Introduction
JAN's Accommodation and
Compliance Series is designed to help employers determine effective
accommodations and comply with Title I of the Americans with Disabilities
Act (ADA). Each publication in the series addresses a specific medical
condition and provides information about the condition, ADA information,
accommodation ideas, and resources for additional information.
The Accommodation and Compliance
Series is a starting point in the accommodation process and may not
address every situation. Accommodations should be made on a case by
case basis, considering each employee's individual limitations and
accommodation needs. Employers are encouraged to contact JAN to discuss
specific situations in more detail.
For information on assistive
technology and other accommodation ideas, visit JAN's Searchable Online
Accommodation Resource (SOAR) at http://www.jan.wvu.edu/soar.
Information
about Asperger Syndrome
What is Asperger Syndrome?
Asperger Syndrome, sometimes
called "high-functioning autism," is one of five pervasive
developmental disorders known as the Autism Spectrum Disorders (NIMH,
2006). People with Asperger Syndrome typically have average or above-average
cognitive ability, but have extreme social deficits (Klin et al.,
2000).
The common characteristics
of Asperger Syndrome are underdeveloped social skills and underdeveloped
communication skills (DSM-IV, 1994). Individuals with Asperger Syndrome
may also have deficits in tactile perception, psychomotor coordination,
and/or visual-spatial organization (Klin et al., 2000).
People with Asperger Syndrome
are self-described loners who may be unable or unwilling to participate
in spontaneous social interaction. Though friendship is desired, frustration
occurs when trying to build social relationships, likely due to previous
failed attempts (Klin et al., 2000).
People with Asperger Syndrome
can excessively elaborate on their own topics of interest, however,
be unable or unwilling to participate in other parts of conversation
or to end a conversation, partially because of the inability to gauge
social context or interpret social cues (Klin et al., 2000).
Gross motor skills, including
posture and gait, and fine motor skills such as manual dexterity may
be under-developed, making people with Asperger Syndrome seem clumsy
or physically awkward (Klin et al., 2000).
What causes Asperger
Syndrome?
In the past, public interest
rose around a theory suggesting a link between the use of thimerosal,
a mercury-based preservative used in the measles-mumps-rubella (MMR)
vaccine, and autism. These theories have been refuted in subsequent
studies by American and Danish researchers (NIMH, 2006). Research
into the causes of autism now involves genetic sampling, and detailed
study of the brain to include imaging, tissue sampling, and post-mortem
evaluations (NIMH, 2006).
How is Asperger Syndrome
treated?
Medications are used to
treat people with Asperger Syndrome. This includes medications for
anxiety, depression, and obsessive-compulsive behavior such as Prozac
and Zoloft, and medication for inattention or hyperactivity such as
Ritalin (NIMH, 2006). Most experts agree that treatment for Asperger
Syndrome not be limited solely to the use of medications. Treatment
can also include behavioral therapy, addressing the development of
interpersonal relationships, time management, self-discipline, goal-setting,
and decision-making (NIH, 2006).
Asperger
Syndrome and the Americans with Disabilities
Act
Is Asperger Syndrome
a disability under the ADA?
The ADA does not contain
a list of medical conditions that constitute disabilities. Instead,
the ADA has a general definition of disability that each person must
meet (EEOC, 1992). Therefore, some people with Asperger Syndrome will
have a disability under the ADA and some will not.
A person has a disability
if he/she has a physical or mental impairment that substantially limits
one or more major life activities, a record of such an impairment,
or is regarded as having such an impairment (EEOC, 1992). To be a
disability covered by the ADA, the impairment must substantially limit
one or more major life activities. These are activities that an average
person can perform with little or no difficulty. Examples are: walking,
seeing, speaking, hearing, breathing, learning, performing manual
tasks, caring for oneself, and working. These are examples only. Other
activities such as sitting, standing, lifting, or reading are also
major life activities (EEOC, 1992).
