunities.

Monitoring and evaluating progress on neuroinclusion

Workplace neuroinclusion is a journey rather than a destination and tracking the effectiveness of measures taken is key to making progress. It requires transparency, compliance with relevant laws and sensitivity. Any monitoring should serve to support evaluation of organisational practice and not to record individual diagnoses. There was some debate during the expert stakeholder interviews and workshops on how organisations can best evaluate their progress towards neuroinclusion. Several used kitemarks such as Disability Confident as a resource, but these are not neurodiversity-specific and receive mixed feedback from employees with lived experience. Other organisations monitored data on employee engagement through regular staff surveys or changes in sickness absence and prevalence of accidents in safety-critical contexts. Case studies 1, 3 and 4 discuss some of these different methods. Examples of good practice are to:

• conduct collaborative evaluation between expert staff (internal or external), line managers and employees with lived experience
• use aggregated business data such as referral cases to occupational health to determine trends and areas of priority
• ensure that policies and procedures are reviewed alongside any data as part of the evaluation process, supported by internal or external HR partners

Case study 2: embedding neuroinclusion in a safety-critical context

The role of environmental adaptations is also important. Case study 2 showcases how a designated neurodiversity team in a large UK-based organisation is championing initiatives which encompass environmental considerations, accessible onsite support and outreach to target, and then support, neurodivergent talent. Such grassroots and structural efforts are paired with role modelling from the top through legitimate leadership.

About the organisation

This case study is a large employer from the engineering and technology sector in the South West of England with approximately 7,000 employees. The organisation is a significant provider of employment to the local community and embeds their responsibility for neuroinclusion into a holistic approach toward sustainable working and community engagement. Some parts of their workforce engage in hybrid working but about 4,000 workers are permanently onsite.

A key challenge for the organisation: supporting recruitment and retention of neurodivergent people

An estimated third of the workforce identifies as neurodivergent, with lower-than-average levels of literacy in many functions. The organisation has a strong commitment to supporting neurodivergent people to gain and remain in employment, which can be complicated by the safety-critical element of some of its work.

The rest of this case study looks at steps the organisation takes to first recruit and then retain neurodivergent people throughout the employee life-cycle.

Solution: targeted recruitment

The organisation engages in active outreach programmes with schools and colleges to identify talent and people who would otherwise not be in work or education, including those with special educational needs. These outreach initiatives encourage people to contemplate new and alternative career pathways they might otherwise not have considered. There is high awareness of the likelihood of educational trauma and low self-image among this population, as well as the enduring impact of covid-19 through home schooling and resultant loss in social skills. During pre-employment, internal champions educate teachers as well as pupils, link with other community initiatives and sports clubs, and use a range of profiling tools to identify skills.

Solution: focus on universal design

Across the entire site there is a constant focus on universal design, with clear environmental design and unambiguous signposting. Accessible walk-in services with advisors strive to 'take the service to the customer'. The organisation makes active use of artificial intelligence and technology adjustments – for example, default headers in documents give simple tips to everyone for how to use immersive technology.

Solution: barrier-free reasonable adjustments process

Procedures for reasonable adjustments are barrier-free and embedded through the employment lifecycle. There is a strong focus on good performance and collective responsibility for keeping everyone safe. Employees are empowered through training and regular encouragement to speak up if they struggle, in the first instance to their line manager, so that accidents can be prevented, and line managers step in and act as necessary.

The organisation emphasises that aligning the ethical, social and business case for neuroinclusion is critical. The first step is to actively move away from diagnostic labels and respect informal self-diagnosis or working diagnosis. There is ambition to continuously improve – applying for awards and sharing best practices internally and externally is a large motivator. Upcoming large-scale projects are about using science to label and score sensory distractions.

Solution: dedicated neurodiversity team

The employer has recently set up a dedicated neurodiversity team which arose from successful but unsustainable self-advocacy efforts by individual employees. These staff made a business case to senior leadership about attracting and supporting neurodivergent talent and addressing retention proactively. This emphasised the cost of re-training when employees leave their job, the difference reasonable adjustments make to retention, and the cost of severe accidents and fatalities, which are more likely in a workplace with low reading capabilities. Costs for reasonable adjustments such as digital reading aids were negligible in comparison. The business case was unanimously endorsed, and SMART (specific, measurable, achievable, realistic, time-bound) objectives were set regarding metrics about talent attraction, retention and outreach programmes for neurodivergent people. The team champions and supports neurocognitive differences in close collaboration with other parts of the organisation such as the people analytics team. Dedicated and accessible resource packs are available to everyone about different conditions as well as training and other initiatives. Neurodivergent carers receive particular attention as an intersecting identity and there is an employee resource group to support this.

Solution: actively collect data and evidence

The organisation is committed to creating an evidence base and has, for example, sponsored postgraduate internal research into neurodivergent and neurotypical strengths and challenges at work. The results demonstrate both groups benefit from universal design such as coloured visual aids (for signage and written protocols) and dedicated neurodiversity support onsite. This research is now informing strategy and practice. The research also emphasised the vital role of legitimate leadership, an approach where leaders hold themselves accountable for positive change for neuroinclusion and disclose their own neurodivergent conditions without shame or stigma but also empower others and delegate tasks and responsibilities. Regular communication signposts legitimate leader role models. The organisation brands itself as a future-looking employer committed to healthy work participation.

