Environmental factors impacting work satisfaction and performance for adults with autism spectrum disorders

Journal of Vocational Rehabilitation 47 (2017) 1–12 1 DOI:10.3233/JVR-170878 IOS Press Environmental factors impacting work satisfaction and performance for adults with autism spectrum disorders Beth Pfeiffera,∗ , Kerri Brauna , Moya Kinnealeya , Maggie Derstine Matczaka,c and Helene Polatajkob a Department of Rehabilitation Sciences, Temple University, Philadelphia, PA, USA b Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada c Aegis Therapies, Allentown, PA, USA Revised/Accepted July 2016 Abstract. BACKGROUND: Individuals with ASD have some of the highest rate of post-graduation unemployment and competitive employment rates are very low. There is substantial research identifying specific person factors influencing employment outcomes, although there is very little research exploring the impact of environmental factors. OBJECTIVE: The purpose of this article is to understand the impact of environmental factors on work satisfaction and performance from the perspective of adults with Autistic Spectrum Disorder (ASD). METHODS: Qualitative interviews were used to gather personal perspectives from working adults with ASD. The data was micro-analyzed for open coding and organized under common categories. When data was saturated, axial coding occurred resulting in multiple categories linked together under a common central theme. RESULTS: Results identified the central category of Facilitators and Barriers of Person and Environment Fit for Work Satis- faction and Performance, which encompassed the categories, subcategories and links between categories. Both environmental factors and person-fit were identified as two overarching categories where barriers and facilitators were present. CONCLUSIONS: Adults with ASD identified that social interactions, attitudes, and the physical or sensory environment impacted perceptions of work satisfaction and performance. Future research is needed to better understand how to reduce environmental barriers in the workplace for adults with ASD. Keywords: Autism spectrum disorder, environment, work performance, job satisfaction 1. Introduction Disease Control and Prevention, 2014). This increase in ASD prevalence, in conjunction with an aging ASD Autism spectrum disorder (ASD) is character- population, ultimately results in a need for appropri- ized by impairments with social communication, ate interventions to support adults transitioning into social interactions, and restrictive repetitive patterns employment settings and other adult roles. Individu- of behaviors and interests (American Psychiatric als with ASD have the highest rate of post-graduation Association, 2013). The Center for Disease Control unemployment compared to individuals with other (CDC) reports that 1 in 68 children are identified learning disabilities (Shattuck et al., 2012), and com- as having ASD in the United States (Centers for petitive employment rates are as low as 6–12% (Hendricks, 2010; Roux et al., 2013). Addition- ∗ Addressfor correspondence: Beth Pfeiffer, PhD, OTR/L, ally, several studies reported very poor employment BCP, Department of Rehabilitation Sciences, Temple University, 3307 N. Broad Street, Philadelphia, PA 19122, USA. Tel.: +1 215 outcomes for adults with ASD regardless of 707 4504; Fax: +1 215 707 7656; E-mail: bpfeiffe@temple.edu. their intellectual abilities (Hendricks & Wehman, 1052-2263/17/$35.00 © 2017 – IOS Press and the authors. All rights reserved 2 B. Pfeiffer et al. / Environmental factors impacting work satisfaction and performance 2009; Henninger & Taylor, 2013; Hurlbutt & variability that can pose as barriers to success- Chalmers, 2004; Wehman, 2013). Overall, adults ful competitive employment. There is a need to with ASD experience more barriers in obtaining jobs, understand the environmental impact in order to maintaining jobs, and have a higher rate of job switch- align the strengths or needs of the person with the ing (Hendricks & Wehman, 2009). environmental demands to guide intervention and Various intervention supports exist for individu- support structures. The International Classification als with ASD during childhood and adolescence. In of Functioning, Disability and Health (ICF) identify contrast, there is a dearth of services for adults with environmental factors as facilitators and/or barriers ASD. A recent study following students with ASD in the performance of daily activities, such as work two years after graduating high school found more (World Health Organization, 2009). Environmental than 50% did not pursue postsecondary education or factors as defined by the ICF include the social, work opportunities (Roux et al., 2013). Additional attitudinal, and physical environments in which peo- research has identified that young adults with ASD ple conduct their lives (World Health Organization, earn less, have fewer jobs, and have less variation in 2009). job types than peers with other disabilities (Newman Research has identified that social and communica- et al., 2011; Roux et al., 2013). This is a vital area of tion skills often have a significant impact on employ- concern for the ASD population and their families, ment outcomes (Hendricks, 2010; Patterson & as one of the overall goals in adulthood is to secure Rafferty, 2001). Adults with ASD face many chal- successful employment. In general, limited research lenges with communication, such as understanding exists exploring employment-related issues for adults directions, the inability to read between the lines, with ASD (Chen, Leader, Sung, & Leahy, 2015). read facial expressions, and read tone of voices, Preliminary research has suggested that adults with asking too many questions, and communicating ASD who received