Environmental factors impacting work satisfaction and performance for adults with autism spectrum disorders

Abstract

BACKGROUND:

Individuals with ASD have some of the highest rate of post-graduation unemployment and competitive employment rates are very low. There is substantial research identifying specific person factors influencing employment outcomes, although there is very little research exploring the impact of environmental factors.

OBJECTIVE:

The purpose of this article is to understand the impact of environmental factors on work satisfaction and performance from the perspective of adults with Autistic Spectrum Disorder (ASD).

METHODS:

Qualitative interviews were used to gather personal perspectives from working adults with ASD. The data was micro-analyzed for open coding and organized under common categories. When data was saturated, axial coding occurred resulting in multiple categories linked together under a common central theme.

RESULTS:

Results identified the central category of Facilitators and Barriers of Person and Environment Fit for Work Satisfaction and Performance, which encompassed the categories, subcategories and links between categories. Both environmental factors and person-fit were identified as two overarching categories where barriers and facilitators were present.

CONCLUSIONS:

Adults with ASD identified that social interactions, attitudes, and the physical or sensory environment impacted perceptions of work satisfaction and performance. Future research is needed to better understand how to reduce environmental barriers in the workplace for adults with ASD.

Keywords

Autism spectrum disorder environment work performance job satisfaction

1 Introduction

Autism spectrum disorder (ASD) is characterized by impairments with social communication, social interactions, and restrictive repetitive patterns of behaviors and interests (American Psychiatric Association, 2013). The Center for Disease Control (CDC) reports that 1 in 68 children are identified as having ASD in the United States (Centers for Disease Control and Prevention, 2014). This increase in ASD prevalence, in conjunction with an aging ASD population, ultimately results in a need for appropriate interventions to support adults transitioning into employment settings and other adult roles. Individuals with ASD have the highest rate of post-graduation unemployment compared to individuals with other learning disabilities (Shattuck et al., 2012), and competitive employment rates are as low as 6–12% (Hendricks, 2010; Roux et al., 2013). Additionally, several studies reported very poor employment outcomes for adults with ASD regardless of their intellectual abilities (Hendricks & Wehman, 2009; Henninger & Taylor, 2013; Hurlbutt & Chalmers, 2004; Wehman, 2013). Overall, adults with ASD experience more barriers in obtaining jobs, maintaining jobs, and have a higher rate of job switching (Hendricks & Wehman, 2009).

Various intervention supports exist for individuals with ASD during childhood and adolescence. In contrast, there is a dearth of services for adults with ASD. A recent study following students with ASD two years after graduating high school found more than 50% did not pursue postsecondary education or work opportunities (Roux et al., 2013). Additional research has identified that young adults with ASD earn less, have fewer jobs, and have less variation in job types than peers with other disabilities (Newman et al., 2011; Roux et al., 2013). This is a vital area of concern for the ASD population and their families, as one of the overall goals in adulthood is to secure successful employment. In general, limited research exists exploring employment-related issues for adults with ASD (Chen, Leader, Sung, & Leahy, 2015).

Preliminary research has suggested that adults with ASD who received vocational services are more likely to obtain competitive employment (Lawer, Brusilovskiy, Salzer, & Mandell, 2009). There are a number of studies that demonstrated improvements in specific employment-related person skills after vocational rehabilitation (Alexander, Ayres, Smith, Shepley, & Mataras, 2013; Dotson, Richman, Abby, Thompson, & Plotner, 2013; Walsh, Lydon, & Healy, 2014). One example is an intensive intervention program called Project SEARCH, which provides transitional services in the form of a school-to-work internship program for students with ASD (Wehman et al., 2014). The program revealed how intensive interventions can provide positive outcomes for students with ASD (Wehman et al., 2014). This intervention explored a multi-component behavior intervention plan and modifications to the job task analysis to produce work productivity and purposeful activity for adults with ASD in the workplace. Much like Project SEARCH, most interventions focus on improving specific skills of the person and modifying the actual job task. There is substantial research identifying specific person factors influencing employment outcomes, although there is very little research exploring the impact of environmental factors and the fit with the person’s characteristics. Policy suggestions based on research recommends that transition-age youth have integrated work experiences in community settings (Wehman et al., 2014). Community-based work environments provide more variability that can pose as barriers to successful competitive employment. There is a need to understand the environmental impact in order to align the strengths or needs of the person with the environmental demands to guide intervention and support structures. The International Classification of Functioning, Disability and Health (ICF) identify environmental factors as facilitators and/or barriers in the performance of daily activities, such as work (World Health Organization, 2009). Environmental factors as defined by the ICF include the social, attitudinal, and physical environments in which people conduct their lives (World Health Organization, 2009).

Research has identified that social and communication skills often have a significant impact on employment outcomes (Hendricks, 2010; Patterson & Rafferty, 2001). Adults with ASD face many challenges with communication, such as understanding directions, the inability to read between the lines, read facial expressions, and read tone of voices, asking too many questions, and communicating in an inappropriate manner (Baldwin, Costley, & Warren, 2014; Bolman, 2008; Hendricks, 2010; Hurlbutt & Chalmers, 2004; Müller, Schuler, Burton, & Yates, 2003). In a study interviewing 18 adults with ASD, all participants identified that challenges with communication within the workplace led to difficulties with supervisors and co-workers (Sperry & Mesibov, 2005). There are a number of communication requirements that take place throughout the work environment from simple small talk to formal discussions.

