research-article

Open access

Toward Inclusive Mindsets: Design Opportunities to Represent Neurodivergent Work Experiences to Neurotypical Co-Workers in Virtual Reality

Authors:

Rachel Lowy,

Lan Gao,

Kaely Hall, and

Jennifer G KimAuthors Info & Claims

CHI '23: Proceedings of the 2023 CHI Conference on Human Factors in Computing Systems

April 2023

Article No.: 783, Pages 1 - 17

https://doi.org/10.1145/3544548.3581399

Published: 19 April 2023 Publication History

All formats PDF

Abstract

Inclusive workplaces require mutual efforts between neurotypical (NT) and neurodivergent (ND) employees to understand one another’s viewpoints and experiences. Currently, the majority of inclusivity training places the burden of change on NDs to conform to NT social-behavioral standards. Our research examines moving toward a more equal effort distribution by exploring virtual reality (VR) design opportunities to build NTs’ understanding of ND workplace experiences. Using participatory design, including generative toolkits and design meetings, we surfaced two main themes that could bridge gaps in understanding: (1) NTs’ recognition of NDs’ strengths and efforts at work, and (2) NTs’ understanding of NDs’ differences. We present a strengths-based assessment of ND traits in the workplace, focusing on how workplaces can support NDs’ success. Finally, we propose VR simulation designs that communicate these themes to represent ND experiences, emphasizing their strengths and viewpoints so that NT co-workers can better empathize and accommodate them.

1 Introduction

"Neurodiversity" (ND) refers to strengths and challenges experienced by individuals with neurological differences such as autism, ADHD, dyslexia and intellectual disability [66]. It is associated with advocacy initiatives moving to shift perception of these differences from "atypical" to a normal variation of the human condition [38, 60]. In response to this and the larger disability rights movement, many companies are starting to recognize and embrace strengths that neurodiverse employees bring to the workplace [37]. For example, the exceptional attention to detail and ability to recognize errors or breaks in a pattern that many autistic individuals have make them especially good employees for technology positions [29, 45, 52]. Moreover, individuals with intellectual and developmental disabilities have been reported as highly motivated and dependable employees [42]. These and other strengths of the ND population translate well to many other complex work activities, and companies such as EY, Fidelity, Ford, Freddie Mac, IBM, JPMorgan Chase, and Microsoft have engaged with neurodiversity-focused programs for training and on-boarding in the workplace [52]. Further, supportive employment programs for ND individuals can increase a ND person’s overall quality of life [21, 42]. Therefore the continued development and implementation of these programs are likely to have a positive impact on members of the ND workforce.

Yet, although the strengths of ND employees—and the benefits of programs to support them—are gaining visibility and traction in the workplace, there is a lack of research focused effective vocational interventions. Knowledge on the topic is often via reports of support programs outside of research, however, these are few and limited in population size, scope, and rigor [26]. A glaring example of the existing gap between ND workers’ needs and the workplace environment is evident in the high unemployment rates of ND individuals in the population [56]. Not only does the high rate of unemployment suggest a largely untapped talent pool, but it also suggests that current efforts to expand perspectives of neurotypical employees and foster a more inclusive environment are falling short.

While there is a need for more research on implementing vocational supports for ND employees, studies have shown successful employment of ND people is contingent on employers’ knowledge, awareness, and attitudes about the population [23, 26, 29, 44]. Therefore, increasing awareness and acceptance of ND employees is likely to yield positive results. Further, one study examining needs and preferences of intellectually disabled (ID) employees, found that when it comes to employment decision-making, they consider interpersonal factors such as social acceptance and understanding by their NT co-workers [62], which are also crucial to employment outcomes [23]. To build NT employees’ knowledge and skills around interacting and communicating successfully with ND employees, training programs must shift the training frame from "curing" ND employees’ behaviors, as the medical model of most vocational training suggests [14, 59], and adopt the perspective of situational and environmental accommodations for those with neurological processing differences that is aligned with the social model of disability [41]. However, there is little research on building effective and inclusive workplace interventions that consider ways to share the burden of change between NDs and NTs [14].

In order to investigate and address the challenges mentioned above, our research explores the use of Virtual Reality (VR) perspective-taking experiences to build NT knowledge and understanding of ND workplace experiences. Perspective-taking techniques have been shown to increase empathetic behaviors for outgroup populations [2, 22, 63]. Affordances of VR such as audio and visual sensory cues can increase a sense ’being there’ [11], which is related to decreased negative bias toward people with disabilities [10]. We approach the problem from both NT and ND perspectives, and incorporate feedback from ND employees and their NT co-workers into a VR experience designed to increase empathy and knowledge of the ND employee experience, and thereby facilitate more inclusive and understanding workplace environments. Because we focus these efforts on training NT employees, our design recommendations shift the burden of change away from ND individuals and create more awareness of their day-to-day workplace experiences in majority-NT environments. We hope to move the future of workplace training away from the medical model of "cure" or "treatment" of those within the population, and toward attitudinal and environmental changes for acceptance, inclusiveness, and appreciation promoted by the social model of disability [35, 38].

This research is an initiative to explore and inform design spaces of virtual reality (VR) intended to build empathy for and understanding of the ND experience in the majority-NT workplaces. Through a participatory design study including a five-day generative toolkit and an interview/design session lasting 1-2 hours, we collected rich data resulting in insights into the experiences of ten ND and four NT participants. From the design sessions, we identified several characteristics of ND employees that can be better supported by NT co-workers. We found these characteristics should be communicated through narrative structures to NT co-workers, and suggest affordances of VR, including sensory manipulation, switching point-of-view and building avatar-user interactions. Using these affordances, we suggest ways to develop experiences that support immersion and perspective-taking to facilitate understanding of the ND workplace experience, thereby creating enduring and active empathetic behaviors that will foster a more inclusive social environment.

2 Related Work

2.1 Neurodiversity in the Workplace

A hindrance to successful workplace outcomes for the neurodiverse (ND) community is the lack of knowledge and awareness regarding their needs and experience on the part of their neurotypical (NT) co-workers [23, 26, 29]. Studies have shown that organizations with no experience employing ND individuals focus on these individuals’ perceived inability to conform to workplace behaviors deemed socially acceptable by NTs [47], creating a non-starter attitude for inclusive employment. For example, autistic employees experience challenges participating in group interactions, flexibility, and managing conflict professionally [25, 45], even as they excel at systematizing and information processing [4]. These challenges often arise in situations governed by NT social rules, which are not always explicitly stated. For example, Morris et al. describe an autistic programmer who responded to code critique by ’blowing up’, not realizing this was viewed unprofessionally. For people with intellectual and developmental disabilities (ID), a major barrier is employers’ willingness to hire them. Heron et al. reported concerns such as healthcare premium costs and the need for specialized training as factors that decrease willingness to hire people with ID [27]. However, a survey conducted by The Institute for Corporate Productivity to understand the landscape of employing people with ID reported that perceived concerns about hiring these employees are significantly higher than challenges of actually employing them [42], indicating a need for more awareness of experiences of people who have actually worked with ND employees.

Creating further tensions, the modern workplace is designed around NT preferences and abilities, and does not consider needs or accommodations of ND employees [31]. For example, differences in communication of autistic employees, such as challenges in reading and understanding facial expressions or tone of voice [33, 34], have a major impact on vocational experience [23, 29]. In response to this, some ND employees prefer asynchronous communication (email, instant messaging), so that they have time to consider the conversation and decide how to respond appropriately while other ND individuals prefer to take direction in person [45]. The recent shift many companies are making to remote work culture has intensified workplace challenges for some ND employees. Not only are technological tools not designed for accessibility by ND individuals [61], but accommodations that are beneficial to ND employees, like conversations structured by turn-taking with protocols that reduce time-pressured responses, are not supported by these tools (or by NT workplace culture in general) [13].

These different workplace preferences demonstrate the unique challenge in this research, as the experience of every ND individual is subjective due to each person demonstrating a range of characteristics and presentations [26]. Another challenging aspect of understanding the needs of ND employees is that the experiences of neurodiversity that make employment difficult can be largely invisible, and therefore can be overlooked by NT co-workers and employers [38]. For example, a common experience of ND individuals is sensory sensitivity to physical environments [3]. From interviews of ND employees working in IT, Morris et al. surfaced that bright office lights and the "open floor plan" work setup are particularly distracting for the ND group, and many feel that quiet, private office spaces would be beneficial to their workplace experience [45]. Further, both computer-based and in-person meetings can be challenging for ND employees. For some individuals, computer-based meetings can elicit feelings of anxiety due to sensory overload and difficulty reading social cues in a virtual environment [13, 71]. Situations and experiences such as those discussed above can detract from the ND individual’s ability to perform their job and execute their workplace strengths.