vocational services are more in an inappropriate manner (Baldwin, Costley, & likely to obtain competitive employment (Lawer, Warren, 2014; Bolman, 2008; Hendricks, 2010; Hurl- Brusilovskiy, Salzer, & Mandell, 2009). There are a butt & Chalmers, 2004; Müller, Schuler, Burton, & number of studies that demonstrated improvements Yates, 2003). In a study interviewing 18 adults with in specific employment-related person skills after ASD, all participants identified that challenges with vocational rehabilitation (Alexander, Ayres, Smith, communication within the workplace led to diffi- Shepley, & Mataras, 2013; Dotson, Richman, Abby, culties with supervisors and co-workers (Sperry & Thompson, & Plotner, 2013; Walsh, Lydon, & Healy, Mesibov, 2005). There are a number of communi- 2014). One example is an intensive intervention cation requirements that take place throughout the program called Project SEARCH, which provides work environment from simple small talk to formal transitional services in the form of a school-to- discussions. work internship program for students with ASD The social environment is a critical factor con- (Wehman et al., 2014). The program revealed how tributing to employment rates and sustainment for intensive interventions can provide positive outcomes adults with ASD. Studies report that social isola- for students with ASD (Wehman et al., 2014). This tion is created for individuals with disabilities by intervention explored a multi-component behavior non-disabled co-workers and supervisors within the intervention plan and modifications to the job task work environment (Antonak & Livneh, 2000). Adults analysis to produce work productivity and purpose- with disabilities also report feeling stigmatized and ful activity for adults with ASD in the workplace. not socially accepted by colleagues (Hall, 2004). Much like Project SEARCH, most interventions Social attitudes within the work environment are focus on improving specific skills of the person and well documented as factors that impact work satis- modifying the actual job task. There is substantial faction and employment for adults with disabilities. research identifying specific person factors influenc- The feeling of being accepted in the workplace is ing employment outcomes, although there is very linked directly to job retention as well as a “posi- little research exploring the impact of environmental tive self-perception and general life satisfaction” for factors and the fit with the person’s characteristics. adults with disabilities (Vornholt, Uitdewilligen, & Policy suggestions based on research recommends Nijhuis, 2013). Additional studies have shown pos- that transition-age youth have integrated work expe- itive work performance of an adult with a disability riences in community settings (Wehman et al., 2014). increases the social acceptance by non-disabled col- Community-based work environments provide more leagues within the workplace (Banks, Charleston,  B. Pfeiffer et al. / Environmental factors impacting work satisfaction and performance 3 Grossi, & Mank, 2001; McLaughlin, Bell, & Stringer, 2. Methods 2004). A recent survey showed lack of appropri- ate understanding from employers and co-workers 2.1. Design as one of the major barriers to successful employ- ment (López & Keenan, 2014). Furthermore, an This qualitative study used grounded theory additional study identified characteristics of employ- methodology to guide data collection and analysis. ers who were reluctant to accommodate and adjust The intent of using a grounded theory approach was the workplace for employees with a disability, to establish a substantive theoretical framework that and its impact on the employee (Richards, 2012). helps explain the environment impact on work sat- Attitudes of others are considered one environ- isfaction and performance for working adults with mental barrier for individuals with disabilities, and ASD (Strauss & Corbin, 1998). Qualitative inter- an important consideration in understanding work views were completed to gain personal perspectives satisfaction and performance for individuals with about the work environment from employed adults ASD. with ASD. Adults with ASD are also known to have atyp- ical behavior patterns in multiple sensory systems 2.2. Participants (Miller, Coll, & Schoen, 2007). These atypical behav- ioral responses present as deficits in regulating the A convenience sample of fourteen English- intensity, degree, and nature of responses to sensory speaking participants were recruited and interviewed input, and can impact daily roles and routines (Miller for this study. All participants were working adults et al., 2007). Common sensory responses reported with a mean age of 40 (SD = 13.8) who were include sensory over-responsivity and sensory under- diagnosed with high-functioning autism, pervasive responsivity (Miller et al., 2007). Adults with ASD developmental disorder not otherwise specific (PDD- can have a combination of sensory responses depend- NOS), or Asperger’s syndrome. Diagnoses were ing on the work environment and the changes that based on the DSM-IV, as participants were diag- occur within the environment. For example, an adult nosed prior to the release of DSM-V criteria. All with ASD might over-react to loud noises within participants had a score of 65 or higher on the the work environment and under-react to someone Ritvo Autism Asperger Diagnostic Scale-Revised talking. Recent research supports the notion of the (RAADS-R), which indicates the presence of an coexistence of under- and over-responsivity in adults autism spectrum disorder. Participants’ occupations, with ASD (Lane, Young, Baker, & Angley, 2010). ages, and perceived job fit and satisfaction are listed Sensory experiences in general are more personal in Table 1. Several