• Schea Fissel-Brannick, PhD

The Differences Between Us are Smaller than the Similarities that Unite Us: The Rising Tide of Neuro

The rates of children diagnosed with autism spectrum disorder (ASD) have been rising dramatically over the last 20 years. The Center for Disease Control and Prevention ([CDC], 2018; based on surveillance data from 2014) estimates that 1 in every 59 children is now diagnosed with ASD (Diagnostic and Statistical Manual – Fifth Edition [DSM-V], 2013). With more and more children receiving a diagnosis of ASD, the prevalence of children with ASD who are transitioning into adulthood is on the rise. Estimates from the last ~ five years suggest that about 50,000 persons with ASD are turning 18 every year (Shattuck, Narendorf, Cooper, Sterzing, Wager & Taylor, 2012). Looking into the future, the U.S. Department of Health and Human Services (HHS; 2017) estimates over the next 10 years, 500,000 individuals with ASD will turn 18. In addition, the CDC estimates that the current incidence (number of cases at any one time), of ASD in children who are ~ 8 years old is anywhere from 500,000 to 1 million. This means that by the year 2030, half to 1 million individuals with ASD will begin turning 18 every year. As adults with ASD transition to adulthood, achieving gainful employment is a major priority for the individual, and her/his family. Given this rise in numbers, employment for adults with ASD must become a priority of ours as well.

The transition from school to paid employment is the first of many crucial transitions for adults with ASD (for additional information on transition needs in mid to later life, please refer to Wright, 2016 in the reading list at the end of this article. Wright’s edited book is an EXCELLENT resource for adults, families, practitioners and community members). For the many, getting a paying job (even better, a job that comes with benefits) is the gateway to opportunities for all the things that make our lives meaningful and fulfilling: acquiring medical coverage, moving into that first apartment, meeting friends at work, doing things with friends outside of work, finding love/partnership, and making autonomous decisions about a life worth living. Jobs allow the many to get to where we want to go in life. In seeking out a job, we often focus on the characteristics or skills of the individual seeking employment. Does this person have computer skills? Is this person organized? How does this person communicate with others? However, in the next section, we will see that another variable, one often overlooked, matters just as much as the individual characteristics of the individual seeking employment.

Modern research studies have shown that persons who are in the process of learning skills will construct expectations for themselves, based on two (primary) variables that interact with each other over time: a) the individual characteristics of the person (for example, individual skills, motivation, mindset), and b) elements of the environment (most generally thought of as anything outside of the person, that the person interacts with and is influenced by; this could be anything from the biological environment (water), to the social environment (teacher expectations, parenting style, and others). The contrasts between two very different theories of reading development exemplify this concept quite well. An early theory of reading development suggested that children must have certain ‘prerequisite skills’ or intrinsic characteristics (e.g., cognitive level), before being ‘ready’ to read (Durkin, 1966). This theory considered only the individual characteristics of the child, but failed to understand the influence of teacher expectations set for the child. In practice, teachers did not teach reading skills to children who were deemed not yet ‘ready to read.’ As reading is not ‘caught’ (meaning not naturally acquired), but for most must be ‘taught’ (meaning learning to read requires direct, explicit instruction; Archer & Hughes, 2010), children who were labeled not ready to read, did not learn to read. What’s worse, most of these children were never determined to be ‘ready,’ and were therefore never taught to read. In the majority of cases, this early failure to teach reading skills to children labeled as ‘not ready,’ was not the fault of the teacher. Rather, this failure was the result of a lack of information and knowledge of what matters for behavioral skill development (e.g., learning to read). As it turns out, the environment (in the example above, teacher expectations) matters quite a bit. The environment is our overlooked variable. In the example above, children did not learn to read because teachers did not expect these children to read. Conversely, recent research suggests that any child can learn to read. The intrinsic characteristics of the child will determine the level of reading support/instruction required and how long learning to read might take, but the environment influences the individual by either supporting or constraining (limiting) the extent to which children will learn to become skilled readers. This back-and-forth influence of the environment on the individual, and the individual influencing her/his environment[1] is important to understand as we explore the frontier of adults with ASD seeking jobs, and employees influencing (setting expectations for) these individuals.

