Working with people with disabilities

Autism, also know as autism spectrum disorder (ASD), is a developmental disability that impacts social interaction, communication, information processing and the need for structure and routine.

Challenges with social interaction stem from an inability to read others and can include: 

– Perceived aloofness
– One-way interaction and/or one-sided conversation often related to a strong area of interest 
– Avoiding eye contact 
– Inability to read body language
– Inability to understand the unwritten rules of social engagement, for example, notions of personal space.

The communication impacts of autism include limited/no speech, difficulty initiating conversation with others and repetitive use of language.

When overwhelmed or stressed, a person with autism may demonstrate repetitive behaviours, for example, becoming preoccupied with particular subjects or unusual objects. They might also engage in repetitive movements such as hand flapping.

Autism can impact work functioning in the following ways:

– Comprehension of information and instructions
– Problem-solving and decision-making skills (due to a focus on the details rather than the big picture)
– Time management and organization 
– Ability to travel or live independently 
– Appropriate behaviours and social skills 
– Grooming and self-care.

People with autism are capable of learning, although it will often take longer than others, and they often require alternative teaching methods and extra assistance.

Another thing to be aware of is that some people with autism struggle to cope with loud and busy environments.

People with mental health conditions often have more than one condition and each can impact employment in different ways. Common examples include:

– Any health condition involving chronic pain and substance abuse 
– Musculoskeletal disorders and major depression 
– Any clinical psychiatric disability and personality disorders 
– Mood disorders (bipolar affective disorder, major depression) and anxiety disorders 
– Any clinical psychiatric disorder and substance dependencies.

Complex co-existing conditions can impact employment differently from singular conditions, for example: 

– It can be difficult to identify employment restrictions
– Optimal treatment and care may not have been obtained for all conditions
– Even if all conditions have been optimally treated, it is more difficult to obtain and coordinate information from multiple health professionals
– A person’s work history and perceptions of what they can manage is an important source of information
– A person’s perceived ability to perform an activity can be the most important factor impacting their work performance.

A person with an intellectual disability may experience challenges in one or more of the following areas:

– Learning
– Communication
– Social skills
– Academic skills
– Vocational skills
– Independent living.

Intellectual disability can have an impact on the following things which are part of employment:

– Literacy and numeracy 
– Comprehension of information and instructions
– Short-term and long-term memory 
– Attention span and concentration
– Problem solving and decision making skills 
– Time telling/management and organisation 
– Ability to travel and/or live independently 
– Appropriate behaviours and social skills 
– Grooming and self-care.

While people with an intellectual disability are capable of learning, their learning is highly dependent on the person teaching them, ie the competence and quality of instruction.

Teaching a person with an intellectual disability will often take longer and require systematic teaching methods.

A learning disability is characterised by a difference in a person’s level of achievement in some specific skill area as compared to their overall level of achievement. It is not the same as intellectual disability.

Most people with a learning disability find learning more challenging than usual because it’s difficult for them to receive and process information.

A learning disability often occurs only in childhood. When it persists into adult life, it is possible for people of average or above average intelligence to experience a significant delay in one or more areas of learning.

Learning disabilities are largely invisible, although some signs can include:

– Uneven or unpredictable performance
– Perceptual impairment, poor coordination or clumsiness
– Impulsive behaviour
– Low tolerance
– Problems in handling day to day social interactions.

The degree of difficulty a person has with learning varies greatly. At work, people with a learning disability are likely to have challenges in one or more of these areas:

– Academic skills (ie reading, writing, spelling, maths and language)
– Skills required for learning (ie persistence, organisation)
– Verbal reception of information
– Written instructions
– Literacy or numeracy requirements
– Attention to detail
– Organisational ability
– Acceptable behaviour and social skills.

People with a learning disability (such as dyslexia) might benefit from the following modifications or adjustments at work.

Smartphones to assist with memory and planning.

– Task cards
– ‘To-do’ lists or checklists
– Screen-reading software (e.g. JAWS)
– Speech-to-text dictation software
– Verbal instructions

Depression and anxiety are the most common mental health conditions in Canada.

Both frequently coexist with other health conditions, such as musculoskeletal disorders and substance dependency. Depression frequently occurs with one or more types of anxiety.