co-morbid conditions includ- and individualized experiences than any standard- ing attention-deficit/hyperactivity disorder (ADHD), ized measure could describe (Ashburner, Bennett, depression, anxiety, oppositional defiant disorder Rodger, & Ziviani, 2013). Therefore, it is impor- (ODD), post-traumatic stress disorder (PTDS), tant to obtain first-hand reports from adults with and bipolar disorder were identified by partic- ASD to explore how these sensory factors impact ipants. Participants identified taking medications their work environment and overall employment for anxiety, depression, ADHD, and bipolar dis- (Smith & Sharp, 2013). order. Additional demographics are provided in The purpose of this pilot study was to understand Table 2. the impact of environmental factors on work per- Participants were recruited through community formance and satisfaction from the perspective of partners and a University Disability Resource Office. adults with ASD. In order to develop feasible inter- Electronic flyers were also emailed to support ventions that have acceptability, researchers need to groups for adults with ASD, community support understand the viewpoints of working adults with programs, and other programs that support individ- ASD. It is important to consider both the person’s uals with disabilities in finding employment. For strengths and needs in relation to the environmental inclusion, participants were required to be eighteen factors, to enhance work performance and overall sat- years of age or older, have a diagnosis of ASD or isfaction. A qualitative approach was used to answer Asperger’s syndrome, and have had worked for at the question, “How do environmental factors impact least twenty hours per week. Participants completed work satisfaction and performance for adults with the RAADS-R to verify the diagnosis of ASD for ASD?” inclusion. 4 B. Pfeiffer et al. / Environmental factors impacting work satisfaction and performance Table 1 Participant occupations, ages and perceived job fit Participant Occupation Age Reported Overall Fit for Number/Pseudonym Job/Perceived Satisfaction 1/Bob Special Education Teacher 46 Moderate Fit/Not Satisfied 2/Dan Part-Time Assistant (at a used bookstore) 30 Good/Satisfied 3/Bill Computer Systems Analyst/Computer Programmer 67 Good/Satisfied 4/Dave Employment Specialist/Job Coach 38 Poor/Not Satisfied 5/Jane IT Call Specialist 49 Poor/Not Satisfied 6/Jill Data Entry Specialist 29 Good/Satisfied 7/Beth Home Health Nurse 37 Moderate/Somewhat satisfied 8/Jen Janitor 36 Poor fit/Not satisfied 9/Barb Communication Specialist 45 Good fit/Satisfied 10/Val Dog Groomer 61 Good fit/Not satisfied 11/Laura Telephonic Customer Service 40 Poor fit/Not satisfied 12/Dawn Junior Developer of Software 21 Moderate Fit/Satisfied 13/Tim IT at Medical College 39 Good fit/Somewhat satisfied 14/Ian Patient Care Tech 38 Moderate Fit/Satisfied Table 2 introductory statement explaining the overall purpose Participant demographics (N = 14) of the interview followed by the general work and Demographic Characteristic n environment questions, as well as additional prob- Gender ing questions to encourage participants to describe Male 6 aspects of their work experiences. Questions intended Female 8 Diagnosis to obtain information on general aspects of the par- Asperger Disorder 9 ticipants’ work (e.g., job type, typical job tasks), as PDD-NOS 1 well as information about their experiences with the High Functioning Autism 4 social, sensory/physical, and attitudinal environment Living Environment Rural/Small Town 3 in their work setting and how this impacted overall Suburban 8 satisfaction and performance. All interviews occurred Urban 3 over the phone at a convenient time and location for Education High School 3 each participant. Interviews were transcribed, cross- Post-Secondary: Two-year College 5 checked, and analyzed by at least two researchers for or Technical Training School investigator triangulation purposes. Some College courses complete 3 College Degree 3 Support Services 2.4. Data analysis Psychological 3 Vocational Training 1 Initially, all interviews were transcribed verbatim No Services 10 and two members of the research team completed microanalysis of the data using both open and 2.3. Data collection axial coding. Each researcher completed a line- by-line analysis of the transcriptions to generate Researchers obtained IRB approval through their initial categories (i.e., benefits, social interactions, university prior to implementation of this study. or environments) during the open coding process Informed consent was obtained from each partic- (Corbin & Strauss, 2014). Data from each subse- ipant either online or in-person. Researchers were quent interview was added to the current categories, all trained in conducting qualitative interviews and and categories were expanded and added when identi- interview techniques were practiced prior to the start fied. Researchers completed the open coding process of data collection. Semi-structured interviews were independently followed by meetings to obtain con- completed with each participant using an interview sensus to ensure consistency in the coding analyses. protocol consisting of 8 general and 5 environ- Consensus was obtained about specific categories and mental work questions (see Table 3) that lasted reflective titles, as well as the coding of words, quotes, between 30 minutes and 2 hours. All interviews were and phrases in each category during post-analysis digitally recorded. The interviews consisted of an discussion of the research team. There was 100%  B. Pfeiffer et al. / Environmental factors impacting work satisfaction and performance 5 Table 3 3. Results Interview questions General Work Questions Results identified six major themes that repre- 1) What is your job? What does it require you to do? sented barriers or facilitators to work satisfaction 2) What do you like about your workday /job? 3) What don’t you like about your work day/job? and performance. Three themes characterized envi- 4) If you could change anything about your work day/job, ronmental factors, while the other three themes what would it be? Why? characterized the person-fit factors (see Fig. 1). 