Key takeaways

• ADHD can affect working life in different ways, and there is no single profile or set of workplace strategies that will work for everyone.
• Understanding the individual's environment, tasks, strengths and lived experience is essential when considering vocational support.
• A diagnosis should not become the sole focus of assessment; the practical question is what is affecting someone's ability to participate and what could help.
• Workplace adjustments need to be individualised, tested and reviewed rather than treated as a one-off solution.
• Strengths-based and neuro-affirming approaches can help move the conversation away from "fixing" the individual towards creating conditions in which they can work effectively.
• Vocational rehabilitation has an important role in connecting the person's health and functional experience with the demands of their work and workplace.

Understanding ADHD at Work: What It Means for Vocational Rehabilitation

Attention deficit hyperactivity disorder (ADHD) is increasingly recognised as an important consideration within workplace health and vocational rehabilitation.

Yet understanding ADHD at work involves much more than knowing a list of diagnostic characteristics.

People with ADHD can experience significant differences in attention, organisation, time management, emotional regulation, sensory processing and task initiation. At the same time, they may bring considerable strengths, including creativity, problem-solving, energy, curiosity and the ability to become highly engaged in areas of interest.

Most importantly, there is no single ADHD experience.

This was one of the central messages from the VRA's recent webinar, Understanding ADHD, delivered by Claire Twomey, founder of ADHD Connections, professional ADHD coach and workplace trainer.

Drawing on her professional experience and her own experience of being diagnosed with ADHD as an adult, Claire explored how ADHD can affect working life, why traditional approaches do not always work, and how practitioners and employers can create more supportive working environments.

For vocational rehabilitation professionals, the discussion raises an important question:

Are we trying to change the person to fit the workplace, or are we working with the person and workplace to create conditions in which sustainable work is possible?

ADHD is not one experience

Claire highlighted that although ADHD has recognised diagnostic presentations, individual experiences can vary considerably.

Factors such as:

• age
• gender
• personal strengths
• previous experiences
• trauma
• masking
• stress
• sleep
• physical health
• life stage
• work demands
• relationships
• social support
• the surrounding environment

can all influence how ADHD is experienced and expressed.

This matters considerably in vocational rehabilitation.

A practitioner may work with two people who both have an ADHD diagnosis but whose workplace difficulties look completely different.

One person may struggle predominantly with sustained attention and task organisation. Another may find sensory distractions, transitions or emotional responses to workplace interactions more challenging.

Consequently, a diagnosis provides important context, but it does not provide a complete vocational assessment.

The question remains:

What is happening for this individual, in this particular work environment, and what is getting in the way of sustainable participation?

Looking beyond the diagnosis

The webinar highlighted a number of difficulties that can affect ADHDers in the workplace, including:

• concentration and filtering distractions
• planning and organising workload
• estimating and managing time
• following multi-step tasks
• initiating tasks
• procrastination and task avoidance
• communication and collaboration
• managing competing demands
• maintaining consistent performance
• processing feedback
• managing sensory input
• transitioning between tasks or environments

However, it is important not to turn these into a checklist of what every person with ADHD will experience.

Acas similarly emphasises that neurodivergent people experience their conditions differently and that adjustments should be based on the individual's particular strengths and challenges.

For vocational rehabilitation, this reinforces the value of functional assessment.

Rather than asking simply:

"What symptoms does this person have?"

we can ask:

"What does this person need to do at work, what happens when they try to do it, and what factors make that easier or harder?"

The workplace environment matters

A person's difficulties cannot always be understood by looking at the individual alone.

Claire used the concept of looking at three interconnected areas:

The person

What is the individual's particular ADHD profile?

What are their strengths, challenges, working preferences and current capacity?

The task

What does the job actually require?

Does it involve sustained concentration, frequent interruptions, complex instructions, competing deadlines, repetitive work or rapid switching between tasks?

The environment

What is happening around the person?

Consider:

• noise
• lighting
• interruptions
• workplace layout
• communication styles
• management expectations
• organisational culture
• opportunities for breaks
• flexibility
• predictability and change

This approach fits naturally with the wider biopsychosocial model of vocational rehabilitation.

The VRA defines VR as a process that considers health and function alongside confidence, workplace demands, relationships, finances and wider life circumstances.

In other words, the same person may function very differently in two different work environments.

That is an important distinction when considering whether someone is struggling because they are "not coping with work" or because the current interaction between the person, their role and their environment is not sustainable.

Moving towards a neuro-affirming approach

A significant part of the webinar explored the idea of neuro-affirming practice.

Claire contrasted this with approaches that focus predominantly on correcting or reducing perceived deficits in the individual.

A neuro-affirming approach recognises that people process information, communicate and interact with their environments differently. The focus shifts towards understanding those differences and creating conditions that support participation.

This does not mean ignoring genuine difficulties.

It means asking a different question.

Rather than:

"How do we make this person function more like everyone else?"

the question becomes:

"What changes could reduce unnecessary difficulty and allow this person to use their capabilities effectively?"

This is highly relevant to vocational rehabilitation because the goal is not simply conformity with a particular workplace norm.

