COVID-19 related factors affecting the experiences of neurodivergent persons in the workplace: A rapid review

1.1Neurodiversity and the neurodiversity movement

Attributed to Judy Singer (sociologist) in the late 1990s and promoted by the journalist, Harvey Blume, the neurodiversity concept is relatively new [1, 2]. The term neurodivergent has been defined as, “having a brain that functions in ways that diverge significantly from the dominant societal standards of ‘normal”’ [3]. This contrasts against the majority of persons who are neurotypical (i.e., their brains process information in ways that meet the expectations of society) [4]. Neurodiversity references the various ways in which brains function and understand information [4]. It positions neuro types such as dyslexia, autism and Attention Deficit Hyperactivity Disorder (ADHD) as natural differences in cognition [2]. Neurodiversity offers a change of perspective which serves to challenge presumed perceptions of normality [5]. As a label, neurodiversity has been described as showing more respect for the dignity of humans [6]. Supporting principles of social justice, this respect should extend to the significant number of neurodivergent persons who are present in a populace. The proportion of neurodivergent citizens is notable. It is suggested that around ten percent of the population has some kind of neurodivergence [7].

Neurodiversity holds a political aspect. A discussion as held among autistic persons and individuals with other kinds of neurodivergence has laid the groundwork for the neurodiversity movement (NDM) [8]. This movement aims to deliver changes in how society looks at and reacts to neurological diversity [9]. The NDM largely involves advancing the civil rights of neuro-minorities [10]. The movement also holds a solid grounding in scientific studies that record the abilities of persons with various medical labels [11]. Donnelly [12] makes the point that some neurodivergent persons are intellectually gifted. Challenging the medical model, Kapp, Gillespie-Lynch, Sherman and Hutman [13] report of the NDM pursuing quality of lived experiences over cure. The movement, however, is not without its critics. There are various disability advocates who are anxious that the movement downplays the challenges confronting individuals with severe cognitive issues [1]. Rothstein (14, p.107) suggests it to be “cruel” to assign the neurodiversity term to those persons who require intensive medical treatments. Russell [15] also recognises an allegation that the movement is not representative of all neurodivergent persons. Nonetheless, the potential for the NDM to support progressive and prideful meanings about neurodivergence should not be downplayed or dismissed.

1.2Neurodivergence and career development barriers

A greater understanding is required of the issues that can damage the careers of neurodivergent persons. Davila, Shectman and Anandan [16] suggest that a need exists to more deeply address the area of inclusion in the workplace, and in particular in relation to the participation of neurodivergent employees. Such inclusion can be undermined by inflexible and inappropriate assessment measures. In this sense, interviews are prejudiced against persons who are atypical in their interactions [17].

Workplaces can also overlook the abilities and requirements of neurodivergent employees [1, 16]. These oversights are not adequately redressed through current policy. It has been reported that nearly 75 percent of workplace policies disregard neurodivergence [7]. The consequences of this policy shortfall can be serious. For instance, open plan office designs are “distracting and unproductive” for neurodivergent employees who are sensitive to sound (18, p.5). Neurodivergence is also reported as being overrepresented among persons who are experiencing long-term unemployment [19]. Contemporary workplaces are challenged to recognise and redress these kinds of persisting inequities.

1.3COVID-19 widespread devastation and the careers of neurodivergent persons

COVID-19 (forthwith to be referred to as COVID) represents a perplexing policy issue. Over a very short space of time, life has been interrupted on a global scale [20]. With 27 cases identified in Wuhan City, China in December 2019, and having not before been detected among humans, COVID-19 is now referred to as a “devastating pandemic” (21, p.S3, 22, p.543, 23). COVID-19 has been depicted as an unparalleled test for healthcare [24]. For numerous persons around the world, the pandemic has shown itself to be the difference between life and death. In this light, COVID-19 is ranked as a prominent cause of fatality [25]. Despite improvements in treatments and promising vaccines, COVID-19 is likely to continue to be around for many years [26].

