Tag Archives: ADHD

A systematic review of interventions to support adults with ADHD at work – Implications from the paucity of context-specific research for theory and practice.

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 By Kirsty Lauder, Almuth McDowall & Harriet R Tenenbaum (2022)

Why is this topic important?

People with Attention Deficit Hyperactivity Disorder (ADHD), or ADHDers, can face workplace challenges that need supporting. Identifying the best support for ADHDers is important because the workplace is somewhere many adults spend their lives!

What is the purpose of this article?
We wanted to know what the evidence is for effective support to see if there is any research about ADHD and the workplace. One way to find out the best forms of support is to evaluate all the published academic research on a topic using a research method called a systematic review.

We found 143 published studies that evaluated support or ‘interventions’ for adult ADHDers. We looked at what was similar and different across all the studies and wanted to know:

  • where the research was conducted;
  • who the research participants were;
  • what kinds of support were evaluated;
  • what kind of support was most effective;
  • what support is relevant to the workplace.

What personal or professional perspectives do the authors bring to this topic?
The authors either identify as neurodivergent and/or have experience of working with people who identify as neurodivergent.

What did the authors find?
1/3 of studies were conducted in North America. The others were from Europe or Asia.

  • Most of the research participants were outpatients of ADHD Clinics, which means they get supported after getting an ADHD diagnosis from a psychiatrist.
  • 61% of the 143 studies evaluated medication and whether it reduces the core ADHD symptoms: inattention, hyperactivity, and impulsivity.
  • The remaining 39% of studies evaluated psychosocial support (training, cognitive behavioural therapy- CBT) or a combination of both medication and psychosocial support.
  • Medication is effective at reducing the core symptoms in the short term.
  • Psychosocial support is effective in improving emotional and social challenges.
  • A closer look at each study revealed the important components of effective support to be:
    • an increased awareness of what ADHD is between the ADHDer and their support network.
    • a good relationship with the medical professional working with the ADHDer.
    • inclusion in group sessions with other ADHDers.
  • No studies were conducted in the workplace or related to the workplace.
  • Some of the skills training and coaching support focused on work-related challenges like time management and performance.

What do the authors recommend?
The authors recommend more research on what effective workplace support is for ADHDers. The more research there is, the easier it will be for practitioners to rely on an evidence-base for decision-making.

The existing research, mapped in this study, shows us which strategies are most effective for ADHDers:

  • A combination of medication and CBT (cognitive behavioural therapy) or skills training/coaching.
  • Involving the ADHDer’s support network.
  • Learning about ADHD and its impact on individuals.
  • A good quality relationship with support professionals.

How will these recommendations help ADHDers now or in the future?
In the future, we can apply these ideas to the workplace to make sure that managers and co-workers are included in the awareness of and support for ADHD, and to ensure that the ADHDer has psychosocial and medical support available.

More information: 

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Introducing the Centre for Neurodiversity at Work

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Accessible Summary

The Centre researchers are Almuth McDowall and Nancy Doyle. They found that science has ignored lots of important questions about neurodifferences. The found most research looked at children not adults or work. It didn’t think about race or gender or sexuality. They wanted to help.

They are working with a board who have different backgrounds. The board are neurodiverse. The Centre wants to make sure that people who are being studied are part of decisions. The Centre wants to help employers get better at including. The Centre wants to help neurodifferent people reach their potential.

Visual Summary

Infographic showing some of the key statistics shared in this blog.

What is the Centre for?

The Centre for Neurodiversity Research at Work (C4NRAW) is spearheaded by the Department of Organizational Psychology in the School of Business, Economics and Informatics at Birkbeck, University of London and Genius Within, a social enterprise focusing on HR and inclusion services. We’d like to introduce ourselves and our research priorities.

How it started

The Centre is Co-Directed by founders Professor Almuth McDowall and Dr Nancy Doyle, both Organizational Psychologists known widely for their expertise in Neurodiversity and organizational psychology. This brings a holistic perspective for this important topic. They met when Almuth supervised Nancy’s PhD, which was an evaluation of coaching as a disability intervention for Dyslexic adults. The PhD included a review of neurodiversity research, in which we discovered that hardly any research is focused on adults. The small amount of funding and publications is not in balance with how many adults there are with different neurotypes. For example:

  • Even though there are almost as many people with Tourette Syndrome as Autistic people, there is almost 50 times as much research about Autistic people as Tourettes.
  • There is also 50 times more Autism research than Dyspraxia research, even though there are 5 times as many Dyspraxic people as Autistic people.
  • Around 63% of ADHD research is aimed at children.
  • 94% of Dyslexia research is aimed at children and literacy.
  • Adults have different concerns compared to children, like memory, organization, and time management skills.