Unfortunately, the above mentioned "unseen" challenges are typically misunderstood by NT employers and co-workers, and can result in termination [8] and social rejection [51]. Complicating the experience of unseen challenges in the workplace, ND employees may camouflage their ND characteristics in part to avoid discrimination and ’fit in’, which can lead to negative mental health outcomes for NDs [32, 39]. Lai et al. found in a sample of 60 autistic adults, both men and women practiced camouflaging, indicating that many adults are well aware of their differences and how to change themselves to fit in [39]. Despite this, many vocational training advocates and programs focus on training the ND individual to accommodate NT workplace norms, rather than focusing on educating the NT employees on how they can adapt their behaviors and attitudes to accept and support their ND co-workers [3, 29].

While vocational training for ND individuals does result in positive outcomes, such as increased interview skills and job placement [29], a 2021 review of literature found that there is a lack of academic research on how employers of ND individuals can build NT employees’ skills for accommodating NDs. The review found that most research on vocational interventions follow the medical model, which assumes that the ’impaired’ individual should adapt to workplaces designed for NTs, ignoring the ways that NT individuals can build more welcoming environments [14]. Additionally, studies show that traditional diversity education approaches, many of which are used in vocational programs, ’problematize’ diversity and focus on assimilation [24], instead of recognizing strengths ND employees bring to environments and building supports for these strengths [4]. Our research intends to shift from designing interventions under the medical and assimilation models to designing an intervention that aligns with the social model, emphasizing the importance of altering the environment by increasing knowledge and building empathy amongst NT employers and co-workers to build workplace experiences that are friendly to ND employees.

2.2 Empathy Building with VR

Building empathy can benefit social interactions, and many organizations have invested in technology to increase empathetic communication [28]. Hoffman defines empathy as "an affective response that is more appropriate to someone else’s situation than to one’s own situation" [30]. This work adopts the view that there are multiple types of empathy, including affective empathy (feeling the same emotions as another) and cognitive empathy (understanding the thoughts of another) [12, 43]. Research suggests cognitive empathy can be improved by active, intentional attempts to detect and draw inferences about others’ emotional state [12]. Perspective-taking is an activity that requires this type of active, intentional engagement, and there is substantial research on how understanding another person’s perspective results in prosocial and empathetic behaviors. Many technologies aim to increase general empathy by employing perspective-taking, where the participant is immersed in an experience from the perspective of another. Traditionally, participants are asked to imagine themselves in another person’s shoes, so to speak, by reading a written scenario or watching a video from the perspective of an outgroup member. However, Martingano et al. report different mediums of perspective-taking activities (e.g., reading vs. VR) could build different types of empathy, where VR is highly effective at building affective but not cognitive empathy [43]. They suggest that this may be because VR simulations are a passive experience that require little cognitive effort by the user. Perspective taking can reduce prejudice, increase understanding of other worldviews, and attenuate biases [63]. Researchers have used this technique to build empathy toward disabled and ND people through "disability simulations," which attempt to replicate the experience of disability for able-bodied and neurotypical people [18].

Table 1:

Group	Pseudonym	Code	Gender	Age	Employment Information
Autistic Participants	Michelle	AS1	Female	57	Therapist (1 month)
	Corinna	AS2	Female	22	Programmer (previous) (3 years)
	Jacob	AS3	Male	38	University Professor (3 years)
	Noor	AS4	Non-binary	30	Occupational Therapy Assistant (4 years)
	Jessica	AS5	Female	25	Writer (3 months)
	Carly	AS6	Female	21	Research Assistant (8 months)
Intellectually Disabled Participants	Sonia	ID1	Female	25	Substitute Teacher
	Charity	ID2	Female	n/r	Restaurant Waitstaff (2 years)
	Richard	ID3	Male	26	Sales Associate (2 years)
	Ari	ID4	Male	n/r	Restaurant Kitchen Staff
Neurotypical Participants	Ann	NT1	Female	67	Nurse Manager(7 years)
	Maria	NT2	Female	34	Government Epidemiologist (4.5years)
	Rebecca	NT3	Female	35	University Professor (7 years)
	Laurie	NT4	Female	38	Board Certified Behavior Analyst (11 years)

Table 1: Participants Demographics

Studies of VR perspective-taking simulations have shown that they can result in empathetic behaviors toward an outgroup population [10, 28], particularly in increasing affective empathy [43]. Further, the more realistic and embodied the experience is, the more likely participants are to expend energy [10] and financial resources [28] to help people with different life experiences. Herrera et al. suggest that a higher level of immersion and interactivity with a perspective taking method is more effective at building enduring empathy [28]. Traditional perspective taking methods, such as imagining an unfamiliar sensory experience can be cognitively taxing for individuals [63], and these methods do not allow for bodily immersion or interactivity. Because VR systems are specifically designed to immerse the user in a simulated experience, they provide an ideal platform to create a novel perspective taking experience, making VR a promising tool for promoting shared understanding and communication between NT and ND employees in the workplace [37].

Virtual reality-based systems can provide experiential learning of outgroup perspectives by using sensory manipulation to build sense of presence [11], which Gehlbach et al. suggest increases positive outcomes for perspective taking experiences using VR [22]. Some of these affordances have been shown to increase feelings of presence in users, including stereoscopic visuals, wide visual field and user-tracking [11]. By manipulating sensory input, VR systems afford the experience of embodiment by producing vivid sensory experiences that allow the user to experience the scenario as if it were happening to them, and thus enhance the processing of the information in the first person [1, 10, 55]. Researchers have found that people who experience VR simulations spend more effort [2] and show greater support for outgroups for longer periods of time [28]. Further, utilizing VR as a perspective taking platform can address the "unseen" workplace challenges that ND individuals face in the workplace that would be difficult to imagine in traditional methods. For example, manipulation of the user’s sensory environment (light, sound, etc.) can simulate environmental sensory sensitivity experienced by ND individuals, an experience that few NT people can imagine [1].

Notably, outcomes of empathy building and disability simulation studies have been inconsistent, leading to criticism that these simulations are not helpful [18] and may actually lead to decreased assessments of capability of disabled people, even as NT participants feel more sympathy for those with disabilities [46, 54]. These findings suggest simulations may be acting as ’pity machines’ rather than building constructive understandings of others. Recently, researchers have suggested that these types of simulations are ableist [53], and make a ‘spectacle’ of disability [6]. Because perspectives and challenges of neurodiversity are novel to NT users, a lack of context and history of lives lived with these differences can produce narrow and inaccurate conceptualizations of the outgroup’s abilities [6], creating a ’pity machine’ which makes people feel bad for outgroup members rather than understanding their complete experience. Embodiment of a person’s disabilities, such as being blind, can lead the user to understand the challenges of the circumstance, rather than the adaptation that is associated with it. Often, simulated challenges fail to suggest an individual’s ability to adapt to them [54]. In fact, some researchers have suggested that asking people to imagine experiences and their reactions within them may not foster constructive empathy, due to what Gallagher termed "the diversity problem" — people tend to imagine what they would do in a given situation instead of imagining how a person with a different life experience may react [20]. This is a recognized problem within the field of disability simulations [6].

Acceptance and awareness of neurodivergent individuals have been pursued in other ways, including positive representations of neurodivergence in the media, as with the autistic Sesame Street puppet Julia [5]. In these representations, NTs can see ND characters in narratives. Narrative structure has been shown to increase empathy, for example narrative-formatted news reporting of healthcare-related dilemmas create more empathy for people in stigmatized groups than non-narrative formatted reporting [49]. Further, building a sense of social presence in virtual reality by increasing the realism of avatars [48, 65], strategies such as sharing personal information [48, 70], showing realistic mannerisms like nodding and blushing [48], and developing in-group associations [70] are factors that increase the experience of immersion [48]. By gathering details about a person’s lived experience, collecting personal viewpoints, environments, mannerisms, and stories, we hope to take advantage of the empathy-building components of narrative structure and social presence to develop VR experiences that lead to enduring empathy.

