The Experience of Autistic Professionals Working in Health and Education: A Systematic Review

This is the authors' abstract. We don't add key points for this paper.

Background: Inclusive health and education services require diverse professionals to inform service delivery, which meet the needs of a diverse population. There is a need to reduce inequalities in employment, and to develop neuro-affirming public services. This requires enhanced understanding of the challenges facing neurodivergent professionals, and solutions informed by lived experience. Methods: This systematic review explored peer-reviewed literature describing the training, recruitment, and employment experiences of autistic professionals working in health and education services. Researchers followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Researchers last searched databases, which included Medline, CINAHL, and PsycINFO, in October 2024. Eligible studies presented data describing the experiences of autistic health or education professionals in employment or training, published in English within the last 15 years. Researchers appraised study quality using the Mixed Methods Appraisal Tool. Researchers synthesized data using a narrative approach. The research team received funding from the Scottish Government. Researchers registered the research protocol a priori with PROSPERO #CRD42023483391. Results: Researchers retrieved 14 studies describing the experiences of 529 autistic professionals working in health or education, although nested studies explored subsets of the same participant populations. Participants described work-related needs, differences, and coping strategies relating to unsuitable environments, stigma, discrimination following disclosure, and inconsistent support. They reported that a neuro-affirming approach was helpful but also used strategies to manage their mental health, including taking time off, using leave, and in some cases resigning from posts altogether. Some participants enjoyed their work and felt they had enhanced understanding of autistic patients and learners. Conclusions: Institutions need to implement policies that assign accountability and responsibility for implementing and maintaining reasonable adjustments and increasing accessibility. Flexibility and acceptance are key to creating an inclusive workplace.