5) What makes your work/job good for you? 6) What is not good about your job for you? The three environmental factors included: 1) social 7) Do you like coming to work? Why or why not? interactions/communication within the workplace; 8) What are the benefits (or motivation) for working for you? 2) attitudes within the workplace; and 3) sen- Environment Specific Questions sory/physical factors (i.e., lighting, noise, or desk 1) What sensory factors or stimuli in your work environment location). The person-fit included: 1) how each per- (i.e. lighting, noises, how loud people are, the amount of son matched up with his/her job based on the job people in one area, clothing requirements, the feeling of chairs and furniture, temperature, the amount of time you need to sit/ characteristics; 2) the skill or passion of the par- stand/move, clutter or organization of space - visual ticipant; and 3) the impact of ASD symptoms. distraction; provide additional examples as needed) effect: Job types and perceived person-fit varied signifi- a. How much you like your work? cantly between participants, as well as reported job b. How you perform at your job? 2) What social interactions in your work environment (i.e. the satisfaction. Table 1 provides an overview of the par- social interactions with supervisors and co-workers, ticipants’ occupations, pseudonyms used throughout interactions with others required to complete the job, amount the results, and their perceived satisfaction and fit it takes to process social information; provide additional with their job as reported during the interviews. examples as needed) effect: a. How much you like your work? b. How you perform at your job? 3.1. Participants’ narratives 3) How does the way other people treat you at work effect: a. How much you like your work? b. How you perform at your job? 3.1.1. Environmental factor: Social 4) What would you change about your work environment? Participants described social interactions as a nec- 5) What do you like about your work environment? essary but challenging part of the work environment. Social interactions varied depending on the type of work of the participant and had both a negative and consensus obtained. When data was completely saturated in the open coding process, axial cod- ing occurred where multiple categories were linked together under a common theme. This process was completed over multiple research meetings by the 2 researchers that completed the open coding process. During axial coding, connections were made among categories and subcategories. Once again, 100% con- sensus was obtained between the two researchers. Finally, a process of “theoretical integration” was used to develop a central category that represented all the categories, subcategories, and the intercon- nections. To strengthen the data collection process and trust- worthiness, data was collected until saturation and two researchers analyzed the data for investigator tri- angulation (Kielhofner, 2006). Open coding of data stopped after the 14th interview, as no new categories or themes were identified by either researcher. As dis- cussed previously, there were two researchers who analyzed the data to “examine the same phenomenon from multiple perspectives” (p. 603) to provide a Fig. 1. Themes of Environmental Factors and Person Fit Identified deeper understanding of the data (Jick, 1979). as Facilitators and Barriers for Work Satisfaction and Performance. 6 B. Pfeiffer et al. / Environmental factors impacting work satisfaction and performance positive effect for adults with ASD. Some partici- the ones that, um, are more appreciative of people pants found social interactions more challenging than with quirks, um, those who don’t like me I think that others. Additionally, at times, the social interactions they, they either think I’m really smart or they think could be a hindrance to work performance and satis- I’m retarded.” Bob stated, “My co-workers talk to faction. For example, Bill reported, “Anytime I have me in an incredibly patronizing way and not very to interact with other people for me it is horribly respectful.” uncomfortable” and Tim stated, “Everywhere I ever In addition to attitudes from co-workers and super- worked, it is always my interpersonal skills that are visors, participants also identified self-perception as bad”. Jill described the experience of working around impacting their overall attitude in the work environ- others in her statement, “When there’s people around ment. Participants acknowledged the status of their I just want to avoid them, especially on my day off. job and their abilities to complete these jobs as But even at work, passing them in the hallway as I impacting their attitude. They liked when the jobs walk to the restroom is so uncomfortable, and I wish I they chose matched their individual skill set. For could just snap my fingers and be in the restroom. I’m example, Ian commented, “I like the fact that I am just not comfortable with people who don’t react the working, you know, at a place that has a very good way I expect.” In contrast, certain participants found reputation that has a top rating.” Laura stated, “I do some social interactions to be positive within the work like that it [my job] is a good match for my tal- environment. Social experiences varied with the type ents . . . and I was very encouraged [by my supportive of