To ensure that VR experiences do not create negative outcomes, we propose simulations of both strengths and challenges of the ND-inclusive workplace experience. We further suggest combining narratives with VR’s capabilities to create immersive, embodied experiences. We suggest VR experiences be structured in a way leading to enduring and constructive empathy. We ground our research in the social model of disability, which posits that disability or difference is not centered with the individual, but rather with the failings of the social environment to recognize and accommodate the natural differences that occur in the human condition [41]. In making the target user of the system the NT co-worker of the ND individual, we aim our efforts at the social environment of the workplace by surfacing design requirements for VR experiences that will facilitate NT understanding of how physical and attitudinal changes to the workplace can support environments where NDs thrive. This focus supports our intention to shift the burden of change and educate NT individuals on how they can better adapt to and accept their ND co-workers.

3 Methods

To investigate the experiences of neurodivergent (ND) individuals in the workforce, we conducted interviews with 10 professionals who identified as autistic (AS) or as people with intellectual disabilities (ID) (AS = 6, ID = 4, ages = 21 - 57, male = 3, female = 6, non-binary/third gender = 1) and 4 neurotypical (NT) professionals (ages = 34 - 67, female = 4) Inclusion criteria were: age 18 years or older, able to engage in conversation, being responsible most of one’s own activities of daily living (e.g., waking up on time, managing self-care routines, etc.). NDs had to work or volunteer for at least one month. NTs had to work with ND co-workers for at least one month. See Table 1 for participant information. We recruited representatives from the ID and autistic ND communities from regional self-advocacy mailing lists (e.g., the Autism Self-Advocacy Network), verbally at local autism and ID events, from a Transition and Postsecondary Education Program for Students with Intellectual Disabilities in the Atlanta metro area, and from research, professional, and personal networks.

3.1 Study Procedure

All study procedures were approved by the Georgia Institute of Technology IRB. Prior to the study, participants completed a short screening in person or via phone, interview, or web form to ensure that they qualified for and understood the nature of the study. On qualifying, researchers gathered contact information and preferred study procedures. Participants were compensated $5 for completing the generative toolkit and $20 for completing the design session.

The study consisted of two phases: a generative toolkit [50] and a design meeting, which consisted of a semi-structured interview and storyboard session. We included flexibility around meeting location (in person-local participants only, online, phone call), generative toolkit response method (on paper, email), number of design meetings (one long or two short meetings), and group or individual meetings (based on participant’s preferences). Four participants (all ID) attended the design meeting in person. Two locals (both AS) attended online. All others lived out of state and participated online via Microsoft Teams. Sonia (ID1) and Charity (ID2) joined in person. Michelle (AS1) joined via a phone call. Jessica (AS5) had two short meetings instead of one long meeting because she felt overwhelmed during the first meeting; she was compensated for both meetings. Our initial study design intended to hold group design sessions. However, we also recognized the importance of accommodating participant communication preferences and so offered individual sessions as well. Only Ann (NT1) and Maria (NT2) preferred a group meeting. In both group and individual meetings, everyone completed the same activities. Ann and Maria’s group meeting took two hours, the maximum time allowed by our IRB. In the group setting, participants drew fewer stories, but spent more time sharing their experiences with each other and reflecting on contrasting experiences. The essentials of online and in-person meetings were the same. The flexibility of online meetings allowed participants to select a comfortable environment and choose whether or not to show themselves on camera. Co-drawing was the point of most difference between in person and online meetings. Whereas in-person participants were able to draw immediately, instruction for using the online drawing tool was needed for remote participants. Finally, technical issues sometimes interrupted in remote sessions (e.g., sound feedback, connectivity challenges) but did not signficantly impact meeting quality.

Figure 1:

3.1.1 Generative Toolkit.

The generative toolkit (Figure 1a) consisted of completing a set of short activities (Figure 1b)—each lasts about 5 to 10 minutes—for five days prior to the design meeting. This ensured that participants had enough time to reflect on their work experiences. Each daily set of questions had a theme, which contained prompts related to the participant’s physical work environment (Day 1), work activities (Day 2), co-worker experiences (Day 3), workplace changes (Day 4), and ideal workplaces (Day 5). Each set of questions moved from concrete to abstract ideas in accordance with recommendations on how to structure cultural probes [50].

3.1.2 Design Meetings.

The design meeting took approximately two hours. We scheduled the meeting within a week of completing the generative toolkit to ensure participants could recall their reflections about work experiences. The design meeting consisted of a semi-structured interview about workplace experiences identified in the generative toolkit, watching examples of existing VR perspective-taking simulations, and generating storyboards about experiences. While exploring participants’ work experiences in a semi-structured interview we used sticky notes (Figure 1c) to organize participants’ ideas into themes and stories in in-person meetings.¹ Then, we proceeded to drawing storyboards. During storyboard generation, participants were shown video excerpts from three VR simulations. Videos were selected by the research team after reviewing news articles which reported on VR systems that target empathy-building. We searched the reported systems in these articles for freely available videos and narrowed our search to those targeting empathy-building for ND. Within this selection, we found videos made by advocacy organizations and for-profit companies; these often simulated the experiences of children. Researchers reviewed videos and selected two. Video 1 was selected because it was made in partnership with NDs and exemplified sensory manipulation capabilities of VR. Video 2 was selected because it exemplified point-of-view switching within VR. Video 3 was selected to demonstrate a workplace environment, as this is the environment considered by this study. Videos 1 and 3 were made by autism advocacy organizations, the National Autistic Society [57] and BBC CAPE [9] and showed sensory overload experiences. One showed an autistic child in a mall [15] and the other an autistic adult in a work meeting [16]. We selected these videos to demonstrate how advocacy organizations represent sensory overload experiences in VR. Both presented stories from the first-person view of the ND person. Video 2 was developed by a private company specializing in law enforcement VR training [64]. It showed an autistic young man experiencing an anxiety attack who interacts with the police in a parking lot. It was developed for officers to recognize and de-escalate situations with ND individuals [69]. In this video, the watcher first adopts the point of view of the autistic young man. Then, the watcher adopts the view of the police officers. This video was selected because it shows the same story from the perspective of the young man and the police, demonstrating the perspective-taking affordance of VR. It also includes an option for users to select different responses to the situation, showing the interactivity of VR. Video 2 dealt with a sensitive subject for the autism community, given the high number of police interactions with autistic individuals [67], and some participants shared reflections about this challenge and considered the importance of perspective-taking to build awareness of neurodivergence. We described all of the videos before showing them to contextualize the excerpts.

We had videos ready for each participant to watch, however the participants were welcome to choose whether to watch them, based on their comfort level with the nature of the videos. Videos were shown in a web-browser on the researcher’s laptop. We used screen sharing to show videos in remote meetings. Watching videos in this way (rather than via VR headset) preserved consistency between remote and local participants, as in-home VR systems are uncommon. Two participants declined to watch videos after hearing the descriptions. Jessica (AS5) declined to watch all three videos because she did not like the ’meltdown’ aspect of the videos. Carly (AS6) declined to watch the third video because of its sensitive nature. The purpose of watching videos was to demonstrate the point-of-view switching and sensory manipulation capabilities of VR. Therefore, for participants who declined to watch any videos, we described the video content and how point-of-view changes and sensory manipulation were demonstrated by the video(s) to provide all users with consistent information.

Participants were asked to draw stories at two points. First, after watching the two videos showing sensory experiences (Mall, Meeting). They were encouraged to select stories with a sensory or emotional component after watching these two videos. Then, after watching the video showcasing perspective-taking (Police Training). They were asked to draw one where they wanted an NT person to take their perspective. Participants were prompted to generate at least one story with a positive experience. For NDs, this was a time they felt proud or successful, and for NTs, this was a time when they admired or appreciated their ND colleague(s). We also asked users to reflect on how outcomes could have been different with or without workplace supports. For in-person visits, storyboards were drawn side-by-side on physical paper. For remote meetings, storyboards were shared via Miro [19], a free online collaborative whiteboard platform. Participants were welcomed to draw stories alone or collaboratively with the researcher. Most participants asked the researcher draw under their direction and they added details. Some drew some or all of their own stories. We generated between two and four storyboards per meeting, depending on time, energy level, and interest of participants.