COVID-19 can threaten not only physical health, but also mental wellbeing. Thite (27, p.13) describes the pandemic as unleashing “chaos and uncertainty”. This global pandemic has disrupted daily habits, seen a revival of xenophobia, and wounded the economy [20]. Prolonged time spent in isolation together with the stressors of dealing with COVID-19 have tested the mental health of many persons [28]. Davila, Shectman and Anandan [16] recognise that an environment has been generated whereby anxiety and stress is elevated for everyone. Donnelly [12] cautions that COVID-19’s interruption of work and home habits has proven to be a significant event for many employees. The initial wave of jobs that have been lost during COVID-19 has been immense [29]. The pandemic has thus generated intense fear and doubt across personal and working lives [30].

As the world struggles with COVID, each day brings with it additional headlines concerning the future of the workplace [1]. While the workplace can be a perplexing and possibly frightening environment for some neurodivergent persons in usual times, it will likely become even more overpowering due to COVID-19 driven uncertainty [31]. Nonetheless, the pandemic is encouraging employers to adjust [32]. COVID-19 is starting to modify views throughout society with many having gained a keener awareness of their environments [2, 33]. Possibilities for COVID-19 disruptions to influence the careers of neurodivergent persons are worthy of scholarly attention. Hence, this rapid review will address the timely question of, in what ways might COVID-19 affect the experiences of neurodivergent persons in the workplace?

2.1Qualitative data collection

A research question (as stated above) was firstly set. Next, the following databases with capacity to inform this review were selected: ProQuest Central; ProQuest Newsstream International databases; Google Scholar; and Google (internet enquiry). Being purposefully constructed to inform the research question, the search term was comprised of: COVID-19 AND neurodiver^* AND workplace. Inclusion criteria were set as follows: search fields = all fields AND Document type = journal article OR grey literature (i.e., news article OR guide OR report) AND language = English AND publication date = 2020 to 2021 AND document refers to possible COVID-related factors affecting neurodivergent staff or prospective staff AND document is accessible. Searches were then conducted and document details imported into EndNote X7.8 with duplicates removed. Following on, abstracts, where available, were inspected for possible relevance. Next, possibly relevant documents were accessed and appraised in detail. Scholarly citations from relevant articles were then included in the study results.

2.2Qualitative data analysis

Enabling a synthesis of the data, the author has applied the thematic analysis technique. As informed by Braun and Clarke [35], this analysis involved a repeated cycle of: 1) inspecting the relevant documents; 2) building a coding scheme, and 3) identifying, naming and reviewing themes and sub-themes.

4.1COVID-related challenges and opportunities for accommodating neurodivergence in the workplace

Accompanying the pandemic are obstacles and opportunities to accommodating neurodivergence in the workplace. Prominent among COVID-related adjustments is the requirement for staff (including neurodivergent staff) to work from home. Sargent [36] observes in a news article that an enormous, unexpected experiment in remote working is presently underway. Significant concerns, however, are mentioned in the literature about neurodivergent employees in this remote work environment. As reported among scholarly and grey literature, such concerns include: micromanagement; video conferencing issues (e.g., fatigue from chaotic Zoom meetings); uncertainty as to the ongoing availability of virtual accommodations; struggles with physical distancing; mental health and wellbeing issues following a disruption to routines; overworking in the home environment; and sensory overload upon returning to the office (e.g., worsening symptoms for OCD employees) [26, 28, 37–46].

Elaborating on Zoom fatigue, it needs to be recognised that not all neurodivergent persons will be comfortable with these kinds of virtual meetings. According to a news report, some might be overwhelmed by many persons who are talking at the same time [45]. The scholarly and grey literature reveal a range of options for those who are uncomfortable with noisy online meetings or with real time, face-to-face interactions. These options include: one-on-one or smaller group Zoom sessions; enabling Zoom captions; reducing anxiety by sending out the agenda beforehand; using chat tools instead of live discussions to raise and address questions; or allowing employees to provide their meeting contributions in advance [16, 45]. News reporting suggests that dyslexic employees might also benefit from making the recordings of Zoom meetings available [45]. Moore [47] too reports of some neurodivergent persons much preferring the precision of text-based communications using tools such as Workplace Chat and Slack.