We also noticed that there were very few studies looking at intersectional exclusion, by that we mean the added layers of bias and discrimination faced by those who are female, belong to the Global Ethnic Majority or LGBTQ+ communities. Autism research tended towards white cishet[1] males, frequently from privileged backgrounds. Most of the dyslexia research (60%) involved scanning the brains of kids to find the bits that are “broken!”

There were only a handful of papers related to ND[2] strengths, though we quickly summarized these and set about publishing them. We started evaluating what “works” so that we could inspire employers to provide the right support.

Our Mission

Our ongoing mission is to focus on addressing the missing research and linking it into employment practice. We want more employers to feel confident in operating neuroinclusive practices so that we can bust through the disability employment gap for invisible disability. Employers often have misconceptions about what neurodiversity means. For example, it is often assumed that dyslexia is difficulty with reading and writing, whereas it can manifest as difficulty with memory, time management, organisation and wellbeing.

Around 22% of the entire population are neurodivergent, but in the UK, just 53.6% of disabled people are currently in work, compared to 81.7% of those who are not disabled. Many more disabled people could succeed in the workplace if they were given access to reasonable adjustments.

Neurodiverse people bring unique qualities to the workplace, including creativity, focus, strategic thinking, innovation and problem-solving. We want neurodivergent adults to work at their best, more of the time. We want to reduce unnecessary barriers to work, and in work see more neurodiverse career progression.

We recently published a paper called “Diamond in the Rough” in which we set out all these research priorities and how we would like to tackle them. Please feel free to click through to our research page if you would like to learn more about what we’ve already achieved.

Centre Membership

Our ambition is for the Centre to be staffed and led by a neurodiverse team: that is a balance of generalists and specialists complementing each other. Nancy is an ADHDer, and we have an Advisory Board which is comprised of researchers, practitioners and those with lived experience. We are currently seeking representation from the LGBTQ+ community, do feel free to reach out, the Board meet twice a year to review research priorities and advise the Directors on ethics and sharing results.

We have several ND PhD and professional doctorate students who are part of the Centre by virtue of studying a Neurodiversity or Disability (including neurodiversity) focused PhD at Birkbeck[3]. They are Uzma Waseem, Charlie Ekton, Jessica Dark, Greg Swaysland and Ben Morris.

We’ll be using this blog to communicate our research findings in an accessible format and start conversations with our wider community. We’ll post calls for research participants and would like to work with our donor team on corporate funding for specific projects. Do feel free to reach out and to join our mailing list if you haven’t already!

We are working towards a world where neurominorities equal specialism rather than exclusion and work is neuroinclusive. We are pioneering the design, evaluation, and practical implementation of Universal Design for Human Resources. We are walking our own talk and making sure that there is “nothing about us without us” in ND research at work. And we are super excited to only just be getting started!

Further Information

[1] “Cis” meaning not transgender and “het” meaning heterosexual.

[2] We’re going to use ND as an abbreviation for neurodifferent / neurodivergent / neurodiverse as we know all three of these can be preferred. We also use Neurominorities as an umbrella term for ADHD, Autism, Dyslexia, Dyspraxia, Dyscalculia, Tourettes and more.

[3] Birkbeck was established with the sole purpose of educating working people through flexible education scheduled so that people who are in work can take part. Therefore social justice has always been at the heart of Birkbeck’s mission.

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Birkbeck’s BabyLab: Investigating neural underpinnings of the social brain

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Anna Kolesnik, PhD candidate in Birkbeck’s Centre for Brain and Cognitive Development (CBCD) discusses the research in motion at the BabyLab, and why we’re crowdfunding to extend this research to toddlers.

How do babies become experts at processing the social world? Can we identify early neural correlates of this specialisation?

Previous investigations carried out at the BabyLab have explored rhythmic activity in the brain in response to social stimuli, finding evidence for early specialisation to faces and gaze as early as 4 months of age. Throughout the second half of the first year, we have seen evidence for increased perceptual narrowing in several aspects of cognition, allowing more efficient processing of incoming information. We also know that by age 2-3 years, toddlers become experts at navigating the social world and tune their attention to relevant information sources. This is also the time where first behavioural symptoms of neurodevelopmental disorders such as Autism emerge. Majority of our current understanding comes from cross-sectional research, which captures a ‘snap-shot’ in development. Here at the BabyLab, we want to study the early years continuously, which will increase our ability to identify and propose intervention strategies for infants at risk.  