3.2 Data Analysis

All interviews were audio-recorded and transcribed for qualitative data analysis automatically by Microsoft Teams. They were then reviewed for accuracy by the first and second author. We examined data for themes that emerged for both of our ND and NT groups together and present them in findings. In combining these groups, we do not suggest that they present with uniform needs, interests, and presentations, only that emergent similarities in our data indicated that ND participants in our sample showed some common desires regarding NT behavior and empathetic changes. Two members of the research team reviewed the transcribed data, using open coding to generate a codebook. Then, they conducted thematic analysis and two main themes related to existing literature on inclusive workplaces and disabilities simulation emerged. We particularly considered the social model of disability, which emphasizes the role of the environment in disability in generating codes. Our initial codebook included codes around environmental characteristics, including physical spaces, policies, and attitudes/actions of co-workers, that can affect ND employees’ experiences at work. This codebook was refined in collaboration with all members of the research team. After finalizing the codebook, the first and second authors independently labeled a sample of 25% of one NT and three ND participants’ data to calculate inter-rater reliability. Researchers achieved over 80% agreement on code assignments, indicating reliable agreement and a mutual understanding of coding. The first author coded all data based on this codebook and presented results to the research team. Adjustments to the codebook were made based on these results. The final codes included Difficult Situations, Positive Situations, and ND Work Characteristics.

4 Results

In this section, we first present messages that ND participants desired to convey to NT co-workers through neurodiversity-focused workplace VR training, and compare them with the messages that NTs thought should be conveyed. We then present how ND characteristics commonly reported by our participants can be represented in VR scenarios. Aligning with the social model of disability [41], we found a pattern in our interviews that NDs’ characteristics can become strengths or weaknesses depending on the environmental support/accommodations they receive. Therefore, we report the scenarios in alignment with the social model of disability, where we structure our findings to emphasize the role of the environment in creating positive work outcomes. Finally, we highlight findings relevant to constructing VR experiences that can convey workplace experiences of ND employees, including opinions and reactions to existing VR simulations and potential representations of internal experiences (e.g., thought patterns, feelings, sensory experiences) in VR.

Table 2:

ND Employee Characteristics	Desired Supports by ND	Success Experiences with Support	Challenges Due to Not Being Supported
Passion, Talent, Creativity	Growth and training opportunities Patience and respectful instruction [ID2],[ID3]	Recognition for excellence [ID1]	Pursuing upward mobility [ID1, ID2]
	Working in area of interest [AS3, ID2, ID3, ID4, AS2, AS6]	Learn task thoroughly [ID4] Perform with enthusiasm [ID2, AS6, AS2] Inspire Others [ID3, ID4]	Poor execution of job, Frustration [AS1, AS2]
	Support for creativity, worker input, and flexibility [AS1, AS4, NT3, AS6]	Innovative ideas [NT3] Producing work quickly [AS3]	Frustration, Being disciplined [AS1, AS6]
Preference for Routines, Consistency, and Detail-Oriented Tasks	Clear guidelines and directions [AS1, AS3, AS2, NT2, NT3]	Completing tasks thoroughly [NT4, NT2]	Feeling unprepared, Unclear how to contribute [AS3] Completing tasks incorrectly [AS2, AS1]
	Sufficient time [AS2, NT2, AS6]	Highly organized output [NT2] Taking on more responsibilities [NT2]	Feeling ’rushed’ [AS2, AS6]
	Structured, Familiar Tasks [AS2, NT2, NT4]	Work smoothly, with few errors serving clients [AS2, NT4] Complete tasks consistently correctly [NT4]	Freezing [NT4]
Social Differences	Explicit social rules and hierarchies [AS1, AS5, NT1]	Working smoothly with others [AS5, NT1]	Being disciplined at work [AS1] Feeling bad when they learn others are upset/uncomfortable [AS1, NT1, NT4, AS5]
	Smaller groups [AS3, NT4]	Pleasant, productive interactions [AS3, NT4] Feeling less stress [AS3]	Conflict and ostracization [NT4]
	Team-oriented, Open-minded co-workers [ID1, ID3, AS1, AS2, AS5, AS6]	Feeling valued and included [ID1, ID3, AS1, AS2, AS6] Social acceptance and interaction [AS3, AS1, ID1, ID2, AS6]	Social anxiety [AS1, AS3, AS5]
Sensory Differences	Physical Accommodations [AS1, AS2, NT4, AS6]	Ability to focus [AS1, AS6]	Making errors due to sensory processing [AS1] Difficulty engaging with co-workers [AS2, AS4, AS6]
	Work task accommodations [AS4, AS5, AS6]	Able to recall meeting information [AS5] Able to recharge [AS4, AS5, AS6]	Exhaustion [AS5, AS6]

Table 2: Summary of ND Employees’ Characteristics and their Desired Workplace Supports

4.1 Inclusivity messages of neurodivergent workers for neurotypical workers.

We identified two major messages that NDs wanted to communicate to NTs about building inclusive workplaces. First, NDs desired to be recognized for their effort to be a part of inclusive teams. Second, NDs desired for NTs to understand their differences. Although our NT participants’ messages and opinions were broadly aligned with ND participants’ reflections and experiences, we found that NTs often failed to recognize ND co-workers’ effort to be a part of a majority-NT team. Below, we explain NDs’ messages in detail and examine possible origins of this discrepancy.

4.1.1 NDs’ desire to be recognized for their effort to be a part of majority-NT teams.

All ND participants wanted to be included, valued, and granted accommodations without judgement. For example, all NDs reported a preference to be on teams where they feel a sense of teamwork and belonging. Our NT participants also recognized the importance of building inclusive teams where people felt belonging. However, NTs’ reflections tended to focus on the importance of non-discrimination in the workforce. This was somewhat different than NDs, who expressed a desire to feel a sense of belonging and teamwork. Some NDs expressed a wish to have more casual, non-work related interactions with co-workers, with one suggesting NTs should “I guess check on [ND co-workers], say hi to them, check how they’re doing.” – Richard (ID3). Several autistic participants who reported their difficulties in reading social cues also expressed the importance of this sense of belonging because workplace socialization and friendships were meaningful to them.

Most importantly, more than a half of NDs (6 out of 10 NDs) wanted their effort to fit into the environment to be recognized and respected. NDs reported a desire to have NTs recognize the effort of conforming to work environments and expectations that are constructed to support NTs. NDs often recognized their own differences, and described various work-arounds and accommodations helpful in making workplaces friendly for them. For example, using a transcription service for meetings or having additional instruction and support when learning new tasks. Many members of our ND group wished to communicate the importance of accommodations to their success and to have their accommodations and efforts respected. As Jessica (AS5) put it, she wanted NT colleagues to recognize the effort to work in environments that are unfriendly to them and advocate for their needs, “How we were able to endure stuff like that and not show it. And like how we’re able to survive and [...] stand up for ourselves and say our accommodations.”

Most NTs (3 out of 4 NTs) also recognized a need to understand NDs’ perspective. However, they often reflected that they thought about and treated ND colleagues like anyone else on the team. While this acceptance of ND colleagues as NT team members shows a willingness to work in inclusive spaces, which is also important to NDs [68], we found that it could sometimes obscure the work that NDs do to be part of those teams. Thinking of NDs as just like the NT members of the team often, unfortunately, fails to acknowledge the ways that ND colleagues must alter their actions and way of being to fit into NT workplace culture. This can lead to a circular problem, where the harder NDs work to conform to NT standards, and the more successful they are at ‘masking’ their ND behavior (suppressing one’s ND characteristics to appear NT [39]), the less aware NT colleagues are of their ND colleagues’ differences. In such situations, NDs take on the burden of altering their behaviors to adapt to NT workplaces, a burden which is largely invisible to their NT colleagues. For example, Noor (AS4) described hiding her sensory difficulties from colleagues because "part of me just feels nervous that it’ll be like, that I’ll become a liability," and Michelle (AS1) described keeping quiet at work because she was worried about saying the wrong thing and being "called insubordinate or labeled something else that was really negative and maybe lose your job." Many ND participants expressed that they would conceal their ND identity and need for accommodations until at least after they had been hired, and some communicated a belief that they had been fired or missed out on job offers because of their ND identity. Within our sample, our participants showed a reluctance to reveal differences and discuss accommodations, and a desire to appear neurotypical to co-workers and employers. Suppressing one’s natural characteristics can lead to negative outcomes in ND individuals, as Carly (AS6) shared, "masking makes me very, very exhausted and it does take a toll on my physical as well as mental health." Masking has been associated with negative health outcomes, such as depression, in literature on autism [39]. This phenomenon was apparent in our data in one report where Laurie (NT4) recounted seeing an autistic colleague huddled by the wall in a cloak room during a work social event that was loud, busy, and unstructured—factors that several autistic participants described as stressful. The social event was put on by a workplace that worked almost exclusively with autistic clients, however the NT organizers did not consider their autistic colleague when they were planning the event despite their professional knowledge of autism. Laurie (NT4) related seeing this participant at the party earlier engaging in conversation and socializing with NTs. The NT in this situation had been presenting like the NTs at the event and the NT colleague described planning to talk with them once they were free. It was not until Laurie (NT4) saw this co-worker in the cloack room that she recognized the toll that the environment took on her colleague.

