NEURODIVERSITY EMPLOYER HANDBOOK
SCHOOL OF HEALTH & SOCIETY
Neurodiversity Employer Handbook: Understanding the Needs of Neurodivergent Apprentices
INFORMATION FOR HEALTH AND SOCIAL CARE EMPLOYERS
Find information to support you in supporting your apprentice including:
/ Neurodiversity and best practice
/ Fundamental challenges
/ Common problems in the workplace
/ What are the benefits of supporting the needs of your neurodivergent apprentice?
/ How can you help?
/ Practice Reasonable Adjustment Plan (PRAP)
/ Supporting your apprentice through difficult times
/ Believe in difference and awareness raising
/ How can the University help?
/ Resources
/ Key Documents
/ Information for other disabilities
/ Acknowledgements
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WHAT IS NEURODIVERSITY AND WHAT LANGUAGE DO WE USE?
Autism:
The term neurodiversity was created in the 1990s by sociologist Judy Singer. It is estimated that 75% of the population have some form of neurodivergence, and around 1 in 4 apprentices may be neurodivergent. Neurodivergence will often amount to a disability under the Equality Act 2010.
Neurodiversity is the diversity of human minds, the infinite variation in neurocognitive function that exists within humanity. It is not a perception, approach, belief, political position or a ‘trait’ that an individual can possess.
The idea of a ‘normal’ brain or one ‘right’ style of neurocognitive function is the equivalent of claiming that one gender, race or ethnicity is ‘correct’.
There is no agreed definition or medical diagnosis, but these conditions are commonly thought to be under the neurodiversity umbrella:
1. Autism
2. Dyslexia
3. Dyspraxia
4. Tourette’s syndrome
5. ADHD
6. Dyscalculia
This list is not exhaustive and other conditions are also considered to be part of the group.
Autism is a neurodevelopmental condition that affects how people interact, communicate, and behave. It’s a spectrum disorder, meaning it affects people in different ways and to varying degrees.
People with autism may have difficulties with:
/ Social interaction: Understanding and using verbal and non-verbal language, forming and maintaining relationships.
/ Repetitive behaviours: Engaging in the same activities or routines.
/ Sensory processing: Experiencing sensations differently than others.
Dyslexia:
Dyslexia is a learning disability that primarily affects information processing. People with dyslexia may have trouble processing visual information, such as letters and words, or auditory information, such as sounds and language.
Some common signs of dyslexia include:
/ Trouble with spelling: Making frequent spelling mistakes, especially with similar-looking words
/ Poor handwriting: Writing letters backwards or upside down, having messy or illegible handwriting
/ Problems with reading comprehension: Struggling to understand what is read, forgetting information quickly
/ Difficulty with language skills: Having trouble learning new vocabulary, using correct grammar, or expressing thoughts clearly
Dyspraxia:
Dyspraxia is a common disorder that affects movement and co-ordination. Dyspraxia can also affect your fine motor skills, such as writing or using small objects.
If you have dyspraxia it may affect:
/ Co-ordination skills: Challenges related to movement such as tasks requiring balance, playing sports or learning to drive a car, poor spatial awareness.
/ Personal organisation: Poor time management, difficulty planning.
/ Social communication: Slow processing, extra mental effort to keep up with a conversation.
/ Sensory processing: Difficulty learning new skills and remembering information.
Tourette’s syndrome tics:
Tourette’s syndrome is a condition that causes a person to make involuntary sounds or movements called tics. Tics may be worse during periods of stress or tiredness. Some people can control their tics for a short time, however this can be tiring.
Some examples of tics include:
/ Physical tics: Blinking, eye rolling, shoulder shrugging, jerking of the head or limbs, grimacing, touching objects and people.
/ Vocal tics: Throat clearing, whistling, coughing, tongue clicking, animal sounds, saying or repeating a sound, word or phrase.
Swearing or saying inappropriate things is a rare symptom called coprolalia and only affects about 1 in 10 people with Tourette’s syndrome.
ADHD:
ADHD stands for Attention Deficit Hyperactivity Disorder. It’s a neurodevelopmental disorder that affects a person’s attention, behavior, and impulsivity. People with ADHD often have trouble focusing, staying still, or controlling their impulses.
Some common symptoms of ADHD include:
/ Inattention: Difficulty paying attention, easily distracted, trouble following through on tasks
/ Hyperactivity: Restlessness, fidgeting, excessive talking
/ Impulsivity: Acting without thinking, interrupting others, difficulty waiting their turn
It’s important to note that ADHD can affect people of all ages, not just children.
Dyscalculia:
Dyscalculia is a learning difficulty that affects mathematical skills. For some, this might affect how they see numbers; others may find reading symbols difficult or using finance and numbers in everyday life a challenge.
People with dyscalculia may struggle with:
/ Life skills involving numbers: Telling the time, handling money.
/ Counting: May be able to count in sequence but find it difficult when counting times tables.
/ Calculations: Learning and recalling number facts and rules.
/ Orientation: Spatial awareness including left and right, following directions.