GAmma and Brain-Based LanguagE Specialization study (GABBLES)
As part of my PhD project, I am running a longitudinal study with typically developing infants which aims to understand the neural basis of auditory and intercessory processing in the first year of life by examining changes in rhythmic neural activity in the brain. Using the predictions set out by Professor Mark Johnson’s ‘Interactive Specialisation’ framework, one of the leading theories of development in the field, we hope to isolate the fundamental sensory processes which precede the infants’ first words

Families with 5-month-old infants were recruited to take part in the study at the BabyLab in the Centre for Brain and Cognitive Development, with additional visits at 10 and 14 months. Fourteen babies form a subgroup of bilinguals, as they are exposed to a language other than English for a significant time. The testing protocol included tasks to evoke oscillatory activity in auditory and visual areas of the brain (which we record from passive sensors placed on the baby’s head). They also completed an eye-tracking session, which measured several aspects of pre-verbal language development and comprehension– including word recognition, language preference, and syllable matching tasks. These were accompanied by a standardised assessment of the infant’s cognitive and motor abilities. After the three visits were complete, parents were asked to complete questionnaires on their child’s behaviour, language and sleep until their children turn 2 years. Currently, data collection is almost complete and our lovely participants are entering toddlerhood.

Future directions
At present time, we are only able to collect parent-report questionnaires about language and social abilities of their toddlers. In some ways, this is useful as we can capture some individual differences in development on a behavioural level (i.e. language experience and vocabulary), and then go back and look at possible biomarkers (activation to a native vowel or attention to native/non-native speakers). Being able to follow up these children using wireless technology once they are verbal and actively engaging with the outside world would provide enormously rich insight into how our early brain specialisation affects later functional development. Further, we may be able to identify critical periods of maturation and change in order to generate the most effective interventions and improve outcomes in children with autism.

We are aiming to secure £30,000 in donations for the equipment for the new ToddlerLab. If you are interested in donating and contributing to the centre’s crucial research into children’s development, please see our crowdfunding campaign page.

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A large-scale research project into early signs of autism and ADHD is long overdue

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TDr Emily Joneshis post was contributed by Dr Emily Jones, a researcher into early markers of autism at the Babylab at Birkbeck and a member of the team which have just launched the Studying Autism and ADHD Risk in Siblings (STAARS) project.

Over 1.4 million people in the UK live with autism or attention-deficit hyperactivity disorder (ADHD). Autism makes it difficult to communicate and interact with other people, and ADHD affects attention and concentration. Autism and ADHD are lifelong disorders that can have a huge impact on people’s lives, affecting their ability to work, live independently or start a family.

Although parents often have concerns about their child from early on, autism isn’t often identified before toddlerhood, and children with ADHD often don’t receive a diagnosis before they reach school age.  Recently there was wide-spread media coverage when singer Susan Boyle revealed she had been diagnosed with Asperger’s syndrome, a form of autism, at the age of 52. She spoke candidly about her relief at receiving a diagnosis which enabled her to make sense of the symptoms she had experienced throughout her life and which had caused her difficulties as a child. Although diagnostic services for autism and ADHD have undoubtedly improved since Boyle was a child, families still speak of the struggles they encounter in trying to access help for their child, a process that can take years and put an unbearable strain on family life.

Providing support for learning in early development can make a real difference to children with autism or ADHD, and the earlier a child receives this support, the more effective it is. Delays in accessing services can make families feel that time is running out for their child. But families can only access services after receiving a diagnosis – which means that being finding ways to identify signs of autism or ADHD in babies, rather than waiting for symptoms to develop in toddlerhood, would make a big difference.

Today (Thursday 23 January), my team at the Babylab at Birkbeck, together with similar teams from across Europe, is launching a new study of infants with older siblings with autism or ADHD. For infants with an older sibling with autism or ADHD, the chances of also having one of the conditions may climb to 20%. Starting in the very first months of life, our scientists will use cutting-edge techniques to study brain and behavioral development in infancy and through to toddlerhood. By looking at what is happening in the brains of infants who later receive an autism or ADHD diagnosis we hope to find the earliest signs of these conditions – before the children go on to develop the behaviours which can be very hard to ‘unlearn’.

We are looking for families with a baby (less than six months old) and an older child with autism or ADHD to help us learn more about the early signs of the conditions. Our work is supported by the UK Medical Research Council, the European Union, and major UK charities like Autistica, and our scientific partners are based in Sweden, Holland, Poland, Belgium and the US. It’s the first time that a study of this nature has been conducted on such a large scale, but by joining together, we believe that we can make the scientific advances that will drive change for the lives of individuals with autism and ADHD and their families.

Listen to the latest Birkbeck Voices podcast, which is about the new STAARS study.

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