More methodically sound research to inform evidence-based guidelines on physical workplace adjustments is required to support neurodivergent workers so they are able to perform effectively without any constraints at work.

That is the conclusion from a joint Switzerland-UK study that undertook a systemic review of English-language studies published between 2000 and 2021 and considered workplace adjustments for a wide range of conditions that fall under the neurodivergence (ND) umbrella. These include Autism-Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADD/ADHD) and dyslexia, or Dyspraxia.

Researchers from Zurich University of Applied Sciences in Switzerland and the University of Surrey and Birbeck University of London in the UK evaluated the evidence around the “extent, robustness and quality of physical workplace adjustments to support occupational longevity, performance and health/wellbeing in neurodivergent workers with specific sensory needs” for a study published in Applied Psychology.

As the researchers note, ND affects around 22% of the general population but ND workers are often unnecessarily excluded from the labour market as their sensory needs are not met. Many ND workers experience challenges in regulating sensory responses or overload, and they may, for example, experience negative responses to specific lighting, sounds or movement. Although workplace designs to accommodate ND workers, such as control over lighting, private offices or quiet zones have become more common, they are difficult to access, their implementation has been limited and they are not always effective.

Of the 20 studies reviewed, the researchers stressed that the research is 'generally not well-developed', is 'methodically weak' and only offers 'indicative effects'. In addition, they argue that the effects of the sensory adjustments that are required to support ND workers have been researched without considering the specific environments and inclusive sampling.

'Such a vacuum is preventing the development of evidence-based practice, including quality control and return on investment specifications,' the researchers note.

'None of the studies focused solely on the efficacy of physical workplace adjustments but explored a mix of psychosocial and physical adjustments in an unsystematic fashion.'

According to the researchers, this unsystematic approach made it very difficult to draw any firm conclusions for a number of reasons.

THE RESEARCHERS FOUND THAT EMPLOYERS REDUCED ACOUSTIC AND VISUAL STIMULATION AS THE PREDOMINANT ADJUSTMENT TO HELP RELIEVE NEURODIVERGENT WORKERS’ SENSORY STRESS

First, most of the studies reviewed used mixed work settings, the researchers found, with only four specifically focusing on office-only settings.

Second, most of the evidence only referred to workers with a primary condition of ASD, which meant that other ND groups were underrepresented.

Third, the researchers found that the studies they reviewed used mixed-diagnoses-type samples that were formally, informally and/or self-diagnosed. This means that it is difficult to tell from these studies which accommodations are useful for which condition.

Finally, they point out that it is not entirely clear whether the results from the study review are a valid representation for both genders with ASD or whether any gender-differentiated adjustment needs exist in the first place.

The researchers’ study review found that employers reduced acoustic and visual stimulation as the predominant adjustment to help relieve ND workers’ sensory stress. Very few studies, however, touched on tactile and olfactory adjustments.

Acoustic adjustments for a range of ND conditions included the use of headphones or earplugs and the provision of private rooms or quiet locations. Visual adjustments specifically for ASD targeted light levels and types as well as screening out visual distractions.

The researchers highlight a number of considerations that should be factored in to any future studies that cover physical accommodations for ND workers.

First, they argue there is a need to 'develop a clear understanding of the sensory needs by ND condition, differentiating sensory modality and hypo- and hypersensitivity'.

SMALL CHANGES TO THE PHYSICAL WORK ENVIRONMENT CAN MAKE A BIG IMPACT FOR NEURODIVERSE WORKERS

They also stress that 'robust approaches should also control for potentially confounding individual characteristics and contextual conditions', including self-diagnosis and gender.

The researchers recommend incorporating Dunn’s Sensory Process Model of sensitivity-environment interaction.

Second, they argue that further research is required to better understand the impact of the sensory physical environment from both the employer and employees’ perspectives, and encourage those using and supporting the implementation of adjustments to get involved in the research.

Third, the researchers say that in order to create evidence-based guidance, it is important first to test effective sensory interventions or adjustments as this will improve their relevance in relation to the individual person and the environment they are working in.

Finally, they argue it is critical that researchers better understand the factors that influence the implementation of workplace adjustments so they can fully grasp “what works, for whom and under what circumstances”.

Jo Yarker, who is a Reader at Birkbeck, University of London, and managing partner of Affinity Health at Work, told IOSH magazine: 'Small changes to the physical work environment can make a big impact for neurodiverse workers. Gaining a better understanding of what works, for whom, is vital, but as we wait for the evidence base to develop we would encourage employers to adopt a test and learn approach, increasing access to adjustments to enable people to optimise their physical work environment – this will not only help neurodiverse workers to stay in and thrive at work, but are likely to help everyone work to their best.'