Examples of good practice

While the organisation recognises that they can put in place many initiatives because of their size and budget, their advice for other organisations wanting to learn from their best practice is:

• culture change is just as important as a big budget for reasonable adjustments – everyone can learn about sensitive and inclusive language
• small supports can have a big impact – for example, being able to recognise signs of sensory overwhelm, and supporting employees to take time out onsite to decompress and then continue to work
• learn from your employees – for example, changing the colour and background of written information can benefit everyone
• conversely, consult your employees before making any changes, even as small as suddenly changing a font colour, particularly where written information is safety-critical (such as a site protocol) – it is better to take a careful approach
• educate the entire work community because not every individual has the resilience to advocate for themselves – inclusion is a joint responsibility
• adjustments must be proportionate to business needs – there is a job to be done, objectives to be met and other workers need to be kept safe

Key messages from chapter 3: creating neuroinclusive workplaces

The key messages on creating neuroinclusive workplaces are:

• becoming a neuroinclusive organisation is a proactive not reactive practice, and likely to be gradual, particularly for small organisations
• training and support to provide baseline knowledge of neurodiversity across the organisation is a key element
• support for line managers is also an important element of a neuroinclusive workplace, as line managers are often the first point of contact for neurodivergent employees
• a dedicated budget and resources around neurodiversity support multiple aspects of neuroinclusion, including awareness raising, training, and reasonable adjustments
• an organisational culture of psychological safety and an awareness of the individual needs of each neurodivergent employee help to both encourage requests for adjustments and ensure the right adjustments are put in place for the individual
• specialist career pathways, including those developed in partnership with existing staff, provide a route to retention and promotion of neurodivergent employees who may not thrive in 'generalist' roles
• monitoring and evaluation of data is a key element of showing that transitions to neuroinclusivity have achieved their stated aims

This chapter addresses the fourth research question: how can line managers best be supported to triage and refer any issues, to have honest and authentic conversations, and to assist with the implementation of any reasonable adjustments?

It focuses on 4 elements and how these can be put into place in organisations:

• recognising the supportive role of line managers as first point of contact for employees, and providing training to support them in putting this into practice
• effective communication across the whole organisation
• reasonable adjustments and accommodations, including referral and support mechanisms
• performance management policies and practices that support line managers and employees 

As well as discussing the literature, and findings from the survey, interviews and workshops with expert stakeholders, this chapter also includes two case studies. Case study 3, about a national retail organisation with very varied roles, looks at how line managers effectively manage and support neurodivergent employees in this complex context. Case study 4, about a community interest company with less than 250 employees, focuses on the clear processes this organisation has in place around performance management, with a focus on communication.

The supportive role of line managers

Organisations should think about a strategic approach and transparent set of principles to support and empower line managers that ensure:

• knowledge – rigorous training and a dedicated point of contact for specialist queries
• awareness – line managers have awareness for any adjustment needs and can then triage and refer as appropriate
• acceptance paired with empowerment where line managers set aside their own biases and assumptions but are also clear about the performance requirements of any job

There was unanimous agreement among the expert stakeholders in surveys, interviews and workshops that line managers play a vital role in neuroinclusion as the first point of contact for talking about, identifying, and implementing reasonable adjustments.

Line managers are a vital source of emotional and practical support. How they facilitate relevant conversations directly impacts the level of inclusion in the workplace climate and how psychologically safe workers feel. Given that line managers have other aspects to their role, supporting staff needs to be recognised as a vital aspect of manager competence and workload. A good starting point is for employers to formalise this in job descriptions and other documentation and then follow up during formal and informal reviews on how these core tasks are being performed. This may include making support of staff a performance criterion for discussion in performance reviews.

Data from the survey of expert stakeholders suggested that there are some differences regarding what experts see as most useful to support line managers versus what is happening in practice as shown in Table 2 below. These data indicate that employers need to support managers with regularly refreshed training on reasonable adjustments. Managers also need support, whether formal through training or informally, to effectively communicate with their teams, and tools and support to manage emotional demands. Good practice is to make sure that all these aspects are addressed in neurodiversity training and ensure that line managers have a designated point of contact to ask for advice if necessary and to debrief any difficult conversations. In smaller organisations, this may mean bringing in specialist advice ad hoc, for example, from an HR partner, and then embedding new knowledge across the organisation.

Survey notes: This survey was conducted with 44 UK-based line managers with responsibility for neurodivergent staff; 2024, by Birkbeck University on behalf of Acas.

The 'other' category includes different types of line manager support on which the expert stakeholders responding to the survey had mixed views. They agreed that co-coaching or mediation can be very useful for complex cases, but that employee resource groups and staff networks are only sometimes a good source of support and knowledge for line managers. One reason for this is that employee resource groups often do not draw consistently on good practice or high quality evidence to inform activities and decisions (McDowall, Doyle and Kiseleva 2023).

Academic and practice evidence stresses the importance of training managers to help them understand neurodiversity and the unique needs of neurodivergent employees (Auticon, 2022; Branicki et al, 2024; Lindsay et al, 2021; McDowall, Doyle and Kiseleva, 2023; Szulc, McGregor and Cakir, 2021; Thompson and Miller, 2024). Managers play a significant role in creating and maintaining neuroinclusive workplaces by recognising and valuing neurological differences and implementing inclusive practices and physical spaces to help all employees thrive. Managers are often the first point of contact for neurodivergent employees (McDowall, Doyle and Kiseleva, 2023). Thus, managers need to feel confident in their roles and to be equipped with centralised, shared resources to support neurodivergent employees. However, many managers do not feel sufficiently trained (Thompson and Miller, 2024) and managers not knowing what to do is a barrier to implementing adjustments (McDowall, Doyle and Kiseleva, 2023). Case study 1 shows an example of how training for line managers is prioritised in a professional services organisation.

Effective communication across the organisation

Employers and managers require specific guidance on how to create neuroinclusive environments. A good starting point is simple, adaptable communication methods (for example, written instructions when directing staff) to ensure accessibility and mutual understanding (City and Guilds, 2024; Made by Dyslexia, 2024; McDowall, Doyle and Srinivasan, 2024). Effective communication needs to be paired with regular feedback to ensure ongoing neurodiversity-sensitive support (Auticon, 2022; Made by Dyslexia, 2024). Case study 4 focuses on neuroinclusive communication in an organisation with a high percentage of neurodivergent workers.

