On the Horizon in Accommodation: ADHD, autism spectrum disorder, mild cognitive impairment, and other emerging issues

Although they are lifelong conditions, autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are often thought of as childhood conditions. Conversely, the popular conception of individuals with age-related cognitive impairment is that they are in extreme old age and have long since retired from active employment. However, as more and more people who were diagnosed with ASD or ADHD as children enter the workforce and as Canadians increasingly work into their senior years, when mild cognitive decline and dementia are more likely to become manifest, the workplace implications of these disorders are becoming clearer. In this session, a panel of experts will provide an overview of these conditions and discuss effective strategies and best practices for accommodation.

• Why do diagnoses such as ASD and ADHD seem to be skyrocketing? Is there merit to the argument that psychiatry and psychology — and the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in particular — are medicalizing conditions and behaviours that would have been viewed as “normal” in the past?
• What is ASD? How prevalent is it in the general population and in the workforce? What is the difference, if any, between Asperger syndrome and ASD? Does the removal of Asperger syndrome from the newest version of the DSM mean that people diagnosed with Asperger syndrome no longer have a valid medical diagnosis or disability that attracts the protection of human rights legislation?
• What is ADHD? Is it the same as attention deficit disorder (ADD)? Do children diagnosed with ADHD “outgrow” it by the time they enter the workforce?
• How, if at all, does mild cognitive impairment (MCI) differ from age-related memory impairment that may be experienced by up to 40 percent of adults over the age of 65? How is MCI related to the diagnosis of mild neurocognitive disorder? Is MCI a warning sign that a worker is developing Alzheimer’s disease or another form of dementia that results in progressive deterioration of mental capacity?
• Do “brain disorders” such as ASD, ADHD, and MCI present special challenges for employees seeking accommodation and for employers providing accommodation? What aspects of these conditions might render them more difficult to address within the existing framework of accommodation? How might stereotypes and stigma associated with these conditions contribute to the challenge of providing accommodation?
• Can employers require different types of medical information from employees seeking accommodation on the basis of one of these disorders? For example, can an employer require a diagnosis? Is medical information from a general practitioner sufficient? Can a detailed neuropsychological evaluation report be required?
• What are examples of innovative accommodations that have been implemented in cases involving these disorders? What are some common accommodations for employees with impairment of “executive function,” which may be associated with these conditions?