The social environment is a critical factor contributing to employment rates and sustainment for adults with ASD. Studies report that social isolation is created for individuals with disabilities by non-disabled co-workers and supervisors within the work environment (Antonak & Livneh, 2000). Adults with disabilities also report feeling stigmatized and not socially accepted by colleagues (Hall, 2004). Social attitudes within the work environment are well documented as factors that impact work satisfaction and employment for adults with disabilities. The feeling of being accepted in the workplace is linked directly to job retention as well as a “positive self-perception and general life satisfaction” for adults with disabilities (Vornholt, Uitdewilligen, & Nijhuis, 2013). Additional studies have shown positive work performance of an adult with a disability increases the social acceptance by non-disabled colleagues within the workplace (Banks, Charleston, Grossi, & Mank, 2001; McLaughlin, Bell, & Stringer, 2004). A recent survey showed lack of appropriate understanding from employers and co-workers as one of the major barriers to successful employment (López & Keenan, 2014). Furthermore, an additional study identified characteristics of employers who were reluctant to accommodate and adjust the workplace for employees with a disability, and its impact on the employee (Richards, 2012). Attitudes of others are considered one environmental barrier for individuals with disabilities, and an important consideration in understanding work satisfaction and performance for individuals with ASD.

Adults with ASD are also known to have atypical behavior patterns in multiple sensory systems (Miller, Coll, & Schoen, 2007). These atypical behavioral responses present as deficits in regulating the intensity, degree, and nature of responses to sensory input, and can impact daily roles and routines (Miller et al., 2007). Common sensory responses reported include sensory over-responsivity and sensory under-responsivity (Miller et al., 2007). Adults with ASD can have a combination of sensory responses depending on the work environment and the changes that occur within the environment. For example, an adult with ASD might over-react to loud noises within the work environment and under-react to someone talking. Recent research supports the notion of the coexistence of under- and over-responsivity in adults with ASD (Lane, Young, Baker, & Angley, 2010). Sensory experiences in general are more personal and individualized experiences than any standardized measure could describe (Ashburner, Bennett, Rodger, & Ziviani, 2013). Therefore, it is important to obtain first-hand reports from adults with ASD to explore how these sensory factors impact their work environment and overall employment (Smith & Sharp, 2013).

The purpose of this pilot study was to understand the impact of environmental factors on work performance and satisfaction from the perspective of adults with ASD. In order to develop feasible interventions that have acceptability, researchers need to understand the viewpoints of working adults with ASD. It is important to consider both the person’s strengths and needs in relation to the environmental factors, to enhance work performance and overall satisfaction. A qualitative approach was used to answer the question, “How do environmental factors impact work satisfaction and performance for adults with ASD?”

2 Methods

2.1 Design

This qualitative study used grounded theory methodology to guide data collection and analysis. The intent of using a grounded theory approach was to establish a substantive theoretical framework that helps explain the environment impact on work satisfaction and performance for working adults with ASD (Strauss & Corbin, 1998). Qualitative interviews were completed to gain personal perspectives about the work environment from employed adults with ASD.

2.2 Participants

A convenience sample of fourteen English-speaking participants were recruited and interviewed for this study. All participants were working adults with a mean age of 40 (SD = 13.8) who were diagnosed with high-functioning autism, pervasive developmental disorder not otherwise specific (PDD-NOS), or Asperger’s syndrome. Diagnoses were based on the DSM-IV, as participants were diagnosed prior to the release of DSM-V criteria. All participants had a score of 65 or higher on the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), which indicates the presence of an autism spectrum disorder. Participants’ occupations, ages, and perceived job fit and satisfaction are listed in Table 1. Several co-morbid conditions including attention-deficit/hyperactivity disorder (ADHD), depression, anxiety, oppositional defiant disorder (ODD), post-traumatic stress disorder (PTDS), and bipolar disorder were identified by participants. Participants identified taking medications for anxiety, depression, ADHD, and bipolar disorder. Additional demographics are provided in Table 2.