NEURODIVERSITY TERMS TO KNOW
Neurodiversity
The whole concept: a biological truism that refers to the limitless variability of human nervous systems on the planet, in which no two can ever be exactly alike due to the influence of environmental factors. Neurodiversity does not mean “neurological disability” or “otherness”, and is not a diagnosis.
Neurodivergent:
A term applied to individuals or groups whose brains process information in a way that is not typical. For example, an autistic person can be described as neurodivergent.
Neurotypical:
Describes an individual or group without any neurodivergence.
Neurodiverse:
Describes a group that includes individuals who represent the spectrum of conditions commonly recognised under the neurodiversity umbrella. A neurodiverse group may also include neurotypical individuals.
Masking:
A strategy used, consciously or unconsciously, to hide neurodivergent traits in order to be accepted in society. Masking is sometimes referred to as ‘social camouflaging’ or ‘passing’ and can have a detrimental impact on the individual’s mental health.
FUNDAMENTAL CHALLENGES
This isn’t your world!
1 Societal structures are organised by neurotypical thinkers and it is estimated that 75% of people hide their neurodiversity in the workplace. This could be for a myriad of reasons, however discrimination in the workplace is very present.
2 Ableism, the exhaustive process of explaining oneself, and mythology of the condition often mean that neurodivergent apprentices experience latent barriers as they progress through their apprenticeship because systems and frameworks are not organised for neurodivergent individuals. For example, the NHS as an organisation has been perceived as being averse to colleagues with difference as they can be perceived as a threat or causing additional labour to other colleagues (Lindsay 2021).
3 Social camouflaging means individuals often feel compelled to ‘camouflage’ their differences in order to be successful or accepted.
How neurodivergence presents in individuals will vary dramatically, and it is impossible to do justice to the diverse range of presentations within this group.
Being misunderstood… is common in all neurodiverse apprentices. It is a challenge commonly seen in apprentice populations and the most frequent issue staff are likely to come across. Reasons why apprentices may feel misunderstood include:
/ Societal stereotyping creates a barrier.
/ Constantly explaining yourself is exhausting.
/ Lifelong misunderstanding has led to the suppression of ‘self’ and is highly problematic for wellbeing.
MEET GINTARE
NURSING ASSOCIATE APPRENTICE, MANCHESTER FOUNDATION TRUST (MFT)
Gintare is autistic and has ADHD, although remained undiagnosed until February 2024 when enrolled as a Nursing Associate apprentice. She had grown up knowing that she was ‘very colourful’ and not interested in small talk, but performed well under pressure when given clear instructions. She had adapted to the natural day-to-day challenges, finding ways to hide or disguise from others.
“Perhaps because my diagnosis came later in life, it feels like I have had two lives. There is the old pre-diagnosis ‘me’, and there is the ‘me’ now. I am still getting to know how to live my new life but learning about my diagnosis is helping me grow.”
Gintare’s autism and ADHD manifests in changes to her facial expressions when overstimulated and difficulty in expressing emotions. When tired, overstimulated, or overwhelmed, she may appear rude or upset, but the truth is, Gintare is very happy approachable and loves her job. In fact, she believes her condition makes her better at it.
“I have always followed rules and find small talk extremely stressful so I avoid it. This means that I can focus 100% on my patients. I have more time for them and they always get the best care from me. The care I give strictly follows policies and guidelines and I am always on time.
“During my apprenticeship I had to rotate into different areas which was extremely challenging, but when one manager introduced me to the next and I didn’t have to explain myself all over again, I felt less judged, labelled and much more accepted by the team.”
The introduction of the NHS Employer Health Passport was key. The Passport was previously used to support those with long term physical and mental health conditions, but not to support neurodivergent apprentices. Leonora Appleby, MFT’s Nursing Associate Development Practitioner, introduced the Passport to Gintare’s work. Leonora said:
“Sharing the Health Passport made a big difference as Gintare didn’t need to put too much energy into explaining her needs every time she worked with someone new. I sincerely admire Ginny’s true, authentic self and the invaluable dedication and passion she has for her role.”
Meriel Burns, Gintare’s University Learning and Development Coach met Gintare before her diagnosis when she experienced difficulties transitioning into her new role. Since then, they have met every 12 weeks for an apprenticeship progress review meeting and, 10 months on, Meriel said:
“Gintare’s Practice Assessor and Clinical Educators were so supportive, and it was they who initially suggested a neurodiversity assessment. We all worked together to come up with some reasonable adjustments and its lovely to see the changes in Gintare.”
Reasonable adjustments like flexible shift patterns have been beneficial for Gintare as routine, consistency, and early shifts allow her to be most productive. She is also given clear, written instructions, provided with information in advance wherever possible, and afforded quiet time following overstimulating situations.
“She is very intelligent, has gained confidence and is brighter in herself. Gintare is extremely honest and speaks out when things need to change. Gintare now has the confidence to challenge which is great to see and she will make a fantastic Nursing Associate. It’s been a privilege to be part of Gintare’s apprenticeship journey and I hope Gintare continues to advocate for neurodiversity in the future.”
COMMON PROBLEMS THE APPRENTICE MAY EXPERIENCE IN THE WORKPLACE
/ Lack of awareness or understanding of neurodivergence.