It should not be assumed that neurodivergent-related accommodations that are effective in an onsite workplace will always be helpful when applied remotely (e.g., in a home office setting). A University of Sheffield guide supports the testing of pre-COVID-19 accommodations for neurodivergent staff in terms of their effectiveness in the home work environment [4]. Workplaces therefore need to invest in independent audits so that an assumption is not made that onsite, approved accommodations for neurodivergent employees will necessarily work well when implemented offsite. This highlights the position that rather than being static, accommodating neurodivergence during a pandemic is a dynamic process.

Reported challenges for neurodivergent staff who are working remotely confront a number of misconceptions about neurodivergence. News articles endorse the notion that autistic employees do not want social contact is a falsehood as these persons can be negatively impacted by the loss of connections that are developed over time [1, 26]. The ableist notion that neurodivergent staff must be micromanaged is undermined by the Neilson [28] news reporting of some autistic persons overworking (i.e., not taking rest breaks, and missing meals when working from home). The concerns of some managers about the day-to-day productivity of persons who are working from home [37] might therefore be misplaced when these are automatically directed at neurodivergent staff. Still, any suggestion that a neurodivergent person will necessarily thrive in a remote working role is questioned by the Donnelly [12] assertion that some of these persons might struggle when the routines in which they often flourish are disrupted. Testing the validity of such news-based assertions, future research is needed to ascertain the possible degree and ease to which neurodivergent persons might establish new routines when working from home.

Notwithstanding the above-mentioned challenges, scholarly and grey literature indicate that a COVID-19 requirement to work remotely can offer opportunities for neurodivergent staff and their employers. These include: offering communication alternatives (e.g., allowing remote access to all meetings); removing on-site challenges for employees with ADHD (e.g., avoiding busy and distracting office settings); enhancing work on a digital platform; and achieving sustained productivity [6, 16, 39, 48, 49]. Remaining cognisant of the potential for Zoom fatigue [43], Moore [47] nevertheless suggests that some neurodivergent employees might prefer meeting interactions that make use of this technology. News articles also purport that COVID-19 can see some neurodivergent persons being hyperaware about the close physical proximity of other team members, while many can be hypersensitive to physical pressure and subsequently struggle with wearing masks [26, 36]. For these individuals, remote working via online technologies would most likely offer a welcome relief to these particular sources of ‘on-site’ workplace stressors. Hence, there are some staff who might perceive a COVID-19 requirement to work from home during lockdowns in terms of a reasonable accommodation for their neurodivergence. Independent audits are again needed to explore the possible extent to which these staff are now successfully working remotely, but who might have had their reasonable accommodation requests to work from home rejected prior to the pandemic.

In their news article, Gilroy and Haque (2, n.p.) note that COVID-19 is changing views throughout society with work from home quickly becoming the “new normal”. It is this so-called, new normal, that holds interesting prospects for workplaces to become better at accommodating neurodivergence where needed. Recognising potential work from home benefits including those of increased productivity and reduced stress, decision makers should consider allowing neurodivergent workers who are concerned about returning to their workplaces to continue with remote working wherever their roles allow [42, 50]. Terise and Armstrong (46, n.p.) depict potential for a pandemic-inspired cultural shift away from obsolete workplace norms as follows:

\begin quoteEmployers have an opportunity to use their collective experience of the coronavirus pandemic to drive a positive, cohesive shift in workplace culture. They can redesign the outdated nine-to-five office lifestyle. \end quote

According to a news reporting, COVID-inspired adjustments hold implications for the recruitment, retainment and advancement of neurodivergent individuals. Video interviews can be helpful in redressing possible bias among panel members as less emphasis is placed upon first impressions [38]. Gilroy and Haque [2] indicate that the success which has been attained with online interviews means that this option will become more commonplace. Accommodations might also be required around COVID-19 messaging originating from the workplace that some neurodivergent staff might find alarming. For example, an employee who was already obsessively monitoring details concerning the virus was bombarded with unwanted daily COVID-19 updates from their organisation [28]. A reasonable accommodation in this instance would be to curtail the sending of these emails with the objective of maintaining employee safety while not adding to anxiety. Moreover, for those neurodivergent persons who might want to return to the on-site office, accommodating office designs might be required. In this respect, Terise and Armstrong [46] advise of the need to provide quiet area alternatives to open plan office settings.