Table 1
Participant occupations, ages and perceived job fit

Participant Occupation Age Reported Overall Fit for

Number/Pseudonym Job/Perceived Satisfaction

1/Bob Special Education Teacher 46 Moderate Fit/Not Satisfied

2/Dan Part-Time Assistant (at a used bookstore) 30 Good/Satisfied

3/Bill Computer Systems Analyst/Computer Programmer 67 Good/Satisfied

4/Dave Employment Specialist/Job Coach 38 Poor/Not Satisfied

5/Jane IT Call Specialist 49 Poor/Not Satisfied

6/Jill Data Entry Specialist 29 Good/Satisfied

7/Beth Home Health Nurse 37 Moderate/Somewhat satisfied

8/Jen Janitor 36 Poor fit/Not satisfied

9/Barb Communication Specialist 45 Good fit/Satisfied

10/Val Dog Groomer 61 Good fit/Not satisfied

11/Laura Telephonic Customer Service 40 Poor fit/Not satisfied

12/Dawn Junior Developer of Software 21 Moderate Fit/Satisfied

13/Tim IT at Medical College 39 Good fit/Somewhat satisfied

14/Ian Patient Care Tech 38 Moderate Fit/Satisfied

Participant	Occupation	Age	Reported Overall Fit for
1/Bob	Special Education Teacher	46	Moderate Fit/Not Satisfied
2/Dan	Part-Time Assistant (at a used bookstore)	30	Good/Satisfied
3/Bill	Computer Systems Analyst/Computer Programmer	67	Good/Satisfied
4/Dave	Employment Specialist/Job Coach	38	Poor/Not Satisfied
5/Jane	IT Call Specialist	49	Poor/Not Satisfied
6/Jill	Data Entry Specialist	29	Good/Satisfied
7/Beth	Home Health Nurse	37	Moderate/Somewhat satisfied
8/Jen	Janitor	36	Poor fit/Not satisfied
9/Barb	Communication Specialist	45	Good fit/Satisfied
10/Val	Dog Groomer	61	Good fit/Not satisfied
11/Laura	Telephonic Customer Service	40	Poor fit/Not satisfied
12/Dawn	Junior Developer of Software	21	Moderate Fit/Satisfied
13/Tim	IT at Medical College	39	Good fit/Somewhat satisfied
14/Ian	Patient Care Tech	38	Moderate Fit/Satisfied

Table 2

Participant demographics (N = 14)

Demographic Characteristic	n
Gender
Male	6
Female	8
Diagnosis
Asperger Disorder	9
PDD-NOS	1
High Functioning Autism	4
Living Environment
Rural/Small Town	3
Suburban	8
Urban	3
Education
High School	3
Post-Secondary: Two-year College	5
or Technical Training School
Some College courses complete	3
College Degree	3
Support Services
Psychological	3
Vocational Training	1
No Services	10

Participants were recruited through community partners and a University Disability Resource Office. Electronic flyers were also emailed to support groups for adults with ASD, community support programs, and other programs that support individuals with disabilities in finding employment. For inclusion, participants were required to be eighteen years of age or older, have a diagnosis of ASD or Asperger’s syndrome, and have had worked for at least twenty hours per week. Participants completed the RAADS-R to verify the diagnosis of ASD for inclusion.

2.3 Data collection

Researchers obtained IRB approval through their university prior to implementation of this study. Informed consent was obtained from each participant either online or in-person. Researchers were all trained in conducting qualitative interviews and interview techniques were practiced prior to the start of data collection. Semi-structured interviews were completed with each participant using an interview protocol consisting of 8 general and 5 environmental work questions (see Table 3) that lasted between 30 minutes and 2 hours. All interviews were digitally recorded. The interviews consisted of an introductory statement explaining the overall purpose of the interview followed by the general work and environment questions, as well as additional probing questions to encourage participants to describe aspects of their work experiences. Questions intended to obtain information on general aspects of the participants’ work (e.g., job type, typical job tasks), as well as information about their experiences with the social, sensory/physical, and attitudinal environment in their work setting and how this impacted overall satisfaction and performance. All interviews occurred over the phone at a convenient time and location for each participant. Interviews were transcribed, crosschecked, and analyzed by at least two researchers for investigator triangulation purposes.

Table 3
Interview questions

General Work Questions

1) What is your job? What does it require you to do?

2) What do you like about your workday /job?

3) What don’t you like about your work day/job?

4) If you could change anything about your work day/job, what would it be? Why?

5) What makes your work/job good for you?

6) What is not good about your job for you?

7) Do you like coming to work? Why or why not?

8) What are the benefits (or motivation) for working for you?

Environment Specific Questions

1) What sensory factors or stimuli in your work environment

(i.e. lighting, noises, how loud people are, the amount of

people in one area, clothing requirements, the feeling of chairs

and furniture, temperature, the amount of time you need to sit/

stand/move, clutter or organization of space - visual

distraction; provide additional examples as needed) effect:

a. How much you like your work?

b. How you perform at your job?

2) What social interactions in your work environment (i.e. the

social interactions with supervisors and co-workers,

interactions with others required to complete the job, amount

it takes to process social information; provide additional

examples as needed) effect:

a. How much you like your work?

b. How you perform at your job?

3) How does the way other people treat you at work effect:

a. How much you like your work?

b. How you perform at your job?

4) What would you change about your work environment?

5) What do you like about your work environment?

2.4 Data analysis

Initially, all interviews were transcribed verbatim and two members of the research team completed microanalysis of the data using both open and axial coding. Each researcher completed a line-by-line analysis of the transcriptions to generate initial categories (i.e., benefits, social interactions, or environments) during the open coding process (Corbin & Strauss, 2014). Data from each subsequent interview was added to the current categories, and categories were expanded and added when identified. Researchers completed the open coding process independently followed by meetings to obtain consensus to ensure consistency in the coding analyses. Consensus was obtained about specific categories and reflective titles, as well as the coding of words, quotes, and phrases in each category during post-analysis discussion of the research team. There was 100% consensus obtained. When data was completely saturated in the open coding process, axial coding occurred where multiple categories were linked together under a common theme. This process was completed over multiple research meetings by the 2 researchers that completed the open coding process. During axial coding, connections were made among categories and subcategories. Once again, 100% consensus was obtained between the two researchers. Finally, a process of “theoretical integration” was used to develop a central category that represented all the categories, subcategories, and the interconnections.

To strengthen the data collection process and trustworthiness, data was collected until saturation and two researchers analyzed the data for investigator triangulation (Kielhofner, 2006). Open coding of data stopped after the 14th interview, as no new categories or themes were identified by either researcher. As discussed previously, there were two researchers who analyzed the data to “examine the same phenomenon from multiple perspectives” (p. 603) to provide a deeper understanding of the data (Jick, 1979).

