Dr. Mary Doherty:

On the prevalence issue, I do not think it is increasing. There is much debate in that regard but most experts of whom I am aware in the field do not believe there is a genuine increase. It is down to two things. It is down to widening of the diagnostic criteria and increased visibility and diagnosis. Many autistic people, particularly autistic adults, are hiding in plain sight in all sorts of sectors and do not disclose, mostly because of stigma and misconceptions, particularly in respect of empathy, for example. I am undertaking a project with a group of autistic psychiatrists at the moment. Of all our members, they are the most over-represented in our membership but they are the least likely to disclose. That is because they would experience an instant loss of credibility among their peers. However, these are the people who understand, in a way non-autistic people cannot, autistic people using their services. They are inundated with referrals from their services from service users who are autistic. Even though their colleagues do not realise they are autistic, they recognise that somehow, they have a way of engaging with autistic people using services.

I am aware of research carried out in Germany which looked at the employment situation of people attending outpatient autism clinics. They found that more than 60% of this cohort were in employment and the two biggest employment fields were education and health and social care. Approximately 23% of autistic adults attending services were working in health and social care. That is a significant hidden minority within the workforce who have so much knowledge to contribute, yet, as a result of stigma, people are inhibited from disclosing. We are aware of medical students and trainees who lost their place in medical school or postgraduate training after disclosing a diagnosis of autism.

There is so much stigma and discrimination. Much of it comes down to the myth that autistic people do not experience empathy, which is absolutely untrue. There is a significant amount of misunderstanding. We need to change the culture so that it is okay to disclose and people are safe to do so and thereby get the supports they need. Too many autistic people in employment are struggling without necessary reasonable accommodations but feel unable to ask for such accommodations because doing so would involve disclosure. Much of it is down to understanding. The experience of being autistic is very different from the experience of not being autistic, yet we autistic people understand one another and communicate among ourselves just as effectively as non-autistic people do among themselves. When one mixes neurotypes, communication can sometimes be more challenging. It should be recognised that autistic people have much to offer, particularly in healthcare and education. Like in medicine, autistic teachers are a hidden minority who have much to offer.