In our sample, the phenomenon of masking was complicated by a hesitation amongst many NDs (7 out of 10 NDs) to reveal their ND identity to colleagues or request accommodations [45]. Several NDs expressed concerns about difficulty finding or keeping a position if potential employers found out about their ND identity. One reported suspecting that they might be excluded from teams in part due to their ND characteristics while another wondered whether their difficulty locating a job was in part due to the ways these characteristics were perceived during interviews. Another reported that they did not talk about their ND identity or accommodations because "I felt that they would make me feel like I’m making up excuses." - Carly (AS6). Many NT colleagues in our sample reported a willingness to alter thought and behavior patterns when they knew about NDs’ needs. One reflected on learning about her colleague’s ND identity, “I felt more empathy and so then it made me feel like, you know, like I would kind of check myself and think, okay, and you know, have a little more patience with this person” – Rebecca (NT3), however it is understandable that NTs volunteering for a research study on inclusive workplaces may be more inclined toward making efforts to understand and support accommodations for their ND colleagues.

4.1.2 NDs want NTs to understand their difference without judgement.

All of our ND participants recognized that their work and social styles can be different than others, so they wanted NTs to understand these differences, but not make assumptions. Our ND participants, particularly our autistic participants, described mannerisms that they engage in which can be seen as different from NT patterns. Two NDs reported concerns around how their colleagues view them in various situations, such as when they do not make eye contact during conversation, or ’stim’ (perform self-regulating repetitive motor movements [36]). Several ND participants (4 out of 10 NDs) wanted NTs to recognize the source of these behaviors as manifestations of their own internal needs rather than see them as rude or off-putting. All of our NT participants also noted these differences, for instance, NTs reported seeing co-workers toe-walk, wear colored glasses in the office, or avoid small talk. A significant concern for many of our ND participants was that these differences would draw negative attention to themselves and lead to misunderstandings.

Regarding these differences, NDs reported wanting NTs to “Please talk to that person and ask them to help you to understand how they are thinking and the reasons behind why they are doing certain things that don’t seem normal to you.” – Michelle (AS1). ID participants often emphasized the importance of respectfully showing people how to do things and recognize that they are "not stupid" - Sonia (ID1), to understand that some people have "slower paces of learning" - Ari (ID4). Our NT participants also wanted to know about their ND colleagues’ needs and differences ahead of time so they did not view them negatively or make assumptions based on the NDs’ traits. NDs and NTs acknowledged that there was not a way for people to fully experience a different way of being, but that there can be “tools and ways to understand and walk alongside” – Michelle (AS1).

Figure 2:

4.2 Representing characteristics of ND Workers in VR

This section describes four emergent characteristics of ND workers reported by both ND and NT participants: (1) Passion, Talent, and Creativity in the Workplace, (2) Preference for Clear Directions, Consistency, and Detail-Oriented Tasks, (3) Social Differences, (4) Sensory Differences. Below, we explain each characteristic and provide examples of how these characteristics manifested as strengths in supportive workplaces, and conversely how tensions emerged when these traits were not understood or supported at their job. Within each section, we also present scenarios that our participants co-created to illustrate how such characteristics emerge in real-life scenarios in order to provide some idea of how these elements may be combined in VR simulations as part of a DEIA training programs.

4.2.1 Passion, Talent, Creativity.

Both ND and NT participants (10 out of 14 participants) often reported on ND’s passion, talent, and creativity for their work. We found that their strong interests could be supported by workplaces that offer growth and training, value workers’ inputs and creativity, and are focused in areas of interest. Many of our ND participants (5 out of 10 NDs) described the job they currently held as their ideal job or provided a clear plan of action to move toward their ideal job. They reported on their excellence and excitement about their work, or growing in their careers. This passion was evident in that most of our ND participants were actively pursuing education, training, and career advancement either within their current companies or through formal degree programs. One ND reported being recognized for excellence within their position, and having a desire to pass on their interests and talents to others. We report a story of Ari (ID4)’s passion for videography supported by a patient and respectful teacher in a scenario (Fig. 2).

Most of our ND participants (8 out of 10 NDs) reported appreciating being able to use their particular strengths in specific positions. For instance, Michelle (AS1) reported a natural talent for music which she is able to use in her work, while Richard (ID3) reported a passion for cars which allowed him to recall inventory items and solve customer problems quickly. Rebecca (NT3) described her ND colleague, a professor, as modifying class curricula to include creative assignments and new materials and engaging with students in a way that led to “a lot of students who absolutely adore her, you know, like where she’s their favorite professor in the attribute, their college success to her.” Workplaces that allowed NDs to exercise their particular talents, supported growth, and allowed participants to exercise creativity within their expertise led to them excelling within their workplaces. We also uncovered reports from NDs of excitement about supporting and teaching new colleagues about their workplace interests.

However, in environments where NDs were not supported in their pursuit of growth or supported in their creativity led to reports of NDs (5 out of 10 NDs) feeling unhappy, seeking other employment, or failing to develop higher levels of skill at work. Michelle (AS1) reported feeling dejected in an environment where her boss refused to meet with her as required by training policies and frustrated when the administrative structure did not intervene on her behalf, while Corinna (AS2) reflected that she felt unhappy and ineffectual when a boss consistently chose to do most of the coding work himself rather than supporting her learning by teaching her.

Figure 3:

Passion and Creativity: Patient and Respectful Instruction Ari (ID4) reported a passion for film making. He learned this skill from a patient mentor. It was important to him to have a patient mentor because Ari becomes stressed when things don’t go as he plans. He described being supported by a mentor who supported his learning pace. Ari described his mentor as, "Really calm. Really respectful. [...] like OK, I’ll help you and we’ll work together on getting this done." Learning about videography from this mentor ignited his interest and created space for film making to grow into a passion. Ari expressed excitement about teaching others about film making, saying a friend he taught is now "really good at filming [...] And that’s so cool!" In Fig. 2, we present a storyboard about Ari’s interactions with different kinds of bosses. He described a supportive boss was patience and checked on him when he was stressed (Panel 3), and an unsupportive boss who yelled and lost his cool when Ari was stressed (Panel 4). In presenting this scenario, a designer can highlight how Ari’s passion for filming was supported by mentors who provided him with opportunities for growth and support which were delivered at a pace which he could learn. Ari reported a tendency to feel dejected on learning new tasks that were difficult; without the support of patient mentors and opportunities for growth within his area of interest, he would be at high risk to give up on his passion. Given support, he learned about his passion well enough to instruct others, becoming a mentor in his area of interest.

4.2.2 Preference for Routines, Consistency, and Detail-Oriented Tasks.

Half of our ND participants demonstrated a preference for routines and consistency in workplaces and a talent for detail-oriented tasks. When supported through clear guidelines and directions, sufficient time, and structured, predictable tasks, ND and NT participants reported success completing work tasks. For example, Jacob (AS3) reported “one of my previous supervisors was impressed by how diligent I was about making sure I always knew what I needed to do.” Jacob’s preference for routine, consistency, and detailed instructions was supported by a supervisor who communicated expectations clearly. This helped him be successful. We saw similar reports from NTs and NDs who reported success at work when directions and expectations were clear.

In unsupported environments where directions and guidelines were not clear, NDs (4 out of 10 NDs) felt unprepared and lost. For example, Jacob (AS3) and Carly (AS6) described having no guidelines for staff meetings and feeling uncertain about how to contribute. Michelle (AS1) and Corinn (AS2) described managers criticizing them for completing tasks differently than expected when there were no clear guidelines. Charity (ID2) told a story where she felt nervous about requesting a schedule change. Charity checked in frequently with her boss about the request even though she knew her boss might feel annoyed because the uncertainty was distressing to her. She stated that clear communication about when to expect a decision would have helped her feel less anxious.

Given clear directions and expectations, sufficient time, and structured, predictable tasks, NDs excelled at detail-oriented tasks such as editing, schedule management, and writing. NTs (2 out of 4 NDs) were impressed with ND colleagues’ high quality, detailed work. Laurie (NT4) reported being impressed with her colleague’s consistently high level of preparation for meetings when most of her colleagues decreased their level of preparation as they increased in experience. In unsupportive environments, when NTs prioritized getting work done quickly instead of doing it well, NDs (2 out of 10 NDs) reported difficulties. Corinna (AS2) expressed the tension she felt between completing something quickly and doing it well, "If you want me to do it, then I need a minute. I need a process it and I want, like, I don’t wanna hack it, I wanna fix it." We share a scenario from Maria (NT2), who described a difficult situation with her ND coworker (Fig. 3). Maria (NT2) described learning how to support her ND colleague by altering timelines.

