Removing Barriers: A Multifaceted Approach to Supporting Neurodivergent Individuals Experiencing Executive Function Challenges in the Workplace
Author’s Note: This research idea was presented at the 2024 Neurodiversity at Work Research Conference hosted in College Park, Maryland. It is not a complete study, it is intended to be a research idea in progress.
Abstract
Approximately 26% of adults in the United States identify as having an apparent or non-apparent disability, with an approximate 15-20% identifying as neurodivergent. While these individuals bring diverse perspectives and competitive advantages to the workplace, they often face barriers related to their executive function skills. This proposed phenomenological research study highlights the needs of neurodivergent individuals experiencing the phenomenon of working in an environment designed for the neurotypical without adequate support. Furthermore, this proposed research investigates the experiences of neurodivergent individuals in corporate roles, focusing on executive function barriers, leveraging impactful support tools, and gaps in implementation.
This proposed study will provide valuable insights for companies on common executive function areas individuals are experiencing barriers in as well as what tools and strategies are most commonly used in order to remove these barriers. The focus of the workplace coaching accommodation is to remove environmental barriers, implement inclusive practices, and improve access to supports for neurodivergent employees, specifically within the scope of executive function. This can not only foster individual success but also enhance innovation and productivity within an individual company.
Keywords: neurodiversity, executive function, workplace inclusion, accessibility, disability
Introduction to the Problem
An estimated 26% of adults in the United States identify as having a disability, with an approximate 15-20% identifying as neurodivergent (Center for Disease Control and Prevention, 2023). The term disability, used in this context, describes those with both apparent and non-apparent conditions. An apparent disability may present as blind/low vision when vision aids are used, or a person using a mobility device. Whereas examples of non-apparent disabilities may be Depression, Autism, ADHD or Chronic Pain, to name a few, and may not be evident to others without the person choosing to disclose. With that said, approximately one quarter of individuals within a company identify as having a disability through self identification or medical identification, even if they did not choose to disclose. Though on average one quarter of employees have a disability, many workplaces have not taken action in accommodating this distinct group of individuals in the workplace, more specifically, neurodivergent with executive function barriers.
Problem Statement
Neurodivergent individuals are experiencing gaps or barriers in regard to their executive function needs within the workplace, specifically, in corporate roles. In order to bridge these gaps, we must remove environmental barriers, educate individuals on inclusive best practices, and improve access to supports in order to advocate for the 26% of individuals who identify as having a disability in the workplace. Many of these executive function barriers are related to time management, workload management, communication, and attention and concentration. However, there is a gap in research in understanding why these gaps exist, and how companies can provide accommodations to bridge them. With that, it is necessary to investigate and conduct a research study to first identify the barriers, then implement tools and strategies through workplace coaching and other accommodations to support this diverse population.
Purpose Statement
The purpose of this proposed research is to first identify the gaps neurodivergent individuals are experiencing in a workplace designed for the neurotypical. Then, to develop supportive best practices for companies, solution-based practices for individuals with disabilities in order to recognize that diversity includes disability, and to advocate for inclusion and equity for all.
Supporting diversity of perspectives and thinking within the workplace is not only the right thing to do, but it also gives companies a competitive advantage and supports an environment for innovative ideas to flourish. In order to quantify these competitive advantages and understand why removing executive function barriers for neurodivergent individuals is necessary, JP Morgan & Chase’s Autism at Work program researched a specific neurodivergent community in those who identify as having Autism Spectrum Disorder, a non-apparent disability. Autism Spectrum Disorder is just one of the many neurodivergent diagnoses that individuals may identify with as they participate in the proposed study. Some of the participants may identify as having one or many neuro-minorities including ASD, ADHD, Dyscalculia, Dyslexia, depression, anxiety, etc.
JP Morgan & Chase found autistic employees are “48% faster and up to 92% more productive than their non-autistic counterparts – with common factors including strong visual acuity, attention to detail, and a superior ability to focus” (Mahoney, n.d.). James Mahoney, the head of Autism at Work at J.P Morgan Chase and Co, also stated that autistic employees were as much as 140% more productive than their peers (Mahoney, n.d.).Though this is one small sample size of individuals who identify as having one subset of neuro-minorities, it accurately portrays the need for advocacy and inclusion in the workplace, specifically through the lens of executive function support. With executive function support accommodations, like workplace coaching, the neurodivergent population will be able to remove the barriers that are causing challenges in the workforce in order to excel and increase productivity, as the JP Morgan Chase study shows.