Getting effective communication right and tailoring adjustments requires specific skill sets. It is thus perhaps not surprising to see research showing that some line managers find dealing with neurodivergent employees draining (Richards et al, 2019). Conversations can come with emotional demands, for example, dealing with strong reactions from others. This underlines the need for specific neurodiversity training (Thompson and Miller, 2024) paired with emotional support for managers.

Managers should think beyond simple categorisations of neurodivergent employees and instead be aware of the different ways neurodiversity can present at work (Apperly et al, 2024). For example, it is important for managers to understand the unique challenges dyslexic employees face, emphasising the need for personalised interventions to help them work more efficiently (De Beer et al, 2022). There are also specific challenges for autistic women at work, as menstrual health and hormonal changes can impact their ability to maintain control over psychological and physical symptoms (Sang et al, 2024). This calls for employers and managers to adapt to the individual needs of neurodivergent employees, rather than relying on a one-size-fits-all model (Michelini et al, 2024).

The work with expert stakeholders explicitly focused on how to prevent and proactively address communication and potential conflicts between neurodivergent workers and their colleagues. Line managers play a vital role, as 61% of survey respondents said that they rely on them to have skilled, honest conversations, or even act as mediators (15%). About a third of experts referenced organisational policies (31%), for example, dignity and respect policies which set out expected standards for interpersonal behaviour, as an effective mechanism to address conflict and communication. A third (32%) referenced co-coaching as effective when line manager and employee are coached together.

Other concrete suggestions to support good practice were:

• ensuring that HR professionals are neurodiversity-trained and then fostering close collaboration between line managers and HR to ensure alignment – for example, clarity on when professional or external mediation is needed 
• using existing processes such as regular developmental feedback for and from line managers to ensure neuroinclusive practice 
• using trained volunteers to support employees in challenging situations

Communication and management of performance is always crucial but can be challenging in organisations where there is a high prevalence of neurodivergent people with differing needs and wants. Case study 3 outlined below includes recommendations for good practice around this type of organisation, with added challenges due to very varied roles spread across the UK.

Case study 3: supporting neuroinclusion across a large organisation

About the organisation

This large UK employer operates across retail and other services throughout the UK.

A key challenge for the organisation: building neurodiverse-friendly environments across different levels and functions

The organisation offers different services across the UK, with employees across many different functions and at different levels. This creates challenges in ensuring the policies and practice to support neurodivergent employees are appropriate for all services and all levels and functions.

This case study looks at how the organisation uses universal design principles and embeds support throughout the employee lifecycle to make progress in fostering an inclusive workplace for neurodivergent employees. It begins with organisation level actions, then moves on to those related to individual employees.

Solution: universal design

The organisation has made significant progress fostering an inclusive workplace for neurodivergent employees by embedding universal design principles and providing support throughout the employee lifecycle. In doing so it speaks to the challenges and successes of building neurodiverse-friendly environments across different levels and functions.

Solution: leadership and line manager involvement

Neuroinclusion is driven by a high level of leadership involvement, with key stakeholders at various levels of the organisation providing oversight and accountability rooted in its broader disability frameworks. Doing so prioritises practical, actionable support over symbolic policies paired with clear and consistent messaging across the organisation through dedicated 'inclusion pioneers' and internal communications. Growing grassroots activity through its Disability Network further embeds accountability within the organisation to align priorities across departments while balancing operational demands with individualised support.

Line managers are also integral to fostering neuroinclusion and receive ongoing support to confidently navigate neurodiversity-related conversations and meet employee needs by combining targeted training, peer learning opportunities, coaching, and consultation with occupational health professionals. The Inclusion Passport is intended as a structured framework for managers to engage in meaningful conversations with employees and implement appropriate adjustments, and the organisation is working on ensuring these are standardised and accessible.

Solution: embedding neuroinclusion in the employee lifecycle

Neuroinclusion is embedded across the employee lifecycle. Recruitment processes have been redesigned to reduce potential barriers – for example, candidates are provided with interview questions in advance to reduce anxiety and ensure equitable preparation. Once onboarded, employees are further supported through tailored adjustments facilitated by tools such as the Access to Work scheme. Assistive technologies such as noise-cancelling headphones, ergonomic seating, and specialist software are made readily available. These resources are accessible to all employees on request, ensuring support without requiring disclosure of neurodivergence.

Solution: collecting data

Practice is evidence-driven, drawing on regular surveys of staff about all elements of neuroinclusion, distinguishing, where numbers are large enough, between the views of neurodivergent and neurotypical workers. Retention rates, bullying and harassment incidents, and the use of the Inclusion Passport are also tracked as key success metrics. Listening groups complement quantitative metrics, ensuring a nuanced understanding of employee experiences and driving continuous improvement. This data-driven approach allows the organisation to assess the effectiveness of its initiatives and make informed decisions.

Solution: ongoing training

The organisation's commitment to ongoing education and training – both mandatory and optional – ensures that awareness of neurodiversity is continuously reinforced. Information is disseminated through the company's intranet, training modules, and manager-led team sessions, ensuring that neuroinclusion remains a priority at all levels.

Solution: Inclusion Passport

A new initiative is the development of an Inclusion Passport, which was developed in response to employee feedback. This provides neurodivergent employees with a portable record of their workplace accommodations and adjustments to reduce the burden regarding disclosure of needs when transitioning between managers or roles. This empowers employees by allowing them to retain control over their adjustments, with managers informed in advance, thus fostering a more supportive and proactive work environment.