3 Results

Results identified six major themes that represented barriers or facilitators to work satisfaction and performance. Three themes characterized environmental factors, while the other three themes characterized the person-fit factors (see Fig. 1). The three environmental factors included: 1) social interactions/communication within the workplace; 2) attitudes within the workplace; and 3) sensory/physical factors (i.e., lighting, noise, or desk location). The person-fit included: 1) how each person matched up with his/her job based on the job characteristics; 2) the skill or passion of the participant; and 3) the impact of ASD symptoms. Job types and perceived person-fit varied significantly between participants, as well as reported job satisfaction. Table 1 provides an overview of the participants’ occupations, pseudonyms used throughout the results, and their perceived satisfaction and fit with their job as reported during the interviews.

Fig.1

Themes of Environmental Factors and Person Fit Identified as Facilitators and Barriers for Work Satisfaction and Performance.

3.1 Participants’ narratives

3.1.1 Environmental factor: Social

Participants described social interactions as a necessary but challenging part of the work environment. Social interactions varied depending on the type of work of the participant and had both a negative and positive effect for adults with ASD. Some participants found social interactions more challenging than others. Additionally, at times, the social interactions could be a hindrance to work performance and satisfaction. For example, Bill reported, “Anytime I have to interact with other people for me it is horribly uncomfortable” and Tim stated, “Everywhere I ever worked, it is always my interpersonal skills that are bad”. Jill described the experience of working around others in her statement, “When there’s people around I just want to avoid them, especially on my day off. But even at work, passing them in the hallway as I walk to the restroom is so uncomfortable, and I wish I could just snap my fingers and be in the restroom. I’m just not comfortable with people who don’t react the way I expect.” In contrast, certain participants found some social interactions to be positive within the work environment. Social experiences varied with the type of work chosen. Some participants worked in large organizations with cubicles, while others worked in a local store with little to no co-worker interactions. Furthermore, some participants did not mind social interaction as long as it pertained to work, but most preferred not to have “small talk.” For example, Dan stated, “I generally get along well with my boss and that’s always a plus. I don’t have to deal with, uh, annoying co-workers, most of the time it’s just me and my boss.” Dawn commented, “You know in terms of interacting with other co-workers in general is not a problem. I don’t need small talk and chit-chat, so I don’t necessarily take part in those things, but when it comes to talking about stuff involving the job or stuff relating to it, I open up”.

3.1.2 Environmental factor: Attitudinal

Participants identified attitudes from support systems both at work and home as impacting work satisfaction and performance. Attitudes were also impacted by the disclosure or non-disclosure of participants’ diagnoses. Lastly, attitudes included perceptions participants have of themselves, as well as their workplace. Participants shared multiple experiences about the attitudes they face within the work environment. Participants reported that they often felt stigmatized and not accepted by their peers due to their diagnosis of ASD. Bob stated, “So, people think just because you have autism that you have lack of emotion and that you want to be alone, which isn’t true”. In regards to attitudes of co-workers, Jane reported, “Either they seem to really like me or they can’t stand me, it’s always kind of been the way with me. It’s usually I think the people who like me are the ones that, um, are more appreciative of people with quirks, um, those who don’t like me I think that they, they either think I’m really smart or they think I’m retarded.” Bob stated, “My co-workers talk to me in an incredibly patronizing way and not very respectful.”

In addition to attitudes from co-workers and supervisors, participants also identified self-perception as impacting their overall attitude in the work environment. Participants acknowledged the status of their job and their abilities to complete these jobs as impacting their attitude. They liked when the jobs they chose matched their individual skill set. For example, Ian commented, “I like the fact that I am working, you know, at a place that has a very good reputation that has a top rating.” Laura stated, “I do like that it [my job] is a good match for my talents ... and I was very encouraged [by my supportive parents].”

Some participants mentioned family support as critical to their success at work. One participant mentioned her parents allowing her to follow her dreams to obtain a degree that matched her skill sets. In general, participants identified that a good family support system allowed them to function at their highest level and provided motivation for working. Laura stated, “ ... he [my husband] takes away a lot of stress; he does all the little things, the running around and the groceries. All the things that impacts my system even so it makes me more able to cope and more able to get out of bed every day and do what I need to do at work.”

3.1.3 Environmental factor: Sensory and physical environment

In general, all participants identified multiple sensory and physical environment factors that impacted their work satisfaction and performance. Almost all participants had issues with florescent lighting within the work environment and many identified issues with temperature (i.e., either too hot or too cold). Additionally, participants found large and loud work environments overwhelming, and most participants preferred to have a small, quiet work area. Participants also identified visual distractions, such as people walking around, a messy or cluttered desk, and loud conversations occurring around them as impacting their work performance. Furthermore, participants who had to wear specific clothing to work had issues with fabric types or styles, whereas participants who had a choice in work attire did not report issues with clothing. For example, Jen stated, “I would change the temperature. I would change the uniform shirt. I would change the steel-toe shoes. I would actually, you know, money not being an issue, I would turn off half of the lights in each of my offices.” Dave reported, “Chaotic, environment loud, noisy, just stuff that has so much distraction you can’t really pay attention to what you need to be doing.” Tim reported, “The lighting, expanding the size of my desk, having my own space, my personal space” improved his work performance and satisfaction.