Theoretical Framework
` The key objective of the data collection is to understand what barriers the individual is facing within the executive function scope. Once the barriers are identified, tools and strategies are applied in order to remove barriers (The How Skills, 2022). Though the overall categories of executive function barriers are known, the refined focus of which are impacting individuals in the workplace at the highest volume are not (Dawson & Guare, 2009). When collecting data, the first question asks what executive function areas were addressed during the coaching process. Executive function skills are the skills that allow for individuals to execute and plan, focus, and engage with multiple tasks throughout their day (British Medical Bulletin, 2020). If there are barriers related to executive function, individuals may need additional support in order to do things such as manage a workload, make decisions, and control impulses (Dawson & Guare, 2009). The executive function areas assessed are based on the Smart but Scattered framework which include: attention and concentration, communication, decision making, impulse control, email management, household management, memory, organization, stress management, reading/writing, task initiation, time management, and general workload management (Dawson & Guare, 2009). It is important to note that executive function areas are often extremely interconnected, and many tools and strategies may be applicable across various categories. After understanding what specific areas were addressed, the focus groups will be surveyed and asked the following questions:
Research Questions
In order to remove environmental barriers, advocate for inclusive best practices, and improve access to supports, the following research questions must be answered:
What are the top executive function areas individuals are experiencing barriers within the workplace?
Which tools, strategies, or interventions are most effective in supporting individuals experiencing executive function barriers in the workplace?
What are the identified gaps in implementing executive function strategies or tools within the workplace?
In order to strengthen the theoretical grounding of this coaching program evaluation, a review of existing research on executive functioning in neurodivergent adults is necessary. This review focuses on the documented challenges faced by this population and the solutions that have been proposed (British Medical Bulletin, 2020). A critical next step is to identify the specific assumptions embedded within the neurotypical paradigm of executive functioning. A deeper understanding of these challenges is essential in developing a more targeted and effective intervention. All coaches use the same content and curricula, however, they leverage different levels of expertise and degrees to fit the needs of the client (The How Skills, 2022).
Rather than a one-size-fits-all intervention, we follow a “What-Why-How” method for supporting our individual clients with a wide range of cognitive patterns. We developed this method using research in education and cognitive science, along with our extensive experience as educators. A parallel questioning technique, called the 5W1H (origin unknown but used commonly in engineering (Goradia, 2023), is a problem-solving method that systematically addresses the what, who, when, where, why, and how of a problem before moving towards a solution. Similarly, the “What-Why-How” approach at The How Skills integrates various perspectives to gain an in-depth understanding of a specific situation before developing the “How” of an accommodation plan. The How Skills coaches focus on the what, why, and how in order to support the individual’s needs, coupled with in-depth probing questions to differentiate instruction appropriately:
What is happening that the client would like to change?
Why is it happening?
How will we change it to get the results the clients want?
The “What-Why-How” method attends to the cognitive AND social elements of a client’s perceived difficulties rather than jumping to using strategies without understanding the root causes (Doyle, 2020). For example, an employee presenting with difficulty with time management might be told by a manager to “use prioritization.” However, this strategy is not linked to the underlying why of the difficulty. There may be a number of related root causes for a time management difficulty, such as task-related anxiety, comprehension challenges, or task initiation difficulties as manifestation of the disability. The “What-Why-How” method in The How Skills coaching relationship might instead look like this:
What: Difficulty managing time that manifests in missed deadlines
Why: The employee struggles with perfectionism and has trouble getting started due to fear of making mistakes, leading to lost time during the early phases of most projects.
How: A 14-week program with specific, measurable goals and targeted support to work on the root cause: task initiation. This likely includes weekly coaching, education, and support focused on targeted skills, such as breaking tasks down into much smaller chunks, using time management systems or bullet journals to understand how long specific tasks take, and working with the employee’s manager to advocate for healthy deadlines.
Stages of the What-Why-How Method
A robust field of literature and practice support our What-Why-How method for engaging with our clients to focus on specific targets for improvement (Doyle, 2020). We describe the research and history of the method, drawing across behavior change research, coaching-client relationship research and theory, learning sciences and cognitive science, and psychology of learning research (Diamond & Ling, 2016). Leveraging the research of field experts like Diamond and Ling (2016) supports the theory portion of our impact; however, the practice portion of impact is seen through internal data collection. Both the theory and practice portions work in tandem to give accurate evaluation and representation of impact.