Solution: balancing employees' needs with business needs

The organisation's tailored approach to reasonable adjustments ensures that neurodivergent employees' needs are met without compromising operational requirements. For example, in refrigerated warehouses employees will have to wear appropriate clothing (for example, gloves) in an environment with little control over noise and temperature. These are essential demands of this role where accommodations cannot be made. Attempts are made to find similar local roles where adjustments can be made – this is not always possible, which means an employee may not be suitable for such a role. Therefore, accommodations are carefully balanced with the essential demands of the role. Escalating decisions about more complex adjustments to senior leadership has alleviated the pressure on local managers to make complex decisions independently, promoting consistency and fairness. Regular check-ins with managers are used to evaluate the effectiveness of adjustments and address emerging needs.

Solution: continued support

Line managers are also integral to fostering neuroinclusion and receive ongoing support to confidently navigate neurodiversity-related conversations and meet employee needs by combining targeted training, peer learning opportunities, coaching, and consultation with occupational health professionals. The Inclusion Passport is intended as a structured framework for managers to engage in meaningful conversations with employees and implement appropriate adjustments, and the organisation is working on ensuring these are standardised and accessible.

Solution: collecting data

Practice is evidence-driven, drawing on regular surveys of staff about all elements of neuroinclusion, distinguishing, where numbers are large enough, between the views of neurodivergent and neurotypical workers. Retention rates, bullying and harassment incidents, and the use of the Inclusion Passport are also tracked as key success metrics. Listening groups complement quantitative metrics, ensuring a nuanced understanding of employee experiences and driving continuous improvement. This data-driven approach allows the organisation to assess the effectiveness of its initiatives and make informed decisions.

Examples of good practice

In sharing their best practice, the organisation cautions against 'window dressing' – superficial initiatives that do not lead to substantive change – and advocate embedding neurodiversity into core practices by:

• improving data collection to understand neurodivergent (and other) employees' experiences, including where underrepresentation and disproportionate impacts exist
• creating dedicated spaces for employees to share experiences (for example, listening groups) – this also helps to refine initiatives and ensure they remain responsive to evolving needs
• addressing specific gaps identified through feedback with tailored interventions
• establishing clear and consistent communication channels for all staff about issues or challenges, in order to align stakeholders and reinforce organisational commitment to neuroinclusion
• strengthening senior leaders' engagement with inclusion initiatives to reinforce their importance, for example through active and visible participation in processes and activities
• regularly reviewing the effectiveness of activities and resources and adapting them as needed – this also recognises that neuroinclusion is a continuous journey requiring sustained commitment and adaptation

Reasonable adjustments to accommodate neurodivergent employees' needs

Academic and practitioner evidence advocates for personalised adjustments to the work environment and recruitment processes to accommodate the specific needs of neurodivergent employees, regardless of work sector or industry (for example, Lindsay et al, 2021; McDowall, Doyle and Srinivasan, 2024; Petty et al, 2023; Auticon, 2022; Lindsay et al, 2021; Szulc, McGregor and Cakir, 2021; Thompson and Miller, 2024). For instance, two practice reports (City and Guilds, 2024; Gain, 2023) concur that flexible work schedules and sensory-friendly workplaces are essential for improving retention and job satisfaction. However, the evidence is not strong because the research lacks rigour, is specific to certain sensitivities such as noise and light, and mainly focuses on autistic workers (Weber et al, 2024). Nevertheless, a sector-specific report highlights the importance of creating neuroinclusive workplaces in the construction industry by focusing on practical adjustments such as providing quiet work areas to maintain a sensory-friendly work environment (Neurodiversity in Construction, 2023). Case studies 1, 2, and 3 discuss reasonable adjustments in the different contexts of professional services, construction and engineering, and retail.

Examples of good practice steps that can be taken for reasonable adjustments include:

• 'pick and choose' menus for resources, such as use of adaptive technology and flexible working, which can be accessed without a need for diagnosis or expensive administrative processes – adjustment budgets should be held centrally with a transparent process for sign-off 
• holistic policies and practices which take account of intersecting identities, such as neurodiversity, gender and caregiving responsibilities, rather than one policy on each – policies should allow for flexible tailoring to needs 
• start from a position of trust, which is not reliant on a formal diagnosis, and which acknowledges lived experience, to support individual needs and harness individual strengths 
• consider universal accommodations such as sensory-friendly environments that benefit everyone

Performance management in neurodiverse environments

How to manage performance in neurodiverse organisations is a neglected topic in research. This is addressed in case study 4. This organisation with less than 250 employees (small and medium-sized enterprise, or SME) takes a stepwise approach beginning with mandatory neurodiversity training from induction onwards and clear management of expectations. The organisation emphasises written policies to ensure common understanding, alongside training managers to expect, and manage, conflict locally first and then engage in mediation and other processes for complex issues.

Case study 4: managing performance in a neurodiverse organisation

About the organisation

This case study is a community interest company with less than 250 employees providing specialist coaching for neurodivergent workers and assessments and training for organisations operating in a neurodiversity context. Around 70% of its staff identify as neurodivergent or disabled, and 65% of its profits are reinvested into the neurodivergent community. The company promotes neuroinclusion by combining lived experience with academic expertise.

A key challenge for the organisation: potential for miscommunication

Because there is potential for miscommunication and misinterpretation in any workforce, but especially so in a majority-neurodivergent workforce (with differing communication styles, for example), the company embeds a range of practices to manage performance and create an inclusive work environment.

The organisation managed this through several solutions, described below in broadly the order that employees would encounter them as they moved through on-boarding and potential miscommunications.

Solution: training in psychological models

New starters receive 8 hours of training in psychological models central to the organisation's values, which include the empowerment model – a strengths-based approach promoting a sense of agency for neurodivergent people – and coping techniques that help workers to focus on the present moment and reduce anxiety. This training aims to provide context for understanding communication and behaviour and is repeated every few years. While this can be an intense introduction to the organisation for newcomers, it serves a crucial function in providing a foundation for resolving conflicts.