Schwam [1] cautions that while organisations want to avail accommodations and advertise that they have a neurodivergent workforce, accommodations can involve a lengthy process to implement and sometimes, even reasonable ones can be refused. However, Miller [43] raises the encouraging point that COVID-19 has helped to redress formal excuses for not offering flexible work environments. Managers who automatically refuse accommodations to neurodivergent staff and prospective staff need to be held accountable for their discriminatory and unreasonable responses. In this light, ethical workplaces should not tolerate any form of neuro-discrimination.

New reports indicate that pandemic inspired accommodations can also serve to brighten the promotional prospects of neurodivergent employees. Greater use of online communications (as a preferred mode of communicating) can help to raise the profiles of these staff members who might have otherwise been invisible to the managerial raider [2]. This adjustment thus holds potential to assist in developing the careers of neurodivergent employees who might not be at ease with face-to-face interactions. Gilroy and Haque [2] also advise that movement towards platforms that are online means that people have more choices to participate in conversations in ways that they desire. It is important that communications and other COVID-related accommodations that collectively work to support the recruitment, retainment and advancement of neurodivergent persons do not fall out of favour post the pandemic.

News article raise potential for large gatherings, work conferences and social events to be more accessible to neurodivergent persons. In this way, virtual events are suggested to encourage greater participation [38]. For example, as a consequence of COVID, hundreds of healthcare staff have attended virtual sessions of the Pharmaceutical Care Manufacturer Association’s annual meeting for 2020 [51]. It is quite reasonable to suggest that at least some of these attendees would be neurodivergent, with a subset of these persons potentially preferring this virtual setting. Beery [39] raises the risk, however, that while academic conferences are currently online, this status quo might change. Similar to the availability of remote meetings and remote work accommodations more broadly, ongoing access to virtual conferences should not be taken for granted.

Scholarly reporting informs that for some autistic employees, virtual interactions can offer respite from the rigors of socialising [44]. A reprieve from social activities, for those neurodivergent persons who might want such rest, is quite different from the removal of access to these activities. It thus remains important that social events remain accessible to neurodivergent employees and that these persons are encouraged to socially engage in ways in which they feel comfortable. In line with news reports, Schwam [1] acknowledges opportunities for social connections to be maintained through such means as virtual social events and newsletter emails. Hence for many persons, the pandemic has helped to make work and social life more accessibility [39]. And while not all neurodivergent employees will need or want to participate in virtual social activities, for those who wish to be involved, access to online social interactions should be availed.

Beery [39] suggests that while persons without disability who are hurrying to resume their face-to-face communications risk reducing accessibility back to pre-COVID-19 levels, opportunities still exist to make accessibility something that is permanent. Such accessible and accommodating workplace environments need to meet the individual needs of neurodivergent staff and prospective staff. According to Terise and Armstrong (46, n.p.), “failing to consult neurodiverse individuals in the design of changes put in place to support them is likely to be ill-informed and could do more harm than good, even if it is well intentioned.”

Accommodating neurodivergence during COVID-19 (or at any other time) raises the topic of disclosure. In light of the pandemic, and in the interests of safety (i.e., safely accessing accommodations), research reporting suggests that there are some persons who will need to disclose their lived experience [52]. It is critical that such disclosure of neurodivergence can be confidently made in safe and supportive work environments. Furthermore, that any reasonable accommodations needed are expeditiously approved and attained.

4.2COVID-related challenges and opportunities for advancing diversity and inclusion (and in particular, including neurodivergence) in the workplace

Pandemic related issues hold capacity to diminish or enhance the acceptance of neurodivergent staff. Such acceptance might be threatened by reductions in mental wellbeing and associated instances of neuro-discrimination. The U.S. Mental Health Index for workers reports that the risk of general anxiety and depression for males are up by 55 and 69 percent respectively, while fears of redundancy can stop neurodivergent employees from discussing their depression with team members [28, 53]. Acceptance in the workplace should not be premised upon one being neurotypical or appearing to be neurotypical. Employees should able to safely discuss issues such as anxiety or depression without experiencing judgement or rejection from management or colleagues.