Conceptual Framework
The proposed research is based on the continuum of the disability critical theory paradigm surrounding executive function and accessibility barriers for the neurodivergent population within the workplace (eLearn Center, 2013). The ontology embedded within the disability critical theory paradigm suggests that the present reality of society is driven by socially constructed biases that are developed as a byproduct of historic narratives. This is seen specifically in the way neurodivergent individuals are viewed by society, based on outdated information about their function and lack of capabilities (Kelly et. al., 2018). The disability critical theory paradigm brings the oppressed group‘s perspective to light in order to generate positive change and bring forth new or improved pathways that seek to alter the present social conditions (eLearn Center, 2013). Individuals with various neurodiversities are living in a world that was designed by the neurotypical and are lacking support to remove executive function barriers as a manifestation of their disabilities. This research highlights that these individuals can provide competitive advantages to companies with adequate support in place (Ahrens Nadjari, 2023). An additional concept that is applied to this research is that of the social model of disability. Social model of disability argues that disability is not solely caused by a person's impairment, but rather by the barriers and limitations society creates for people with impairments. This can be applied further in sharing that the limitation comes from the workplace limitations, rather than the disability itself (Corker and French, 1998).
Research Design and Methods
Individuals with ADA qualifying disabilities or medical conditions will take part in executive function coaching as a part of either a workplace accommodation offered through their respective companies, or a personal pursuit to remove barriers and as such, pay privately for services. Workplace accommodations require formal diagnoses and tend to address more of workload management, time management, etc. whereas private pay services do not require a formal diagnosis, and tend to address more life/household management, thus, requiring two focus groups. In Focus Group A, the tools and strategies used are expected to be more work-centric, whereas in Focus Group B, the tools and strategies used are expected to be more household management-centric. Diagnostic information is typically included in the consultation notes, however, it is not imperative to the coaching process as the curricula is differentiated to fit the client’s needs regardless. All individuals participating must be 18 or older and able to provide written consent, as seen in Figure A. The individuals will either be approved for this accommodation through their employer, then referred to the executive function company, The How Skills, or, will navigate this journey, again, through private pay. Focus Group A is composed of individuals referred by their company, whereas Focus Group B is composed of individuals on a personal pursuit to remove barriers, paying privately. The individuals are separated into Focus Group A or B, with no other intersectionality or qualifying factor. This workplace coaching support lasts on average 12-14 weeks and allows employees from Group A and B to work 1:1 with coaches in order to support employees in identifying and leveraging their strengths; teaching systems and strategies and providing tools to improve in areas where the employee may be experiencing barriers.
During the midpoint session, typically session 6, and the final session, typically session 12, an anonymous survey will be given to each individual. During the survey, the responses will not require a name in order preserve anonymity of the individual and the employer in preventing any personalized data from being entered.
Each individual, whether in Focus Group A or B, is given the survey twice, once at the midpoint and once at the culmination of the coaching accommodation. The survey content remains the same for Group A and Group B; however, the survey has two forms in order to delineate data based on the employer. The survey questions are identical at both the midpoint and endpoint for all groups and individuals; however, the individual may select different responses based on their progression through coaching, thus, diversifying the data set within data collection.
Data Collection and Procedure
The key objectives of the data collection that will be given to the focus groups and utilized in the survey are as follows:
What are the top executive function areas you are experiencing barriers within the workplace?
What tools, strategies, or interventions are most impactful in removing your executive function barriers?
What are the identified gaps in implementing or practicing executive function strategies or tools within the workplace?
These questions are collecting data to answer their corresponding research questions and will be asked via survey in each focus group. Alongside the observation of tool and strategy efficacy, this participatory action research also investigates the coaching interventions effectiveness to give live feedback to improve processes. After six months, or until theoretical saturation is met, the data will be analyzed for specific codes and themes as shared by the clients of The How Skills in Focus Group A and Focus Group B. The six month duration is chosen in order to recruit individuals, and allow individuals time to complete their coaching accommodation of 12-16 weeks. It will take an approximate two months to recruit individuals and begin the research, and an approximate four months to complete their accommodation or projected coaching period. The projected population size in both focus group A and B combined is approximately 100 clients, with about 80 individuals coming from Focus Group A, and 20 individuals coming from Focus Group B. This disparity is due to recruitment.
Analysis Method
Thematic Analysis will be used for the research method in order to identify recurring themes and patterns within qualitative data, such as interview transcripts or focus group discussions (Braun & Clark, 2006). The researchers will code the data based on these themes and then analyze their relationships to answer research questions 1-3. The researchers will analyze approximately once every 2 months, and then the final analysis will take place at the culmination of the study at 6 months, or theoretical saturation, whichever occurs first. Literature in tandem with prior coaching knowledge suggests that themes for Focus Group A may be life/household management, and Focus Group B may be time management (British Medical Bulletin, 2020). Based on previous internal research, particular neurodivergence tends to align more with specific executive function areas, such as individuals with ADHD may experience the greatest barriers with the executive function category of attention and concentration barriers, and individuals with Traumatic Brain Injury may experience the greatest barriers with the executive function barriers of memory (The How Skills, 2022). This survey does not particularly take data on the intersections of identity, such as disability diagnosis, but trends of barriers can be expected based on significance of disability (The How Skills, 2022).