Routines, Consistency, and Detail-Oriented Tasks: Adjusting Timelines Maria (NT2) told a story of a time when she recognized her work style did not support her ND colleague. She changed her work style so her colleague could thrive (Fig. 3). Maria recognized that providing her ND colleague with a long document to edit shortly before a deadline meant her ND colleague’s tendency to produce detailed notes created tension with team members who had to address all of the detailed edits on a short timeline. Maria changed the work timeline. She started providing her ND colleague with documents sooner. This extended the amount of time between getting edits done and the publication date. With this adjustment, the ND colleague’s detail-orientation was recognized as a strength and the team appreciated her work. NT team members knew they could rely on their ND colleague to take over tasks with more details. Once supports were introduced for this ND colleague to work smoothly together with NTs, the ND colleague was highly successful. Maria expressed admiration for them, saying that they were “a whiz at technical editing of reports [...] They also put together some of the most organized Excel spreadsheets I’ve ever seen.”

In this scenario, a VR workplace training could represent the ND person’s detail-orientation as a characteristic. They could emphasize the need for a timeline that supported detailed work. Without this support, the ND’s detail-orientation could become a point of stress. With a supportive longer timeline, the ND could became valued within their team, and put their skills to work for the team.

4.2.3 Social Differences.

Many of our ND participants (6 out of 10 NDs) expressed an interest in feeling like they were part of a team. Participants enjoyed friendships and casual socialization with co-workers. Carly (AS6) reported "I love our lab lunches and our lab hangouts!", while Jacob (AS3) wished for more organized work socialization. Social anxiety and difficulty reading social situations emerged as common difficulties, particularly for autistic employees. We uncovered reports of NDs having a difficult time navigating situations where there were unstated social rules and subtle cues, such as when it was okay to interrupt a meeting or what kinds of jokes were acceptable in the workplace (4 out of 14 participants).

When NDs were supported by explicit guidelines for social interactions and clear hierarchies, had team-oriented, open-minded co-workers, and could interact in smaller groups, NDs felt included and confident in social interactions (8 out of 14 participants). Having clear guidelines, such as using specific language (e.g., “Let’s talk later”) or rules like ’don’t use swear words in work meetings’ made social expectations more visible to NDs. NDs typically perceived clear and explicit discussions about expectations helpful when they were non-disciplinary. NDs and NTs reported that interacting with just a few people felt more comfortable than large meetings. NDs also reported feeling more comfortable with people who were members of the ND and/or LGBTQIA+ spectrums, were in creative professions, and who were willing to engage in non-typical social interaction. For instance, Jacob (AS3) reported “I’m not very good at generic small talk[...] it’s good to have people who are okay with that.” In workplaces where supports were not in place, NDs and NTs reported getting into conflicts. For example, Rebecca (NT3) described a colleague whose professional disagreements escalated into personal attacks. She proposed that "a more clearly defined supervisor and supervisee relationship" could have supported resolution. Instead, Rebecca and her co-workers “all kind of avoided [the ND colleague]” to avoid conflict.

Figure 4:

Social Differences: Explicit Social Instruction Jessica (AS5) described a workplace where she was supposed to email people before going by their desks (Fig. 4). This expectation was not made clear to her. She stopped by people’s desks whenever she needed something. She did not pick up on the implicit expectation that she should email before visiting co-workers. Her colleague told her this rule directly. Because she had a hard time reading social cues, she was unable to understand that she wasn’t doing what was expected. After she was told that she should email people, she changed her behavior immediately. Jessica reflected that she appreciated her colleague telling her what to do and that "I wish they would have told me sooner." When the rule was made explicit, she could follow the workplace norms confidently. She reported perceiving her co-worker as kind and helpful for telling her the expectation.

Representing this situation, a designer could highlight difficulty reading social cues. They could show the difficult situation of having implicit social rules and demonstrate how in an unsupported workplace, an ND employee may not learn these rules, and team members may become annoyed with their colleague.

4.2.4 Sensory Differences.

Sensory differences are prevalent within the autism community in particular, however sensory processing difficulties occur in other ND populations as well [40]. In our sample, autistic participants (4 out of 6 autistic participants) reported challenges with physical spaces that were difficult for them to exist and work in. Our ID participants occasionally reported frustrations with sensory experiences at work, such as screaming children, however these were not reported as significant problems for them at work. Autistic participants reported difficulty with bright and fluorescent lights, loud spaces, and simultaneous conversations. When granted physical equipment and work task accommodations, they reported more success in the workplace (2 out of 6 autistic participants). One NT also reported that her autistic colleague used equipment to help him work in difficult sensory environments. We uncovered reports of NDs wearing protective gear (e.g., sunglasses, headphones), using recording devices in meetings, benefiting from additional meetings, and taking extra sensory and mental breaks (e.g., spinning, leaving work area) before difficult situations to help them carry out their work duties successfully. Michelle (AS1) described being allowed to wear sunglasses which helped her avoid migraines and drowsiness at work, while Carly (AS6) described wearing headphones with a specific type of background noise to focus. When participants worked in environments that were aggravating to their needs, they reported struggling to focus and succeed. For instance, Jacob (AS3) recalled trying to participate in a multi-person interview and having difficulty focusing on the questions directed at him due to simultaneous conversations, after which he was not offered the position. Carly (AS6) described difficulty processing language when her environment was creating uncomfortable sensory experiences, "Sometimes when people are talking to me, it sounds like a different language. Like, I don’t understand what people are saying." We share Michelle (AS1)’s story of how accommodations helped her manage working in an environment with fluorescent lights (Fig. 5).

Figure 5:

Michelle (AS1)’s Story: Bright Lights and Work Accommodations Michelle (AS1) reported sensory difference that impacted her ability to work comfortably within various environments. She described how fluorescent lighting at work was uncomfortable for her and made it difficult for her to think (Fig. 5). She described a story in which she was experiencing difficulty due to fluorescent lights despite wearing sunglasses. Her colleague’s phone broke and he came to her for help. Placed in the situation of responding to this unexpected event, the lighting environment made it difficult for Michelle to generate a clear solution. She suggested action that resulted in the equipment breaking, resulting in disciplinary action. In this case, the environment prevented her from thinking clearly and she was involved in situation that resulted unfavorably for herself, her colleague, and the company. In situations where the environment had natural lighting, she reported feeling more relaxed and less stressed. Without the additional burden of a hostile sensory environment, she reported feeling more relaxed and able to think clearly to address issues.

In this situation, a VR scenario may highlight the characteristic of sensory differences. In a hostile environment, the ND may have difficulty navigating thinking clearly or focusing in crisis moments. In a more friendly environment, the ND may be able to think clearly and execute a plan for a crisis.

4.3 Reactions to VR perspective-taking examples

Here, we report our participants’ reactions to three existing VR perspective-taking simulation videos that we showed during the study. We showed sensory overload simulations in a mall [15] and during a meeting [16], and VR perspective taking simulation [69]. We first describe the opposing views that our participants had about VR perspective taking.

4.3.1 Opposing Views on VR Perspective Taking.

We found a tension amongst ND participants, who reported competing opinions about immersive VR simulations demonstrating the first-person experience of being ND. Most ND participants reported some interest in simulations representing their different experiences. Noor (AS4) suggested that experiencing the ND perspective could help NTs understand the differences in experiences to "understand and walk alongside.", while Carly (AS6) highlighted the importance of giving different perspectives on the same experience, to "make compassionate, informed decisions." However two participants, Jessica (AS5) and Carly (AS6), expressed some concerns with the simulations we presented. They relayed concerns that having people experience what was happening inside of ND brains was intrusive and not always helpful. Jessica (AS5) commented that although the intention was to bridge gaps in understanding, these simulations were harmful because they emphasized sensory overload experiences and what she called ’meltdowns’. She felt that they portrayed NDs in a negative light and failed to show their strengths. The reactions of Jessica and Carly echoed reported tensions in the literature around disability simulations, which have been reported to dis-empower the voice of disabled people [6], lower opinions of skills of disabled people [18, 46, 54], and increase confusion, fear, and embarrassment about disabilities [18, 46, 54]. Jessica summarized her discomfort around first-person representations of the ND experience, “I can’t really explain it, but I don’t like it. You have your mind and I have mine and, you know, autistic [people] don’t try to do this for neurotypical people. […] So why are you guys doing that to us?”. Jessica and Carly’s opinions were in alignment with criticisms around disability simulations that describe them as making the experience disabled persons a ‘spectacle’ [6]. Jessica and Carly suggested moving away from the first person perspective by showing a person seeing from the NT perspective that the ND person is having a hard time and seeing ways that they can support them, or showing the ND being strong by asking for accommodations. In the discussion section, we consider the tension between uncovering internal experiences that build empathy while respecting the autonomy of NDs and developing experiences that call on NTs to think constructively and contribute to solutions.

