Occupational Risk Prevention in People with Autism Spectrum Disorder: A Review of the State of the Art

Abstract

People with Autism Spectrum Disorder (ASD) face significant barriers to accessing and maintaining employment, many of which stem from work environments that fail to accommodate their neurological diversity. This article aims to analyze the occupational risks faced by autistic individuals in the workplace. A total of 39 scientific studies were reviewed, and the results identified nine predominant thematic categories of occupational risks. Particularly prominent were deficient communication, lack of structured support, cognitive overload, and difficulties coping with change. The reported situations were examined in detail, with attention paid to their specific contexts. A clear predominance of psychosocial risks over ergonomic ones was observed. The review also highlights several underexplored yet equally relevant risk factors, such as discontinuity in supported employment programs, difficulties in requesting reasonable accommodations, discrimination, a lack of professional recognition, and the negative effects of digital or remote environments, such as isolation. This study underscores the importance of recognizing unsafe conditions arising from the lack of neurodiversity-informed adjustments as a necessary step toward implementing organizational and social adaptations in the workplace.

1. Introduction

Various authors have contributed to the definition of autism. Autism Spectrum Disorders (ASDs) are characterized by deficits in social interaction and communication, as well as atypical sensory sensitivity and repetitive behavioral patterns [1,2,3]. In addition, a neurodiversity perspective emphasizes the inherent diversity of human neurobiology and the multiple ways in which the brain and mind can develop [4]. In recent years, the number of diagnosed cases of individuals with ASD has increased significantly. This growth is largely attributed to the development of more advanced screening methods, which have enabled more accurate identification of these neurobiological conditions [2].

However, despite advances in diagnosis, unemployment remains a significant issue affecting autistic individuals worldwide. Although many possess valuable skills, it is estimated that approximately 80% of autistic people are unemployed globally [5]. The employment rate for individuals on the autism spectrum is considerably lower than that of other disability groups, including those with other neurodevelopmental conditions [6,7,8], and substantially below the rate observed in the general population [9]. In addition, autistic workers experience disproportionately high levels of job insecurity, underemployment, and unemployment [10] compared to non-disabled workers [2].

In addition to high unemployment, autistic individuals are often employed in positions that do not match their level of professional qualification. It has been reported that overeducation relative to the job performed is common among autistic workers [4,11]. Those who do obtain employment are frequently placed in volunteer roles, part-time positions, low-paid jobs, or roles requiring minimal qualifications [1,5,7,12]. Discrimination becomes more evident when considering that autistic individuals tend to earn less than their peers with comparable qualifications. They also change jobs more frequently and are often employed part-time [1,13]. Compared to peers with other disabilities, autistic employees also earn less [3].

Despite these challenges, numerous studies have demonstrated that autistic individuals possess superior abilities in some areas that can be highly valued in the workplace. Attention to detail is one of the most prominent characteristics among autistic individuals [3,4,9,14,15].

Moreover, it has been emphasized that adults with ASD exhibit many strengths that can enhance job performance, such as logical reasoning, reliability, and focus [9]. It has also been noted that autistic individuals bring strong skills in managing large volumes of data [3]. Additional valuable traits in the workplace have been identified, including logical and mathematical acuity, exceptional computer skills, and photographic memory [16]. Further strengths have been highlighted, such as cleanliness and organizational ability [17].

It has been suggested that implementing workplace accommodations can support autistic individuals in gaining employment and enable employers to benefit from the unique set of skills that these individuals may offer [18]. Many workplaces are not designed to meet the needs of autistic individuals, which can hinder their performance [4]. Despite the clear need for accommodation, in practice, few adjustments are made for individuals with ASD in the workplace. Both autistic and non-autistic employees often report being unaware of any specific accommodations that have been implemented [12].

In this context, when autistic individuals are exposed to work environments that are not designed to meet their specific needs, the risk of incidents, occupational accidents, and reduced employability may increase. Autistic adults of working age experience greater difficulty maintaining long-term employment compared to non-autistic individuals [19]. Although employment is generally considered beneficial, it has also been observed that it can pose challenges related to mental health, anxiety, and other emotional difficulties [3]. Nearly all medical conditions are more prevalent in this population. This increased vulnerability to illness may heighten the risk of workplace incidents and accidents if not adequately addressed.

From a regulatory perspective, the United Nations Convention on the Rights of Persons with Disabilities (2006) establishes, in Article 27, that States must ensure safe and healthy working conditions and adopt reasonable accommodations for persons with disabilities, including those with ASD. Similarly, the International Labour Organization’s guidelines on occupational safety and health management provide a framework for integrating risk prevention at all levels. Although autism is not explicitly mentioned, the inclusion of vulnerable workers or those with specific needs is considered a cross-cutting principle. In line with these frameworks, the 2030 Agenda for Sustainable Development includes, among its Sustainable Development Goals, Goal 8 (Decent work and economic growth) and Goal 10 (Reduced inequalities), both of which promote the labor inclusion of people with disabilities and the adoption of safe working conditions.

Despite regulatory progress around inclusion, the scientific literature indicates that workplaces remain unsafe for people with ASD due to the lack of specific and adapted assessments. This results in potentially hazardous conditions that, in many cases, are not detected nor properly managed by traditional occupational risk prevention systems. At the same time, the tools and methods used in occupational risk prevention practice are predominantly designed for neurotypical populations, which limits their effectiveness in identifying specific risks for this group [20]. Therefore, many relevant risk factors are excluded from general protocols. This disconnects between the needs of individuals with ASD and the available solutions represents a gap at both the scientific and technical levels.