/ Wariness around disclosing their condition.
/ Weakness in planning and personal organisation.
/ Challenge in interpreting instructions and learning new skills and behaviours.
/ Struggles relating to intuition, initiative or ability to prioritise.
/ Difficulty timekeeping and sequencing.
/ Lack of understanding of social etiquette and the knowledge to ask for help.
/ Sensory overload.
/ Coping with change.
It is important to know that, although some skills might not be present initially, there is no evidence that the apprentice cannot acquire them with your support.
Remember: neurodivergence presents differently in each individual, so planning support without the input of your apprentice can be problematic. Talk to them to see what support they would benefit from.
BY SUPPORTING THE NEEDS OF YOUR NEURODIVERGENT APPRENTICE, YOU WILL:
/ Bring real skills and strengths like out-of-the-box thinking, creative solutions and deep focus to the workplace.
/ Make sure your apprentice feels included and understood..
/ Develop a positive workplace culture and improve employee morale and engagement.
/ Reach a broader client and customer group.
/ Support workforce retention and attract high quality staff through career progression.
/ Optimise your staff skill mix.
/ Develop the talent you need in your workforce by maximising the strengths of your apprentice.
/ Add value to your organisation, increase innovation, and enhance productivity.
/ Be legally compliant.
HOW CAN YOU HELP?
At the start of the apprenticeship
/ Ask the apprentice directly about their condition or if they are in the process of receiving a diagnosis - do not assume.
/ Ask the apprentice about themselves.
/ Ask who they would like to know about their condition and who will share this information. It is worth clarifying if the apprentice wants you to tell other staff members or not, and that all parties have a clear understanding on sharing information.
/ Clarify at the start of a placement which - if any - sensory stimuli are a challenge and how the apprentice deals with it.
/ Be open about neurodivergence - it is not an insult to discuss the matter.
/ Pre-start visits can be extremely useful in orientating individuals to the spaces they are going to be working in, where things are kept and where to go on their first day. They are a real anxiety settler.
/ Avoid information overload at the start.
/ Back up verbal information with written information (e.g. placement handbook, induction booklets), and consider using a Dictaphone to record the orientation.
During the apprenticeship and ‘off the job’
/ Off-the-job placement pre-visits can be extremely useful in orientating individuals to the temporary spaces they are going to be working in, where things are kept and where to go on their first day.
/ Before your apprentice starts their temporary placement, ask who they would like to know about their condition and who will share this information.
/ Regular check-ins with the apprentice about diagnosis sharing are always beneficial.
/ Avoid information overload during the apprenticeship.
/ Back up verbal information with written information (e.g. written feedback or practice reasonable adjustment plans), and consider feedback or progress review meetings to be recorded on a Dictaphone.
Learning a new skill and interpreting instructions
/ Do not assume a neurodivergent apprentice will be able to learn just from observing others.
/ Avoid giving multiple tasks at once.
/ Be very minimal and concise with your use of language, keep it clear and unambiguous.
/ Sense check with your apprentices, use lists and consider using Dictaphones.
/ If appropriate, ask the apprentice to repeat back the instruction so you are both clear on the meaning of the instruction.
/ Start a shift with a ‘to do’ list that is clear on its meaning. This will help clarify the apprentice’s objectives and keeps them on task. The list can either be written or recorded.
/ Fill in the hidden details. Remember some apprentices may not be very intuitive and will need explicit instructions. For example, outline each step of a procedure, including cleaning up to ensure that your apprentice is aware of the full process through to completion. This can be learned, but it may require some prompting.
/ As apprentices progress they may not need the same amount of input. Since skills can be built and acquired, this level of intervention may only be required for a short time.
Learning time management
/ Some neurodivergent apprentices may go down a rabbit hole and become hyper-focused on a task, resulting in time blindness. Before setting a task, offer clear guidance on how long you expect the activity to take.
/ We all learn time management differently which can be confusing for very literal learners, therefore having the same person demonstrate something can be useful until the apprentice has completely got the hang of it.
Social times and creating spaces
Opportunity for downtime
/ Some individuals may see taking a break with other staff members as continued ‘work’ and they may need down time away from people. Others will be fine with it. Either way, this should be accommodated.
Make rules explicit
/ Social rules can be difficult to read, so knowing when to speak in a staff meeting and for how long may need to be made clear. Equally, social banter can be confusing.
/ If your neurodivergent apprentice makes a social misstep, for example by oversharing, don’t be afraid to have an open and honest discussion with them about appropriate communication in the workplace.
/ Understandably, you might want to shy away from this conversation as it can be difficult. However, use it as an opportunity for your apprentice to learn, address their actions and put it right if required.
No coercion
/ Although it is important not to exclude your apprentice in social interactions, you should also be comfortable with silence - it doesn’t mean they aren’t enjoying your company. Autistic individuals in particular can find small talk stressful so don’t expect it.
/ If there is a social event, don’t coerce anyone into attending. They might really appreciate the offer, but find social events too stressful.
