The neurodiversity toolkit, is an iOH member benefit and consists of checklist for OH consultations.

The toolkit outlines key considerations for management referrals involving employees who identify with one or more neurodevelopmental conditions, including ADHD, autism, dyslexia, and DCD or Development Coordination Disorder otherwise known as dyspraxia.

Neurodivergent employees can face various challenges at work linked to communication differences, the environment in which they work, and executive functioning, such as planning, organisation, remembering instructions, completing tasks, working memory and information processing. It is important to consider whether your booking process is inclusive even before the appointment takes place, think about offering a range of options such as telephone, face-to-face or remote video appointments.  Virtual appointments provide an opportunity for a neurodivergent employee to take part but remain in a familiar environment, potentially reducing anxiety and removing the need to travel. Always check before you start the appointment that they have access to a private space, where they will not be disturbed or overheard with a reliable internet connection, or offer a telephone appointment as an alternative.

Research suggests that attendance may improve when appointments can be self-scheduled digitally. Also consider offering multichannel automated reminders, through text message and email. Pre-appointment information should be clear and ideally set out in bullet points, include the clinician’s name, the purpose of the assessment, what will happen during the assessment and duration. Make sure there is a telephone number, or email address should they have any questions beforehand.

At the start of the appointment, introduce yourself and clearly explain what the assessment will involve. Use plain, jargon-free language and keep your explanation brief – processing and retaining lots of verbal information may be challenging. For video appointments, suggest they can use captions – some neurodivergent people find it easier to follow spoken information when supported by text.

During the assessment be aware that neurodivergent people may take longer to process your questions and may require repetition before providing an answer. Focus on asking one question at a time allowing time to respond.  Be mindful that some neurodivergent workers may have challenges with self-advocating or communicating their challenges and needs and may require additional questioning.

Be aware, that mental health conditions such as anxiety and depression could have been the trigger for the referral, they may report feeling stressed or burnt out. However, it is important to spend time gathering some background information to provide context. These challenges often co-occur with neurodevelopmental conditions, and they could be experiencing challenges with executive functioning, social communication, sensory sensitivities or emotional dysregulation. Query any recent changes in their role, personal life, health, could they be peri-menopausal – hormone fluctuations can intensify experiences.

If someone self-identifies with one or more neurodevelopmental condition such as ADHD, Autism, Dyslexia, DCD/Dyspraxia it is important to remember they may be protected under the Equality Act 2010.

It would be helpful to have a list of referral pathways following your assessment, such as access to specialist neurodiversity workplace needs assessments through your organisation, in partnership with another occupational health provider, a third-party supplier, or Access to Work. A neurodiversity specialist assessor can identify more nuanced support needs based on the specific or complex challenges experienced in their role. This could include coaching to develop strategies to support their performance and work or access to assistive technology to support with task completion.

In the meantime, there are several interim measures you may wish to suggest.  Consider in-built technology solutions for example Microsoft Office have a range of accessibility functions including text-to-speech and speech-to-text, or a noise cancelling headset if they struggle to work effectively in a noisy environment.  

At the end of the appointment, set clear expectations about what will happen next. This can help reduce anxiety and ease rumination or worry. Explain who will receive the report and when, confirm that they can review it in advance, and outline any onward referrals you would recommend. Finally, invite any questions so they leave feeling reassured and clear about the next steps.