Most courts have agreed
with the activities listed by the EEOC. For example, in Brown v. Cox
Medical Centers, 286 F.3d 1040 (8th Cir. 2002), the Court noted that
the "ability to perform cognitive functions" is a major
life activity. In Gagliardo v. Connaught Laboratories, Inc., 311 F.3d
565 (3d Cir. 2002), the court held that "concentrating and remembering
(more generally, cognitive function)" are major life activities
(Fram, 2004).
For more information about
how to determine whether a person has a disability under the ADA,
visit http://www.jan.wvu.edu/corner/vol02iss04.htm.
Accommodating
Employees with Asperger Syndrome
(Note: People with Asperger
Syndrome may experience some of the limitations discussed below, but
seldom develop all of them. Also, the degree of limitation will vary
among individuals. Be aware that not all people with Asperger Syndrome
will need accommodations to perform their jobs and many others may
only need a few accommodations. The following is only a sample of
the possibilities available. Numerous other accommodation solutions
may exist.)
Questions to Consider:
1. What limitations is
the employee with the Asperger Syndrome experiencing?
2. How do these limitations
affect the employee and the employee's job performance?
3. What specific job
tasks are problematic as a result of these limitations?
4. What accommodations
are available to reduce or eliminate these problems? Are all possible
resources being used to determine possible accommodations?
5. Has the employee with
Asperger Syndrome been consulted regarding possible accommodations?
6. Once accommodations
are in place, would it be useful to meet with the employee with
Asperger Syndrome to evaluate the effectiveness of the accommodations
and to determine whether additional accommodations are needed?
7. Do supervisory personnel
and employees need training regarding Asperger Syndrome?
Accommodation Ideas:
Speaking/Communicating:
Individuals with Asperger Syndrome may have difficulty communicating
with co-workers or supervisors. For people with Asperger Syndrome,
poor communication may be the result of underdeveloped social skills,
lack of experience/exposure in the workforce, shyness, intimidation,
behavior disorders, or low self-esteem.
Provide advance notice of topics to be discussed in meetings to
help facilitate communication
Provide advance notice of date of meeting when employee is required
to speak to reduce or eliminate anxiety
Allow employee to provide written response in lieu of verbal response
Allow
employee to have a friend or coworker attend meeting to reduce or
eliminate the feeling of intimidation
Time Management:
Individuals with Asperger Syndrome may experience difficulty managing
time, particularly if involved in an enjoyable or exciting task. This
limitation can affect their ability to complete the task within a
specified timeframe. It may also be difficult to prepare for, or to
begin, less-desirable work activities.
Divide large assignments
into several small tasks
Set a timer to make an alarm after assigning ample time to complete
a task
Provide a checklist of
assignments
Supply an electronic
or handheld organizer, and train on how to use effectively
Use a wall calendar to
emphasize due dates
Impulsivity: Individuals
with Asperger Syndrome may exhibit over-activity or impulsive behavior.
This could be disruptive to the work environment or could inhibit
efficient and effective work performance.
Provide structured breaks to create an outlet for physical activity
Use a job coach to teach/reinforce techniques to control impulsivity
Allow the employee to
work from home
Review conduct policy
with employee
Adjust method of supervision
to better prepare employee for feedback, disciplinary action, and
other communication about job performance
Use services of the Employee
Assistance Program (EAP) if available
Provide private workspace
where employee will not disturb others by tapping, humming, or fidgeting
Stress management:
Individuals with Asperger Syndrome may have difficulty managing stress
in the workplace. Situations that create stress can vary from person
to person, but could likely involve heavy workloads, unrealistic timeframes,
shortened deadlines, or conflict among coworkers.
