Thinking differently about neurodiversity

Sarah Guthrie: Welcome to the Acas Podcast. I'm Sarah Guthrie and today we're focusing on neurodiversity. What is it, why it matters in the workplace, and how workplaces can support neurodiversity in meaningful and practical ways.

I'm joined by Dr Nancy Doyle, Chief Exec and founder of Genius Within, which provides evidence-based neurodiversity inclusion, Adrian Ward, head of disability partnerships at the Business Disability Forum, which brings together business, government and disabled people to create a disability smart world and Erin Fulton-McAlister, a workplace adviser at Acas. Thanks for joining me today.

Adrian Ward, Erin Fulton-McAlister and Dr Nancy Doyle: Hello. No problem.

Sarah: So there's lots of different language around neurodiversity and the language shifts a lot, which we've all discussed actually in the past. And I wondered if we could start with that in mind and very simply – what is it that we're talking about when we use words like neurodiversity? Nancy, do you want to kick us off?

Nancy: I do. Yeah, thank you. So I think, broadly speaking, the word neurodiversity relates to the idea that we are all diverse, that there is cognitive diversity in the strengths and weaknesses of the human species.

Some of us are good at most things. Some of us are good at specialist things to the exclusion of other things. And we have this kind of range of what's possible in our human thinking and skill and ability profile.

Sometimes the word neurodiversity gets used as a proxy for a handful of conditions that are often known by other titles as well, such as neurodevelopmental disorders, hidden disabilities, specific learning disabilities. My working title for those at the moment is neurominorities, because they are less likely than being a neurotypical.

So if you are a neurotypical, it means that broadly speaking, you're competent in all areas of thinking, you know, you're kind of average in all areas of thinking, or maybe you're above average.

If you are in a neurominority, it means you have some specialist thinking skills and some specific difficulties. And that includes ADHD, autism, dyslexia, dyspraxia, dyscalculia, dysgraphia. And those are the main inclusions.

We sometimes also include tic disorders such as Tourette's, we sometimes also include mental health and chronic neurological conditions. Because like the others, what happens when you have those conditions is you end up with a big difference between your skills and your weaknesses. So because of the weaknesses, neurominorities are typically covered by Equality Act protection and disability legislation worldwide. But it's important to remember that those conditions come with strengths as well.

Sarah: Thanks, Nancy. That's a really kind of holistic introduction. What struck me when you were talking is that this is an umbrella term, it is in itself diverse. And I wondered, how does that diversity of the difference between ADHD and dyslexia affect how people identify with, and see this as something that they need to think about?

Nancy: So concepts like autism, ADHD, and dyslexia are very much diagnoses of exclusion. They're things that we decide people have when we've exhausted all possible other explanations for difficulties in skill or behaviour. And actually, the science of those categories is moving on incredibly quickly at the moment. And there is some evidence from neuroimaging studies, that actually the kind of brain differences are not that great, and that those conditions have more in common than they do have separate, and actually what we currently call a diagnosis of dyspraxia or dyslexia might really be a symptom cluster.

And from my own professional practice working with thousands of neurominorities over the last few decades, I would say that people come to the workplace with very similar problems. So 92% of my clients, no matter which label or brand they are associated with, 92% of them struggle with memory and concentration. 82% struggle with organisation, 78% with time and 67% with communication skills. And I've run this study over thousands of thousands of participants, and it's always about those numbers.

So I think from a business perspective, what's more useful, rather than trying to think, "autistic people will need this" or "dyslexic people will need that" or even to think that an autistic person doesn't have dyslexic symptoms or that an ADHD person isn't also slightly dyspraxic. So instead of getting hung up over labels, what's more important is just to say, "how can I support you to work at your best? What are the things that you're doing really well? What are the things that you're struggling with? What kind of reasonable adjustments might we put in, to scaffold you and augment you and to enable you to really thrive in the workplace?" And we can ask that question without detailed descriptions of conditions, and what may or may not be happening in the brain.

Adrian: Yeah, I mean, just to jump on the back of what Nancy said there, I’m in complete agreement. And it's a lot of the work we do, with the organisations that we work with, is actually trying to change that culture of either trying to get a diagnosis or trying to pigeonhole or label people either into particular roles or particular solutions for those individuals. And actually encouraging them to think more about barriers that they might be encountering, how to remove those barriers, the support that an individual might require, etc etc. So really flipping the thought process from not trying to label and pigeonhole to actually just: what does an individual need to be able to flourish in the role that they're in?