Solution: policies promoting clarity, fairness and respect

Company policies and practices aim to support an effective and neuroinclusive environment by promoting clarity, fairness, and respect in workplace interactions. For example, a specific policy outlines standards for professional behaviour and communication clearly and in detail. This addresses not only expectations for response times and clear communication about worker needs and preferences (that may be related to neurodivergence, such as sensory sensitivity), but also those for handling emotions at work and setting boundaries in workplace relationships. Guidance on social media interactions and the emotional aspects of relationships is provided to all workers. The policy encourages direct, constructive feedback instead of informal complaints or informal information-sharing.

Solution: transparent communication practices

There is a strong focus on reducing miscommunication through transparent communication practices including decision logs, meeting minutes, and accessible documents free of jargon, as well as 'clean feedback', which aims to distinguish evidence from inference. To promote a climate of psychological safety, the principle of double-loop learning (reviewing not just what happened but also why it happened and what can be learned from it) is embedded in the organisation's culture. This approach facilitates the interrogation and evaluation of unspoken assumptions, norms, and objectives to identify and address root causes in miscommunication. Feedback sessions between managers and employees are encouraged quarterly to normalise constructive communication.

Overall, the goal is to pre-empt and reduce conflicts and enhance productivity by prioritising fairness and clarity. The company's view is that people are empowered to perform their best when they know what is expected of them and the barriers to doing their job have been removed.

Solution: structured approach to misunderstandings

When workplace misunderstandings, conflicts, or emotional challenges arise, line managers address these through a structured approach with successive stages. Early resolution stages involve daily one-to-one meetings between line managers and involved parties to unpack issues without HR involvement. If this does not solve the issue, subsequent stages incorporate HR involvement with documentation and focus on reasonable adjustments, co-coaching, health-related support, disciplinary actions, and, if necessary, mutual agreement to end the employment relationship. The process is designed to address underlying structural barriers to effective performance and well-being such as undiagnosed conditions or unreasonable job demands.

Solution: 'wash-ups'

There is a commitment to apologising when things go wrong and to engaging in 'wash-ups'. This involves reviewing an experience to identify what went well, what did not, and how things could be done differently in future. 92% of its staff recommend working at the company, and turnover is below 8%, compared to around 34% nationally.

Examples of good practice

This organisation focused more on principles for good practice, which include:

• a clear stepwise process for managing performance
• training on clear communication from onboarding onwards
• emphasis on psychological safety and resolving interpersonal issues
• clear and formal policies and guidance on expected behaviour
• a focus on the value to productivity of early conflict resolution 
• commitment to reviewing what went well and what could be improved

Key messages from chapter 4: supporting line managers in good practice

The key messages around supporting line managers in good practice for neurodivergent employees are:

• there are three main elements to this – knowledge, awareness, and acceptance paired with empowerment
• adaptable communications are a powerful tool to ensure good communication across an organisation, but managers in particular may require training on clear communication with neurodivergent employees
• reasonable adjustments should have a tailored element, as not all people with the same neurodivergent condition will find the same adjustment helpful
• performance management needs to begin with clearly communicated expectations for neurodivergent employees

This chapter addresses the question: how can line managers' (and other relevant stakeholders' such as equality and diversity practitioners) organisational knowledge about neurodiversity and positive attitudes to neurodivergent workers (whether disclosed, diagnosed, or not) best be supported?

This chapter focuses on initial and ongoing training in neurodiversity and neuroinclusion, alongside evaluating the effectiveness of the training, through findings from interviews and focus groups with stakeholders.

The value of ongoing training in neurodiversity and neuroinclusion

All expert stakeholders in the interviews and focus groups agreed on the need to make regular training on neurodiversity mandatory as part of initiatives to address health and safety, and diversity, and to follow up and refresh learning regularly, something that is discussed more in case study 1.

Training should go beyond insight into specific conditions and address a range of topics including communication, conflict resolution, team dynamics, and reasonable adjustments. A fifth of expert stakeholders responding to the survey said that they rely on in-house neurodiversity specialists to determine the quality of training (case study 2 also discusses the value of an in-house team in a large engineering organisation). This might not be an option for smaller organisations that rely on word of mouth or other advice. Instead, they should refer to high quality evidence published by Acas, professional societies, or national charities specific to a business context. To ensure training quality it is vital to:

• harness input from neurodivergent individuals to co-create training – this ensures relevance but needs to be balanced with an evidence-based approach, for example, to ensure alignment with employment law, research from psychology and neuroscience can be drawn upon alongside organisational diversity scholarship
• smaller organisations could access targeted consultancy input to ensure alignment with best evidence and legal compliance, or seek out high-quality evidence from reliable sources
• recognise that the experiences of individuals can vary substantially, and consultation processes involving neurodivergent individuals can be demanding for participants
• ensure that the time needed to participate in consultations is factored into overall workloads and that the process is accessible through clear communication and options for how to participate, such as in a focus group or through submitting a written response
• ensure that training is delivered in an inclusive way and is not condition-specific because of the high likelihood of co-occurrence so that neuroinclusion is part of wider conversations about inclusion
• assess organisational needs and ensure that training provision covers broad topics, including adjustments as productivity tools, how to work with someone accounting for all their experiences and identities, leveraging pre-approved adjustment catalogues and handling candid and positive conversations
• agree in advance what effective training will look like and how this will be assessed, and collect objective data (for example improvement in organisational metrics such as retention) and subjective data (how well is the training received)
• transfer learning by evaluating other training initiatives and draw out principles for good practice – for example, regarding robustness of content and format of delivery

This chapter uses evidence from surveys, interviews and focus groups with expert stakeholders to discuss what 'good' looks like for proactive reasonable adjustments, moving from general principles to practices for everyone, to practices for more complex cases.