Provide praise and positive reinforcement
Refer to EAP
Allow employee to make telephone calls to doctors (and others) for
support
Provide sensitivity training
for workforce
Allow the presence and
use of a support animal
Modify work schedule
Maintaining Concentration:
Individuals with Asperger Syndrome may experience decreased concentration
which can be attributed to auditory distractions (that can be heard)
and/or visual distractions (that can be seen). People with Asperger
Syndrome report intolerance to distractions such as office traffic,
employee chatter, and common office noises such as fax tones and photocopying.
To reduce auditory distractions:
Purchase a noise canceling headset
Hang sound absorption panels
Provide a white noise machine
Relocate employee's office space away from audible distractions
Redesign employee's office space to minimize audible distractions
To reduce visual distractions:
Install space enclosures (cubicle walls)
Reduce clutter in the employee's work environment
Redesign employee's office space to minimize visual distractions
Relocate employee's office space away from visual distractions
Organization and Prioritization:
Individuals with Asperger Syndrome may have difficulty getting or
staying organized, or have difficulty prioritizing tasks at work.
This is likely the result of limited executive function, which are
cognitive skills required to prepare and execute complex behavior
like planning, goal setting, and task completion.
Develop color-code system
for files, projects, or activities
Use weekly chart to identify
daily work activities
Use the services of a
professional organizer
Use a job coach to teach/reinforce
organization skills
Assign a mentor to help employee
Allow supervisor to prioritize
tasks
Assign new project only when previous project is complete
Provide a "cheat
sheet" of high-priority activities, projects, people, etc.
Social Skills: People
with Asperger Syndrome may have difficulty exhibiting appropriate
social skills on the job. This might manifest itself as interrupting
others when working or talking, demonstrating poor listening skills,
not making eye contact when communicating, or inability to correctly
read body language or understand innuendo. This can affect the person's
ability to adhere to conduct standards, work effectively with supervisors,
or interact with coworkers or customers.
Behavior on the job:
Review conduct policy with employee to reduce incidents of inappropriate
behavior
Provide concrete examples to explain inappropriate behavior
Provide concrete examples to explain consequences
Recognize and reward appropriate behavior to reinforce appropriate
behavior
Provide a job coach to help understand different social cues
Use training videos to demonstrate appropriate behavior in workplace
Encourage all employees to model appropriate social skills
Use role-play scenarios to demonstrate appropriate behavior in
workplace
Working effectively with supervisors:
Provide detailed day-to-day
guidance and feedback
Offer positive reinforcement
Identify areas of improvement
for employee in a fair and consistent manner
Provide clear expectations
and the consequences of not meeting expectations
Give assignments verbally,
in writing, or both, depending on what would be most beneficial
to the employee
Establish long term and short term goals for employee
Adjust supervisory
method by modifying the manner in which conversations take place,
meetings are conducted, or discipline is addressed
Interacting with co-workers:
Provide sensitivity training to promote disability awareness
Allow employee to work
from home when feasible
Help employee "learn the ropes" by providing a mentor
Make employee attendance
at social functions optional
Allow employee to transfer
to another workgroup, shift, or department
Encourage employees
to minimize personal conversation, or move personal conversation
away from work areas
Memory: Individuals
with Asperger Syndrome may experience memory deficits that can affect
their ability to complete tasks, remember job duties, or recall daily
actions or activities. This could be caused by a side-effect from
medications. It could also be due to disinterest in the activity or
misunderstanding the activity's level of importance.
Provide written instructions
Allow additional training
time for new tasks
Offer training refreshers
Prompt employee with
verbal cues
Use a flowchart to describe
the steps involved in a complicated task (such as powering up a
system, closing down the facility, logging into a computer, etc.)
Provide pictorial cues
Use post-it notes as
reminders of important dates or tasks
Safely and securely maintain
paper lists of crucial information such as passwords
Allow employee to use
voice activated recorder to record verbal instructions
Provide employee directory
with pictures or use nametags and door/cubicle name markers to help
employee remember coworkers' names
Encourage employee to
ask (or email) with work-related questions
Multi-tasking: Individuals
with Asperger Syndrome may experience difficulty performing many tasks
at one time. This difficulty could occur regardless of the similarity
of tasks, the ease or complexity of the tasks, or the frequency of
performing the tasks.