Other points to raise:
“Choosing not to ‘disclose’ a diagnosis is not a sign of moral weakness in an individual; the ‘ownership’ of an individual’s diagnosis is theirs and theirs alone. Therefore, an insistence on disclosure from any organisation is not appropriate and contributes greatly to the strengthening of the medical model of disability” (Sullivan, 2021)
Therefore, start from a place that doesn’t have negative connotations. It isn’t an insult to be a neurodivergent! They may have struggled for years but not realised it.
How do you ask someone if they are neurodivergent?
Approaching the topic of neurodivergence with sensitivity and respect is crucial. Here are gentle and respectful ways to ask someone if they are neurodivergent:
“I’ve noticed you are excellent with X but seem to struggle a bit with Y”
“Hey, I hope it’s OK to ask, but I’m curious if you identify as neurodivergent? I ask because I want to understand and support you better, but only if you’re comfortable sharing.”
“I’ve been learning more about neurodiversity lately, and it got me thinking. Would you be comfortable sharing if you consider yourself neurodivergent?”
“I’ve read some fascinating articles about neurodiversity recently, and it’s made me more aware of how diverse our experiences can be. Have you ever thought about neurodiversity in relation to yourself?”
This approach communicates openness, respect for their boundaries, and a genuine desire to understand and support them while acknowledging the individual’s autonomy in sharing personal information. It’s essential to allow them the space to share at their own pace and comfort level.
MEET ANIKHA
NURSING ASSOCIATE APPRENTICE, TAME VALLEY PRIMARY CARE NETWORK (PCN)
Anikha was diagnosed with dyslexia in high school when her time-consuming study methods, handwriting and reading comprehension were first identified as barriers to her studies. Until recently, Anikha found it difficult to say “I have dyslexia” as she faced stigma in school and was asked lots of uncomfortable questions. Anikha left school with only a couple of GCSEs but was accepted by the NHS as a Cadet where she received additional support. Now, she is on her way to becoming a Registered Nurse.
“When I applied for the job, I may not have mentioned my diagnosis at all because I was so worried that it would be given to someone without additional needs. I know of people who have been turned down because of this. It’s really unfair.
“I don’t like to speak about my dyslexia. I don’t want to be treated differently and I don’t like fuss. But, now that I am nearing the end of my apprenticeship, I am much more confident and assertive. I want to encourage others to speak up. Don’t hide away and be open to sharing your diagnosis.”
Anikha’s dyslexia affects how she expresses herself in writing and it takes more time to process written text, which can lead to her losing concentration or experiencing anxiety. Going to new and different places can be difficult for her. To help in the workplace, Anikha has a consistent Practice Supervisor and Practice Assessor, and was allocated additional study time. Appointment times were also reviewed to ensure patient safety and reduce pressure on Anikha. With the support of her employer and reasonable adjustments, Anikha feels that her dyslexia and spelling struggles are not holding her back.
“I have assistive software to support my studies and, in the workplace, we have a computer system with a really reliable and accurate auto-correct function. This means I can do my job safely and efficiently.”
“My Practice Assessor, Katherine knows about my dyslexia and I feel very well supported by her. She encouraged me to do things myself and didn’t just do them for me - sometimes people will just do it for you, but that’s not OK! It would be good if all employers would educate their staff about dyslexia and other types of neurodivergence. There is still so much stigma about it.”
Katherine Bradford, Nurse Director at Tame Valley PCN and Anikha’s Practice Assessor, said:
“I recognised early on that Anikha struggled going to different places. It unsettled her, but I didn’t know how to help or what to suggest. I wanted her to feel supported, but I didn’t know how to approach Anikha or what information I could share. I gave her my time and support, and we talked. I opened myself up to learning about how to support neurodivergent apprentices and found great strength in the support from the University, as well as Anikha herself.”
“Anikha is a model apprentice and a little ray of light. She is super organised, reliable, always 100% prepared and keeps on top of everything. I never had to chase her for anything. She smiles, is well mannered and honest in every aspect. She is very much valued and respected in the surgery.”
Communication, feedback and transparency
If there is a lack of clear communication about standards and expectations between a manager and their neurodivergent apprentice, it can be easy for the apprentice to not realise that they are underperforming – or even failing. If not addressed, this underperformance can escalate and lead to fitness to practice hearings.
Research suggests that, when staff members use indirect phrases like “it was OK” or “it wasn’t bad”, neurodivergent individuals can interpret this literally and be unaware of the need to improve. This can result in the apprentice falling behind or not getting the results they expect which can be very distressing.
/ Transparent conversations need to take place without delay. You cannot wait until the end of a placement as individuals then have no opportunity to address concerns or learning shortcomings.
/ No one wants to hurt or offend anyone. However, clear, professional feedback given sensitively can be the most helpful way to ensure success. They will thank you for this. Using hints and vague language is unhelpful and confusing.
/ It is reprehensible to see someone is not performing or progressing well and saying nothing to them. The journey a neurodivergent person has been on to get into University can be tougher than most, so staff need to be as facilitative as possible in their success.