Some participants mentioned adaptations to the work environment, which reduced sensory or physical aversions. Modifications occurred in environments that were more controllable, such as a small office or when a participant worked alone and had autonomy over the environment. Additionally, participants who had noise aversions found noise-canceling headphones an effective adaptation. Barb mentioned, “So if I have my noise canceling headphones and I’ve got the little screen, I can focus on what I am doing. If those things aren’t there I can’t get my work done.” Jen stated, “I like that I control the lights to a certain extent. If I do have a really wicked headache you know I can use, use half the lights.”

3.1.4 Person-fit: Job characteristics

Participants consistently commented on various work characteristics that improved work performance and satisfaction. Most participants preferred consistency in routines and having flexibility in schedules. When schedules were highly structured, participants experienced a higher rate of stress. Dawn commented, “The other positives ... the flexibility, not micromanaging, being flexible and accommodating with schedules, coming in late, for whatever reason, being home a morning, or couple hours in the morning because a plumber has to come and fix plumbing in the house.” Participants also reported that sudden changes in schedules were perceived as distressing. Jane reported, “I get pretty route and routine, and having to do something at the last minute, I have a hard time.”

Other job characteristics that impacted work satisfaction included the commute to work, benefits of work, and work autonomy. Participants reported dissatisfaction with long commutes, and preferred short and easy commutes. Additionally, participants identified benefits of working as good pay, recognition for a job well done, independence, maintaining their lifestyle, and work making them “feel good.” Beth shared, “It makes me feel good when I can teach something to someone and they tell me ‘Wow, now I understand it better than anyone’s ever told me.”’ Within the work environment, autonomy was a recurring theme in that participants valued having independence in completing their specific job duties. Bill reported, “I don’t really have to deal with the upper management of the organization very often ... I have a lot of freedom and know what needs to get done, so I get it done.”

On the other hand, some job characteristics decreased work satisfaction and performance, such as having a non-stimulating job, being understaffed, not having enough breaks, having too many people around, and micromanagement. Jill stated, “I’m stuck in a building with constant machines beeping and fluorescent lights and then supervisors staring over my shoulder and telling me what I’m doing wrong every five minutes.” Val reported, “They had 4 managers who were not groomers, chasing me around for not cleaning this properly, for putting my tools in the wrong place”.

3.1.5 Person-fit: Skills and passions

Participants recognized skills and passions as important factors in work satisfaction and performance. Participants termed “skills” as unique talents they possessed to complete the tasks at hand. “Passions” referred to the internal emotional state of the participant when he/she found a job that was meaningful to complete. Skills and passions were also linked to personal interests. Participants who found jobs that match their skills sets and passions were much happier than those who did not find a job that matched their passions. Barb exclaimed, “I love the job itself. I am a very good editor and I’m a very good writer and a decent self-taught graphic designer. So I love all the tasks that I have to do. That stuff I just absolutely love I would probably do it for free, you know if I could.” Val stated, “I love grooming dogs. I love being hands-on with dogs. I love talking to dogs. I love touching dogs. Dogs know that. Dogs know who likes them and who doesn’t like them. I know animal behavior. I love making them look good.” Dan commented, “Doing something that most of the time I love and being able to get paid for it, uh, is, is a huge benefit.” In contrast, those who did not identify a match with skills and passions reported dissatisfaction. For example, Bob reported, “I’m not satisfied at all. I do curriculum development all over; I’ve been all over the country in the areas of autism and inclusion, transition and employment. So I’m doing stuff that’s way beyond the view of the classroom. And in situations like this is annoying, galling, and disrespectful. I have a book coming out in two months by a publisher. So, very - a lot of dissatisfaction.”

3.1.6 Person-fit: ASD symptoms

Participants identified that symptoms associated with the ASD condition impacted their work satisfaction and performance. Symptoms identified by participants included impairments with social communication, social interactions, anxiety, limited interests, routines, and sensory issues. In particular, participants identified challenges with social skills as a barrier, which usually produced anxiety and stress when at work. Bob commented, “You know a person may have the cognitive abilities and the skills to be able to perform that job, but there might be environmental factors such as that social environment or the other components that really make it so that the person wouldn’t be able to be successful.”

Another common symptom associated with ASD perceived as impacting work satisfaction and performance by participants was rigidity and the need for consistency in routines or schedules. Participants reported that sudden changes in schedules or routines impacted work satisfaction. Participants identified routines and schedules as both positive and negative factors in the work environment. Some perceived these as positive, as the participants knew what to expect from their day. Jen said, “There’s part of me that likes the routine of it. I can tell you right now between 11:00–11:15 I’ll be cleaning the toilet in the high school main office. I can tell you around 12:00, I’ll be done vacuuming, and all the stuff I’ll need to vacuum in that complex and I’ll be moving to the high school nurse’s office”. In contrast, it was perceived as negative for some, as strict schedules with time constraints fostered anxiety and stress. Jane shared, “I get pretty route and routine, and having to do something at the last minute. I have a hard time. I would be so stuck on staying within the scheduling, because you know, at a call center, they’re all about scheduling but I came to the realization that it was stressful and made me crazy, and then somebody told me legally they have to give me breaks so regardless of when I get off a call I just, I take the break and that doesn’t matter where I am.”