Separate tasks so that
each can completed one at a time
Create a flow-chart
of tasks that must be performed at the same time, carefully labeling
or color-coding each task in sequential or preferential order
Provide individualized/specialized
training to help employee learn techniques for multi-tasking (e.g.,
typing on computer while talking on phone)
Identify tasks that must
be performed simultaneously and tasks that can be performed individually
Provide specific feedback
to help employee target areas of improvement
Remove or reduce distractions
from work area
Supply proper working equipment to complete multiple tasks at one
time, such as workstation and chair, lighting, and office supplies
Explain performance standards
such as completion time or accuracy rates
Situations and Solutions:
An employee with Asperger
Syndrome works for a large marketing firm. Though she is knowledgeable
in her field, she has difficulty participating in work activities
with her team. JAN suggested job restructuring, which allowed her
to work independently while providing information to her team electronically.
This gave the employee the social distance she needed to be comfortable,
yet also provided the team with information needed to move forward
with marketing campaigns.
A new hire at a fast-food
restaurant has Asperger Syndrome. He completes his job tasks quickly
and efficiently then remains idle until someone tells him the next
task to perform. The manager complains that the employee "just
stands around" and "looks bored." JAN suggested the
use of a job coach to help learn the job, and how to stay occupied
during down time. JAN also suggested using a training DVD from www.ConoverCompany.com
to help build workplace social skills.
An applicant with Asperger
Syndrome is applying for a research position with a chemical company.
He has a verbal communication deficit, though can communicate properly
through handwriting and by email. The employer wants to provide accommodations
during the first stage interview, which involves answering questions
from a three-person search committee. JAN suggested providing the
questions in advance and allowing the applicant to furnish written
responses during the interview.
A professor with Asperger
Syndrome had difficulty keeping daily office hours, and experienced
anxiety because the timing of students' consultations was unpredictable.
JAN suggested modifying the schedule as an accommodation. The professor
keeps all required office hours, but only during three workdays. JAN
also suggested adjusting the method by which students obtain appointments,
asking students to schedule at least one day in advance and when possible,
allow the professor to conduct consultations electronically, by phone,
or by instant messenger. In addition, JAN suggested documenting each
student consultation to ease his anxiety about the meeting and to
refresh his memory about previous meetings with the student.
Products:
There are numerous products
that can be used to accommodate people with limitations. JAN's Searchable
Online Accommodation Resource (SOAR) at http://www.jan.wvu.edu/soar
is designed to let users explore various accommodation options. Many
product vendor lists are accessible through this system; however,
upon request JAN provides these lists and many more that are not available
on the Web site. Contact JAN directly if you have specific accommodation
situations, are looking for products, need vendor information, or
are seeking a referral.
Resources
References
American Psychiatric Association.
(1994). Diagnostic and statistical manual of mental disorders (4th
ed.). Washington, D.C.
Center for Disease Control
and Prevention (2006). How common are Autism spectrum disorders? Retrieved
January 8, 2007, from http://www.cdc.gov/ncbddd/autism/asd_common.htm
Equal Employment Opportunity
Commission. (1992). A technical assistance manual on the employment
provisions (title I) of the Americans with Disabilities Act. Retrieved
October 28, 2005, from http://www.jan.wvu.edu/links/ADAtam1.html
Fram, David. (2004). Resolving
ADA workplace questions: How courts and agencies are dealing with
employment issues. National Employment Law Institute Publication,
17th edition.
Klin, A., Volkmar, F.R,
& Sparrow, S.S. (2000). Asperger syndrome. New York, Guilford
Press.
National Institute of Mental
Health. (2006). Autism spectrum disorders (pervasive developmental
disorders). Retrieved January 8, 2007, from http://www.nimh.nih.gov/publicat/autism.cfm#intro