Erin: Yeah, I completely agree. And I think that, from an Acas point of view, a lot of what we’re going to be talking about is really just good management. And it’s about supporting people as individuals, rather than because they have a label.

Nancy: There is a tricky balance in this because, you know, when we go a little bit wide of 'this affects everybody, everybody is neurodiverse, neurodiversity of everybody, it's about asking all individuals and good management', which I 100% endorse. And I think people could get very tied up worrying about whether they're doing the right thing or not. And actually, if they were just doing good management, it would probably be okay.

But what we do have to remember with neurodiversity and neurominorities, is that a lot of the time these are disabling conditions. And somebody said to me, once, "well, we all have difficulty concentrating sometimes". And I said, "what you've just said to me, as a woman with ADHD, is the equivalent of me saying to you, as a woman using a wheelchair, we all have trouble walking sometimes".

There are statistically significant differences in people's skill levels that means the things that we do as managers are legal obligations – they're not nice to have, they are good management, but they are also legal obligations. And when we don't do them, we are not creating the level playing field that we want to create for all our employees. So they're not preferences, they’re requirements.

And the kind of things that I would draw attention to are things like, you know, allowing people to not abide by a hot desking policy. If you are very easily distracted, or you know, have that kind of high sensory awareness that comes with autism, you might find there's a certain point in the office where it's quiet enough for you to focus and concentrate. And you might simply be unable to do that, unless you're at that point in the office.

So an organisation might allow you to choose your desks, they might allow you to work from home more frequently, they might allow you to book out a meeting room, if you had to do a report that you were really concentrating on or wear earphones to cut out background noise. So there's lots of things people can do. And they might look like preferences. But it's the difference between functioning and not functioning, as opposed to being a little bit annoyed and being a little bit, you know, okay.

Sarah: So there's a very clear difference in severity, almost?

Nancy: Yeah, yeah. Yeah, people aren't choosing to stop concentrating, people aren't choosing to take longer over typo checking and reading through edits, they're not doing that deliberately. It's not because they're… they haven't got a moral character deficit, it's not that they need to try harder or shape up or put a bit more effort in. It's that the parts of the brain that do those particular functions aren't as well connected or don't work as well, or are too busy processing a whole load of other information that's coming in from the rest of the environment.

So it's really important that people know that there are observable, measurable, definite brain differences that mean certain jobs are easy and certain jobs are hard. And when we assign words like 'prefer' or 'try' or you know, 'work a bit harder on' around the things that people are deficient in, you know, it's like telling somebody who's deaf to listen harder.

Sarah: This might be quite an obvious question, because I feel like you're all bringing up elements of it anyway. But I wondered, Adrian, when you're talking to businesses about this topic, what do you say when they ask you, "well, why do we need to focus on this?"

Adrian: Yeah, and it does definitely come up as a question. It's difficult. In this world, when you work in this world, it becomes very glib just to come back with a, "well, why wouldn't you?" kind of response. But I know that's not necessarily always helpful to get the right engagement.

But one of the things I always say to an organisation, you know, if you're truly committed to inclusion, you should be looking at how you attract, recruit, retain, and develop neurodiverse talent within your organisation. So my biggest sort of push back and biggest sort of line I'll take with an organisation is about tapping into the widest pool of talent you possibly can do.

And if people need more information around that, and you know, I talk to people about actually, how healthy it is for an organisation to have a workforce that has a real diverse range of thinking. So where people do think differently to others within that organisation, where creative thinking is really encouraged and fostered and allowed to flourish within an organisation, how some people are very solution-focused and great problem solvers. Again, why wouldn't you want people with those sorts of skills within your organisation, people that can massively grasp complex concepts very quickly? Again, why would you not want people with those sorts of skills within your organisation? So it's trying to help organisations just think wider than perhaps some of the stereotypes, some of the myths, some of those sort of pigeonholed views.

Erin: The other thing to bear in mind here is that the law says you have to. Being neurodivergent will usually amount to a disability under the Equality Act 2010. And this means that organisations have a legal obligation to make reasonable adjustments to the workplace, and to the individual's role, that will remove or minimise any disadvantage to that individual.