Employers and their expectations for adults with ASD matter just as much, as the intrinsic skills of the adult seeking a job. The employee who performs at a low level, but whose employer expects that s/he performs at a high level will adapt to perform at a high level. Conversely, the employee who performs at a high level, but whose employer expects s/he will perform at a low level, will adapt to perform at a low level. As such, it is important to consider and know what the employment environment looks like, in addition to understanding the strengths and needs of adults with ASD seeking paid employment. Understanding both variables, matters. We will start with a summary of the rather disheartening state of employment environments for adults with ASD. Keep in mind, that as with all things, advocacy, opportunity, and possibility are only ever born out of tremendous social needs. Identification of these needs will lead us to discover the heartening, positive attributes of adults with ASD that make for ideal employees. Only by starting with knowing the needs, can we find hope and a path toward advocating for the gainful employment of adults with ASD.

Many studies and economic reports have found that fewer than 15% of adults with ASD achieve paid employment (Lounds-Taylor & Seltzer, 2010; Roux et al., 2013; Shattuck et al., 2012), approximately half participate in (typically) non-inclusive adult activity centers without pay, and roughly a quarter of individuals have no daytime activities (Roux, Rast, Anderson, & Shattuck, 2017). Those who are employed are often overqualified for the positions they hold. Most adults with ASD live with their parents/family or in a group home; of the individuals that live at home, roughly 40% of these families don’t have/can’t access funds for in-home supports (Roux, Rast, Anderson, & Shattuck, 2017). The majority of adults with ASD have other medical or mental health diagnoses in addition to autism, requiring regular doctors’ visits and medication management (Gotham, Brunwasser, & Lord, 2015); yet without medical insurance coverage as a benefit of paid employment, adults with ASD may rely primarily on funds made available by applying for Medicaid via State Developmental Disability Agencies, or applying for funds via the Social Security Administration (Povey & Michael, 2016). Such applications are lengthy and difficult to complete, and are often slow to be approved; many may even be waitlisted, per application criteria or availability of funds. Even after considering these numbers, it continues to astound, that in addition to costs incurred by the government to provide such supports, adults with ASD incur an additional estimated 175-196 billion dollars in annual costs for medical care, housing, and loss of money the individual would make if he/she were employed and making minimum wage (Buescher, et al., 2014). Keep in mind that this estimate reflects the current state of economic need, and is based on estimates that approximately 50,000 individuals with ASD are turning 18 each year; not the 2030 estimates when this number is projected to get ten times bigger.

“Any intelligent fool can make things bigger and more complex... It takes a touch of genius - and a lot of courage to move in the opposite direction.” ~ E. F. Schumaker

As we shift to consider the positive attributes and characteristics of adults with ASD that make for great employees, we must consider another idea that should be intuitive, but is not often realized: all persons with autism are much more similar to neurotypical persons, than they are dissimilar. When a person with autism is born, s/he is not born with a singular “autistic” brain, s/he is born with a human brain; but one that is predisposed (neuro-genetically) to perceive, experience and come to know this world from a slightly different viewpoint[2]. This viewpoint is simply one that we do not fully understand, and it is one that is not our own (for a comprehensive list of the ways that humans have dealt with differing viewpoints that we do not understand, please reference any non-fiction text on the history of the world). The idea of neurodiversity[3], simply asks that we be willing to acknowledge the following: I am unique and you are unique; there are differences in the ways that we see and know the world, but such differences are small in light of the fact that we are so, so similar.

With this understanding, it is possible to see that every adult with ASD represents limitless employment potential, just as any other human who wants to work. With this idea as our foundation, let’s briefly review individual characteristics and the employment potential of this rising, untapped workforce. The Tables[4] below (Table 1 and 2) summarize characteristics of social communication (Table 1) and behavior (Table 2) observed in adults with ASD (as a reminder, these are the two areas in which all adults with ASD will require some degree of support). Many of these characteristics are misperceived as barriers or limitations; these misperceptions are summarized in column 2. The 3rd column reframes these misperceptions as strengths/positive attributes valued by many employers, and includes recommendations for simple accommodations/adaptations that can be made to support adults with ASD in the workplace.