Some of the conditions associated with anxiety are:

– Generalized anxiety disorder
– Obsessive-compulsive disorder
– Panic disorder
– Phobic disorders
– Post-traumatic stress disorder.

In severe cases, depression can cause extreme fatigue and inability to perform any activities.

Although depression and anxiety are among the most treatable mental health conditions, more than 40% of people living with these conditions are not receiving treatment.

Lack of understanding of anxiety and depression in the community and workplaces is common. Some of the symptoms of these conditions can be easily misinterpreted as low motivation or lack of interest. When people living with these conditions feel they are not understood or accepted, their motivation and decision-making skills are impacted.

One of the best ways to support an employee living with anxiety or depression is to implement workplace training to educate other employees and increase awareness of these conditions.

Employees with a mental health condition might benefit from the following modifications or adjustments at work:

– Flexible working arrangements, eg working from home, working part-time, change of start/finish times
– Longer or more frequent breaks
– Partitioned area or private office to reduce noise/distractions
– Division of large projects into smaller tasks
– ‘To-do’ lists or checklists
– Regular meetings with supervisors.

Acquired brain injury (commonly referred to as ABI) is an umbrella term for any brain damage that occurs after birth.

ABI is a complex, often hidden disability which may cause long term changes and difficulties in five areas that can impact how people function at work:

– Cognitive functioning such as memory, concentration levels, initiative, problem solving and flexibility
– Neurological functioning such as epilepsy
– Physical and sensory abilities such as vision changes, hearing impairment or reduced ability to move one side of the body
– Psychological wellbeing including behavioural issues such as loss of inhibition and outbursts
– Communication difficulties such as word slurring, speech impairment or excessive talking. 

Most people with physical disabilities are experts in their own needs and will have a strong understanding of how their disability will impact their work.

The term physical disability is used to cover a range of conditions. The impact of these in the workplace varies greatly.

Physical disability includes:

– Quadriplegia and paraplegia
– Musculoskeletal conditions and back injury
– Multiple sclerosis
– Arthritis
– Spina bifida
– Polio
– Occupational overuse syndrome (formerly known as RSI or repetition strain injury)
– Amputation.

While some of these conditions are defined as injuries to the nervous system, the impacts in the workplace are physical.

The common impact of this type of disability is physical functioning, ie mobility, dexterity or stamina. In most cases, job redesign, flexible hours and workplace modifications can accommodate physical disabilities in the workplace.

Employees with a physical disability might benefit from the following modifications or adjustments:

– Ramps
– Scooter
– Stairlifts
– Automated doors
– Height-adjustable workstations
– Vehicle modifications
– Accessible bathroom
– Accessible lift
– Handrails
– Accessible computer keyboards, mouses
– Adapted office furniture or equipment
– Speech-recognition (speech-to-text) software.

Substance abuse problems affect many people in society, and often, these people also have other mental health conditions such as depression, schizophrenia and bipolar disorder. 

A substance abuse problem is diagnosed when there is a significant level of distress or impairment in social, occupational or other important areas of functioning associated with the substance use. 

People experiencing both mental health and substance abuse problems are often described as living with complex co-existing conditions. The most common type of substance abuse is drugs and alcohol, which can have a significant impact on someone’s ability to gain and maintain employment.

Drugs and alcohol can:

– Impact on daily functioning
– Affect health either directly (as a result of disease) or indirectly (through poor nourishment)
– Be associated with difficult family relationships.

Be impacted by the need to fund the drugs or alcohol, or by withdrawal symptoms when unable to maintain sufficient levels of intake.

As a result of substance abuse, some people experience associated impairment and acquired brain injury, which can have long-term impacts (even after withdrawal from substances).

Abuse of substances such as drugs and alcohol can impact a person’s functioning at work in the following ways:

– Lack of motivation and energy
– Difficulty maintaining focus and concentration
– Inappropriate behaviour and social interaction
– Low productivity levels
– Inability to handle stressful situations
– Poor planning and organizational skills.

People with substance abuse problems have more success in employment when there is:

– A commitment to reduce or cease the use
– Appropriate interventions to allow for withdrawal
– Ongoing support for maintenance
– Replacement prescribed medication (in some cases)
– Other appropriate treatment or counselling support.