The goal is meaningful and sustainable participation in work.

Strengths are part of the assessment

One of the more striking points from the webinar was how difficult some people with ADHD can find it to identify their own strengths.

Years of criticism, perceived failure and comparison with others can influence how someone sees themselves.

Claire described how some clients struggle to recognise what they naturally bring to work, even when others can see those qualities clearly.

This matters because confidence and self-belief can influence how someone approaches challenges, communicates their needs and responds when something goes wrong.

A strengths-based vocational assessment therefore needs to ask not only:

• What is difficult?
• What is affecting work?
• What support is required?

but also:

• What does this person do particularly well?
• When have they performed at their best?
• What conditions were present?
• What interests or motivates them?
• What skills have helped them overcome previous challenges?
• How could those strengths be incorporated into their working environment?

The aim is not to romanticise ADHD or suggest that every characteristic is automatically a strength.

It is to develop a balanced understanding of the individual.

When high performance is not sustainable

Another particularly relevant theme was the difference between performance and sustainable performance.

Claire described how someone with ADHD may perform exceptionally well when starting a new job or project.

Novelty, interest and stimulation can create high levels of engagement.

But if the environment becomes repetitive, predictable or less stimulating, maintaining that same level of performance may become increasingly difficult.

This can create a confusing pattern for employers:

"They were doing brilliantly when they started. What happened?"

The answer may not simply be motivation or attitude.

The person's interaction with the work may have changed.

For VR practitioners, this raises an important assessment question:

What does this person's performance look like over time?

A short period of very high performance does not necessarily demonstrate that a particular working pattern is sustainable.

Likewise, a period of difficulty does not necessarily mean that someone lacks the capability to do the job.

Understanding the conditions that influence performance can provide a much more useful basis for intervention.

Perfectionism, procrastination and pressure

The webinar explored what Claire described as three interconnected workplace experiences: perfectionism, procrastination and pressure.

Perfectionism can develop around previous experiences of criticism or failure.

Someone may spend excessive time checking work, struggle to delegate or avoid handing something over because it does not feel "good enough".

Procrastination can then be misunderstood as laziness or lack of commitment.

Claire's perspective was that procrastination may instead be an outcome of difficulty with task initiation, overwhelm, boredom, competing demands or depleted capacity.

Pressure can come from both external expectations and the individual's own expectations of themselves.

This creates an important consideration for workplace conversations.

If someone is struggling with performance, simply increasing pressure may not solve the underlying problem.

It may make it worse.

Feedback needs psychological safety

The Q&A provided an especially useful practical example.

An occupational therapist asked how an employer could give necessary feedback to an employee with ADHD who appeared to focus heavily on the negative elements of feedback while overlooking the positives.

Claire's response was not to suggest that employers should avoid constructive feedback.

Instead, she emphasised the importance of creating opportunities for the employee to process what they have heard.

Questions such as:

• How do you feel about what I've just shared?
• What are you taking away from this conversation?
• Is there anything you're unhappy or unclear about?

can create space for the individual to process the information rather than leaving them to interpret it alone.

This also connects with a wider principle of good workplace practice: feedback should be clear, specific and focused on behaviour and outcomes rather than assumptions about character.

For someone who may experience criticism particularly intensely, psychological safety can be particularly important.

The aim is not to remove accountability.

It is to create conditions in which feedback can actually be heard, understood and acted upon.

Workplace adjustments should be individual

Workplace adjustments were another important part of the discussion.

Claire described both self-facilitated strategies and changes that may need to be facilitated by the workplace.

Potential adjustments might relate to:

• concentration
• sensory environment
• communication
• workload
• planning
• time management
• task structure
• breaks
• transitions
• working location
• flexibility

However, there is an important warning here:

An adjustment is not automatically effective simply because it is commonly recommended for ADHD.

What works for one person may not work for another.

Acas makes the same point in its current guidance: employers and workers should work together to identify appropriate adjustments, and adjustments should be reviewed rather than assumed to solve every difficulty immediately.

For vocational rehabilitation practitioners, this provides a useful framework:

Assess → identify the barrier → develop an intervention → implement → review → adapt.

Adjustments may take time to work

One particularly useful point from the webinar was that introducing an adjustment does not necessarily produce an immediate change in performance.

Someone may need time to:

• learn how to use the adjustment
• develop a new routine
• build confidence
• recover from a period of burnout or sustained difficulty
• understand what works for them
• make further modifications

This is important for employers and practitioners alike.

An adjustment should not necessarily be judged as unsuccessful simply because performance does not change immediately.

The same principle applies to rehabilitation more broadly.

Change takes time.

What happens when the routine breaks down?

Another useful concept from the webinar was the importance of planning for recovery from setbacks.

For someone with ADHD, developing a successful routine may be challenging enough. Maintaining it indefinitely may be harder still.

If a person falls out of the routine, they may experience shame or self-criticism, which can make restarting even more difficult.

Instead of treating this as failure, Claire suggested developing a plan for what happens when the system stops working.

In vocational rehabilitation, this is highly relevant.