work chosen. Some participants worked in large parents].” organizations with cubicles, while others worked in Some participants mentioned family support as a local store with little to no co-worker interactions. critical to their success at work. One participant men- Furthermore, some participants did not mind social tioned her parents allowing her to follow her dreams interaction as long as it pertained to work, but most to obtain a degree that matched her skill sets. In gen- preferred not to have “small talk.” For example, Dan eral, participants identified that a good family support stated, “I generally get along well with my boss and system allowed them to function at their highest level that’s always a plus. I don’t have to deal with, uh, and provided motivation for working. Laura stated, annoying co-workers, most of the time it’s just me “ . . . he [my husband] takes away a lot of stress; he and my boss.” Dawn commented, “You know in terms does all the little things, the running around and the of interacting with other co-workers in general is not groceries. All the things that impacts my system even a problem. I don’t need small talk and chit-chat, so I so it makes me more able to cope and more able to don’t necessarily take part in those things, but when get out of bed every day and do what I need to do at it comes to talking about stuff involving the job or work.” stuff relating to it, I open up”. 3.1.3. Environmental factor: Sensory and 3.1.2. Environmental factor: Attitudinal physical environment Participants identified attitudes from support sys- In general, all participants identified multiple sen- tems both at work and home as impacting work sory and physical environment factors that impacted satisfaction and performance. Attitudes were also their work satisfaction and performance. Almost all impacted by the disclosure or non-disclosure of participants had issues with florescent lighting within participants’ diagnoses. Lastly, attitudes included the work environment and many identified issues perceptions participants have of themselves, as well with temperature (i.e., either too hot or too cold). as their workplace. Participants shared multiple expe- Additionally, participants found large and loud work riences about the attitudes they face within the work environments overwhelming, and most participants environment. Participants reported that they often preferred to have a small, quiet work area. Par- felt stigmatized and not accepted by their peers due ticipants also identified visual distractions, such as to their diagnosis of ASD. Bob stated, “So, people people walking around, a messy or cluttered desk, think just because you have autism that you have and loud conversations occurring around them as lack of emotion and that you want to be alone, which impacting their work performance. Furthermore, par- isn’t true”. In regards to attitudes of co-workers, Jane ticipants who had to wear specific clothing to work reported, “Either they seem to really like me or they had issues with fabric types or styles, whereas par- can’t stand me, it’s always kind of been the way with ticipants who had a choice in work attire did not me. It’s usually I think the people who like me are report issues with clothing. For example, Jen stated,  B. Pfeiffer et al. / Environmental factors impacting work satisfaction and performance 7 “I would change the temperature. I would change now I understand it better than anyone’s ever told the uniform shirt. I would change the steel-toe shoes. me.”’ Within the work environment, autonomy was I would actually, you know, money not being an issue, a recurring theme in that participants valued having I would turn off half of the lights in each of my independence in completing their specific job duties. offices.” Dave reported, “Chaotic, environment loud, Bill reported, “I don’t really have to deal with the noisy, just stuff that has so much distraction you can’t upper management of the organization very often . . . really pay attention to what you need to be doing.” I have a lot of freedom and know what needs to get Tim reported, “The lighting, expanding the size of done, so I get it done.” my desk, having my own space, my personal space” On the other hand, some job characteristics improved his work performance and satisfaction. decreased work satisfaction and performance, such Some participants mentioned adaptations to the as having a non-stimulating job, being understaffed, work environment, which reduced sensory or not having enough breaks, having too many people physical aversions. Modifications occurred in envi- around, and micromanagement. Jill stated, “I’m stuck ronments that were more controllable, such as a small in a building with constant machines beeping and office or when a participant worked alone and had fluorescent lights and then supervisors staring over autonomy over the environment. Additionally, partic- my shoulder and telling me what I’m doing wrong ipants who had noise aversions found noise-canceling every five minutes.” Val reported, “They had 4 man- headphones an effective adaptation. Barb mentioned, agers who were not groomers, chasing me around for “So if I have my noise canceling headphones and I’ve not cleaning this properly, for putting my tools in the got the little screen, I can focus on what I am doing. wrong place”. If those things aren’t there I can’t get my work done.” Jen stated, “I like that I control the lights to a cer- 3.1.5. Person-fit: Skills and passions tain extent. If I do have a really wicked headache you Participants recognized skills and passions as know I can use, use half the lights.” important factors in work satisfaction and perfor- mance. Participants termed “skills” as unique talents 3.1.4. Person-fit: Job characteristics they possessed to complete the