Sensory processing
Sensory integration issues are very commonplace in neurodivergent individuals, especially regarding sounds, lighting, textures and smells. These stimuli can really add to the exhaustive working environment and result in diverse responses. It is worth clarifying at the start of a placement which - if any - of these things are a challenge and how the apprentice deals with it.
How can you support your apprentice?
Every neurodivergent person is different and requires different levels of support. Below are some actions and accommodations that may help your apprentice achieve their potential in the workplace. Have a conversation with them to see what you should implement.
/ Factor regular downtime into the day.
/ Loop ear plugs quieten noises but keep sound quality clear.
/ Provide a quiet space and screened workstation for write up time.
/ Close doors and windows to reduce background noise.
/ Pre-warn for events like fire alarm testing.
/ Introduce your apprentice to new or unusual sounds like emergency buzzers.
/ Allow self-stimming spaces*.
/ Adapt lighting.
/ Reduce smells such as perfumes, aftershaves, shampoos or air fresheners.
/ Make adjustments to their work schedule and encourage flexible working arrangements, for example changing the apprentice’s working day to start earlier or finish later.
*Self-stimming is repetitive movements or noises that can take the form of mild rocking, clicking fingers, humming, pacing, twirling an object or using a fidget toy. Wherever possible this should be allowed (as long as it isn’t interfering with anyone else) and no comment made about it. This is a sensory regulation activity that helps individuals to feel calm and focus.
PRACTICE REASONABLE ADJUSTMENT PLAN (PRAP)
While reasonable adjustments must be considered for disabled employees, making the right workplace adjustments is often seen as a time consuming, costly and complex exercise. But, in reality, many of the adjustments that can be hugely beneficial for neurodivergent apprentices are inexpensive, small and simple to implement.
Using a reasonable adjustment plan in practice can help to clarify exactly what requirements an apprentice needs. A PRAP is not a self-improvement plan but can be a real game changer for the apprentice as all their rrequirements are clearly outlined and communicated to relevant individuals.
A PRAP is a flexible, dynamic plan but isn’t something that should shield an apprentice who is not achieving as they should. If this is the case, the usual process should be followed.
PRAPs need to be collaborative but led by the apprentice, and it is essential that the University is involved in this process. You are not assessing someone’s suitability for reasonable adjustments, and you are not assessing an apprentice’s suitability for qualification status.
You are considering three things:
1 What are the competencies required for this apprentice?
2 What is the adjustment request?
3 In my opinion, is that reasonable?
If you feel as an employer or assessor that a request cannot be made or will directly hinder an apprentice meeting their required competencies, you are within your rights to refuse. However, this needs to be part of a conversation with both the apprentice and University.
Consider the following in your conversation with your apprentice:
/ How does the apprentice prefer to spend a break?
/ Do they need some modelling of telephone conversations?
/ Do they need items of equipment or assistive software programs with training in their use?
SUPPORTING APPRENTICES THROUGH DIFFICULT TIMES
Why meltdowns, shutdowns or panic attacks may occur and how you can help:
Meltdowns
/ Meltdowns are often the result of situations that are highly stimulating or create high levels of anxiety which feel like they can’t be escaped. When someone is in this situation their reaction is either flight, fight or freeze. If the person cannot escape that leaves two options: either fight or freeze.
/ Meltdowns are similar to the fight response.
/ When an autistic person is having a meltdown, they often have increased levels of anxiety and distress which can be interpreted as frustration, a ‘tantrum’ or an aggressive panic attack.
It’s important to understand that meltdowns are not ‘temper tantrums’. They are a reaction to a highly distressing situation or environment. Meltdowns are very physically tiring and emotionally draining for the individual. This is because the person has been in a distressing situation and has had a highly adrenalised and emotionalised response.,
Shutdowns
If meltdowns are equivalent to the fight response, then shutdowns are similar to the freeze response.
They are often the result of situations with high demand in one or more of the following areas:
/ Social situations.
/ Situations that require a lot of thinking.
/ Lack of sleep.
/ Very emotional situations.
/ Situations that are very active or physical.
An analogy for a shutdown is like a computer trying to turn on but there isn’t enough power to do so. In a shutdown, a neurodivergent person might not seem like themselves because they’re so overwhelmed that their focus has shifted to the basic functions. As they are at a reduced ability to process what is going on around them, they may struggle to communicate as they normally do. This can result in your apprentice becoming mute or having difficulty forming coherent sentences.,
How can you help?
Be aware of the possible signs:
/ Agitated, loud, aggressive, crying, swearing, slamming objects, sighing heavily, increase of self-stimming activities, argumentative, repeatedly questioning.
/ Stillness, staring, ‘switched off’ , speechless, zoned out, unresponsive, unable to process instructions.
/ A decreasing awareness of colleagues’ responses to them, either verbal or non-verbal.
BELIEVE IN DIFFERENCE AND AWARENESS RAISING
There is still a widespread lack of awareness about neurodiversity, but diversity is everywhere. It is an essential component of every workforce and the more you and your team know, the easier supporting your neurodivergent apprentice will be.
/ Get away from the notion of ‘curing’ people or putting things ‘right’. Neurodivergent individuals may think or react in different ways to you, but this is an essential part of life.