Reflecting a workplace culture that is accepting of neurodivergence, neurodivergent staff should not feel threatened in any way about discussing the elevated mental health challenges that some might experience during a pandemic. However, news reports suggest that economic disruptions following the pandemic can translate into autistic persons often being the first to be fired and the last employed [26]. Care is therefore needed so that COVID-related economic challenges do not transform into the unethical practices of ‘moving on’ neurodivergent employees from the workforce or discriminating against these persons in recruitment processes. These bigoted, neuro-discriminatory practices have no place in ethical workplace cultures that endeavour to be inclusive of neurodivergence, either during a pandemic or at any other time.

Economic and mental health challenges that accompany the pandemic need not necessarily lessen the level of acceptance of neurodivergence in the workplace. Despite COVID-19 related closures to training, the MetLife company continued to enhance its diversity via its recruitment and retention strategies [54]. Moreover, scholarly articles assert that COVID-19 disruptions offer an opportunity to establish new benchmarks for workplace inclusion [20, 27, 55]. Moreover, news reporting raises potential economic gains to be had from the acceptance and recognition of neurodivergence in leadership teams, particularly in troubling times. The Ultranauts organisation managed to continue to grow its revenue (up 50 percent) during COVID-19 with autistic persons in the leadership team [56]. Good leaders view diversity in its many forms, and this outlook encompasses neurodivergence (i.e., diversity of thinking) [57].

According to news reports, aspects of the pandemic hold potential to discourage or encourage empathy for neurodivergent staff. Commencing with indifference, the costs that are imposed by COVID-19 risk seeing a dilution or eradication of diversity and inclusion from company agendas [38]. The pandemic has shown that some organisations see diversity and inclusion as a nicety rather than a central value [38]. Neilson [28] also reports that empathy should not rely on a pandemic that concerns us all. Nevertheless, Miller [58] suggests that communications with staff about the adjustments that can assist them during COVID-19 might encourage empathy more broadly. COVID-19 lockdowns and the fears that are experienced in public places can give neurotypical persons a taste of this discomfort [40, 59]. Indeed, many neurotypical persons have experienced mental health issues under lockdown conditions [6]. Carr-Fanning (6, p.20) in a scholarly article expands upon this matter as follows:

\begin quoteAnecdotal evidence suggests that the COVID-19 lockdown highlighted some of the issues people with different interactional preferences experience trying to function in a world not designed to include them. When lockdown happened, many neurotypical people struggled with their mental health and wellbeing. \end quote

Neilson [28] recognises that neurodivergent persons have developed strategies that are useful in trying times and that these can be shared with persons who are having their first lived experiences with anxiety or depression. COVID-19 also holds potential to encourage self-empathy among neurodivergent staff. In this way, the “new normal” together with inclusive organisational cultures might allow neurodivergent staff to be their true selves and to use their abilities to the benefit of their employers (31, 47, n.p.).

As suggested by news reports, COVID-19 promotes a need for receptive systems and initiatives that are supportive of individual difference, including that of neurological difference [32, 60]. Encompassed among these progressive initiatives are Employee Reference Groups (ERGs). ERGs are voluntary groups that are led by employees [61]. These groups aim to help to make workplaces more inclusive by assisting in the understanding of the needs of diverse cohorts [38, 61]. From a mental health perspective, an ERG can support the mental wellbeing of employees [62]. This review also includes an example whereby neurodivergence has been included among the diversity groups as offered by a workplace [63]. In the wake of COVID, and recognising opportunities to achieve positive change through a greater inclusion, workplaces need to ensure that neurodivergence is not overlooked among the ERGs that are availed to staff.

4.3COVID-related guide to accommodating and including neurodivergence in the workplace

Box 1 provides a baseline guide to supporting neurodivergent employees and prospective employees during (and after) a pandemic. Workplaces that wish to do more than to talk about diversity and inclusion (and in particular, the inclusion of neurodivergent persons) need to invest in these measures.