So, yes, it is important from a legal point of view. And there are really potentially huge consequences if you ignore that point of view. But it's not only, as Adrian's already said, that there's a threat if you don't do it. There are huge advantages to your organisations if you do do it.

Sarah: So it's good for your business, for your organisation, and there's a legal obligation. How do you do that, then? What do you think are the main barriers for organisations? And how can we overcome them to create a workplace which does help people thrive to their fullest potential?

Nancy: I think that the majority of workplaces are reluctant to be flexible and change. And we've got to get a bit more creative about how we organise work. So, you know, most office spaces, for example, are organised around the idea that clocks needed to be adjacent to paper ledgers. Because that's when they were invented in the sort of 1800s. And, actually, that's not really true in a remote working world. And we all know that now, because we've all just lived through the COVID-19 pandemic, or are still living through should I say.

So there's a whole bunch of norms that we have assumed are reasonable. And so, because we've designed our workplaces around those norms, that's where we're creating disability. We've assumed that all humans, in order to have value, must be able to spell and read efficiently, must be able to operate fine motor control devices, must be able to sit still and concentrate for hours at a time, and must be able to think well in busy, loud environments. And when you think about human evolution, and those particular characteristics of human behaviour, they're actually not very typical at all. It's a bit weird.

And as our workplaces continue to evolve and progress into the future of work, what we need to do is start designing work around the skills that we need, rather than the things that we're used to because we've always done them that way. So we can start with this idea of changing our systems and being systemically inclusive, and then personalised to what an individual needs. Whereas at the moment, what's happening is we don't think we have to change our environments at all. And we're putting a lot of energy and effort into making an individual able to cope with it, but actually the environment might not be suitable for the workplace at all.

I'd like to see in 20 years time whether we still need to sit still to concentrate at all. You know, will people that need to sit still have sedentary dependent concentration disorder instead of people that like to move having ADHD? You know, we could flip all of this on its head. Will people that only like to communicate using literacy rather than video communication be called hyperlexic dependent syndromes, do you know what I mean? [Laughs] There's lots of ways we could flip this, but it's about I think, just really thinking about the work that you want and the performance that you need, and designing your jobs and environment around the output rather than the input.

Adrian: For us and how we work with organisations, we look across that kind of complete employee journey or life cycle and talk with organisations about a whole range of things, but things like from the attraction of candidates, making sure that recruitment processes are barrier free and as inclusive as possible.

And then we will work with organisations around what are they doing that actually retains that talent once you've recruited them. So, have you got that onboarding process right? Is it easy to get adjustments? Nancy touched on the built environment. And one of my big bugbears is around progression and development. I've certainly seen a tendency of actually the focus being on attracting candidates, getting candidates into roles, but then not necessarily really thinking about actually how they are developed and progress within that organisation.

So there's a whole range of areas that an organisation should be thinking. But if they think about that employee life cycle, from the point that they're attracted to make an application all the way through to how they can then flourish and progress within that organisation, they're areas that we'd really encourage organisations to focus on.

Erin: An example that I've come across is an organisation who had an applicant who declared that they were autistic and requested that the panel avoid hypothetical questions. Now, I know that's one of the very common ones. But this organisation decided that they would not do it for just that individual, they would do it for everybody in that recruitment round.

And they did things like give all of the candidates the questions that they were going to ask 20 minutes before the interview itself, to give them an opportunity to think about their best examples, not just the first thing that comes to their head. They did an exercise in which they gave somebody a scenario that related to the job that they would be doing and asked them about that situation, and whether it was something they’d experienced before – which I realise sounds hypothetical, but in the situation wasn't. And what they found was that that recruitment process worked significantly better at getting good people in than their previous one had done. And actually, they've adopted that for all recruitment going forward across the entire organisation.

Nancy: Just wanted to come in on the point of, kind of, how do you know what you should be doing and trying this and asking people what they need, and having lists of things that you can try. And I think, you know, this is a big ongoing learning, and the big grey area in this is what is a reasonable adjustment? So we know there are lots of things you can do as adjustments, and not all of them will be reasonable for your organisation to put in, and where is that boundary of reasonable?

And one of the things that I'm seeing a lot of at the moment, which I find really concerning, is where people are going for that advice. I worked with an assistive technology expert Neil Milliken, and the Business Disability Forum, to write a commissioning framework for commissioning neurodiversity inclusion services. Because it's a bit of a minefield. Do you need a psychologist, a mental health nurse, a professional coach, a teacher, an educator, you know who's got the professional expertise in this field? It's really difficult.