/ How you support your apprentices in your place of work can have a profound effect on their wellbeing and quality of life.
/ You can make a world of difference with some small changes!
Better awareness
A more informed workplace will naturally be more inclusive, meaning that neurodivergent employees will feel safe to talk openly and honestly with a manager and colleagues. Additionally, educating staff may also help neurodivergent employees who have not been formally diagnosed or who were not fully aware of how their neurodivergence affects them.
/ A better awareness of neurodiversity and the different forms of neurodivergence is fundamental to creating a more inclusive workplace (Neurodiversity at work, Acas, 2016: p.16).
/ Employers taking steps to educate their workforce can remove misconceptions and dispel myths associated with neurodivergence.
/ A better-educated workplace can make it easier for neurodivergent employees to tell their manager about their diagnosis. This in turn makes it easier for the manager to provide appropriate support.
/ Neurodivergent employees often do not tell their manager or colleagues because a lack of general awareness within the workplace means they fear being thought stupid, perceived as lazy and making excuses, or seeking special treatment (Neurodiversity at work, Acas, 2016: p.46).
HOW CAN THE UNIVERSITY HELP?
Disability Inclusion Service
The University of Salford has a dedicated Disability Inclusion Service (DIS) that works with learners who have declared a disability or condition to the University at any point throughout their studies at Salford.
DIS supports apprentices with a range of conditions, such as:
/ Autistic Spectrum Conditions (ASC), ADHD, dyslexia, dyspraxia and other specific learning difficulties.
/ d/Deaf and hard of hearing.
/ Visual impairments and vision loss.
/ Mental health conditions.
/ Mobility conditions.
/ Physical conditions.
/ Long term health conditions such as diabetes, epilepsy and HIV/AIDS.
What services does DIS offer?
/ Screening and learning needs assessment (see Appendix B).
/ Promoting inclusive and accessible teaching to all.
/ Working with individual apprentices to create a Reasonable Adjustment Plan to help them overcome the barriers to study that they may experience.
Inclusive and accessible teaching
We aim to deliver an excellent experience focused on apprentice success so that every single apprentice has equality of opportunity. This includes:
/ Access to teaching resources at least 24 hours in advance.
/ Facilitating the taking of notes.
/ Providing reasonable tutorial time to support an learning.
/ Permitting apprentices to record taught classes.
/ Providing opportunities to develop and practice presentation skills.
Programme Team Support
Individual Learning Model (ILM)
The University has a model to ensure apprentices’ education is tailored to their individual needs. The ILM helps the apprentice to:
/ Identify their strengths and areas for development.
/ Set SMART goals to help achieve ambitions.
/ Identify when additional challenge and stretch are needed.
/ Receive support from their employer and the University.
/ Get the right support at the right time from the right people.
The ILM consists of:
1 An individual learning plan (ILP).
2 Individual SMART goals.
3 Reasonable Adjustment Plan (RAP) (where required).
4 Individual progress status (RAGB).
5 Supportive Action Plan (SAP) (where required).
6 Progress Review Meetings (PRMs).
7 Review of ILP.
FREQUENTLY ASKED QUESTIONS
Is neurodiversity classed as a disability?
For the purposes of equality law, some neurodivergent conditions such as ADHD, autism, dyspraxia, dyslexia, and dyscalculia are recognised as disabilities.
Why does neurodiversity awareness matter in the workplace?
Neurodiversity awareness in the workplace is not only important for employers when it comes to discharging their duty to provide reasonable adjustments for anyone with a disability, including neurodivergent conditions, but to ensure that these workers flourish.
Is there any financial support for employers to support making reasonable adjustments?
Access to Work is available for disabled apprentices to support with financial costs of reasonable adjustments in the workplace. The workplace is responsible for putting the support in place and then reclaiming this cost from DWP. Further information can be found in appendix A.
The Department for Education’s report exploring the funding and support for apprentices with additional support needs draws attention to the following (‘Exploring the funding and support needs for apprentices with additional support needs’, Department for Education, 2018):
/ Additional Learning Support of up to £150 per month is granted to meet costs associated with learning aids and adaptations. This funding is
often used to support neurodivergent learners.
/ £1,000 in employer and provider payments is available for apprentices aged 19-24 with an Education Health and Care Plan.
Is there any financial support for apprentices if they have a physical or mental health condition or disability?
Yes, support is available through the Access to Work Scheme for:
/ Specialist equipment, e.g. specialist hearing equipment.
/ Assistive software and technology.
/ Adaptations to vehicles and taxi travel.
/ Physical changes to the workplace.
In addition to Access to Work, additional learning support funding is available through ESFA. This can include:
/ Specialist mentor and/or study support.
/ Assistive software required for their studies and training to use this.
For more information see Appendix A.
How can I nurture my neurodivergent apprentice in the workplace?
There are a number of ways that employers can not only help to support any areas in which a neurodivergent worker may struggle, but to play to their strengths, ensuring that these workers flourish including:
/ Awareness training for managers, especially in the context of equality and discrimination; workplace policies and practices which do not disadvantage those with neurodivergent conditions; and a neurodiversity policy, or an equal opportunities or disability policy dealing with neurodivergence.
