Adults with autism have a strong desire and need for employment that matches their strengths, skills, and interests [1-3]. Yet, adults with autism are far less likely to be employed than their neurotypical counterparts [4-6], with global estimates of unemployment rates for adults with autism ranging up to 80% [7]. In Australia, the estimated rate of workplace participation for adults with autism is 42%, compared to 53% for individuals with other disabilities and 83% for those without a disability [8]. For adults with autism who do manage to secure employment, they are all too often in posts that are deemed unsuitable: either inconsistent with their skillset and abilities (mal-employment) or for which they are overqualified (underemployment) [9,10]. They can also find it difficult to maintain such employment [4-6].

A variety of barriers to successful employment outcomes for adults with autism have been identified at each stage of the recruitment and employment experience, including conventional hiring processes that are unsuited to candidates with autism, limited promotion of and requests for workplace accommodations, and a lack of employment-related and mental health supports [5,11,12]. Traditional job application and interviewing processes typically rely on in-vivo problem-solving skills and the navigation of complex social situations, which can pose unique challenges to some candidates with autism during recruitment [13-16]. Moreover, once in the workplace, employees with autism often report multiple environmental challenges, including navigating social expectations, experiencing aversive sensory stimuli, and stigmatizing attitudes from managers and coworkers [2,3].

Many organizations acknowledge a lack of awareness and knowledge of autism in the workplace [17], which has been linked to increased prejudice and stigmatizing attitudes [18]. For example, some employers perceive the costs of supporting employees with autism as outweighing any potential benefits [19,20]. This is despite evidence suggesting that employing adults with autism can provide substantial benefits, such as increased work ethic and quality of work, without incurring additional costs [21-24]. These studies underscore the need for more research to explore ways to reduce stigma and improve understanding of autistic people in the workplace.

Conversely, studies have identified a range of personal and environmental factors that can lead to successful employment outcomes for adults with autism [1,25,26]. Personal factors include having the knowledge to navigate recruitment and employment processes, work-related experience or skills, and insight into one’s strengths and challenges [25]. However, environmental factors have been identified as potentially having the greatest impact on successful employment for autistic people [26,27]. These factors include positive employer attitudes toward and awareness of autism, collaboration between the autistic employee and the workplace, and the provision of adequate support and accommodations, including mental health support [5,26,28,29].

While all autistic people experience autism in different ways and have different needs [30], there is some commonality in identified workplace supports. These include support in relation to executive skills, such as attention, planning, and problem solving [31]; navigating social environments within the workplace, which can be a source of both anxiety and confusion; and managing challenging sensory information [2]. There is also greater recognition that many autistic people experience co-occurring mental health concerns, such as depression and anxiety, associated with disability [32]. In fact, recent research found that mental ill health is a predictive factor in both vocational confidence and participation in adults with autism [18,33]. These findings suggest that mental health supports adapted to the needs of autistic people may be particularly important for workplace programs.

Research also points to the importance of the degree of “fit” between the job and the individual [25]. This job-matching process may need to take into account the task and social demands of the role, as well as individual skills, such as cognitive abilities, preferences, and sensory needs [2,3,17,25]. The better the job fit, the more likely the individual will succeed [25], highlighting the need for customized, tailored approaches that match individuals to specific roles.

The provision of appropriate support and accommodations can be dependent upon candidates disclosing their autism. However, many adults with autism are reluctant to disclose due to stigma and previous experiences of discrimination [34,35]. For adults with autism who do wish to disclose, the process is shrouded in tension, stress, and confusion as to how and when it should be done [35,36]. When adults with autism receive support to disclose, they are more likely to experience positive outcomes and receive the required accommodations [34,35,37]. Thus, any support program should support adults with autism in this nuanced process of disclosure during the selection phase.

A growing number of successful programs have been developed with the aim of recruiting and retaining neurodivergent employees [38-41]. Findings from these programs highlight the strengths and benefits that employees with autism can bring to an organization, such as diversity in thinking. In addition, they have identified the need for a range of accommodations, including building autism awareness in organizations seeking to employ autistic people, adapting recruitment and interviewing processes, and providing ongoing support to autistic job seekers and employees with autism once they are in their roles [38-41]. To date, however, programs have tended to focus on one aspect of these recommendations rather than providing comprehensive end-to-end support and adaptations for employees with autism and their employers.

To improve workplace outcomes for adults with autism, there is a clear need for a holistic end-to-end approach, focusing on enhancing employers’ attitudes toward and understanding of autism, as well as providing adequate accommodations and services for candidates with autism throughout their recruitment and workplace experience [2,17,25,28]. Moreover, a tailored approach is required, matching work opportunities to an individual’s skills and strengths and providing workplace support based on individual needs, preferences, and experiences [3,25,28].

