Physical workplace adjustments to support neurodivergent workers: A systematic review

Abstract

AbstractDerived from the concept of neurodiversity, neurodivergence is an umbrella term for various conditions such as Autism‐Spectrum Disorder (ASD), Attention‐Deficit/Hyperactivity Disorder (ADD/ADHD), Dyslexia, or Dyspraxia, which affect approximately 22% of the population. Sensory difficulties and overload are a common symptom. The provision of physical workplace adjustments for neurodivergent workers, such as workplace design solutions, has become popular in practice, yet their utility remains unsubstantiated. This review evaluates the evidence for physical workplace adjustments and their link to occupational longevity, performance and health/well‐being in neurodivergent workers. A systematic review (PRISMA guidelines) of studies published in English between 2000 and 2021 focused on these inclusion criteria: adult office workers clinically considered neurodiverse, their families, colleagues, employers, experts and vocational programme staff; at least one physical workplace adjustment; and all types of empirical study designs. The theoretical framing was based on the ecological model of person–environment fit supplemented by the International Classification of Functioning, (ICF) disability and health and environmental stress theory. Quality assessment and data synthesis were undertaken. Of the 319 studies identified, 20 met the eligibility criteria; the majority addressed ASD. Most studies described a combination of adjustments to address different environmental stimuli. The most frequent adjustments addressed sound distractions (e.g. single‐person offices) and light sensitivity (e.g. light control), which were related to occupational longevity, performance and health/well‐being. A range of other adjustments addressed aspects such as environmental control, crowding or decompression rooms. There is insufficient evidence to fully evaluate the usefulness of adjustments, partially due to methodological shortcomings. Despite the variety of challenges with the sensory physical environment acknowledged in the literature for neurodivergent conditions, there is a paucity of evidence. Given the potential of physical adjustments to improve work and health outcomes, we highlight the necessity for more theoretically driven and methodologically sound research.