/ Awareness training for staff to create a positive, supportive and inclusive workplace culture where acceptance of neurodiversity is the norm: one in which all staff feel confident to disclose their condition and seek the support that they may need, as well as one in which employers can fully realise the benefits of a neurodiverse workforce.
How do I support apprentices to access additional learning support?
There are a number of ways that employers can help apprentices to access additional learning support including:
/ Embrace flexible working. Even minor changes can help the apprentice to access the support needed to successfully complete the apprenticeship.
/ Negotiate a reasonable time and time allowances for accessing additional support in work as part of their legal right to reasonable adjustments. For example, the apprentice may require time
to access Specialist Study Skills Tutoring or Mentoring, as recommended in their Learning Needs Assessment.
/ Be guided by the individual in terms of what they need to perform at their best.
/ Make them aware of support services within the University.
How do we embrace neurodiversity in the workplace?
/ Allow neurodivergent workers to channel themselves into tasks where they excel, rather than demanding that they continue to perform tasks to which they are less suited wherever possible.
/ Empower neurodivergent voices. Your own neurodivergent staff are often well placed to inform you of how the organisation can be more neuroinclusive.
RESOURCES
Explore the links below if you’re looking for more information about neurodiversity in general or specific diagnoses. The following charities and organisations have in-depth guides to help you support your neurodivergent staff members, as well as blogs and interviews with neurodivergent individuals where you can learn more about their experiences.
ADHD / ADHD Foundation adhdfoundation.org.uk
Autism / National Autistic Society autism.org.uk
/ Employment Autism employmentautism.org.uk
Dyscalculia, Dyslexia and Dyspraxia
/ British Dyslexia Association bdadyslexia.org.uk
Neurodiversity
/ NHS nhs.uk
/ NHS England Workforce, Training and Education hee.nhs.uk
/ Neurodiversity Celebration Week neurodiversityweek.com
/ The Brain Charity thebraincharity.org.uk
Tourette’s Syndrome
/ Tourettes Action tourettes-action.org.uk
KEY DOCUMENTS
/ Acas: Disability at Work
Advice and support pages
/ Brown, N. (Ed.). (2021). Lived Experiences of Ableism in Academia: Strategies for Inclusion in Higher Education
DOI: 10.46692/9781447354123
/ Department for Education: Exploring the Funding and Support for Apprentices with Additional Support Needs Research report, April 2018
/ Department for Education: Support for Apprentices with Learning Difficulties and Disabilities
Guidance, August 2024
/ Nursing and Midwifery Council: Disability and Accessibility
Guidance, January 2024
/ Sullivan, J. (2021). ‘Pioneers of Professional Frontiers’: the Experience of Autistic Students and Professional Work Based Learning, Disability & Society
DOI: 10.1080/09687599.2021.1983414
/ UNISON: Disability Equality in the Workplace Report, 2020
INFORMATION FOR OTHER DISABILITIES
How do apprentices share their disability?
Apprentices are encouraged to share information about their disability and any additional learning needs early in their apprenticeship journey. They are given the opportunity to do this at onboarding and registration. We encourage apprentices to be proactive in contacting support services before they start. Sharing this information can help with the transition into their learning and allows the Disability Inclusion Service to discuss any support that your apprentice may need to ensure they get the most out of the experience.
Who is supported?
Our Disability Inclusion Service supports apprentices with a range of conditions, such as:
/ d/Deaf and hard of hearing.
/ Visual impairments and vision loss.
/ Mental health conditions.
/ Mobility and physical conditions.
/ Long term health conditions such as diabetes, epilepsy, and fibromyalgia.
If apprentices do not yet have a diagnosis, the team can discuss this with them and give appropriate advice. They may be able to access support while they wait for an assessment or be supported to make a referral for a screening.
What support is available?
Learners are offered a Neurodiversity Screening which looks at neurocognitive areas, wellbeing and study skills to identify strengths and challenges. The screening takes into account a range of neurocognitive traits with a person-centred approach. Recommendations for support are made following their screening which can include a Reasonable Adjustment Plan, funded support and signposting to other relevant teams including Wellbeing and Counselling.
Support and reasonable adjustments are individualised and discussed with an apprentice. Adjustments and relevant information are put into a Reasonable Adjustment Plan and shared with the apprentice and School. This can include:
/ Background information about their disability, including any strategies that they may already use in their learning.
/ Adjustments to assessments, for example, rest breaks and additional time.
/ Coursework extensions.
/ Adjustments to practical and oral assessments.
We understand that needs can change, so our support services are able to review adjustments at any stage in an apprentice’s journey.
Mental Health
/ University of Salford’s Wellbeing and Counselling Service salford.ac.uk/askus/topics/wellbeing-andcounselling
/ Mind: Mental health at work mind.org.uk/workplace/mental-healthat-work/
/ Able Futures: Mental health support for apprenticeship providers able-futures.co.uk/mental-health-support-forapprenticeship-providers
Epilepsy
/ Young Epilepsy youngepilepsy.org.uk
Visual Impairments
/ Royal National Institute of Blind People rnib.org.uk
D/deaf and Hard of Hearing
/ British Deaf Association bda.org.uk
ACKNOWLEDGEMENTS
We would like to thank Nicole Blythe (Programme Lead for Nursing Associate Apprenticeships at the School of Health and Society, University of Salford) for recognising the need for an employer resource and for commissioning and creating this document.