tasks at hand. “Pas- Participants consistently commented on various sions” referred to the internal emotional state of the work characteristics that improved work performance participant when he/she found a job that was mean- and satisfaction. Most participants preferred consis- ingful to complete. Skills and passions were also tency in routines and having flexibility in schedules. linked to personal interests. Participants who found When schedules were highly structured, participants jobs that match their skills sets and passions were experienced a higher rate of stress. Dawn commented, much happier than those who did not find a job that “The other positives . . . the flexibility, not micro- matched their passions. Barb exclaimed, “I love the managing, being flexible and accommodating with job itself. I am a very good editor and I’m a very good schedules, coming in late, for whatever reason, being writer and a decent self-taught graphic designer. So home a morning, or couple hours in the morning I love all the tasks that I have to do. That stuff I just because a plumber has to come and fix plumbing absolutely love I would probably do it for free, you in the house.” Participants also reported that sudden know if I could.” Val stated, “I love grooming dogs. I changes in schedules were perceived as distressing. love being hands-on with dogs. I love talking to dogs. Jane reported, “I get pretty route and routine, and hav- I love touching dogs. Dogs know that. Dogs know ing to do something at the last minute, I have a hard who likes them and who doesn’t like them. I know time.” animal behavior. I love making them look good.” Dan Other job characteristics that impacted work sat- commented, “Doing something that most of the time isfaction included the commute to work, benefits I love and being able to get paid for it, uh, is, is a of work, and work autonomy. Participants reported huge benefit.” In contrast, those who did not identify dissatisfaction with long commutes, and preferred a match with skills and passions reported dissatisfac- short and easy commutes. Additionally, participants tion. For example, Bob reported, “I’m not satisfied identified benefits of working as good pay, recogni- at all. I do curriculum development all over; I’ve tion for a job well done, independence, maintaining been all over the country in the areas of autism and their lifestyle, and work making them “feel good.” inclusion, transition and employment. So I’m doing Beth shared, “It makes me feel good when I can stuff that’s way beyond the view of the classroom. teach something to someone and they tell me ‘Wow, And in situations like this is annoying, galling, and 8 B. Pfeiffer et al. / Environmental factors impacting work satisfaction and performance disrespectful. I have a book coming out in two months as improving social relations within the work envi- by a publisher. So, very - a lot of dissatisfaction.” ronment. Tim shared, “Helping performance, my job performance, like being in that room with the other 3.1.6. Person-fit: ASD symptoms team members, and the common interests, not just Participants identified that symptoms associated Star Trek but even the work stuff and all the IT, we with the ASD condition impacted their work sat- generally know Windows, we know Windows 7, we isfaction and performance. Symptoms identified know server operating systems, we know umm, have a by participants included impairments with social background with memory and hard drives and all that communication, social interactions, anxiety, limited stuff that obviously you would know in this kind of interests, routines, and sensory issues. In particular, job, that’s a social thing that we all have in common, participants identified challenges with social skills as umm experience and knowledge of and that definitely a barrier, which usually produced anxiety and stress helps my performance.” Those who worked directly when at work. Bob commented, “You know a per- with customers reported that sharing common inter- son may have the cognitive abilities and the skills to ests with customers improve their work performance. be able to perform that job, but there might be envi- Dan commented, “Um, I’m very good at, you know, ronmental factors such as that social environment or giving advice about what books to read based on the other components that really make it so that the a person’s interest; particularly in subjects that I’m person wouldn’t be able to be successful.” interested in. And when I see someone who I recom- Another common symptom associated with ASD mended a book to and they come back to the store and perceived as impacting work satisfaction and per- tell me, ‘Oh, oh I loved that series’ or ‘I loved that formance by participants was rigidity and the need book that you recommended, thank you so much’, for consistency in routines or schedules. Participants that’s a really great feeling.” reported that sudden changes in schedules or routines As discussed previously, participants identified impacted work satisfaction. Participants identified various sensory issues that impact the work envi- routines and schedules as both positive and nega- ronment. These sensory experiences varied from tive factors in the work environment. Some perceived participant to participant, however there were com- these as positive, as the participants knew what to mon themes. Some of the common sensory issues expect from their day. Jen said, “There’s part of me among the participants included lighting, noise, that likes the routine of it. I can tell you right now visual distractions, busy environments, and temper- between 11:00–11:15 I’ll be cleaning the toilet in the ature. Tim reported, “When it’s really crazy busy, high school main office. I can tell you around 12:00, that can sometimes decrease