Participants also identified interests to be important when finding a job. Most participants shared that successful jobs were those that matched their skills, interests, and passions. Each participant had specific interests that were unique to him/her as to why the work environment was positive. Participants also identified sharing common interests with co-workers as improving social relations within the work environment. Tim shared, “Helping performance, my job performance, like being in that room with the other team members, and the common interests, not just Star Trek but even the work stuff and all the IT, we generally know Windows, we know Windows 7, we know server operating systems, we know umm, have a background with memory and hard drives and all that stuff that obviously you would know in this kind of job, that’s a social thing that we all have in common, umm experience and knowledge of and that definitely helps my performance.” Those who worked directly with customers reported that sharing common interests with customers improve their work performance. Dan commented, “Um, I’m very good at, you know, giving advice about what books to read based on a person’s interest; particularly in subjects that I’m interested in. And when I see someone who I recommended a book to and they come back to the store and tell me, ‘Oh, oh I loved that series’ or ‘I loved that book that you recommended, thank you so much’, that’s a really great feeling.”

As discussed previously, participants identified various sensory issues that impact the work environment. These sensory experiences varied from participant to participant, however there were common themes. Some of the common sensory issues among the participants included lighting, noise, visual distractions, busy environments, and temperature. Tim reported, “When it’s really crazy busy, that can sometimes decrease performance, like, when there’s a lot of multitasking going on. Uh, otherwise, uh, I generally work pretty well.” Ian stated, “ ... Unfortunately one of our focus is on early childhood so there is lots of loud children around too. So if I have my noise-canceling headphones and I’ve got the little screen, I can focus on what I am doing. If those things aren’t there I can’t get my work done.”

4 Discussion

This study investigated the perspectives of working adults with ASD regarding how environmental factors impact work satisfaction and performance. Participants identified social interactions, attitudes, and the physical or sensory environment as barriers or facilitators of work performance and satisfaction. Consistent with previous research, results from the current study identified the social demands of the environment as a significant barrier. Previous research reported interactional difficulties of the person as one of the most significant barriers to successful employment outcomes for adults with ASD (Baldwin et al., 2014; Bolman, 2008; Hendricks, 2010; Hurlbutt & Chalmers, 2004; Müller et al., 2003; Sperry & Mesibov, 2005). In the current study, adults perceived a lack of fit between the demands of the social environment and social skills. However, perceived social demands varied from participant to participant, as some reported comfort with interactions that pertained to work related information, while others reported any type of social interaction as an uncomfortable experience.

Research identifies numerous benefits to employers when hiring an individual with ASD. Job qualifications are often less of a concern than the ability to meet the social requirements of the workplace (Hendricks, 2010). Previous research, focusing on the perspectives of supervisors and co-workers, identified social issues as impacting negatively on job performance and at times leading to termination (Bolman, 2008; Hendricks, 2010). Adults in the current study had similar perspectives. Participants reported that job skill deficits were not a barrier in comparison to the social factors inherent in the job and overall environment. In our study, participants reported strong skill sets in a variety of work settings. Participants were “proud” of their talents, and some had found a job that matched these skills, however social interactions impacted perceived work satisfaction and/or performance.

In the current study, attitudes of others impacted the experience in the workplace of the adult with ASD. This was identified as either a facilitator or barrier to work satisfaction and performance, depending on the attitudes of supervisors, co-workers, and family members. Supervisors had the most substantial impact as reported by participants. In a recent study exploring the attitudes of employers and co-workers, it was reported that lack of appropriate understanding by employers and co-workers was a barrier to successful work outcomes for adults with ASD (López & Keenan, 2014). In the current study, participants shared both positive and negative attitudes within the work environment. For example, participants identified that when their supervisors understood their condition, they offered modifications to the work environment, such as noise-canceling headphones or adaptations to their schedules. However, when co-workers or supervisors did not understand the participants’ condition, relationships were more challenging, which created social isolation within the work environment. These results suggest that programs targeting the education of co-workers, supervisors, and employers regarding the unique needs and strengths of individuals with ASD have the potential to enhance overall work satisfaction and performance for adults with ASD. Additionally, research has identified that co-workers and supervisors who have had a previous positive work experience with an adult with a disability are more likely to demonstrate positive attitudes in subsequent situations (Banks et al., 2001; McLaughlin et al., 2004).

All participants in the current study identified the sensory environment as a barrier to work satisfaction and performance. A study by Gillott and Standen (2007) identified sensory stimuli as a major stressor to individuals with ASD within the work environment. Davidson (2010) compiled information from 45 autobiographical texts written by adults with ASD to identify the barriers to socio-spatial inclusion. Authors in their autobiographies wrote at length about how external sensory stimuli are perceived very differently from that of neurotypical (NT) individuals, which results in a sense of exclusion associated with being out of place in mainstream space (Davidson, 2010). These atypical sensory responses may vary from hypersensitivity, where a person is overwhelmed and overloaded by the sensory stimuli in the environment, to hyposensitivity, where a person does not perceive relevant stimuli for the task. Others have described difficulty using their senses simultaneously, resulting in sensory confusion when there are too many multisensory stimuli to process. Although adults with ASD have described the profound impact of certain types of sensory stimuli on their daily lives in autobiographies, there are limited studies that explore the work environment and how sensory experiences impede work satisfaction and work performance (Davidson, 2010). Participants in the current study only identified sensory environmental factors as a barrier when there were no environmental adaptations available or supported. These finding suggest that environmental adaptations supported by supervisors have the potential to eliminate a potential major environmental barrier. Many of the adaptations identified by participants in the current study required only a minimal investment or impact on others in the environment.

