What are the factors/features/dimensions that are most important for adults with NLD who wish to obtain and maintain a job?

I have encountered persons with NLD in many walks of life who have fared rather successfully in their occupations. I am usually asked to see persons with NLD for neuropsychological assessment when psychosocial problems of a crisis or chronic nature have become unbearable for them or for those close to them. Intensive investigations of these individuals and of those published studies of adults with NLD (See Question #14) constitute many of the sources of my knowledge about satisfactory job/vocational opportunities for persons with NLD. Other conclusions are drawn from observation of those who have managed to function reasonably well in any number of occupations.

What I have learned about persons with NLD and their occupations may be divided into three categories: role of assessment; job application and interview; and, highly desirable features of the workplace. These dimensions are considered within the framework of seeking an occupation/vocation within the increasingly competitive work-force. Patterns of behaviour typically practiced by persons with NLD in the past (and the further in the past one goes, the better this gets) are, for the most part, no longer successful. The physicians, professors, monks, lawyers, and others who qualified for their professions 60 years ago and who have been maintained in them, by hook or by crook, no longer serve as adequate exemplars for the rigours of the job market faced by the person with NLD in the 21st century. I guess this is, in one very real sense, unfortunate. But, to dwell on this for very long gets us nowhere. Today, we do not have many monasteries, or sinecures, or professions that treat people in anything but a dog-eat-dog (and God save the hindmost) manner.

Role of Assessment.

It is important to have the results of a detailed, comprehensive examination of the person's neuropsychological assets and deficits prior to making any decisions about job choices. This information should reveal which broad categories of jobs would likely fall within the scope and capabilities of the individual. The person's current neuropsychological status has important implications, not only for the choice of a job but also for the determination of the modifications that are necessary or desirable if the person with NLD is to have some success in a particular workplace. An analysis of this sort should reveal those dimensions of any particular workplace that are acceptable "as is" and those that should be altered and/or those for which compensatory strategies and aids will be required. But, first the person with NLD has to get the job.

Job Application and Job Interview.

Virtually all jobs require some form of job application and a subsequent job interview. With respect to the application, it is best for the person with NLD to seek assistance, including editing for content and form. As for the interview itself, it is likely that the person with NLD will approach it in an anxious manner (just as most others do). This anxiety is likely to persist throughout the interview, even in the face of attempts by the interviewer to quell it. Bottom line: As with all other situations that are novel (See Question #4), the person with NLD needs to be prepared for the job interview. This might take the form of simulating the interview experience, and suggesting and practicing appropriate modes of behaviour throughout such simulations. Absent this type of detailed preparation, the person with NLD is quite unlikely to be able to demonstrate the skills that he/she has and, worse, may "turn off" the interviewer.

Highly Desirable Features of the Workplace.

A partial listing of these follows:

The workplace should be highly structured. This structuring should take into account the person's neuropsychological status as well as his/her idiosyncratic penchants, proclivities, and propensities.

The person with NLD should have access to a professional familiar with NLD who is prepared to advise him about his present workplace situation, anticipated changes therein, and preparation for any proposed training/education that may be necessary for job success. It would probably be impossible to overestimate the importance of this resource for the adult with NLD.

Changes in job requirements should be introduced gradually. Many breakdowns in the workplace occur because colleagues, supervisors, and others overestimate the capacities of the person with NLD for dealing with changing circumstances, especially when these are rapid and/or unfamiliar/novel (See Question #4). Care needs to be exercised when introducing the person with NLD to novel situations. Without cautious, measured introduction to such situations, there can be very negative consequences for the adult with NLD. Indeed, disastrous consequences can ensue if supervisors overestimate the actual capacities for countenancing change that the adult with NLD has at his avail (See Questions #19 and #33).

It is usually best to arrange for the adult with NLD to work on projects that he can do by himself. Exposure to workplace teams needs to proceed on a very gradual basis, with much attention given to the adult's comfort level. As part of this introduction, it is well to provide others in the workplace with information regarding the pace at which the adult with NLD can proceed without undue anxiety. Although the pace of their work may be rather slow, most adults with NLD really do wish to succeed. Hence, they often stay at work for many hours more than required in order to complete their assignments. This should be encouraged, so long as the adult with NLD perceives his successes as positively reinforcing and the extra time required is not unreasonable.

Additional Considerations.

Persons with NLD tend to be quite gullible. Unscrupulous individuals can easily exploit this. Hence, it is important that the person with NLD not be exposed to such individuals, and that he have clear avenues for seeking assistance and counselling if and when he is subjected to any indignities along these lines.

Inappropriate verbalizations, including rude and disrespectful utterances, are frequent in the repertoire of persons with NLD (See Question #22). These are seldom intended and their implications most often not understood by the person with NLD. Gentle suggestions for more appropriate verbal interactions are far more helpful than are angry denunciations. The former can often be understood by the adult with NLD; the latter, simply make the situation worse by increasing the anxiety that arises from failure to understand the reasons for such retorts. Also, negative outbursts directed to the person with NLD provide no positive guidance that would be useful for future interactions and skill developments.

One dimension that does not distinguish the person with NLD from anyone else is the need for "a shoulder to lean on." The person with NLD usually requires this much more than do normally developing peers. Indeed, the presence of what a colleague of mine was wont to call "a hitching post in the galaxy of life" is a very essential requirement for the person with NLD, whether the crisis that ignites this need is the job or any number of other psychosocial circumstances.

Concluding Remarks.

These observations may sound unduly pessimistic. But, the need to proceed in this fashion is real. Overestimating the capacities of the person with NLD is never a good strategy (See Question # 19). At the same time, underestimating his/her potential for learning to behave adaptively is decidedly unproductive. Skill learning is possible, even probable, for the person with NLD. Failure to provide appropriate learning experiences for necessary skills is the principal problem that we often see as limiting the development of adaptive behaviour in persons with NLD (See Question #21 ). It is common for the person with NLD to arrive on the job with a history of negative experiences of failure across a wide spectrum of circumstances. Continued experiences of failure on the job, with subsequent episodes involving criticism and even ridicule, can be very disheartening and, in turn, encourage a vicious circle of anxiety and gradual worsening of performance. In the long run, only appropriate skill learning would be expected to arrest this process and turn these failures into successes.