Autism Plus: Autism and Co-occurring Disabilities
The co-occurring disabilities listed here are those seen more frequently in autistic people than in the general population*. Each disability affects and is affected by autism. It is important to think about co-occurring disabilities when considering what accommodations and supports an autistic employee may need.
* https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30289-5/fulltext
ADHD
About 50% of autistic people are also identified as having ADHD*. For these workers, executive functioning difficulties are likely to require additional supports, including use of shared calendars, organizational support, and opportunities for working alongside others doing similar tasks.
*Rong, Y., Yang, C. J., Jin, Y., & Wang, Y. (2021). Prevalence of attention-deficit/hyperactivity disorder in individuals with autism spectrum disorder: A meta-analysis. Research in Autism Spectrum Disorders, 83, 101759.
Anxiety
Anxiety is common in autistic youth and adults and may be a response to sensory overload. The autistic employee with anxiety may benefit from smaller workgroups and remote participation in meetings, and advance notification of changes.*
* Djela, M. (2021). Change of autism narrative is required to improve employment of autistic people. Advances in Autism, 7(1), 86-100.
Intellectual Disability
It is estimated that 40% of autistic people also have an intellectual disability, though this may be inflated somewhat by a bias towards autistic people receiving services. These employees may benefit from the assistance of OVR and an Employment Specialist, though some will work independently. Autistic workers with ID can be excellent employees with he right supports.
* Maenner MJ, Shaw KA, Baio J, et al. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016. MMWR Surveill Summ 2020;69(No. SS-4):1–12. DOI: http://dx.doi.org/10.15585/mmwr.ss6904a1
Epilepsy
A disorder that causes recurring seizures, epilepsy is far more common in autistic than non-autistic people (10-20% for autistic and 1.5% non-autistic*). Seizure triggers are different for each person and type of epilepsy but can include fluorescent or flashing lights and sounds of specific frequencies. The essential support here is understanding of the condition and avoidance of triggers.
* Liu, X., Sun, X., Sun, C., Zou, M., Chen, Y., Huang, J., … & Chen, W. X. (2022). Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis. Autism, 26(1), 33-50.
Gastrointestinal Disorders
Gastrointestinal disorders (GI) are some of the most common co-occurring disorders in autistic people. Researchers do not know all of the reasons for this; restrictive eating is associated with GI disorders but the cause and effect relationship are unknown.*
*Baraskewich, J., von Ranson, K. M., McCrimmon, A., & McMorris, C. A. (2021). Feeding and eating problems in children and adolescents with autism: A scoping review. Autism, 25(6),
PTSD
The rate of post traumatic stress disorder (PTSD) in autistic people is estimated at 30%-60% as opposed to 4.5% in non-autistic research participants*. Employers should take care to avoid potential triggers and respond calmly and compassionately to PTSD responses. Understanding the types of events that can add further trauma is essential.
*Rumball, F., Happé, F., & Grey, N. (2020). Experience of trauma and PTSD symptoms in autistic adults: risk of PTSD development following DSM-5 and non-DSM-5 traumatic life events. Autism Research, 13(12), 2122-2132.
Sleep Disorders
It typically takes an autistic person longer to fall asleep than a non-autistic person. They also spend less time in REM or deep sleep. The causes are unknown, but sleep disorders can be caused by conditions like gastrointestinal problems, ADHD, depression, or anxiety. It can also be a result of sensory sensitivities to light, sound, touch (e.g. a wrinkle in a pillow), or the temperature of the room. A job with flexible working hours is ideal for many autistic people, greatly increasing productivity*.
*Martin, V., Flanagan, T. D., Vogus, T. J., & Chênevert, D. (2023). Sustainable employment depends on quality relationships between supervisors and their employees on the autism spectrum. Disability and Rehabilitation, 45(11), 1784-1795.
Depression
Autistic adults experience depression at rates 4 to 8 times higher than neurotypical peers. Some signs of depression in autistic adults include decreased energy levels, lower ability to mask, and indifference to previously important specialized interests. Employers can support autistic workers with depression by ensuring they are not further stigmatized or excluded and by offering robust Employee Assistance Plans.
Schedule a consultation with ISAW to learn more at isaw.hdiuk.org
Contact: Bev Harp at baharp2@uky.edu or Brittany Granville at bgr263@uky.edu