Guide to managing Autism at work

Managing Autism at work occupational health news

Guide to managing Autism at work 

Autism is a lifelong condition and is a disability which affects how people communicate and interact with the world. One in 100 people are on the autism spectrum and there are around 700,000 autistic adults and children in the UK.

Autism is a common reason for referral to occupational health. Many employers will find themselves supporting an employee with Autism at some point.

If you haven’t already, it’s likely that you will interview or work with someone with Autism at some point in your career. As the prevalence of the condition is increasing, so is the likelihood that it will grow as a workplace risk too.

Although the prevalence is growingone recent report suggested this is because professionals and parents are getting better at recognising the condition.

What is Autism? 

Autism is a spectrum condition, which means the symptoms and effects of the condition can vary greatly between different people. Autism is sometimes referred to as Autism Spectrum Disorder or ASD. However many people who are autistic, or have children who are, do not like the term ASD because the reference to ‘Disorder’ is so negative.

Autistic people see, hear and feel the world differently to other people. Although there are some common difficulties shared by autistic people, the condition affects different people in different ways. Some may be unable to communicate with other people at all, whilst others may struggle with emotional regulation, have learning difficulties or struggle with some social situations. 

Because the condition varies so greatly, people are sometimes diagnosed with different levels of Autism (one, two or three) with the most profound effects at the higher end of the scale. A diagnosis of Asperger’s Syndrome (which has itself become a contentious term) is now often diagnosed as Level 1 ASD.

How is it treated? 

The condition is lifelong and as it is not a disease or illness it cannot be treated or cured by medical intervention.

Although there have been many trials looking at treatments for Autism, none have been successful. One highly anticipated trial evaluating Oxytocin (a hormone used widely during childbirth) recently showed no significant difference to treatment with a placebo.

The most successful strategies to support people with Autism so far have involved adaptation and understanding, rather than intervention.

Tips for recruiting someone with Autism 

Many people with Autism may be put off applying for jobs if recruitment advertisements have generic requirements, such as “good
communication skills”. However, lots of autistic people have exceptional skills and can thrive in many working environments.

Autistic people have been shown to be able to incredibly successful salespeople, computer programmers, lawyers, doctors, accountants and statisticians. Mozart, Einstein, Bill Gates, Charles Darwin, Tim Burton and Steve Jobs are considered by some to have been somewhere on the spectrum.

People with Autism can often demonstrate exceptional concentration, perseverance, reliability, attention to detail, technical skills
(e.g. computing) and often excellent memory and recall.

Employers should also consider that:

  • A candidate may not declare that they are autistic when applying for a job, as some people may be concerned about perceived social stigma and sometimes stereotypes or other biases being applied.
  • If a candidate does declare they are autistic at the application stage, it will be essential to make reasonable adjustments. This is to ensure the candidate has a fair opportunity to demonstrate their skills, experience and competencies.
  • This step is essential to ensure compliance with the Equality Act 2010; asking every candidate the same questions may not be sufficient to show equality of opportunity.

Tips to help hold an equal interview 

  • Many interviews are structured to place an emphasis on conversational ability and social skills, which many people with Autism may struggle to convey.
  • It is essential that interviewers consider that eye contact may not be maintained and that the candidate may not respond to body language.
  • Candidates may struggle to adapt between formal and informal tones, or to think in abstract ways; for example if asked about hypothetical situations.
  • It is definitely worth providing clear directions and instructions on what to do upon arrival at the interview location in advance. It may be worth considering sharing the questions in advance too.
  • It will help to let the candidate know who they will be meeting in advance, confirming their role in the interview and providing a timetable for what will happen (e.g. “we’ll spend the first ten minutes talking about you, then move on to spend ten minutes talking about your technical experience”).
  • If you can, it is worth providing access to a quiet waiting space, where the candidate can avoid auditory, visual or social stimulation. Allowing the candidate to prepare and use written notes may be helpful.
  • The more specific the pattern of questions, the better. For example, “What information governance processes did you use in your last job?” may elicit a better response than “what would you do to look after people’s data”.
  • It may be necessary to prompt the candidate if you need more information. It may also be necessary to let the candidate know when you have enough information too.
  • Interviewers should be prepared to accept literal responses, for example, a question asking “how did you approach your last role?” may elicit an answer “by bus and then I walked.”
  • It is worth offering the candidate the opportunity to take breaks before starting the interview, as well as asking them if they’d like to be accompanied by a person of their choosing too.

Impact on work 

Many of the impacts of Autism on work relate to communication. It can be difficult for some people with autism to read others body language or social cues. Often, there can be difficulties in setting or achieving performance targets, although there are strategies than can be used to help overcome these difficulties.

If an autistic employee’s health is affecting their work, sensitivity will be beneficial in approaching the issue. The same strategies that can underpin a successful interview can readily be applied to appraisals and performance reviews; giving good notice, confirming the topics to be discussed in advance etc.

Because Autism is a disability it will fall within the scope of the Equality Act 2010 and employers have a legal duty to consider adjustments to the role or environment before exploring capability for the role, if it becomes necessary.

The Health & Safety at Work Act 1974 stipulates that an employer must seek advice from a ‘competent person’ before dismissal on health grounds. That can be an individual’s GP, although that route may not be objective or impartial.

Under Access to Medical Reports Act 1988 legislation a patient can object to information being included in a report from a GP to an employer. They can insist changes are made before the report is released.

Occupational health support 

Occupational health advice on the other hand is independent and objective. Employees can only insist that factually incorrect information in a report is removed, rather than the opinions or advice of the occupational health clinician.

Although it is perfectly possible to get good occupational health advice from an occupational health nurse or a doctor with a Diploma in Occupational Medicine, the higher the degree of specialism and the more relevant the qualification, the more defensible the advice becomes. There’s more on this topic in our guidance on choosing an occupational health doctor.

The Society of Occupational Medicine has also published a really helpful guide to commissioning support, with specific guidance on steps to consider when arranging workplace assessments in-situ.

Reasonable adjustments at work 

The Equality Act 2010 means employers must consider making reasonable adjustments to support people with a disability in the workplace. Adjustments relating to Autism are often very specific to the individual, because the range, severity and scope of the spectrum can vary so much.

Autistic employees may sometimes benefit from:

  • Help with sensory stimuli; screens around desks, noise-cancelling headphones or quiet working location may be helpful
  • Highly specific instructions about how to carry out tasks, perhaps written clearly, even for seemingly simple tasks
  • Providing timetables for daily, weekly or monthly tasks may be helpful 
  • Providing written guidance about workplace practices, such as how to approach colleagues, may help.
  • You may need to consider providing a mentor or buddy to help with the role or specific tasks
  • Short and frequent reviews may be better than monthly, longer, performance reviews 
  • Feedback should be sensitive and direct, an autistic employee may not understand body language or implied guidance
  • Access to agreed or identified safe or quiet spaces can be helpful in case the employee becomes anxious or overwhelmed
  • Allowing the employee to use a card to show others when they are becoming anxious or overwhelmed may be helpful
  • Giving as much notice as possible to any changes to a role or environment will be helpful
  • Consider offering training to employees on neuro-diversity or Autism – the National Autistic Society has lots of different
    courses, e-learning programmes and resources

Other sources of support for employers 

The Access to Work scheme may fund support for employers and employees.

The National Autistic Society provides lots of guidance and support including an Employment Training Scheme, a Workplace
service and an Autism at Work Programme for employers. 

A firm of employment lawyers has an excellent summary of the case law and some advice surrounding neurodiversity at work.

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