Work and career

How the guideline described the situation

For people with Asperger syndrome or high-functioning autism (the guideline’s own terms), the guideline described, on the basis of a 2017 study: despite often good educational qualifications and independent living, they tend to have poorly paid jobs with few hours, frequent changes of job and longer periods of unemployment. ^{[1, Ch. C.10.3]} Under favourable conditions, however, there is a good chance of employment. ^{[1, Ch. C.10.3]} The guideline relied mainly on data from the USA and England. ^{[1, Ch. C.10.3]} These are group findings; they say nothing about the individual case.

Applying for jobs

To improve chances in applications, adolescents and young adults who want to apply for a training or job position should, on request, receive specific application training that includes role plays and concrete exercises (evidence level 2, grade of recommendation B). The programme can be supported by video-based training in a virtual environment (grade of recommendation 0). The training should also pay attention to the fit between individual talent and the desired training or occupation. For people with intellectual disability, measures to support applications that are adapted to cognitive skills should be offered. ^{[1, Rec. 113]} The recommendation reached strong consensus. The guideline also summarised the British NICE guideline for adults: for people without or with a mild learning disability who have difficulty finding or keeping work, individual supported employment programmes were recommended, including help with writing CVs and applications and with preparing for interviews. ^{[1, Ch. C.10.3]}

Workplace and employer

For adolescents and adults who cannot obtain training on the open labour market, the guideline recommended, in a consensus-based recommendation (strong consensus), individually guided support at an employer geared to autism. This includes continuous guidance in dealing with supervisors, in structuring oneself and working independently, in taking on responsibility and in social interaction with colleagues. ^{[1, Rec. 114]} In addition, employers or supervisors should be advised and supported on how to deal with the person before work begins; informing colleagues can be considered with the involvement of the person concerned. ^{[1, Rec. 114]}

For the design of working conditions, the same recommendation named: ^{[1, Rec. 114]}

• ask about and take into account over- and under-sensitivities when designing the workplace,
• keep the workplace, work processes and working hours consistent and design break times so that they serve recovery,
• structure the workplace well and clearly,
• enable flexible working-time models and working from home,
• where needed, offer vocational promotion measures that prepare for training or employment through guided placements in different areas and special school lessons.

For people with intellectual disability, measures adapted to cognitive skills and socio-emotional abilities should be offered within a needs-based support plan agreed with those affected. ^{[1, Rec. 114]}

Vocational rehabilitation

In the case of unemployment and impending inability to work, it should be checked individually whether a vocational rehabilitation measure comes into question. It should be adapted to the needs, abilities and strengths of people with autism. It should be noted that in autism there can be a large discrepancy between social and daily-living, motor and cognitive abilities, so that vocational suitability and capacity can be underestimated on the one hand and overestimated on the other. Staff of rehabilitation measures should receive information about autism (consensus-based, strong consensus). ^{[1, Rec. 115]} Which benefits exist for this is described in the article Benefits for participation in working life.

What studies show – and what they do not

The guideline stated: the body of studies on vocational rehabilitation is poor overall; further research is urgently recommended. ^{[1, Rec. 116]} It relied mainly on a 2017 systematic review, 46 of whose 50 studies came from the USA and which apply to Germany only to a limited extent. The body of studies was best for programmes to improve job skills at work (one randomised study) and to prepare for job interviews (two randomised studies). ^{[1, Ch. C.10.3]} According to the guideline’s account, specialised vocational rehabilitation services lowered costs compared with standard care and contributed to better outcomes; at the same time they were the most expensive compared with the rehabilitation of other groups. ^{[1, Ch. C.10.3]}

Sources and literature

1. DGKJP, DGPPN et al. Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter. Teil 2: Therapie. Interdisziplinäre S3-Leitlinie, AWMF-Reg.-Nr. 028-047, Langversion, Stand Text 02.05.2021 (Kap. C.10.3 mit Empf. 113–116). – Guideline (in German); validity expired on 23 March 2026 according to the DGKJP overview ^[2]
2. DGKJP. Aktuelle Leitlinien (Eintrag 028-047: „Gültig bis 23.03.2026“). https://www.dgkjp.de/wissen/aktuelle-leitlinien/ – Professional society (website in German)