Table 1

Reframing Impairments in Social Communication as Positive Employment Characteristics:

Social Interaction and Communication

Example 1:

Areas Impacted in ASD:

Theory of Mind: Understanding one’s own and others’ states, feelings, thoughts, and perspectives

Perception of Characteristics as Barriers/Limitations:

May communicate too much/too little information. Communication style may be unconventional/atypical. Communication may not match any inferred social ‘needs’ of the context or communication partner. May not appear interested in topics discussed by others. May perseveratively initiate conversations about topics of interest that may be unfamiliar, or un-preferred by others. Communication may appear very direct/honest. May not use or understand abstract concepts such as jokes, slang, jargon, similes, metaphors, or words that have multiple meanings.

Perception of Characteristics as Strengths/Positive; possibly requiring Simple Accommodations/ Adaptations:

Communication is honest/genuine. Communication with employers and coworkers will always be direct and concrete. Complete absence of any ego at work. Interested in topics discussed by others, but may not know how to join the conversation. Won’t sacrifice productivity for water-cooler conversations; little interest in office politics. The quality of directness/candor that neurotypical persons shy away from in the workplace (often due to awareness or fear of social reprisal), limits employees’ communication with each other and with administration. Ego and fear of looking bad drive many inefficient and detrimental office communications and lead to lower productivity and lower employee satisfaction. Adults with ASD model for others, dismissiveness of office politics and emphasize getting the job done.


Adults with ASD want to engage in social interactions; these individuals simply require a ‘slowing-down’ of conversation (processing verbal, abstract information in conversations is difficult to keep up with) and a willingness to explain social concepts (often abstract) more directly.

Consider the following example: If I am speaking with my friends in Spanish, and you wish to join the conversation, but speak only English, the success of the conversation will depend on our joint willingness to translate our respective ‘codes’ so we can both understand and participate in the conversation; the conversation would probably slow down a bit; there may be more of a need to repair communication breakdowns, if our relative translations fail.

Example 2:

Areas Impacted in ASD:

Joint Attention: sharing attention with another to a referent in the environment.

Perception of Characteristics as Barriers/Limitations:

May not look at you/may look at you too often during conversation. May not use or recognize subtle gaze shifts that communicate social information (e.g., glancing in the direction of a person to communicate, “that guy”).

Perception of Characteristics as Strengths/Positive; possibly requiring Simple Accommodations/ Adaptations:

Eye contact is overrated. It is neither required nor always preferable for adults with ASD or for neuro-typical adults, to have a good or productive conversation/interaction.

What happens when we come in contact with a loud noise? An unkind statement? A high-pressure social context? A mean email? Someone staring at you? Meeting at someone you admire? We close our eyes; we look away. This is one of many natural ways of regulating our response to sensory input. Avoiding eye-contact is simply a strategy for regulating state.

Accommodations/ Adaptations:

Everyone can support conversations by simply not expecting eye-contact.

Example 3:

Areas Impacted in ASD:

Gestures and Non-verbal Communication: all of the physical ways we communicate information without speaking.

Perception of Characteristics as Barriers/Limitations:

May not use physical gestures during interactions (e.g., waving) and may not understand gestures used by others. Gestures may appear unconventional (e.g., waving may look different). Body proximity may be too close or too far away during social interactions. Facial expressions may not match the inferred needs of the social context (appearing expressionless, when others are sad); may not recognize the meaning of facial expressions in others.

Perception of Characteristics as Strengths/Positive; possibly requiring Simple Accommodations/ Adaptations:

All behavior (anything one could observe) is communication. All that’s required to understand is to take the perspective of the other; to ask, what is her/his behavior telling me about what s/he is thinking, feeling, understanding, or wanting? Reframing behaviors we typically categorize as ‘different’ as having communicative intent is important. Taking the perspective of another is often called ‘Theory of Mind.’ We know of this term in reference to ASD, that persons with ASD may have difficulties thinking about the internal states of others. But it turns out that neurotypical people aren’t consistently great at taking others perspectives. We should accept, and actually expect that adults with ASD will communicate nonverbally in a way that differs from our own. This expectation would allow us to enter social interactions with adults with ASD with an open perspective seeking to understand/learn, rather than label nonverbal communication as odd/different and therefore non-communicative. All behavior is communication; all of it.