4.3.2 Sensory and Emotional Representations in VR.

Figure 6:

An important aspect of conveying the experiences of ND employees to NTs is gaining insight into their internal, invisible experiences (e.g., thoughts, feelings, sensory processing), for example feelings of anxiety that arise in situations that are not typically stressful for NTs or sensory processing differences that NTs may not be aware of or understand. Making invisible experiences visible to NTs can uncover the work that ND workers must regularly do to exist and thrive in the same environments as NTs, addressing NDs’ primary message of making NTs aware of the work that they do to be a part of majority-NT teams.

During the design meetings, we asked ND participants to describe their internal and physical experiences at different moments, and develop potential representations of their internal experiences in VR. Our participants sometimes communicated metaphorically, for instance Jacob (AS3) described having a "filter of what I wanna say [...] with words bouncing off if it’s not the right thing to say, and then some break through" to describe conversation challenges while Carly (AS6) described the feeling of needing to stim as an over-filled balloon—"if we pump it one more time, it’s actually going to explode. So we need to very carefully release". Some participants communicated directly how their body felt, "[I] kind of start to sweat a little bit" - Richard (ID3). Others spoke directly about the effort they make to contain their feelings, "I try not to lose my cool. A tense body - but I keep it in. I hold it in." - Ari (ID4), and the thoughts and strategies they use when they are upset, "So I’ll take a walk and I’ll listen to my music on my Airpods and walk around. And it keeps me happy." - Charity (ID2). These different representations and strategies can make the internal efforts that NDs experience visible to NTs, building an understanding of the larger effort that their ND colleagues expend in environments that are not set up to support their ways of being. NDs hoped that NTs would make an effort to change their behaviors if they could see a representation of NDs’ challenges - "If they [NT colleagues] could see the word cloud and word channel maybe that would help people be quieter, and they might notice me struggling." - Jacob (AS3). In Fig. 6, we show representations of internal experiences generated during storyboard activities.

5 Discussion

Motivated by the goal of fostering workplaces that are welcoming toward neurodivergent (ND) workers, we examined how we can use immersive VR perspective-taking simulations to develop inclusive mindsets in neurotypical (NT) workers. Aligning with the social model of disability [41], we want to bring attention to how environments can support ND workers. Researchers in HCI have emphasized how technological systems can be developed to support ND individuals rather than focusing on encouraging them to change their behaviors to be more in line with NT standards [7, 13, 58, 59], therefore our research contributes to this area by considering how technology can build accessible workplaces by encouraging NT employees and managers to adopt more inclusive policies and behaviors.

By working with both ND workers and NT workers who have worked with NDs, we developed a rich understanding of the work activities, scenarios, and internal experiences of ND employees in workplaces. In particular, our findings suggested that VR perspective-taking technology, which allows users to become immersed in narratives by creating realistic sensory and physical environments, has the potential to address two main messages that ND participants wanted to communicate to their NT co-workers: (1) Recognizing ND’s differences and (2) Recognizing their efforts to be involved in a NT majority community. However, we also identified a potential danger of VR perspective-taking technology which can cause users to perceive NDs as less capable by focusing on their difficulties but not their strengths. VR perspective-taking experiences are often structured as disability simulations that drop users into a body without context. Martingano et al. criticize these types of experiences for arousing affective empathy (feelings on behalf of another person), but not cognitive empathy (understanding what another person is feeling) because they are a passive way to ’try on’ a disability and do not engage the user in active consideration of others’ experiences [43]. Research suggests that processes under conscious control, notably involving active mental processing of another’s mind state, can increase cognitive empathy [12]. Below, we make design suggestions that work toward VR disability simulations that showcase NDs’ strengths and encourage active engagement. Then, we discuss ways that designers can encourage NTs to ’be with’ ND workers and privilege ND viewpoints. Finally, we propose ways of building awareness of the environment’s impact on NDs through narratives when designing ’being-with’ VR simulations.

5.1 Highlighting Strengths and Creativity, and Physical and Social Environment Support

The message communicated most often by our ND participants was that simulations should focus on strengths and creativity of NDs working in majority-NT environments, highlighting the effort they make to be a part of inclusive teams. Commercially available empathy simulations often focus on what Jessica (AS5) referred to as ‘meltdowns’—typically moments where a ND person is experiencing a sensory overload and is unable to focus. NDs were concerned that these types of simulations would make them look less able than their NT peers. This concern is validated by a body of research showing a lower perception of abilities following disability simulations [18, 46, 54]. Furthermore, simulations that drop a person into non-typical mind or body fail to account for the lived experience, focusing on bodily differences instead of environmental barriers [54]. Despite this concern, most of our ND participants valued the way that sensory manipulation capabilities of VRallowed NTs to experience, or ’try on’ NDs’ unique sensory responses. This can also help NTs to experience how NDs work hard to adapt to environments designed for NTs, which was the first message that our ND participants wanted to communicate to NTs. To represent ND’s unique sensory and emotional experiences in VR, our ND participants provided ideas of using the analogy of fire, balloon, and a pressure cooker. Designers could adopt these representations to highlight ND’s experiences and efforts. However, at the same time, they should balance this with a potential danger of perceiving differences as less able.

Therefore, inspired by the spirit of social model of disability, we recommend that VR simulations where users ’try on’ an ND experience should emphasize how ND’s unique characteristics can benefit work teams when they are supported by physical and social environments. By doing this, designers can avoid the pitfall of showing only difficulties of NDs. Furthermore, designers can incorporate the ways that NDs manage challenges that do arise, so that NTs can learn about NDs’ creative coping strategies for managing differences. This approach addresses the recognized shortcoming of traditional disability simulations which exclude recognition of strengths and skills those with chronic differences have built up to manage difficult environments [46, 54].

Even with a move toward recognizing strengths, ’trying on’ simulations may fail to maximize growth of cognitive empathy if they do not have tasks that actively engage users’ cognition, such as building attention to a target’s emotional state or emotional intensity [12]. For that reason, we also suggest that these types of ’trying on’ simulations be used in context with activities that build active engagement with the environment, such as assessing the user’s mental or emotional state as Martingano et al. suggest [43]. In the next section, we consider other ways for users to actively engage with the environment.

5.2 Privilege the ND Viewpoint

Designers who wish to branch outside of traditional ’trying-on’ disability simulations and design experiences that focus on ’being with’ a ND person, for example through VR avatars, should consider how to privilege the ND viewpoint in these experiences. Previous work on empathy-building suggested that meeting a ND person directly is likely to result in the highest level of empathy in NTs [18]. However, it may not be feasible to facilitate these interactions directly, therefore we recommend the design of simulations that can encourage NTs to ’be with’ NDs, see them as well-rounded individuals, and demonstrate how users can ’walk alongside’ their ND colleagues. These types of simulations can address the second message communicated by our ND participants—a desire to have their differences understood. Our participants communicated concerns that their colleagues may make incorrect assumptions about them based on atypical actions or behaviors, viewing them as rude, disinterested, or less competent than NTs. Several NTs also communicated that knowledge about neurodiversity could be helpful for understanding their colleagues in the workplace. As Bennet and Rosner describe it, the experience should emphasize ‘being with’ rather than ‘being like’ others, building empathy through the process of listening, interacting, and creating experiences that encourage continued connection [6]. For instance, experiences that introduce NTs to ND avatars, develop their personas, and encourage interaction between these groups. These experiences can support NTs’ understanding of the needs commonly reported by NDs, creating a medium through which NTs can hear the direct viewpoints of NDs. In a study on blindness simulations, Silverman et al. recommending focusing on successful accommodation experiences and demonstrating model behaviors that sighted individuals can enact to support blind individuals [54]. Adapted to ND groups, this may include demonstrating to NTs how characteristics that may appear unusual are important for NDs’ workplace success and how they can best learn what supports and advocacy will support their ND colleagues’ well-being. Developing inclusive policies, attitudes, and behavior repertoires that support ND profiles can create a workforce that is prepared to reach out to ND workers and support their success.