Case studies 1, 2 and 3, earlier in this report, also include elements of practice for reasonable adjustments across larger organisations in engineering, retail and professional services. Case study 4 takes a different approach, embedding neuroinclusion through the organisation to reduce the need for further specific adjustments.

Move away from compliance-based processes

Although organisations need to ensure that processes are compliant with employment law, a merely compliance-based approach is insufficient because good practice is reliant on psychological safety. Regardless of any diagnosis, employees need to feel safe enough to state needs, and line managers must be competent, through effective training as discussed in chapter 5, to lead potentially sensitive conversations so that trust is established.

Standardisation of processes and practices

Standardisation of processes and practices removes burden on line managers – this means having a clear and central process for approval of adjustments, which is the same for every employee with simple forms and guidance.

Stakeholders noted in the interviews and focus groups that it was a challenge that initial conversations are often left to line managers, the result being that practice is inconsistent and varies widely. To counteract this, it is important that processes are streamlined, budgets centralised and communication straightforward, and referral processes reiterated through multiple communication channels.

Diagnosis not required

A proactive reasonable adjustment process should not be contingent on diagnosis or disclosure – 75% of expert stakeholders stated in the survey that neither is necessary in their workplace. Well-structured adjustment policies and processes have a system for 'quick wins,' such as access to software or low-cost equipment granted without long-winded approval. Line managers in all organisations, regardless of budget and size, can have early conversations during recruitment and onboarding about 'how do you do your work best?' This way, the conversation is about functioning rather than diagnosis, and it is up to the employee to disclose.

Universal, low cost adjustments for neuroinclusion

Similarly, there are many universal accommodations that are cost-neutral or low-cost, such as access to flexible work options, flexible start times, inclusive meeting formats (with regular summaries), and simple corporate communication. Employers and those in HR functions need to counteract the assumption that adjustments are always costly and resource intensive, for example, through ‘pick lists’ of low cost adjustments, or national campaigns on reasonable adjustments from Acas. Organisations should also put emphasis on rebranding adjustments as performance-enhancing tools, rather than a remedial support mechanism. Doing so counteracts stigma and puts focus on effective performance.

'Access' passports for reasonable adjustments

Systems such as 'access' or 'health' passports can allow people to state their adjustment needs in summarised form to ensure continuity of support as they are portable across job roles – but passports may need revision where work changes are significant.

Specialist involvement when necessary

More complex needs require HR and specialist involvement and potentially a workplace needs assessment. This is to ensure that adjustments are individually tailored but that organisational resource and work demands are also considered.

Particularly for small businesses, who may not have specialist internal functions or large dedicated budgets, it is vital that industry specific federations and professional bodies promote awareness of external programmes such as Access to Work.

Key messages from chapter 6: what does ‘good’ look like?

The key messages around what 'good' looks like are:

• a merely compliance-based approach is insufficient because good practice is reliant on psychological safety
• standardisation of processes and practices removes burden on line managers
• a proactive reasonable adjustment process should not be contingent on diagnosis or disclosure
• there are many universal accommodations that are cost-neutral or low-cost
• systems such as 'access' or 'health' passports can allow people to state their adjustment needs in summarised form to ensure continuity of support
• more complex needs require HR and specialist involvement and potentially a workplace needs assessment

National policy

This research sets out the following recommendations for UK policy at a national level.

Government support for neurodivergent people

Government policies relating to inclusion, fairness and parity across society, especially in the workplace (such as Make Work Pay) must include support for neurodivergent people and neuroinclusion. This should include consideration of the impact on neurodivergent people of different levels of access to diagnosis and early life support, which can impact readiness for work and lead to disadvantage in employment. Early and equitable support in education is vital and needs to be continued through to training and employment. Neurodivergent people's voices should be heard in all aspects of consultation, for example, through a panel of experts through experience.

Consider neurodiversity across neurodivergent conditions

Any government initiatives focused on work must consider neurodiversity across conditions and refrain from a singular focus on only one condition, as is being done with the proposed Connect to Work framework. Initiatives that form part of the wider 'Make Work Pay' reforms should apply a disability and inclusion lens to policy design and implementation.

Collect good quality statistics

Collect good quality labour force statistics within the context of the recommendations from the Inclusive Data Taskforce, as part of the Transformed Labour Force Survey. This should explore the feasibility of including all prevalent neurodivergent conditions (including ADHD, autism, dyslexia, dyspraxia, and Tourette's Syndrome) as an inclusive category, rather than focusing on just one condition (previously autism) and analysts should conduct intersectional analysis. This will allow for the targeting of resources and programmes accordingly, whether by governments or by organisations.

Promote the principles of the Equality Act 2010

Government policy should promote understanding of the principles of the UK Equality Act and related adjustments and support for all neurodivergent conditions, even those not considered disabling. Equally, government policies and agencies such as Acas or Access to Work should signpost that adjustments need to be practical in a business context as not every adjustment is reasonable for every organisation.

Organisational policy and practice

Policy and organisational integration:

• embed neurodiversity into existing policies and practices, such as equality, diversity and inclusion, with sensitivity to intersecting identities
• engage in genuine consultation across organisations regarding neuroinclusive policies, practices and activities but also recognise that this can be onerous on neurodivergent workers – ensure that workload is explicitly recognised and offer corresponding support
• make all policies, but particularly those relevant to neurodivergent employees, simple and accessible, review language and wording through the lens of lived experience, and seek expert input (for example, on the legal perspective or from an HR partner) as appropriate
• map and review policies to an existing framework such as universal design and consider neuroinclusion throughout the entire employee lifecycle

Neuroinclusive design for all:

• consider neuroinclusive environment design for the benefit of all – for example, clear and unambiguous signposting, sensory-friendly lighting and normalised wearing of noise cancelling headphones in workplaces where this is possible
• small changes matter, such as fonts and colours used on any written information
• champion inclusive meeting formats (short and to the point) and simple corporate communications