We would also like to thank Jo Sullivan (Senior Lecturer for Work-based learning at the School of Health and Society, University of Salford) for contributing large amounts of content for this handbook by sharing her own work, research, and endless wisdom. Jo champions progressive conversations regarding autism and the latent barriers individuals from this group face in pursuit of a professional career. She is also a contributor to the book ‘Lived Experiences of Ableism in Academia’.
We extend our gratitude to Rebecca Murphy (Disability Inclusion Service Manager, University of Salford) and Helen Worrall (Marketing Manager, University of Salford) for their thorough proofreading of this document and for contributing expertise, knowledge, and content that extends well beyond neurodiversity.
We also appreciate Alexander Leonard from Access Salford for providing valuable feedback to enhance this handbook’s accessibility and ensure it includes clear information that will help employers better understand and support their apprentices.
Additionally, we are grateful to Rowena Grant for her insightful advice on language and for sharing her lived experience as an autistic person who also has ADHD, which has enriched the guide’s authenticity and relevance.
Lastly, it is important to extend our sincere gratitude to the contributors of our case studies for sharing their personal experiences in an exceptionally humbling, candid and open manner:
Gintare Vilemaite
Leonora Appleby
Meriel Burns
Manchester Royal Infirmary NHS Foundation Trust
Anikha Parveen
Kathrine Bradford Park View Group Practice
APPENDIX A
Access to Work
What is Access to Work
Access to Work is an individualised discretionary support grant scheme that provides personalised support to disabled apprentices (and others). Access to Work is help from the Department for Work and Pensions and does not need to be paid back.
Examples of help available to apprentices
/ Specialist equipment (or alterations to existing equipment).
/ Help towards the additional costs of taxi fares if the individual cannot use public transport to get to work.
/ A communicator, advocate or BSL interpreter.
/ Free support via Access to Work’s dedicated Mental Health Support Service if they are feeling low, upset and struggling to keep up with their apprenticeship.
To qualify for this service, the apprentice must:
/ Be in an apprenticeship (attending or signed off sick).
/ Have a mental health condition that has resulted in absence, or is causing difficulties to remain in their apprenticeship.
Amount of grants
There is no set amount for an Access to Work grant, but the grant will only cover the support needed or the apprentice to stay in work.
There is an annual cap on the total amount of support that can be provided under Access to Work; this is currently set at £66,000.
What Access to Work cannot cover
The Equality Act 2010 places a duty on an employer to make reasonable adjustments for disabled employees. Access to Work funding cannot be used to support these adjustments.
Access to Work will also not fund items which are regarded as standard equipment, standard business costs or standard health and safety requirements. This means that any item which would normally be needed to do the job, whether a person is disabled or not, will not be paid for.
How long is Access to Work funding available for?
Access to Work funding agreements can cover up to three years. Reviews normally take place annually to assess if continued or further funding is needed.
How to apply:
The apprentice can apply via the Access to Work webpage: gov.uk/access-to-work/apply
Or call Access to Work on: Telephone: 0800 121 7479
APPENDIX B
Apprentice Screening and Learning Needs Assessment
How are apprentices referred for a Neurodiversity Screening?
Apprentices at the University of Salford are offered an online Neurodiversity Screening. A referral for this screening is made by the Disability Inclusion Service following a request from an apprentice. The apprentice is sent a link and can complete the screening independently. Following completion, they are contacted to discuss their personalised profile.
What is Neurodiversity Screening?
The Neurodiversity Screening assesses an individuals’ strengths and challenges related to neurodivergent conditions like ADHD, dyslexia, and autism. The tool helps to identify hidden barriers and study skills gaps, and provides insights into wellbeing and cognitive areas. It is not a diagnostic assessment.
Is the screening evidence-based?
Yes. The platform’s development is informed by extensive research and collaboration with experts in the field of neurodiversity. Researchers, psychologists, and educators contribute
to its design and content. The screening combines research, validation, data analysis, and user feedback to create evidence-based tools for supporting neurodivergent individuals.
What happens next?
A personalised profile is discussed with the apprentice during a Learning Needs Assessment. The discussion explores the impact of identified traits in the apprentice’s learning, wellbeing, and ability to complete their current course. Additional learning support is identified through this holistic assessment with the apprentice.
What can be recommended?
Additional learning support is split into three areas: non-medical helper support, technology and software, and academic reasonable adjustments.
/ Non-medical helper support includes one-to-one Specialist Mentor Support, Specialist Study Skills Support, and Assistive Technology Training.
/ Technology and software can include a laptop loan and assistive software, e.g. text-to-speech or notetaking licenses for the duration of study.
/ Academic reasonable adjustments can include assessment and teaching adjustments as outlined in an apprentice’s Reasonable Adjustment Plan.
