Neurodiversity programmes may be causing harm, landmark review warns

The volume of research on neurodiversity in organisations has grown sharply since 2020, with publication rates accelerating year on year through to 2025. Yet according to a sweeping new editorial review in the International Journal of Management Reviews, quantity has not translated into quality, coherence, or practical usefulness. The paper, written by Nancy Doyle, Miriam Moeller, Dana L. Ott and Matevž Rašković, argues that the field remains scattered across disciplines, dominated by a narrow range of experiences, and theoretically underdeveloped in ways that could actively undermine the neuroinclusion efforts it is meant to support.

The findings make uncomfortable reading for organisations who have invested heavily in neurodiversity programmes. The authors' central argument is that neuroinclusion should be understood not as a discrete HR intervention but as a system-level change whose effects ripple across interconnected organisational, relational and societal contexts. Treat it as a simple fix, and the evidence suggests you will produce unintended consequences.

The DDT problem

To illustrate the risk, the authors draw a striking parallel with environmental science. When Rachel Carson documented the effects of the DDT pesticide in Silent Spring, she showed how a seemingly targeted technological solution produced cascading, delayed and often invisible harms across entire ecosystems. The authors apply the same logic to neuroinclusion: a well-intentioned workplace adjustment can create misalignments elsewhere in the system, undermining both inclusion efforts and broader organisational effectiveness.

The analogy extends to biodiversity and cultural diversity research, where 50 years of evidence shows that intervening in complex systems using dominant norms, without accounting for interdependence and within-group variation, frequently causes more harm than it prevents. The authors argue that neurodiversity policy is at precisely this risk.

Treating autism or ADHD as homogeneous categories, for instance, generates narrow stereotypes around strengths and deficits that may resonate for some individuals but render others invisible or mischaracterised. As a result, institutional responses can unintentionally privilege certain profiles of neurodivergence while marginalising others, reproducing inequity under the guise of inclusion.

Widely used approaches come in for particular scrutiny. Standardised accommodations such as blanket remote working policies for sensory challenges, formal diagnosis requirements as a gateway to support and rigid accessibility definitions tied to minimum legal compliance all raise serious empirical and theoretical questions. Such approaches may inadvertently reward visibility and self-advocacy while excluding those who experience communication, fatigue or disclosure differently.

Who the research is about

A related problem is who gets studied. The literature has historically been shaped by a focus on white, cisgender, middle-class boys and men in developed countries, predominantly in the technology sector. The paper finds that the vast majority of published research concentrates in a small number of western, educated, industrialised, rich and democratic contexts. Large parts of Africa, Latin America, the Middle East, Central and South Asia and Oceania are substantially absent from the literature.

This reflects deeper epistemological assumptions about what counts as neurodivergence, what counts as normal and whose experience of cognitive difference is treated as the default. The authors call for Indigenous psychology perspectives and non-Western understandings of cognition to be incorporated into the field, arguing that the variability of norms, stigma processes and agency across socio-cultural settings cannot be captured by the current literature's dominant frameworks.

The research is also narrowly focused on autism in ways that risk using neurodiversity as a synonym for a single condition, creating problems for people with dyslexia, dyspraxia, ADHD, dyscalculia, Tourette's syndrome and other forms of neurodivergence whose working styles may look quite different.

Power, agency and the 'rescuer' dynamic

One of the paper's sharper arguments concerns the power dynamics embedded in how reciprocal communication is currently framed in organisations. The authors identify a blind spot in the literature: calls for reciprocal communication have frequently been mis-framed as neurodivergent employees voicing their needs, with managers adapting in response. This is not reciprocity; it is a parent-child dynamic. It positions the neurodivergent employee as either a child to be rescued or a problem to be managed, and assumes that neurotypical managers always have greater capacity to accommodate others' needs, which may not be the case.

The authors draw on transactional analysis to argue that neurodivergent employees must be understood as relational agents embedded in accountable workplace dynamics, not as passive recipients of accommodation. This shift in framing has practical implications: it opens space for neurodivergent people to develop self-awareness, communication skills and reciprocal engagement rather than being held exempt from those expectations. It also, crucially, does not absolve organisations of their structural responsibilities.

The research the field is not doing

The paper is equally direct about the methodological gaps that are holding the field back. Most existing research is cross-sectional, conducted at a single level of analysis, and reliant on self-report data, most often from neurodivergent employees reflecting on adverse experiences. While this has been essential in documenting marginalisation, it risks narrowing the evidentiary frame in ways that make kindness and accommodation alone appear sufficient to address systemic inequities.

What is almost entirely absent is rigorous evaluation of whether interventions actually work. There is little comparative research examining whether management training programmes improve key organisational outcomes including psychological safety, wellbeing, engagement, performance, promotion rates, turnover, or absenteeism. Quasi-experimental designs are rare, randomised controlled trials are virtually non-existent and multi-level analyses incorporating managerial and organisational perspectives remain limited. Return-on-investment studies that would allow organisations to assess the feasibility and proportionality of adjustments are also lacking.

The authors call this pattern indicative of a field still in an early stage of empirical maturation, and issue a direct call to social science funding bodies to prioritise rigorous, longitudinal and multi-level research.

Four priorities for what comes next

The paper sets out four interconnected research priorities. The first is an ontological and epistemological reorientation away from deficit logics: research must move beyond frameworks that treat neurodivergence primarily as dysfunction or impairment, while still taking impairment, distress and support needs seriously. The emerging biopsychosocial model, which situates neurodivergence within a social ecology of mental functions rather than reducing it to individual pathology, is identified as a more productive foundation.

The second priority is more reflexive engagement with power, reciprocity and agency: treating neurodivergent people as active participants in shaping their work contexts rather than as objects of organisational structures and discourse.

The third is stronger attention to cultural and institutional contingencies: how neurodivergence is defined, experienced and governed varies across societies, and research must integrate cross-cultural, Indigenous and institutional perspectives to capture that variation.

The fourth is intersectionality. The compounding effects of neurodivergence with race, gender, sexuality, socioeconomic background and other identities remain poorly understood. Research that examines these intersections can not only deepen understanding of inequality and privilege but also open space for theorising the survival mechanisms and agency of neurodivergent individuals who hold multiple marginalised identities.

What it means for practice

For HR professionals and EDI leads, the paper's implications cut both ways. On one hand, it validates the urgency of the agenda: neurodivergent individuals remain disproportionately excluded from meaningful and sustained employment, facing pathologisation, stigma, uncertainty around disclosure and organisational systems that privilege neurotypical norms. The case for action is not in question.

On the other hand, the paper is a clear warning against assuming that well-intentioned interventions are working, or that the research base is robust enough to tell you whether they are. The authors argue for proactive, flexible and participatory systems across research, education, employment and healthcare that centre both access and agency, and that resist the temptation to standardise responses to an inherently heterogeneous population.

The goal, as the authors frame it, is to move beyond symbolic inclusion towards substantive transformation. That requires a more mature and reflexive research cycle, more diverse voices shaping what gets studied and how, and a willingness to treat neuroinclusion as the complex, system-level challenge the evidence suggests it actually is.

'Neurodiversity in Organisations: Taking Stock and Shaping Future Research' is published in the International Journal of Management Reviews as part of a special issue on neurodiversity in organisations.

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