Leadership and accountability:

• senior leaders take strategic responsibility for neuroinclusion and set transparent targets for continued positive change
• signpost leadership commitment to neuroinclusion through role modelling and sharing of neurodivergent experiences in senior teams
• in doing so, focus on psychological safety, so that everyone feels safe to share struggles and learn from mistakes – ensure that any learning is shared and embedded
• champion and actively sponsor employee resource groups and other grassroots activities, and ensure that these groups engage with high quality evidence to support practice
• make neuroinclusion and inclusion more widely an explicit part of the line manager role via, for example, references in guidance documents such as job descriptions and workload expectations

Reasonable adjustment processes:

• rebrand reasonable adjustments as performance-enhancing tools to put the focus on harnessing strengths and supporting effectiveness
• consider a centralised budget and streamlined process to provide barrier-free access to adjustments and a consistent approval process
• remember that many adjustments are no or low-cost and can be embedded into day-to-day practice, such as clear and unambiguous communication and inclusive meeting formats
• ensure that any adjustments take into the account the requirements of the job role and resources of the organisation
• stop making adjustments contingent on diagnosis, as this is not legally required – instead, put focus on supporting talents and individual functioning
• where practicable, consider flexible work options such as working from home to reduce sensory overwhelm and accommodate different work styles – however, there are likely to be a lot of industries and roles where this is not an option, such as the 4 included in the case studies

Supporting line managers to triage and refer any adjustments through:

• training – regular training on neurodiversity (if in-house budgets are too limited to commission regular training, use resources provided by national charities, attend neurodiversity at work conferences, exchange good practice with other similar organisations)
• triage and refer – ensure that managers are equipped to spot issues with employees' behaviours (for example, notice when employees forget things or find it hard to understand the intention), empowering managers to share these observations
• supportive conversations – enable line managers to have honest conversations about how employees work at their best and ensure that they have authority and knowledge to embed simple adjustments such as slight changes to start and finish times
• accessible sources of advice – establish clear points of contact and advice for line managers, for example, at what point to commission a workplace needs assessment, and who and where in the organisation they can turn to for more information or support

Training and awareness:

• commit to and embed neurodiversity training across all employees

Performance management and conflict resolution:

• recognise that in a neurodiverse organisation, with different working styles and preferences, misunderstandings and conflict can occur – try to pre-empt these where possible
• train managers to have honest conversations which legitimise individual experience while also conveying the requirements of the job role, so that expectations are clear
• consider referral options such as co-coaching for more complex cases
• ensure that any training on neurodiversity also addresses the emotional demands of working in neurodiverse teams

Monitoring and evaluation:

• set clear diversity and neuroinclusion targets, monitor data (for example, on turnover and employee engagement) and target activity accordingly

Neurodiversity prevalence rates are likely to increase as awareness grows. Thus, employers need to be aware that at least a fifth of the working age population will identify as neurodivergent, that co-occurrence (more than one condition) is common, and that employees may not have had fair access to diagnosis and support early in life.

Neuroinclusion and harnessing the talent of neurodivergent workers must be addressed through a holistic organisational and policy approach as part of wider equality, diversity and inclusion and wellbeing initiatives. Clear processes and policies are key to reducing the administrative burden resulting from a reactive and not proactive approach.

Direct support for line managers is vital, as is a barrier-free process for reasonable adjustments independent of a formal diagnosis. To reduce administrative burden, it is good practice to review all policies and processes through the lens of neuroinclusion and apply best practice principles such as universal design. These emphasise, for example, flexibility and accessibility for all.

Those responsible for policy making at national and organisational levels must consider all the elements discussed above. National policy makers in particular need to consider the 5 key recommendations:

• support neurodivergent workers through government initiatives such as the proposed Connect to Work framework
• join up wider ranging employment policy reforms, such as those proposed under 'Make Work Pay' with the greater diversity and inclusion agenda, while considering the specific needs of neurodivergent employees
• consider neurodiversity across all conditions, rather than focusing on just one
• collect and make use of good quality data which allows for neurodivergent people's responses to be analysed as a group
• promote the principles of the Equality Act 2010

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Language and terminology are important in the neurodiversity field and change with community preference. We used these definitions and principles:

• employee resource groups – voluntary and employee-led groups that aim to promote diversity issues in their workplace context
• neurodiversity is the breadth of human functioning across all neurotypes – people think, feel and act in different ways
• neurodivergence and neurodivergent and neurominority refer to people with a distinct neurotype who identify with one or more relevant conditions
• neurotypical(ity) describes most people who do not identify with relevant conditions – the researchers note that not everyone likes the terms typical and divergent but have used these for clarity
• neuroinclusion is an organisation-level approach to anticipate and accommodate that there will always be a range of neurotypes with different ways of functioning and preferences for work
• neutral language – where possible the researchers used neutral language such as condition rather than disorder, or dependency need instead of low functioning
• person first – the researchers used person first language where possible such as dyslexic person rather than person with dyslexia to acknowledge current community preference
• reasonable adjustments are "changes an employer makes to remove or reduce a disadvantage related to someone's disability" – they are specific to a worker, for physical or mental conditions and relate to any aspect of work (Acas guidance on reasonable adjustments)

The research method

The research approach was as follows:

1. A rapid assessment of evidence (a tightly framed approach to systematically evaluating literature), covering prevalence and trends for neurodiversity.
2. Work with expert stakeholders, an expert stakeholder consultation, covering best practice principles and breadth of evidence, described in more detail further down this report.
3. 4 in-depth organisational case studies for neuroinclusion, covering what good looks like and depth of evidence.

The inclusion criteria for the rapid assessment are outlined in a separate Appendix E (available from the researchers on request as a large text table). This report section documents information from 28 sources, of which 19 were academic and 9 were practitioner literature, across empirical research, practical guides, and conceptual papers.