In an activity where the perspective to be taken is one of a person with distinct mental processing, as in a demonstration of neurodiversity, it is particularly pressing to ensure users come to understand what another person’s experiences may lead them to do rather than relying on their own mind and experiences to react. This can avoid what Gallagher called the ’diversity problem’—the tendency to bring one’s own assumptions and views into perspective-taking activities, thereby removing the life experiences of the other from the activity [20]. Facilitating interactions between NDs and NTs where NT avatars can communicate varied interpretations and responses of events can support NTs to understand the viewpoints of their colleagues.

Another factor that increases empathy is the recognition of similarities between one’s self and another, which can include building in-group framing [70]. This can be achieved by building similarities of appearance or characteristics [48], and showing an avatar’s interest in what the user is doing [48]. Designers can use Table 2 as a starting point to identify similarities between ND avatars in stories and the NT users experiencing a VR simulation in which they interact with ND avatars. By pairing NT users with an avatar who demonstrates similar characteristics, interests, or work tasks as the NT, NT users would be more likely to identify with them during the experience and develop in-group framing. Once in-group framing is established, the ND’s accommodations can be framed as an important tool to get work done, combating ND’s concerns of their differences being seen as a ’liability’ - Noor (AS4) or accommodation requests being viewed as ’insubordinate" - Michelle (AS1). Immersive VR experiences can translate to changes in attitudes and behaviors in the real world [17], therefore presenting accommodations as a normal, mundane, and necessary part of the working world during realistic narratives that use in-group framing between NT users and believable ND characters can establish acceptance and appreciation of NDs in the workplace.

5.3 Designing the Narrative Structure around the Social Model of Disability

In this section, using narrative structures, we discuss how VR experiences that encourage users to ’be with’ NDs can focus NTs’ attention on ways that work environments can support or fail to support NDs. Communicating facts through narrative structures can build empathy for stigmatized groups more effectively than non-narrative structures [49], therefore relaying environmental challenges through narratives is likely to encourage empathy. Through the lens of the social model of disability and its focus on changing the social environment as opposed to the individual [41], narratives intended to create more inclusive workplaces for ND individuals should be centered on environmental awareness. This can be achieved by designing VR that aims to increase NTs’ understanding of how ND people experience the NT-situated world, and how different levels of social support can create opportunities for success or challenges [59]. Table 2 lists ND characteristics reported by our participants. We present the results of these characteristics being supported, leading to opportunities for ND success, and the results of characteristics not being supported, leading to ND challenges. We suggest conveying both supported and unsupported perspectives through narrative experiences, giving the NT user a full understanding of how environments impact the experience of those around them. During the narrative experience, NTs should build a connection with NDs while having opportunities to actively assess the environment [43], such as by interacting with an ND avatar in conversations that surface how they are thinking or feeling, or viewing biosignals/listening to verbal descriptions of emotions as in previous research [12, 48].We suggest that narratives include details taken from rich, first-person accounts of ND people. For example, Table 2 could be a tool to support designers to build narratives showing complex representations of NDs based on first-person accounts of NDs and their NT colleagues. We suggest that presenting ND avatars based on first-person stories and accounts will convey complexity to build NT’s understanding of the multiplicity of ND characteristics, strengths, preferences, needs, and life experiences. For example, designers could demonstrate how one user’s passion manifests as skill for film editing, while another emerges in music, or show how some (but not all) ND people have difficulties in fluorescent lighting or loud environments.

Facilitating understanding between NTs and NDs is complicated by the fact that ND people have a wide range of experiences and characteristics. Even within a sample limited to two groups of the ND community, we found substantial variation within and between groups. For example, in the area of sensory difference, some users reported difficulty with sounds, others with visuals, and still others reported no substantial difficulties at all. While the experiences of ND people with the same ND identity (e.g., autism, ADHD) may be similar in some respects, we encourage designers to offer variation of experiences built in partnership with the group or groups to be represented, and emphasize that the unique nature of each ND person’s experiences in design. Moreover, people with the same challenge may have different ways of understanding or responding to these challenges. Highlighting workplace social and physical environments during engaging narratives told by various NDs can call attention to what is and is not helpful in work environments for different NDs. This can help NTs understand how inclusive policies and attitudes can support ND workers’ success.

6 Limitations

Neurodiversity is a broad and rich category of people. This study explored commonalities of only two representative groups of neurodivergent individuals, autistic individuals and people with ID. The work situations, such as strengths at work, difficult situations, and accommodations, may shift in the case of other types of neurodiverse identities, which is beyond the scope of this study.

Moreover, despite reaching out to a number of recruitment areas, our work is limited in the number of participants. We especially had difficulty recruiting NTs who have worked with NDs. Many of our NDs reflected that they do not discuss their ND status at work, so it is likely that many NTs may be unaware that they work with ND coworkers. To address a small sample size limitation, we collected a rich dataset on our participants to fully understand their experiences. Study participants were engaged with our study for several days completing the generative toolkit, and then completed a two-hour design meeting which allowed us to better understand rich nuances that emerge in individual workplaces. The exploratory nature of our study contributed to providing initial design suggestions to VR design spaces that can build NTs’ understanding of ND workplace experiences by revealing rich and nuanced experiences of our participants. Although this initiative provides novel contributions to HCI, future research can further advance our work by developing a real system based on our design suggestions and conducting a long-term deployment study. Furthermore, when building the real system, future work should consider how building sensory simulations could affect VR sickness of both NTs and NDs. Finally, the authors of this paper all identify as NT. Two have significant personal and professional connections to the ND community. Our research methods were structured to elevate the first-person ND perspective, however we acknowledge that our perspective and biases likely influence our data collection methods and analysis. To align more closely with our population, the first author maintains a volunteer position working with students at a TPSID at a metro Atlanta university in courses that include content on employment. We also connected with ND self-advocates in the community to understand the perspectives of this community regarding this project to build our study and interpret findings in a way that was informed by their views.

7 Conclusion

This research presents design considerations for a VR system that can build empathy and understanding of the ND workplace experience in the NT co-worker. We found that VR perspective-taking technology could address two main messages that NDs want to communicate to their NT co-workers. First, recognizing NDs’ differences. Second, appreciating ND’s efforts to be involved in a NT majority community. However, our results also revealed that VR perspective-taking could cause NTs to perceive NDs as less capable. Therefore, we suggest designing VR simulations that represent ND experiences without creating negative outcomes. This work contributes to the HCI body of research focused on accessibility and inclusivity of the ND population, and further pushes the field to consider shifting the frame of interventions from behavioral change of the ND workforce to creating a more empathetic, understanding, and accommodating social environment. This present research is unique in its efforts to convey the perspectives of the ND experience in the workplace through VR affordances and narrative techniques, and intends to open the door to more socially-focused interventions.

Footnote

During online meetings, we found that the additional visual stimulation of virtual sticky notes could distract participants and thus stopped using them after several meetings to support a better participant experience.

References

[1]

Sun Joo Ahn, Joshua Bostick, Elise Ogle, Kristine L Nowak, Kara T McGillicuddy, and Jeremy N Bailenson. 2016. Experiencing nature: Embodying animals in immersive virtual environments increases inclusion of nature in self and involvement with nature. Journal of Computer-Mediated Communication 21, 6 (2016), 399–419.

Abstract

1 Introduction

2 Related Work

2.1 Neurodiversity in the Workplace

2.2 Empathy Building with VR

3 Methods

3.1 Study Procedure

3.1.1 Generative Toolkit.

3.1.2 Design Meetings.

3.2 Data Analysis

4 Results

4.1 Inclusivity messages of neurodivergent workers for neurotypical workers.

4.1.1 NDs’ desire to be recognized for their effort to be a part of majority-NT teams.

4.1.2 NDs want NTs to understand their difference without judgement.

4.2 Representing characteristics of ND Workers in VR

4.2.1 Passion, Talent, Creativity.

4.2.2 Preference for Routines, Consistency, and Detail-Oriented Tasks.

4.2.3 Social Differences.

4.2.4 Sensory Differences.

4.3 Reactions to VR perspective-taking examples

4.3.1 Opposing Views on VR Perspective Taking.

4.3.2 Sensory and Emotional Representations in VR.

5 Discussion

5.1 Highlighting Strengths and Creativity, and Physical and Social Environment Support

5.2 Privilege the ND Viewpoint

5.3 Designing the Narrative Structure around the Social Model of Disability

6 Limitations

7 Conclusion

Footnote

References

Cited By

Index Terms

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