Example 4:

Areas Impacted in ASD:

Relationships and Friendships

Perception of Characteristics as Barriers/Limitations:

May appear uninterested in others. May shy away from contexts involving social interactions. May have difficulties making friends or maintaining friendships.

Perception of Characteristics as Strengths/Positive; possibly requiring Simple Accommodations/ Adaptations:

Loyalty towards and genuine concern for others. Won’t cancel on you last minute, and will do exactly what s/he says s/he will do. Such friendships are free of the ego involved in most relationships; there is no desire to show off, be the best at something, or control and manipulate others. There is also less of a priority on talking, and more emphasis on doing. Solid friendships are based on doing stuff together; talking while doing stuff can be together; talking while doing stuff can be complimentary, but not always. Consider the barriers of talking while watching a movie together, while working out or taking a fitness class, while playing a game, or simply being present with another.

Table 2

Reframing Impairments in Behavior as Positive Employment Characteristics


Example 1:

Areas Impacted in ASD /Areas Impacted: Repetitive Motor Movements

Perception of Characteristics as Barriers/Limitations: May demonstrate atypical hand movements (hand posturing, finger play, hand flapping), may demonstrate gross motor movements that are repetitive (rocking back and forth)

Perception of Characteristics as Strengths/Positive Attributes or Characteristics requiring Simple Accommodations/ Adaptations: All humans use repetitive motor movements to regulate our state. We tap our feet repetitively, twirl our hair, or twirling a pen in our hand. Because these movements are conventional, they are often overlooked in neurotypical humans. If adults with ASD perceive information differently, it follows that the ways in which they regulate their own state will be different, and in some cases, more extreme. Acknowledging these as differences, not deficits, can open our perspective to supporting adults with ASD and any overt responses to sensory information (see accommodations/ Adaptations for Hypo/Hyper-responsiveness to sensory information below)

Example 2:

Areas Impacted in ASD /Areas Impacted: Insistence on Sameness

Perception of Characteristics as Barriers/Limitations: Preference for doing the same tasks/activities in the same way/order.

Perception of Characteristics as Strengths/Positive Attributes or Characteristics Requiring Simple Accommodations/Adaptions:

Strengths: Adults with ASD will follow all workplace rules, to perfection. These employees are immensely dependable, and will perform systematic tasks with meticulous attention to detail and precision.

Accommodations / Adaptations:

May need to explicitly identify exceptions to rules.

Example 3:

Areas Impacted in ASD /Areas Impacted: Fixated/restricted Interests

Perception of Characteristics as Barriers/Limitations: Focusing on the details and less on the big picture. Hyper-focused areas of interest or a limited range of interests.

Perception of Characteristics as Strengths/Positive Attributes or Characteristics requiring Simple Accommodations/ Adaptations: Strengths: Interests that are fixated on work-oriented tasks allows for sustained attention to any/all assigned tasks through completion. Strong productivity levels. Attention to all details of any task. Strong procedural skills.

Accommodations/ Adaptations:

All humans perform better in environments that feel safe, and that promote homeostasis .

Example 4:

Areas Impacted in ASD /Areas Impacted: Hyper/hypo-responsiveness to sensory information.

Perception of Characteristics as Barriers/Limitations: Exaggerated or reduced responses to touch, visual information, auditory information, tactile information, smell, proprioception, ect.

Perception of Characteristics as Strengths/Positive Attributes or Characteristics requiring Simple Accommodations/ Adaptations: Adults with ASD perceive sensory information differently, and may therefore need to adapt their working environment by removing sensory input (e.g., noise-cancelling headphones, dimmed lighting or specialized glasses) or adding sensory input (e.g., desk treadmill, music). Such accommodations require no more than employer approval for use, and do disrupt/impact other employees.

The state of employment for adults with ASD presents with a variety of needs, but these needs also pose opportunities for employers presented with the untapped potential of a neurodiverse workforce; this workforce has many characteristics, skills, and strengths that are valued by employers. The increasing numbers of adults with ASD requires that companies and employers consider the massive potential of this workforce; we must have strong expectations that match the strengths and needs of each individual. Reciprocally, adults with ASD and their families must advocate for the many skills such individuals offer employers (see the list of recommendations below). In his dedication for the book, Autism Spectrum Disorder in Mid and Later Life, Dr. Scott Wright (2016) echoes the importance of individual-environment relationships, stating: “Building a bridge takes both sides to work together.”

