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Autism - girls severely underdiagnosed and D&I initiatives need to do more

Who am I? After being diagnosed with ADHD at 26, I became frustrated at the lack of support and awareness of this condition in society and in workplaces. I am trying to build Flair, the first holistic health platform for people for people with ADHD & other neurodiversity (because I have autism and dyslexia as well). The mission is to empower people with neurodiverse people to thrive.


National Autism Awareness month

In this blog post, I share my personal experience with autism and the workplace. It is difficult for me to celebrate being autistic, since the statistics speak for itself. My community is bullied and discriminated against. There is a lot of work to do to raise awareness about autism and for diversity and inclusion strategies in workplaces. Key points:

  • ADHD and autism have a high co-occurrence level (30-45%)

  • Autism is severely underdiagnosed in girls

  • The grim statistics, autism and unemployment

  • D&I strategies need to be talking about neurodiversity and need to do more for autism awareness acceptance

  • Simple workplace adjustments that will help autistic people

Autism, Aspergers and ADHD co-occurrence

I have ADHD, dyslexia and autism (or aspergers). ADHD and autism are two distinct conditions, though there are some behavioural traits that overlap. Over 50% of individuals diagnosed with autism also have ADHD ( With Aspergers, the co-occurrence is 70%. This means people diagnosed with aspergers are likely to have ADHD traits as well. People diagnosed with aspergers usually have symptoms on the "milder side" of the autism spectrum. The important thing to note here is that it is a spectrum of experiences and symptoms. There is no one set definite list of symptoms. Everyone's experience of autism or aspergers will be different.

The high co-occurrence level of autism and aspergers with ADHD is one of the many reasons I realised I was also on the spectrum. I associate more of my traits with asperger's though.

Autism is severely underdiagnosed in girls

Boys have an autism diagnostic prevalence of 4x compared to girls. This is also similar to ADHD where girls are underdiagnosed. A history of gender bias research in this field has lead to gender biased diagnostic criteria's. Combined with societal gender norms contributes to the underdiagnosis of girls for autism and other neurodiverse conditions.

As I do more research into ADHD and autism, I realised there is actually very little we know about girls with co-occurring neurodiverse conditions.

It is likely that girls with ADHD and aspergers (people like me), exhibit very different symptoms to what is conventionally understood as autism. I align with the asperger's symptoms of finding it difficult to recognise humour and sarcasm (basically just reading social situations is difficult for me) but I don't align with other listed symptoms such as trouble expressing feelings or preference for routine.

The grim statistics, unemployment and mental health

This is where it gets difficult for me to find autism month a celebration month. The statistics speak for itself.

  • 22% of autistic adults are in employment (ONS)

  • High unemployment rates amongst the population leads to higher levels of anxiety and depression

  • Students with autism are 60% likely to be bullied

These statistics make me angry because there is nothing about being autistic that pre-disposes us to unemployment or mental health risk. It is simply the social construct of society and workplaces that do not understand how people with autism think and behave. We are expected to mask and conform in order to function in a society that is not doing enough to accept us for who we are.

D&I never talk about neurodiversity. Now is the time to step up and do more for the autistic community

From my experience, neurodiversity is never spoken about as part of D&I strategy. I wonder why? Is it because neurodiversity is an invisible condition? This has made navigating the workplace a nightmare for me. A lack of awareness and accommodations contributes to the problem. I'll just share some examples of a few things that made my working day a struggle.

  • Open plan offices do not work! These are meant to foster "spontaneous" collaboration and conversations, but this makes it very hard for an autistic person to work. We prefer conversations when we have planned for them

  • Open plan offices and constant background chatter I have very heightened sensory processing issues so inability to shut out the background noise made it very difficult to focus on any work.

  • The office lights and temperature Again having a heightened nervous system meant that the office lights combined with fluctuating temperatures made me feel physical sick. Natural sunlight is so important for me and most offices just did not have the luxury of having desk space near a window physically

  • Work gatherings always meant large numbers of people We all know an important part of work culture is to socialise. But in our workplace culture, socialising often means 10+ people in a small confined space. This is hugely anxiety inducive for someone with autism.

What can organisations do to support people with autism?

I don't have all the answers, but these are suggestions I have based on experience

  • Start with Autism awareness training. Because autism is a spectrum and actually, many people with autism won't fit in to what the media has portrayed as being autism.

  • Workplace adjustments!

    • Open plan offices are unavoidable, but consider making separate meeting rooms available for people with autism to use

    • Give autistic people (to be honest, any neurodiverse person) the option to have noise cancelling headphones

    • Create silent working zones for quiet work

    • Give the option for an autistic person to select where they want their desk is located/ have more choice of work arrangements

    • Flexibility in working arrangements

    • Have work social events be a mix of small groups and large groups and be mindful of the accessibility needs of employees who attend them.

  • Adopt a strengths based approach to supporting autistic employees

    • This is really important because autistic people have an abundance of strengths to offer. Managing us means acknowledging our strengths rather than trying to make us be better at skills we just won't ever be good at.

It's time that all organisations recognise that within D&I is neurodiversity and autism. And we need to do more because the statistics show that not enough is being done for the autistic community.

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