Therefore, this study protocol proposes a framework that encompasses 8 key areas (Figure 1) to promote inclusive workplaces and enhance recruitment and retention of employees with autism before and during a 12-week placement at consulting firm Ernst and Young (EY). First, both the individual and the workplace are assessed to ascertain strengths and the supports needed to enable inclusive workplace practices. For the individual, this assessment includes their history of employment, strengths, skills, and interests, as well as expectations regarding job demands and practical requirements. For the workplace, it includes current workplace practices and safety within those practices, role and organizational demands, employer beliefs and attitudes, and existing presence and potential for inclusive support practices. Appropriate workplace adaptations can be recommended at this stage to enhance inclusive practices.

Next, training is provided, where required, to both workplace staff and candidates with autism. For the workplace, this training is designed to target knowledge and awareness, stigmatizing attitudes, and implementation of inclusive workplace practices. It also aims to influence adaptations to recruitment, onboarding, and employment processes across the organization. For candidates with autism, the training prepares and empowers them to navigate recruitment and workplace practices and roles, disclosure in the workplace, and the provision of workplace support and accommodations.

Candidates with autism are then matched with a role based on their preferences, strengths, and skills and provided with any necessary workplace accommodations during a 12-week placement.

Ongoing support is provided to both the organization and the candidates with autism throughout the program. The organization receives support during recruitment, onboarding, and the 12-week placement to continue disability and autism education and offer ongoing guidance on specific situations as they arise. Similarly, employees with autism receive support from mental health and autism workplace specialists throughout the placement, providing employment and mental health support, and tailored guidance addressing individual and contextual (workplace) challenges.

Drawing on the framework and available research, this study protocol describes a pilot program that encompasses an end-to-end 12-week supported work placement for adults with autism, based on individual needs, strengths, and preferences, as well as workplace training for candidates and workplace staff. Employers’ attitudes, knowledge, and confidence in supporting autistic people in the workplace before and after taking part in the program will also be explored. The results will provide researchers and employers with greater insight into how to optimize job fit and direct resources that can improve employment outcomes for adults with autism.

The study’s primary aims will be divided into 2 separate streams.

The study uses an exploratory mixed methods cohort design with qualitative and quantitative data collected at multiple time points. Adult participants with autism will be screened for eligibility and invited to complete workplace skills training sessions at the University of Sydney’s Brain and Mind Centre (BMC), before attending an interview, an onboarding session, and a paid 12-week placement at EY in Sydney, Australia. EY managers and colleagues will complete a 2.5- to 3-hour training session, either face-to-face or online, before supporting the adults with autism through their 12-week placements.

The screening data of participants with autism will be collected via online questionnaires and face-to-face psychometric assessments, while baseline, midpoint, and postprogram data from adults with autism and baseline and postprogram data from colleagues and managers will be collected via online questionnaires. Postprogram semistructured qualitative interviews will be conducted with all participants via Zoom (Zoom Communications).

The protocol has received research ethics approval from Belberry Human Research Ethics Committee (HREC 2020-11-1229-A). Participants will be paid a standard wage for their internship hours but will not be paid for assessments conducted before or after the internship program for assessments or training. Participants will not be made aware whether their job is likely to be extended post internship. This is a discussion that will not be expected to happen and not until after the internship is complete.

Adults with autism taking part in previous workplace programs indicated that they want placements that match their skills and interests [38]. Data from the executive function screening measures and baseline questionnaires will therefore be used to develop a personalized profile of strengths, skills, and preferences for each autistic candidate. This profile will include areas of interest; preferred working, communication, and feedback styles; executive function strengths; and preferred ways to manage potential challenges.

The profiles will be provided to EY’s DE&I Team, alongside CVs developed during the workplace skills sessions. The DE&I Team will use these documents to match the candidates’ strengths, skills, and experience with available roles within the participating teams, or to work with teams to create tailored roles for the duration of the 12 weeks. It is hoped that the better the job fit, the more likely the individual will have a successful workplace experience [5,25].

Once roles have been identified or created, the candidates with autism will be invited to interview. Interviews will be held in-person, with online options dependent on COVID-19 restrictions. Conventional interviewing practices can pose a number of challenges for candidates with autism [1,12]. To help overcome these barriers, standard interview processes may be adapted by, for example, reducing the interview duration; providing example questions in advance; allowing additional time and flexibility in how questions are answered; adapting the surroundings based on individual needs and preferences; and minimizing conventional interview requirements, such as eye contact and small talk. These changes will allow participants with autism a more supportive environment where they can focus on showcasing their strengths and skills rather than expending energy on interpreting ambiguous questions, dealing with sensory overload, or masking.

Adaptions to onboarding will be recommended to make processes more accessible to candidates with autism, including reducing the time required for in-person and online onboarding to two half-days, delivering shorter sessions, and creating new written and graphic process documentation to allow for different learning styles. A buddy system will also be implemented during onboarding and throughout the 12-week placement to give employees with autism additional support and a designated go-to person to provide consistent guidance and feedback [5].