Arguably, the future of employment is neurodiverse; with the benefits far outweighing the barriers. The logical question that follows is of course, What can I do about all of this? To begin forming your own ideas about potential answers to this question, a list of recommendations for advocacy is presented below. This list is not a mandate; it is imply intended to be useful for anyone wishing to advocate for the gainful employment of adults with ASD, and all of the individual, family, community, employer, company, and economic benefits that accompany such employment.

Recommendations for Advocacy –

  • Individualized Vocational Supports/Programs: Vocational programs that are not individualized for the needs of persons with ASD have generally shown poor outcomes including: a) unemployment, b) underemployment, or c) participation only in sheltered employment contexts (Cimeria & Cowan, 2009; Magiati, Tay & Howlin, 2014; Taylor & Mailick, 2014). However, post-secondary supported employment programs that are individually tailored to maximize skills and motivation, support core needs in social communication and behavior, and provide liaison services between individuals and potential employers have shown positive employment outcomes. These positive outcomes[1] have included:

  • Getting and keeping a paying job

  • Contributing meaningfully to the economy, communities and society

  • Improvement

  • decreased requirements for continued support long-term

  • decreased cost of services long-term

  • decreased economic burden for parents, and importantly

  • substantially improved quality of life for individuals

  • Access your Community: Community-Academic Partnerships (CAPs) offer collaborative solutions[2] by which reciprocal relationships between adults with ASD, their families, researchers and communities, can be built. Such partnerships promote:

  • development of evidence-based intervention programs for immediate use in real world contexts

  • family and community stakeholder access to knowledge/training, supports and intervention programs to improve employment outcomes for adults with ASD. Successful CAPs are founded on mutual trust, respect, and shared goals between researchers, community stakeholders and families, and typically result in the development of a tangible product or program

  • Early Advocacy and Support Matter: Individuals with greater parent support and advocacy have shown better employment outcomes (Magiati, Tay & Howlin, 2014; Taylor & Mailick, 2014). The earlier such supports are provided also matters. Students who are on individualized education plans (IEPs) must have (Under IDEA) post-secondary transition goals by age 16, with many successful transitions supports starting earlier around age 14. Advocating for earlier transition planning provides students with ASD with more time to develop skills, explore employment options, and develop connections with possible employers. Increased time for transition planning/process is also hugely beneficial for parents/caregivers because parents have more time to learn about navigating the post-secondary world. Students with ASD who may require additional time to meet transition goals may be eligible to receive free and appropriate educational transition supports through their 22nd birthday. A period of two to four years of supported employment intervention is commonly reported for adults with ASD to achieve sustained gainful employment.

  • Continued Advocacy and Support Matter: Adults with ASD will require continued employment support in early adulthood to successfully adapt to workplace changes and maintain/improve communication between employees with ASD and employers/co-workers (Westbrook et al., 2012). The costs of supported employment services are expensive, but over time may lead to decline in cost-of-services compared to wages-earned and improved quality of life when compared to sheltered, segregated work contexts (Cimera & Cowan, 2009; Mawhood & Howlin, Alcock, & Burkin, 2005). Post-secondary training and vocational rehabilitation services, show to benefit adults with ASD include:

  • Liaison supports matching individual interests/motivation to well-fitting jobs, and providing employer/co-worker training (Westbrook, Nye, Fong, Wan, Cortopassi & Martin, 2012; Wright, 2016)

  • Workplace Accommodations/ Adaptations: As noted above in Tables 1 and 2, many beneficial accommodations/adaptations are easy and cheap for employers to provide. The provision of such supports involves communication with employers, and often employer education.