performance, like, when I’ll be done vacuuming, and all the stuff I’ll need to there’s a lot of multitasking going on. Uh, other- vacuum in that complex and I’ll be moving to the high wise, uh, I generally work pretty well.” Ian stated, school nurse’s office”. In contrast, it was perceived as “ . . . Unfortunately one of our focus is on early child- negative for some, as strict schedules with time con- hood so there is lots of loud children around too. So straints fostered anxiety and stress. Jane shared, “I get if I have my noise-canceling headphones and I’ve got pretty route and routine, and having to do something the little screen, I can focus on what I am doing. If at the last minute. I have a hard time. I would be so those things aren’t there I can’t get my work done.” stuck on staying within the scheduling, because you know, at a call center, they’re all about scheduling but I came to the realization that it was stressful and 4. Discussion made me crazy, and then somebody told me legally they have to give me breaks so regardless of when I This study investigated the perspectives of work- get off a call I just, I take the break and that doesn’t ing adults with ASD regarding how environmental matter where I am.” factors impact work satisfaction and performance. Participants also identified interests to be impor- Participants identified social interactions, attitudes, tant when finding a job. Most participants shared that and the physical or sensory environment as barriers successful jobs were those that matched their skills, or facilitators of work performance and satisfac- interests, and passions. Each participant had spe- tion. Consistent with previous research, results from cific interests that were unique to him/her as to why the current study identified the social demands of the work environment was positive. Participants also the environment as a significant barrier. Previous identified sharing common interests with co-workers research reported interactional difficulties of the  B. Pfeiffer et al. / Environmental factors impacting work satisfaction and performance 9 person as one of the most significant barriers to suc- results suggest that programs targeting the education cessful employment outcomes for adults with ASD of co-workers, supervisors, and employers regard- (Baldwin et al., 2014; Bolman, 2008; Hendricks, ing the unique needs and strengths of individuals 2010; Hurlbutt & Chalmers, 2004; Müller et al., with ASD have the potential to enhance overall work 2003; Sperry & Mesibov, 2005). In the current study, satisfaction and performance for adults with ASD. adults perceived a lack of fit between the demands Additionally, research has identified that co-workers of the social environment and social skills. However, and supervisors who have had a previous positive perceived social demands varied from participant to work experience with an adult with a disability are participant, as some reported comfort with interac- more likely to demonstrate positive attitudes in sub- tions that pertained to work related information, while sequent situations (Banks et al., 2001; McLaughlin others reported any type of social interaction as an et al., 2004). uncomfortable experience. All participants in the current study identified Research identifies numerous benefits to employ- the sensory environment as a barrier to work sat- ers when hiring an individual with ASD. Job isfaction and performance. A study by Gillott and qualifications are often less of a concern than the Standen (2007) identified sensory stimuli as a major ability to meet the social requirements of the work- stressor to individuals with ASD within the work place (Hendricks, 2010). Previous research, focusing environment. Davidson (2010) compiled information on the perspectives of supervisors and co-workers, from 45 autobiographical texts written by adults with identified social issues as impacting negatively on ASD to identify the barriers to socio-spatial inclu- job performance and at times leading to termina- sion. Authors in their autobiographies wrote at length tion (Bolman, 2008; Hendricks, 2010). Adults in the about how external sensory stimuli are perceived very current study had similar perspectives. Participants differently from that of neurotypical (NT) individu- reported that job skill deficits were not a barrier in als, which results in a sense of exclusion associated comparison to the social factors inherent in the job with being out of place in mainstream space and overall environment. In our study, participants (Davidson, 2010). These atypical sensory responses reported strong skill sets in a variety of work settings. may vary from hypersensitivity, where a person is Participants were “proud” of their talents, and some overwhelmed and overloaded by the sensory stimuli had found a job that matched these skills, however in the environment, to hyposensitivity, where a per- social interactions impacted perceived work satisfac- son does not perceive relevant stimuli for the task. tion and/or performance. Others have described difficulty using their senses In the current study, attitudes of others impacted simultaneously, resulting in sensory confusion when the experience in the workplace of the adult with there are too many multisensory stimuli to process. ASD. This was identified as either a facilitator or bar- Although adults with ASD have described the pro- rier to work satisfaction and performance, depending found impact of certain types of sensory stimuli on on the attitudes of supervisors, co-workers, and fam- their daily lives in autobiographies, there are lim- ily members. Supervisors had the most substantial ited studies that explore the work environment and impact as reported by participants. In a recent study how sensory experiences impede work