A sustainable return-to-work plan should consider not only:

"What will you do when things are going well?"

but also:

"What will you do when things become difficult again?"

That could include identifying early warning signs, agreed review points, people to contact and strategies for re-establishing supportive routines.

What this means for vocational rehabilitation

The VRA's positioning document describes vocational rehabilitation as a biopsychosocial, work-focused process that can involve assessment, problem-solving, work-focused goals, adjustments, graded return and stakeholder coordination. It explicitly recognises that VR can support people who are employed, self-employed, job seeking or economically inactive because of ill health.

The ADHD webinar provides a useful practical example of what that can mean.

For someone with ADHD, effective vocational rehabilitation may involve looking at:

The individual

• strengths
• functional challenges
• health
• confidence
• previous experiences
• coping strategies
• current capacity

The work

• task demands
• workload
• deadlines
• communication
• degree of autonomy
• level of stimulation
• opportunities for variety

The environment

• sensory demands
• workplace culture
• management style
• communication expectations
• flexibility
• available support

The sustainability of the plan

• what happens when circumstances change?
• how will adjustments be reviewed?
• what happens if the person becomes overwhelmed?
• how can successful strategies be maintained?

This is the difference between simply recommending an adjustment and delivering meaningful vocational rehabilitation.

From "fixing the person" to improving the fit

Perhaps the most important takeaway from the webinar is that vocational rehabilitation does not need to start with the assumption that the individual is the problem.

Sometimes the difficulty lies in the interaction between:

person + task + environment.

Changing any one of those elements may alter the outcome.

That might mean helping the individual develop new strategies.

It might mean changing the way a task is structured.

It might mean modifying the environment.

It might mean improving communication between the employee and manager.

Often, it will involve several of these simultaneously.

This is consistent with the wider spirit of vocational rehabilitation: collaborative, flexible, strengths-focused and centred on the whole person rather than a diagnosis alone.

Final thought

Understanding ADHD at work is not simply about recognising symptoms.

It is about understanding how an individual interacts with their work.

For vocational rehabilitation professionals, that means remaining curious about the person behind the diagnosis, avoiding assumptions about what ADHD "looks like", and exploring what enables that individual to work effectively and sustainably.

The question is not:

"How can we make this person fit the workplace?"

It is:

"What needs to change so that this person can participate, contribute and sustain their work?"

That shift in perspective can change the entire rehabilitation conversation.

Assessment and practical resources

The webinar included several tools and approaches that practitioners may find useful when exploring an individual's ADHD profile and workplace needs.

These included:

• ADHD screening tools – useful as an initial indication that further assessment may be appropriate, but not diagnostic in themselves.
• Executive function questionnaires – to explore areas of strength and difficulty across executive functioning.
• Processing modalities – exploring how an individual takes in and engages with information and their environment.
• Character strengths work – helping individuals identify abilities they may have difficulty recognising themselves.
• Values exploration – connecting work and tasks with what matters to the individual.
• "Legend list" / achievement reflection – reviewing previous successes to identify patterns of capability and counter an overly negative view of past performance.
• Defining challenges – breaking a broad experience of "ADHD difficulties" into specific, manageable functional challenges.

These should be used thoughtfully and within the practitioner's competence. A screening tool should not be presented as a diagnosis, and practitioners should be clear about the purpose and limitations of any assessment they use.

National guidance and further reading

NICE – ADHD

The NICE guideline on attention deficit hyperactivity disorder (NG87) provides recommendations covering the recognition, diagnosis and management of ADHD across the lifespan.

Read the NICE guideline on ADHD

Acas – Neurodiversity at work

Acas provides practical UK workplace guidance covering neurodiversity, reasonable adjustments, communication and creating more inclusive workplaces.

Acas: Neurodiversity at work

Acas – Adjustments for neurodiversity

This guidance includes practical examples relating to concentration, written communication, organisation and time management, sensory overload and workplace support.

Acas: Adjustments for neurodiversity

Acas – Talking about neurodiversity

This resource explores how employers can approach conversations about neurodiversity sensitively and support workers whether or not they have a formal diagnosis.

Acas: Talking about neurodiversity

Access to Work

The UK Government's Access to Work scheme can provide practical support for disabled people and people with health conditions who need support to start or remain in work.

Access to Work – GOV.UK

Equality Act 2010

The Equality Act 2010 provides legal protection against disability discrimination and includes a duty on employers to make reasonable adjustments in appropriate circumstances.

Equality Act 2010 – GOV.UK

About the speaker

Claire Twomey is the founder of ADHD Connections, a professional ADHD coach, speaker, trainer and facilitator. Following her own ADHD diagnosis in 2015 and subsequent coaching experience, Claire developed her professional work around ADHD education, coaching and workplace inclusion.

Her work focuses on supporting professionals and organisations to develop more neuro-affirming approaches to ADHD in the workplace through education, advocacy and culture change.

During the VRA webinar, Claire combined professional knowledge with lived experience to explore how ADHD can affect working life and how practitioners and employers can better support sustainable participation in work.

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