Previous research has identified the importance of job match for adults with ASD (Mawhood & Howlin, 1999). Morgan and Schultz (2012) used an ecological approach in one study with successful employment outcomes for adults with ASD. They propose that an ecological model considers the person’s individual attributes in relation to environmental demands, both of which are necessary factors for successful outcomes. The concept of finding the right fit for a person within the environment context is often called “person-environment fit” (Law, 1996). In the current study, participants acknowledge a “right fit” for a job as a vital aspect for work satisfaction. Person-fit considered how each person’s skills, characteristics, and passions matched up with the requirements of the job. The importance of these person factors aligning with environmental demands also permeated the interviews as a key factor for work performance. A person reported satisfaction with his/her job, although identified issues with work performance if there was a lack of person-environment fit.

It is important to acknowledge limitations of the study, as it was intended to provide an initial exploration of environmental factors impacting work performance and satisfaction only from the perspectives of adults with ASD. The study did not consider the perspectives of co-workers and supervisors who may perceive a very different experience than the adults with ASD. Since it was identified in both the current study as well as in previous research that the attitudes and social interactions with co-workers and supervisors are important factors in both work satisfaction and performance, these additional perspectives could provide a necessary lens to identify interventions and support structures to improve the person and environmental fit for adults with ASD. This seems especially important, as the social environment was perceived as one of the most significant barriers in the workplace for adults with ASD. Additionally, there were more female participants in the study than male, which is in contrast to ASD prevalence of approximately 4 males to 1 female. There are a number of possibilities for this, including a convenience sample that volunteered for the study. There is some research suggesting that females may have less social involvement than males with ASD. It is possible that the social requirements of participating in an interview and the interactions with the researchers may have contributed to the skewed male to female ratio. It is also possible that there are more females working 20 hours a week than males, although this is not clearly documented. Additionally, it is important to note that this is a qualitative study not intended for generalization. Future research is needed to understand the impact of the environment from multiple perspectives, and to identify effective interventions to improve the person and environment fit.

Results of the study identified environmental factors and person-fit as both facilitators and barriers to work satisfaction and performance for adults with ASD. Specifically, adults with ASD identified that social interactions, attitudes, and the physical or sensory environment impacted perceptions of work satisfaction and performance. Person-fit between individual characteristics and job requirements were also identified as an important factor. Results suggest a need to consider interventions that address environmental factors in order to improve person-environment fit, and education for co-workers and peers to improve attitudinal environments. Additionally, it is important to consider interventions that teach individuals with ASD effective coping strategies and self-advocacy skills to obtain necessary environmental accommodations in the workplace for improved work satisfaction and performance.

Conflict of interest

All of the authors declare that they have no financial conflict of interest.

Funding

This study was funded through a grant from the American Occupational Therapy Foundation (AOTFIRG13PFEIFFER).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

Alexander

J. L.

, Ayres

K. M.

, Smith

K. A.

, Shepley

S. B.

, & Mataras

T. K.

(2013). Using video modeling on an iPad to teach generalized matching on a sorting mail task to adolescents with autism. Research in Autism Spectrum Disorders, 7, 1346–1357.

American Psychiatric Association. (2013), Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Antonak

R. F.

, & Livneh

(2000). Measurement of attitudes towards persons with disabilities. Disability and Rehabilitation, 22, 211–224.

Ashburner

, Bennett

, Rodger

, & Ziviani

(2013). Understanding the sensory experiences of young people with autism spectrum disorder: A preliminary investigation. Australian Occupational Therapy Journal, 60, 171–180.

Baldwin

, Costley

, & Warren

(2014). Employment activities and experiences of adults with high-functioning autism and Asperger’s disorder. Journal of Autism and Developmental Disorders, 44, 2440–2449.

Banks

, Charleston

, Grossi

, & Mank

(2001). Workplace supports, job performance, and integration outcomes for people with psychiatric disabilities. Psychiatric Rehabilitation Journal, 24, 389.

Bolman

W. M.

(2008). Brief report: 25-year follow-up of a high-functioning autistic child. Journal of Autism and Developmental Disorders, 38, 181–183.

Centers for Disease Control and Prevention. (2014). Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 sites, United States, 2010. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, DC: 2002), 63(2), 1.

Chen

J. L.

, Leader

, Sung

, & Leahy

(2015). Trends in employment for individuals with autism spectrum disorder: A review of the research literature. Review Journal of Autism and Developmental Disorders, 2, 115–127.

10.

Corbin

, & Strauss

(2014), Basics of qualitative research: Techniques and procedures for developing grounded theory (4th ed.). Sage: Los Angeles.

11.

Davidson

(2010). It cuts both ways’: A relational approach to access and accommodation for autism. Social Science and Medicine, 70, 305–312.

12.

Dotson

W. H.

, Richman

D. M.

, Abby

, Thompson

, & Plotner

(2013). Teaching skills related to self-employment to adults with developmental disabilities: An analog analysis. Research in Developmental Disabilities, 34, 2336–2350.

13.

Gillott

, & Standen

P. J.

(2007). Levels of anxiety and sources of stress in adults with autism. Journal of Intellectual Disabilities, 11, 359–370.

14.

Hall

(2004). Social geographies of learning disability: Narratives of exclusion and inclusion. Area, 36, 298–306.

15.

Hendricks

(2010). Employment and adults with autism spectrum disorders: Challenges and strategies for success. Journal of Vocational Rehabilitation, 32, 125–134.

16.

Hendricks

D. R.

, & Wehman

(2009). Transition from school to adulthood for youth with autism spectrum disorders: Review and recommendations. Focus on Autism and Other Developmental Disabilities, 24, 77–88.

