vrijdag 14 maart 2008

AD/HD at Work- Solutions for employees and employers

- notes from talk.July 2007.ECOC

We will consider-
  • Strategies employees can use to cope with ADHD in the workplace and other support available to them.
  • Should an employee disclose their AD/HD? Strategies and accommodations employers/Human Resources can use to support individual AD/HDers.
  • Good practice models for employment and recruitment of people with disabilities, specifically AD/HD

Core symptoms/AD/HD

  • Inattention
  • Hyperactivity/impulsivity
Looking at adults

  • DSM-iv produced with children in mind
  • Symptoms in adults often manifest differently
  • Less hyperactivity
  • Impulsivity more salient-spending habits, internet use, etc
  • Adults may be able to inhibit impulsivity – but more effort/difficulty then others
  • Often undiagnosed and untreated.
  • Develop coping skills that mask the visible impairments

  • Deficits more apparent in adults include:Working memory,emotional and motivational regulation, organisation, planning, and problem solving
  • These problems often most obvious in the workplace
A Caution

  • AD/HD is not a learning disorder.
  • It’s a disruption in the application of knowledge-at the point of performance of knowledge not its acquisition
Why should employers care?

  • 4.2% workforce fulfilled diagnostic criteria (American study/European epidemiological data consistent)

  • Clinical Experience Belgium
    (Oswald/Stes 2005)
  • Asked medical professionals about the rate of adult AD/HD in the general population-60% concurred with epidemiological data
  • But 35% had never diagnosed adult ADHD
-29% knew another professional with experience in the field they could refer patients to


  • Pyschoeducation
  • Medications
  • Time management and organisation coach
  • Career counselling to get the best job fit
  • Management of co morbid disorders
  • Support groups
Different levels of awareness in adults

  • Adults who were diagnosed in childhood or later and had continued treatment/awareness
  • Adults who have never been diagnosed
  • Adults who were diagnosed in childhood but poor follow through
Successful Adults
  • High levels of insight
  • Channel hyperactivity and restlessness
  • Volunteer for novel tasks
  • May display increased deficits in proportion to their successes -amplifies once subtle defects”(Rapport et al., 2001)
Adults with difficulties in the workplace

  • More difficulty finding and keeping employment
  • Less insight
  • Pattern of low self-worth, depression, and poor motivation
  • Poor communication
  • Learning barriers
  • Accommodations are necessary
Adults who adjust their expectations.

  • Accept lower paid work to minimise stress
  • Have part time or no paid work
  • Black economy
  • Voluntary sector
  • Exchange economy
  • Family, hobbies ,communities etc
Problems reported by employers

Turgay et al,Netherlands,2001)

  • Poor levels of work perfomance
  • Impaired task completion
  • Lack of independent skills
  • Poor relationships with supervisors
  • Poor planning/organisation
  • Can’t sustain attention to routine tasks e.g. paperwork
  • Procrastinates
  • Internally restless
  • fidgety. may be physically overactive
  • Impulsive decision making
  • May be unable to work well independently
  • 0ften late for work, meetings , appointments
  • Changes job impulsively
  • Less able to follow directions carefully
  • Poor self discipline
  • Poor time management
  • Stressed/ over emotional
  • Impaired communication skills

Career Choice

Option of Entrepreneurship

In many countries high percentage entrepreneurs ADHD.Unfortunately, low level of state support and entrepreneurs vs employment in Belgium

What other sectors?
  • From the Adult AD/HD report (2005)
  • 1500 people questioned from 14 professional groups in US
  • People in occupations freer from constraint and office tend to show more behaviours consistent with AD/HD
  • Typical careers for ADHD adults:
  • Professional athletes
  • Tradespeople (plumbers, electricians, carpenters, gardeners).
  • Entertainers (actors, musicians) construction workers
  • Healthcare professionals
  • Elected officials

  • Less likely to find people with ADHD in structured working environments and high disciplined fields
  • Teachers, lawyers, law enforcement agents, media professionals
  • Office, bank, and retail workers

Keys to Success on the job
  • Modify/redesign job to emphasize strengths and weaknesses
  • E.g. moving around whilst still getting work done/photocopying
  • Starting in a job-Build Social Supports- Initiate - Ask questionslook for unwritten rules,establish feedback.

  • Find a coach or mentor or peer worker/tutor
  • Tape important meetings/use note taking to concentrate
  • Notebook organising systems diary PDA
  • http://www.rememberthemilk.com/
  • Harder tasks when most alert
  • Schedule supervisory meetings /reviews more often
  • Customised employment

  • Should you disclose your disability to an existing employer?Consider if you need accomadations

  • Some will view you more negatively, rigidly refuse accommodation-.Other think you can do the job and are willing to make accommodations

Accommodations for employees

  • Don’t request before you know the job description or Immediately after a mistake is made
  • You may be viewed as using your Disability as an excuse
Advantages to Employers of Offering Work Accommodations

  • Retain Valuable Employee
  • Increased employees productivity/company productivity
  • Eliminated training costs new employee
  • Increased employees attendance
  • Improved morale
  • Improved safety
  • For every dollar spent on accommodations got back 10 dollars in benefits
  • (from US Job accommodation network)

  • Disability is an issue which directly affects colleagues at work and in their personal lives
  • Managers who take a leadership position on disability gain both technical skills in change management and job design but also an increased ability to recognise and enable human potential
  • Disability confidence is one of the best ways to build flexible management skills - an area in which managers report they need support

  • Read Your business case for an overview of the facts and areas which may be relevant to your business case
  • Action
  • Employers’ Forum on Disability guidance sets standards for UK business on disability
  • The Disability Standard provides a framework for action which covers every area where disability impacts on the business

May 2008 press release on study of adhd and absenteeism in 10 countries

Other resources

Communication in the workplace for people with ADHD

Action Slips, lapses and mistakes