Based on previous literature, showing that both employees with autism and their managers and colleagues benefit from ongoing support [5,38], the research team will provide weekly check-ins to all participants throughout the 12-week placement. The check-ins will be by email, phone, or Zoom calls depending on personal preferences. Both sets of participants will also be encouraged to call, text, or email researchers at other times should they need additional ongoing support or feedback. In addition, adults with autism will be offered mentoring sessions with an independent mental health-focused clinical psychologist and autism workplace specialist, who can provide more specialized workplace mentoring, mental health support, and career advice should it be required. Should this be required, support will be provided by a clinical psychologist working in the laboratory of the CAN Research but independently from this specific research study. This particular clinic has extensive experience working with the mental health needs of adults with autism and complex cases (eg, suicidality, acute mental health needs) will determine the level of support and whether withdrawal from the program is appropriate.

Accommodations lists will be created by participants during the workplace skills sessions so that the workplace can implement preferences in advance of autistic participants starting in their roles. This will ensure that participants will arrive in an environment already set up to support their individual differences and unique needs [28]. By reducing the anxiety associated with disclosure and requesting accommodations [34,36], including being unsure of what is available and how to ask for it, autistic participants will be able to more confidently and comfortably settle into their roles [1,5]. The accommodation lists will also provide a greater awareness of how simple and inexpensive most accommodations can be [20]. Options for accommodations may include noise-canceling headphones; natural lighting; clothing preferences; quiet desks; supportive software; preferences for instructions, meetings, and performance reviews; and support with prioritizing and managing workflow.

Measures, data sources, and time points are summarized in Tables 1 and 2. Measures have been selected that assess different aspects of the framework, which feed into the primary and secondary objectives for each stream.

As this is an exploratory pilot program, 10-15 adults with autism will be recruited, alongside their managers and coworkers. Outcomes for both streams will be determined by:

This study seeks to explore the feasibility of a 12-week supported workplace program that includes adaptations and accommodations before and during the placement. It will also investigate employers’ attitudes, knowledge, and confidence in supporting employees with autism. Crucially, it builds on previous research and workplace programs to include workplace and candidate training sessions and ongoing tailored specialist support for both adults with autism and their managers and colleagues. It is anticipated that participating in the supported workplace program will result in improved workplace outcomes for adults with autism, as measured by job satisfaction, mental well-being, and general well-being. It is expected that the program will increase employers’ knowledge and confidence in supporting people with autism in the workplace.

There have been a number of supported workplace programs developed to improve employment for neurodiverse employees [38-41]. However, these programs tend to focus on a specific accommodation or only one element of employment, for example, adapting typical hiring and interviewing practices. This study incorporates the accommodations and supports identified in previous studies to propose an end-to-end framework. This framework aims to enhance recruitment and retention of employees with autism by providing support to both the employees and their managers before, during, and after the 12-week program.

The benefits of employment are well recognized. Improving workplace outcomes for adults with autism can offer significant benefits for the autistic community and the employment sector [21,22]. As well as economic independence, employment can offer adults with autism a sense of identity and accomplishment, improve quality of life, provide structure and opportunities for social interaction, and facilitate a contribution to society with less reliance on government funding [22,29]. Conversely, unemployment has been associated with lower life satisfaction and ill health [66].

Many adults with autism display myriad strengths that can contribute to the workforce, including excellent attention to detail, an expansive memory, an affinity for rules and guidelines, and the ability to analyze complex patterns in social and physical environments [23,24]. Workplace-specific research suggests adults with autism have higher levels of reliability, trustworthiness, attention to detail, and accuracy in visual tasks; expedient levels of concentration and memory; and lower levels of absenteeism than their counterparts [1]. By exploring the barriers, facilitators, and individual characteristics associated with successful employment, this study will provide employers with greater insight into where and how to direct resources in order to attract and retain talented candidates with autism. In turn, this will enhance the well-being and life satisfaction of adults with autism who want to work but have been unable to find roles that suit their strengths and skills. The findings from this study will be disseminated through publication in peer-reviewed journals.

A growing number of programs with the aim of recruiting and retaining neurodivergent employees have been developed. However, these programs have tended to focus on providing a specific accommodation rather than end-to-end support. A strength of the current study is the implementation of an end-to-end framework to support employees with autism throughout the 12-week work placement. The mixed methods approach will allow for an in-depth analysis of the individual factors contributing to successful employment. We note, however, that the findings of this work may not be generalizable to all work contexts. EY primarily employs individuals with university-level education. They also have an established intention to increase neurodiverse employment throughout their workforce. Finally, we note that the individual assessments conducted on this sample size will provide limited opportunity to detect meaningful outcomes for predicting success. The completion of these measures is aimed at collecting pilot data for a much larger trial.

The findings from this study will provide a greater understanding of factors relating to successful employment for adults with autism as well as provide insight into current attitudes in the workplace. Greater insights into current attitudes and knowledge of autism in the workplace, and the impact of a structured training program, will also help inform the development and implementation of much-needed similar training programs at other organizations. Former UN Secretary-General Ki-Moon [7] has called for companies to understand autistic individuals’ “unique and often exceptional skills, and to enable work environments where they can excel.” This study seeks to take another important step toward realizing that reality.