Ethical Considerations
All individuals who will take part in this anonymous research study will be able to provide written consent based on cognitive ability. These individuals had the capacity to understand the questions asked as well as their willingness to take part in verbally responding to the 3 research questions asked. An internal IRB will evaluate the research protocol.
Next Steps
The next steps to this proposed research are to recruit individuals to take part in this study. Focus Group A naturally has an influx of clients due to partnerships with tech companies and referrals from the accommodation teams to take part in workplace coaching. Recruitment for Focus Group B may be a bit more challenging, as these individuals self-refer. Marketing through various social media platforms, specifically LinkedIn and Instagram will support recruitment for this focus group. Recruitment will occur on a rolling basis throughout the next 6 months with again, a projected 100 individuals., or until theoretical saturation is reached. Because individuals taking part in the coaching process and the study is running concurrently, there will be no financial compensation or incentive.
Summary
In conclusion, despite the estimated 26% of the US population living with disabilities, many workplaces lack effective measures for accommodating them, particularly those with non-apparent disabilities like neurodivergent individuals experiencing executive function barriers. While many choose not to disclose their condition, addressing this critical issue can significantly impact inclusion and unlock the potential of a diverse workforce. Moving forward, exploring the specific challenges faced by these individuals, along with relevant accommodations and the benefits of a neuro-inclusive environment, through this research study will be crucial in creating a more equitable and thriving workplace for all.
References
Ahrens Nadjari, J. (2023). Understanding the Lived Experiences of Young Adults with Down
Syndrome as Emerging Societal Members: A Phenomenological Study (p. 128 pages)
[Drexel University]. https://doi.org/10.17918/00001706
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in
Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
British Medical Bulletin, Volume 135, Issue 1, September 2020, Pages 108–125,
Capper, C. A. (2019). Organizational theory for equity and diversity: Leading integrated, socially
just educatiIon. Routledge.
Centers for Disease Control and Prevention. (2018, August 16). CDC: 1 in 4 US adults live with
a disability. Centers for Disease Control and Prevention. Retrieved September 10, 2022,
from https://www.cdc.gov/media/releases/2018/p0816-disability.html
Corker, M. and French, S. (eds) 1998: Disability Discourse. Buckingham: Open University Press
Creswell, J. W. (2002). Educational research: Planning, conducting, and evaluating quantitative
and qualitative Research. Merrill Prentice Hall.
Dawson, P., & Guare, R. (2009). Smart but scattered: The Revolutionary "executive skills"
approach to helping kids reach their potential. Guilford Press.
DCEG Staff. (2022). Neurodiversity. National Cancer Institute.
https://dceg.cancer.gov/about/diversity-inclusion/inclusivity-minute/2022/neurodiversity
Diamond, A., & Ling, D. S. (2016). Conclusions about interventions, programs, and approaches for improving executive functions that appear justified and those that, despite much hype, do not. Developmental cognitive neuroscience, 18, 34–48. https://doi.org/10.1016/j.dcn.2015.11.005
Doyle, N. (2020). Neurodiversity at work: a biopsychosocial model and the impact on working adults. British Medical Bulletin, 135(1), 108–125. https://doi.org/10.1093/bmb/ldaa021
eLearn Center (Universitat Oberta de Catalunya) Follow. (2013, October 15). Research
paradigms: Ontology's, epistemologies & methods. SlideShare.
https://www.slideshare.net/eLearnCenter/research-methods-uoc-2013.
Goradia, S. (2023). How to do better analysis with the 5W1H method. Medium.com. Accessed 12 January 2024.
Kazanjian, M. (1998). Phenomenology & education . Editions Rodopi BV.
Kelly, M., Dowling , M., & Millar , M. (2018). The search for understanding: The role of
paradigms. Nurse Researcher (2014+), 25(4), 9.
doi:http://dx.doi.org.ezproxy2.library.drexel.edu/10.7748/nr.2018.e1499
Mahoney, J. (n.d.). J.P. Morgan autism at work. J.P. Morgan Autism at work.
The How Skills. (2022). Apparent and non-apparent disabilities. In The How Skills LLC. The How
Skills.
Authors: Jamie Ahrens Nadjari, Ed.D; Paige Porter, MiT