So we put together a commissioning framework, which kind of enables you to go through the main issues of risk, safeguarding, insurance, training, credibility, and work out whether – for the size of the project you've got or the, you know, the need you have in your organisation, whether you're commissioning the right people. It's a really helpful resource.

The BDF [Business Disability Forum] and Acas both provide excellent resources in this respect. It's about going for advice to people that can give you credible advice based on a wide range of experience and professional training, as opposed to their own anecdotal case study of one.

Sarah: Thank you, Nancy. And we will put a link to that in the episode notes for this episode. I think it's available for free for two weeks. So if you're listening to this, grab it while it's available. We've been talking a lot about what we can do now. But I'm very curious to know what you think we should be doing in the future. Where would you love to see us, the workplace, the future of the workplace, move on this topic?

Nancy: So I think where we're headed is universal design, systemic inclusion. I think we're still stuck in compliance based inclusion. So we're waiting for people to fail and then we're buffering around them. We've got quite a lot of token inclusion where we're bringing in groups of people that have specific conditions for specific skills, like autistic coders, which is sadly lacking in intersectional wisdom and tends to kind of repeat, repeat, repeat, repeat the same type of person. It's not really where we should be headed.

The idea of systemic inclusion, where it's just the way things are done around here. So all of the things that my two colleagues on this call have said about kind of reviewing your policies, reviewing your structures, you know, really thinking about the eventual design – where we need to be headed is where this isn't a thing any more. Where we don't have a diversity and inclusion team, where disability support is part of the typical HR functionality. The kind of things you need you can order from a stationery order or are built into the training development programme.

And if you think about the prevalence, one of the things we've done looking at our cohorts over the last decade is notice that a sizeable proportion of our clients come to us for help when they're promoted. So it's on promotion, when all of a sudden their job role changes a little bit or they have to do slightly different things, that's when they need adjustments and support.

So rather than wait for people to fail, why don't we just say, “okay, so as part of our new manager onboarding, we know that for about 15 to 20% of people, they're going to need extra support in these areas. So we built this into our manager onboarding, so as our manager onboarding courses start, here's the specific ones around managing concentration time, here's your additional literacy resources from the assistive technology suite. Off you go”.

Sarah: Thank you. Adrian?

Adrian: So I think there's a, I'm sensing, I think there is a real opportunity to build on some of the momentum that appears to be there at the moment. It's about actually, how do we harness this real thirst for knowledge and information that's there at the moment, and keep that conversation going and evolving as much as we possibly can?

And then my final sort of comment is that – perhaps it's more of a question than a comment. But I just wonder whether COVID and the pandemic and how that's changed how we work, whether that could or should create new and better opportunities moving forward.

Erin: So I think what I would like to see would be, organisations get to a point where individuals feel confident in asking for support because of what they are seeing, because they believe that the organisation really will be flexible and provide the adjustments that they need, without any kind of disadvantage to those individuals.

I'd like to see line managers feel confident in providing that support and in having those conversations with members of their team. Not as a one off but as an ongoing conversation and ongoing support.

I would like to see colleagues within those teams get to a point where they feel that seeing their colleagues doing things differently, or perhaps being managed differently, is a sign of good management and a sign that they can ask for support if they need it as well, rather than unfair treatment.

And ultimately, I'd like to see that organisations and individuals together will, through doing these sorts of things, reap the benefits of diversity.

Sarah: Thank you. That is a brilliant note to end on, which I am reluctant to do, as there's clearly more to discuss here.

We've touched on some really big questions about the whole nature of work and how we design it. And as well as we've been going big, we've also had some really good principles and insights like not getting hung up on labels, rethinking your systems and your policies, redesigning them, getting expert advice, and not relying on stereotypes or lived experience inappropriately. It's been a fascinating podcast. So Adrian, Nancy and Erin, thank you.

This has been the Acas Podcast. I've put links to helpful resources on neurodiversity, including the neurodiversity commissioning framework that Nancy mentioned, which is available for free for two weeks. And we've also put some links to advice.

If you're looking for bespoke support to help you increase your diversity and inclusion, then Acas also offers free chats with advisers. If that's of interest to you, then I've put a link to the number and the contact form in the notes as well.

Thanks for listening.