  • Achieving Sustained, Paid Employment Benefits Adults with ASD in Many Ways: Getting a paying job leads to many other associated benefits and opportunities. These opportunities lead to improved quality of life for adults with ASD, just as they do for neurotypical adults who hold down jobs. Some of these benefits include:

  • Increased quantity and quality of opportunities for adults with ASD to interact with others in socially meaningful ways

  • Improvement/maintenance of social skills and cognitive engagement

  • Improvement/maintenance of adaptive daily living skills

  • Increased autonomy, community inclusion and participation

  • Hiring Adults with ASD Benefits Companies, Employers, and Co-workers in Many Ways: In addition to the positive attributes and outcomes of employees with ASD, the employers and companies that employ adults with ASD also garner direct and indirect benefits; including:

  • Increased employee retention, and lower turn-over rates

  • Increased worker and company productivity

  • Increased positive workplace attitudes and positive interactions between coworkers

  • Direct financial benefits related to retention and productivity of more than $1000.00

We are ALL neurodiverse. I am unique and you are unique; there are differences in the ways that we see and know the world, but such differences are small in light of the fact that we are so, so similar. Let’s give adults with ASD the chance to do life, on their own terms; all they need to live such a self-directed life…is a little bit of help.

Reading List:


Wright, S. (2016). Autism spectrum disorder in mid and later life. London, UK: Jessica Kingsley

Publishers. Retrieved from:

Diagnostic Manuals and Governmental Reports:

American Psychiatric Association (2013). Diagnostic and Statistical Manual – Fifth Edition.

Washington, DC: American Psychiatric Publishing. Retrieved from:

Center for Disease Control and Prevention [CDC]. (2018). Prevalence of autism spectrum

disorder among children aged 8 years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveillance Summary 2018;67(No. SS-6):1–23. DOI:

Harwood, R., & Novonty, T. (2017). Youth with autism spectrum disorder transitioning to

adulthood. Washington, DC: US Department of Health and Human Services. Retrieved from:

Roux, A. M., Shattuck, P. T., Rast, J. E., Anderson, K. A. (2017). National Autism Indicators

Report: Developmental Disability Services and Outcomes in Adulthood. Philadelphia, PA: Life Course Outcomes Research Program, A.J. Drexel Autism Institute, Drexel University. Retrieved from:

Works Cited:

[1] This theory (called different things by different areas of study: e.g., transactional theory, neuro-constructivism, dynamic systems, ect), applies to all things in our world; from humans to animals, and from plants to planets, to infinity and beyond (Lightyear, 1995).

[2] This statement was crafted to be reductionist in nature, as a comprehensive review of the state of science on the etiology of ASD is outside the scope of this article. All scientists generally agree that autism is the result of interactions between genes, the brain, the environment, and behavior over time; however, the contributions of each of these to the profile observed in each individual child is unknown. There is no singular identified cause of ASD that anyone knows of at this time.

[3] Neurodiversity refers to many things, but most generally to the idea that every brain is uniquely different, but critically similar in terms of what makes us human in the first place. Such neurological differences should be accepted as typical variations, much like the neurological variations that lead to differences considered to be conventional (e.g., personality, intelligence, athleticism, or artistic ability).

[4] Please note that this table is meant to represent population-level information. This means that the characteristics in Tables 1 and 2 represent a list that is representative of a group of people but will not fully represent the characteristics of each individual person with ASD. To illustrate this point, let’s consider a group of people are all scientists. There are a couple key characteristics that almost everyone in the group will have. However, if we examine an individual scientist, say Albert Einstein, we would notice that he may fit with some of the group level characteristics of scientists, but probably wouldn’t match the characteristics of all scientists, and likely has some characteristics that aren’t on the list. This was/is a good thing.

[5] Homeostasis refers to a state of equilibrium or balance in our physiological system. Learning and productivity are best when we are in homeostasis. Those who are above this range typically require a dampening of sensory input to regulate state (turning down lights, leaving busy social situations, putting on headphones). Those who are under this range, typically need increased sensory input to regulate state (e.g., coffee, music, fidgets, alerting lighting or color)

[6] Researchers who have reported positive outcomes of individualized programs include: Burke et al., 2010; Cimeria & Cowan, 2009; Garcia-Villamisar & Huges, 2007; Howlin, Alcock, & Burkin, 2005; Keel, Mesibov, & Woods, 1997; Mawhood & Howlin, 1999; Strickland, Coles, & Southern, 2013. Links to access these articles are provided in the reading list below.

[7] Information on benefits of community-academic partnerships was summarized from Drahota et al., 2016. The link to access this article is provided in the reading list below.

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