17.

Henninger

N. A.

, & Taylor

J. L.

(2013). Outcomes in adults with autism spectrum disorders: A historical perspective. Autism, 17, 103–116.

18.

Hurlbutt

, & Chalmers

(2004). Employment and adults with Asperger syndrome. Focus on Autism and Other Developmental Disabilities, 19, 215–222.

19.

Jick

T. D.

(1979). Mixing qualitative and quantitative methods: Triangulation in action. Administrative Science Quarterly, 24, 602–611.

20.

Kielhofner

(2006). Research in occupational therapy: Methods of inquiry for enhancing practice. FA Davis.

21.

Lane

A. E.

, Young

R. L.

, Baker

A. E.

, & Angley

M. T.

(2010). Sensory processing subtypes in autism: Association with adaptive behavior. Journal of Autism and Developmental Disorders, 40, 112–122.

22.

Law

, Cooper

, Strong

, Stewart

, Rigby

, & Letts

(1996). The person-environment-occupation model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy, 63, 9–23.

23.

Lawer

, Brusilovskiy

, Salzer

M. S.

, & Mandell

D. S.

(2009). Use of vocational rehabilitative services among adults with autism. Journal of Autism and Developmental Disorders, 39, 487–494.

24.

López

, & Keenan

(2014). Barriers to employment in autism: Future challenges to implementing the Adult Autism Strategy. Portsmouth, United Kingdom: University of Portsmouth.

25.

Mawhood

, & Howlin

(1999). The outcome of a supported employment scheme for high-functioning adults with autism or Asperger syndrome. Autism, 3, 229–254.

26.

McLaughlin

M. E.

, Bell

M. P.

, & Stringer

D. Y.

(2004). Stigma and acceptance of persons with disabilities understudied aspects of workforce diversity. Group and Organization Management, 29, 302–333.

27.

Miller

L. J.

, Coll

J. R.

, & Schoen

S. A.

(2007). A randomized controlled pilot study of the effectiveness of occupational therapy for children with sensory modulation disorder. American Journal of Occupational Therapy, 61, 228–238.

28.

Morgan

R. L.

, & Schultz

J. C.

(2012). Towards an ecological, multi-modal approach to increase employment for young adults with autism spectrum disorder. Journal of Applied Rehabilitation Counseling, 43, 27–35.

29.

Müller

, Schuler

, Burton

B. A.

, & Yates

G. B.

(2003). Meeting the vocational support needs of individuals with Asperger syndrome and other autism spectrum disabilities. Journal of Vocational Rehabilitation, 18, 163–175.

30.

Newman

, Wagner

, Knokey

, Marder

, Nagle

, Shaver

, & Wei

(2011). The post-high school outcomes of young adults with disabilities up to 8 years after high school: A report from the National Longitudinal Transition Study-2 (NLTS2). Institute of Education Sciences National Center for Special Education Research, US Department of Education, Washington, DC.

31.

Patterson

, & Rafferty

(2001). Making it to work: Towards employment for the young adult with autism. International Journal of Language and Communication Disorders, 36, 475–480.

32.

Richards

(2012). Examining the exclusion of employees with Asperger syndrome from the workplace. Personnel Review, 41, 630–646.

33.

Roux

A. M.

, Shattuck

P. T.

, Cooper

B. P.

, Anderson

K. A.

, Wagner

, & Narendorf

S. C.

(2013). Postsecondary employment experiences among young adults with an autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 931–939.

34.

Shattuck

P. T.

, Narendorf

S. C.

, Cooper

, Sterzing

P. R.

, Wagner

, & Taylor

J. L.

(2012). Postsecondary education and employment among youth with an autism spectrum disorder. Pediatrics, 129, 1042–1049.

35.

Smith

R. S.

, & Sharp

(2013). Fascination and isolation: A grounded theory exploration of unusual sensory experiences in adults with Asperger syndrome. Journal of Autism and Developmental Disorders, 43, 891–910.

36.

Sperry

L. A.

, & Mesibov

G. B.

(2005). Perceptions of social challenges of adults with autism spectrum disorder. Autism, 9, 362–376.

37.

Strauss

, & Corbin

(1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks, CA: Sage.

38.

Vornholt

, Uitdewilligen

, & Nijhuis

F. J.

(2013). Factors affecting the acceptance of people with disabilities at work: A literature review. Journal of Occupational Rehabilitation, 23, 463–475.

39.

Walsh

, Lydon

, & Healy

(2014). Employment and vocational skills among individuals with autism spectrum disorder: Predictors, impact, and interventions. Review Journal of Autism and Developmental Disorders, 1, 266–275.

40.

Wehman

(Ed.) (2013). Life beyond the classroom: Transition strategies for young people with disabilities (5th ed.). Baltimore, MD: Brookes Publishing.

41.

Wehman

, Schall

, Carr

, Targett

, West

, & Cifu

(2014). Transition from school to adulthood for youth With Autism Spectrum Disorder: What we know and what we need to know. Journal of Disability Policy Studies, 25, 30–40.

42.

Wehman

P. H.

, Schall

C. M.

, McDonough

, Kregel

, Brooke

, Molinelli

, ... Thiss

(2014). Competitive employment for youth with autism spectrum disorders: Early results from a randomized clinical trial. Journal of Autism and Developmental Disorders, 44, 487–500.

43.

World Health Organization. (2009). International classification of functioning, disability, and health. World Health Organization.