satisfaction exploring the attitudes of employers and co-workers, and work performance (Davidson, 2010). Partici- it was reported that lack of appropriate understand- pants in the current study only identified sensory ing by employers and co-workers was a barrier environmental factors as a barrier when there were to successful work outcomes for adults with ASD no environmental adaptations available or supported. (López & Keenan, 2014). In the current study, These finding suggest that environmental adaptations participants shared both positive and negative atti- supported by supervisors have the potential to elim- tudes within the work environment. For example, inate a potential major environmental barrier. Many participants identified that when their supervi- of the adaptations identified by participants in the sors understood their condition, they offered current study required only a minimal investment or modifications to the work environment, such as impact on others in the environment. noise-canceling headphones or adaptations to their Previous research has identified the importance of schedules. However, when co-workers or supervi- job match for adults with ASD (Mawhood & Howlin, sors did not understand the participants’ condition, 1999). Morgan and Schultz (2012) used an ecological relationships were more challenging, which created approach in one study with successful employ- social isolation within the work environment. These ment outcomes for adults with ASD. They propose 10 B. Pfeiffer et al. / Environmental factors impacting work satisfaction and performance that an ecological model considers the person’s Results of the study identified environmental fac- individual attributes in relation to environmental tors and person-fit as both facilitators and barriers demands, both of which are necessary factors for suc- to work satisfaction and performance for adults with cessful outcomes. The concept of finding the right ASD. Specifically, adults with ASD identified that fit for a person within the environment context is social interactions, attitudes, and the physical or often called “person-environment fit” (Law, 1996). In sensory environment impacted perceptions of work the current study, participants acknowledge a “right satisfaction and performance. Person-fit between fit” for a job as a vital aspect for work satisfac- individual characteristics and job requirements were tion. Person-fit considered how each person’s skills, also identified as an important factor. Results sug- characteristics, and passions matched up with the gest a need to consider interventions that address requirements of the job. The importance of these per- environmental factors in order to improve person- son factors aligning with environmental demands also environment fit, and education for co-workers and permeated the interviews as a key factor for work per- peers to improve attitudinal environments. Addition- formance. A person reported satisfaction with his/her ally, it is important to consider interventions that teach job, although identified issues with work performance individuals with ASD effective coping strategies and if there was a lack of person-environment fit. self-advocacy skills to obtain necessary environmen- It is important to acknowledge limitations of tal accommodations in the workplace for improved the study, as it was intended to provide an initial work satisfaction and performance. exploration of environmental factors impacting work performance and satisfaction only from the perspec- Conflict of interest tives of adults with ASD. The study did not consider the perspectives of co-workers and supervisors who All of the authors declare that they have no finan- may perceive a very different experience than the cial conflict of interest. adults with ASD. Since it was identified in both the current study as well as in previous research that the attitudes and social interactions with co-workers Funding and supervisors are important factors in both work satisfaction and performance, these additional per- This study was funded through a grant from the spectives could provide a necessary lens to identify American Occupational Therapy Foundation (AOT- interventions and support structures to improve the FIRG13PFEIFFER). person and environmental fit for adults with ASD. This seems especially important, as the social envi- Ethical approval ronment was perceived as one of the most significant barriers in the workplace for adults with ASD. Addi- All procedures performed in studies involving tionally, there were more female participants in the human participants were in accordance with the eth- study than male, which is in contrast to ASD preva- ical standards of the institutional and/or national lence of approximately 4 males to 1 female. There are research committee and with the 1964 Helsinki decla- a number of possibilities for this, including a conve- ration and its later amendments or comparable ethical nience sample that volunteered for the study. There is standards. some research suggesting that females may have less social involvement than males with ASD. It is pos- Informed consent sible that the social requirements of participating in an interview and the interactions with the researchers Informed consent was obtained from all individual may have contributed to the skewed male to female participants included in the study. ratio. It is also possible that there are more females working 20 hours a week than males, although this is References not clearly documented. Additionally, it is important to note that this is a qualitative study not intended for generalization. Future research is needed to under- Alexander, J. L., Ayres, K. M., Smith, K. A., Shepley, S. B., & Mataras, T. K. (2013). 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