To address the research questions about neuroinclusion, the role of line managers, a positive approach to reasonable adjustments and examples of good practice, the researchers undertook work with an expert stakeholders using 3 different methods:

• a web-based survey with 44 practitioners
• 1 in-person and 1 online workshop with 23 participants in total
• 4 in-depth interviews (see Appendix C for more details)
• 4 case studies, which involved 10 online interviews, review of policy documents and one site visit

All stages of the research sampled across:

• different organisation sizes from very small (specialised consultancies in neuroinclusive design for example) to very large-scale organisations with over 40,000 employees
• different sectors including finance, service industry, engineering and construction
• specialists in neuroinclusion including clinicians, psychologists and legal experts

This report looks at each research question in turn, using a mix of evidence from the rapid evidence review, surveys, interviews and workshops with stakeholders, and case studies. The report begins with the broad trends in academic and practice literature, moving through how organisations can create neuroinclusive workplaces, how line managers can be supported, and how organisational knowledge can be supported, then what 'good' looks like for proactive reasonable adjustments. It finishes with recommendations for national and organisational policy and practice and a short conclusion.

Rapid assessment inclusion criteria

For the rapid assessment of practice and academic literature, we set a timeframe of 4 weeks to locate and summarise evidence. These were our inclusion criteria:

• research which is relevant to the UK – ideally draws on UK samples, or acknowledges the UK context, and addresses the research questions
• for academic papers – high quality publications from peer reviewed literature to cover a breadth of approaches including systematic reviews, quantitative or qualitative studies and commentaries to identify future trends
• published during the last 5 years in English
• for practitioner publications, where they are published annually, the most recent report, unless different reports from the same publisher or author address different angles
• a balance of practice and academic literature overall – to integrate various sources, the researchers drew on principles from 'Evidence-Based Management' (Briner, 2019), which is an approach that encourage the synthesis of evidence from different sources such as academic literature, stakeholder views and practice guidelines

Participant details

In-person

The in-person work involved 8 participants.

This included:

• EDI specialists
• trade unions
• organisational development experts
• employment law experts
• psychologist

Representing these sectors:

• public sector
• engineering
• law
• specialist consultancy
• clinical practice

Online

The online work involved 15 participants.

This included:

• equality, diversity and inclusion (EDI) specialists
• environmental design
• HR managers
• occupational health
• lived experience advocates

Representing these sectors:

• private sector including IT
• creative industry
• finance

In-depth interviews

The in-depth interviews involved 44 participants.

This included participants from a variety of specialisms or job roles:

• equality, diversity and inclusion specialists
• line and senior managers
• coaches
• adjustment specialists
• occupational health

Representing a variety of sectors including:

• health and social care
• transport
• finance
• charity
• education
• media

Format including case studies

Surveys

The surveys focused on:

• trends in organisational practice
• support for specialist career pathways
• the use of data
• adjustments and disclosure
• the role of specialist services (for example, occupational health)
• support for line managers

Some example questions included:

• how do you support line managers regarding neuroinclusion? (multiple choice and open-ended)
• examples of good practice (open-ended)
• the research literature tells us that understanding communication between neurodivergent and neurotypical people is important but not always effective – how do you address this? (tick all that apply)

In-person and online work

The in-person and online work focused on:

• best practice in neuroinclusion
• supporting line managers
• making adjustments barrier-free
• how to evaluate success

Some example questions included:

• when neuroinclusive policies and practices are effective for everyone (employers, employees, other stakeholders) it's like what?
• what is best practice to support specialist talents and career pathways?

In-depth interviews

The in-depth interviews focused on the same areas. They added insights into specific functions and areas of practice.

Questions included:

• what are your insights from various perspectives (for example employer, employee, employee relations?)

Case studies

Case studies focused on the same areas. They also looked at any areas of practice the organisation was particularly advanced in.

Questions included:

• how do you manage neurodiversity across teams and functions?
• what are your priorities, and how do you address them?

Where the academic and practice evidence converge is summarised below. While there is considerable attention in the practice literature to neuroinclusion in the context of organisational structure, climate, and a sensory-friendly physical environment, there is less academic evidence on these topics.

All literature concurs that:

• line managers play a vital role
• adjustments need to be tailored
• neurodiversity training needs to target knowledge and attitudes

Summarised below are key themes from the evidence – where an issue is one that the researchers focused on during the work with expert stakeholders because published academic evidence is not clear, this is indicated with 'from expert stakeholders' in brackets.

Key themes from the academic and practitioner evidence

Understanding of neurodiversity

• increasing recognition of the benefits of including neurodivergent employees – focus on strengths
• co-occurrence is likely – focus on functions rather than conditions
• consider intersectional experience (for example, race, gender)
• neurodivergent employees may not disclose due to fear of stigma 
• neurodivergent employees need personalised support and a holistic approach

Line managers

• line managers as first responders are key to building a neuroinclusive workplace
• need to train line managers on neurodiversity 
• give managers the resources to handle the emotional demands of supporting neurodivergent employees (from expert stakeholders)
• encourage flexible communication and feedback skills to support neuroinclusion

Reasonable adjustments

• structural adjustments (for example, flexible work) enable workforce participation
• need for low-cost, high-impact personalised adjustments
• legal protection is insufficient
• regular and honest conversations between managers and employees to embed and review
• barrier-free referral process (from expert stakeholders)
• need for sensory-friendly work environments (academic literature weak)

Organisational climate and structures

• importance of regularly reviewing job design
• importance of open commitment to neuroinclusion – inclusive policies, practices, and universal design 
• ongoing training and awareness programs for managers and employees to foster positive attitudes 
• equipping HR teams and line managers to foster a neurodiversity-supportive climate
• leadership involvement and sponsorship crucial for embedding neuroinclusion
• key role of psychological safety