In this context, the general objective of this study is to analyze the occupational risks faced by individuals with ASD in workplace settings. To address this, the following research question is posed: What occupational risks are recurrently addressed in autistic workers, and which ones have received insufficient attention? This article is structured as follows: Section 2 describes the methodology, which is based on the application of the PRISMA method; Section 3 presents the main findings obtained through thematic analysis of the selected studies, identifying the risk factors addressed in the scientific literature; and Section 4 highlights the relevance of these factors for designing inclusive work environments and prevention strategies tailored to neurodiversity.

2. Materials and Methods

This study consisted of a systematic review of the scientific literature, structured according to the PRISMA methodology (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), with the aim of identifying and classifying the risk factors faced by autistic workers. The completed PRISMA checklist is provided as Supplementary Material. To deepen understanding of this topic, the main sources of information were the Scopus, Web of Science, and PubMed databases. The review was carried out between March and June 2025. No time restrictions were applied to the inclusion of studies; all available works identified through the search strategy were considered regardless of their year of publication. The search strategy focused on analyzing the presence in titles of English-language terms related to the fields of occupational risk and autism, using the following search equation: (“Autism” OR “ASD” OR “Developmental Disabilities”) AND (occupational OR workplace OR work) AND (safety OR risk OR health OR hazards). An initial screening of titles and abstracts revealed the limited availability of specialized literature on the topic.

To complement the information, an advanced search was conducted using the following equation: ((TI = ((autis* OR ASD) AND (occupational OR work* OR employment OR adult*) NEAR/2 (safety OR risk* OR support* OR adapt* OR adjustment OR hazard))) NOT TI = (child* OR student OR scholar OR school OR teenager OR learners OR “medical provider” OR boys OR girls OR infant)) NOT AB = (child* OR student OR scholar OR school OR teenager OR learners OR “medical provider” OR boys OR girls OR infant); the syntax and operators were adapted according to each database’s requirements.

Out of a total of 342 documents initially retrieved, 139 were duplicates, resulting in 203 unique articles. Among these, 86 were classified as document types other than scientific articles (e.g., meeting abstracts, awarded grants, theses, books, conference papers), and 2 were not related to the research topic, as they addressed neither autism nor occupational risk. Additionally, 4 records could not be retrieved in full text.

Table 1. Records excluded from this study.

Reason	Exclusion Criteria	Number of Articles Excluded (n)
1	Children and teenager	9
2	Professionals providing support to individuals with ASD	14
3	Etiological factors of ASD in ancestry	2
4	Medical setting	20
5	Mental health	12
6	Social skills in non-workplace settings	10
7	Diagnosis of ASD profile	5

details the exclusion criteria applied to ensure the relevance of the selected studies to the workplace context of individuals with ASD. A total of 72 articles were excluded, distributed across several specific categories.

Nine articles focusing on children and adolescents were excluded, as the scope of this review is the workplace environment, not educational or developmental settings. Additionally, 14 articles were excluded for focusing on professionals who provide support to individuals with ASD and the impact of such work on those professionals. Two articles that examined the etiological factors of autism in family ancestry were also excluded, as they did not provide relevant information on workplace risk management.

Twenty articles addressing medical care for individuals with ASD were excluded, as they did not relate to occupational contexts. Furthermore, 12 articles dealing with psychological support, 10 focused on communication and social skills, and 5 exploring autism diagnosis and assessment were excluded because, while important, these topics were not centered on the workplace environment.

These exclusion criteria ensured that the review focused exclusively on studies providing specific information about the occupational inclusion and health of individuals with ASD, thus enhancing the practical relevance of the findings. In total, 39 bibliographic records were selected for inclusion in the review (Figure 1).

Studies were selected that addressed the work experiences of individuals with ASD, both in conventional workplaces and in supported employment programs. Due to the heterogeneity of the material analyzed where risk factors were not always explicitly formulated as such these, hazardous situations were inferred through close reading and detailed analysis of the content provided in studies offering empirical evidence on the working conditions of this population. Although occupational risk assessment was not the primary focus of the reviewed studies, the qualitative descriptions included were analyzed, and in the absence of terminology directly referring to occupational risks, similar terms such as challenges, difficulties, problems, and barriers were identified as potential occupational risk factors.

Risk factors were manually extracted and classified through thematic content analysis. Using a coding process, the data were grouped into common thematic categories. These categories included: harassment, communication, changes or routines, cognitive load, social isolation, lack of support, sensory overload, person–job mismatch and dysregulated behaviors. This approach enabled the identification of both the most frequently reported risk factors and those less explored in the literature, serving as a basis for preventive recommendations.

Risk sources were distinguished according to whether they originated from the physical or organizational characteristics of the work environment, the structure of employment support, the use of digital or remote settings, or the absence of reasonable accommodations. Additionally, risk factors were classified by their psychosocial or ergonomic nature, and the frequency of each type was analyzed across the reviewed studies.

3. Results

This section analyzes the studies included in the review with the aim of identifying the occupational risk factors faced by individuals with Autism Spectrum Disorder in the workplace. These factors are described from diverse perspectives across the selected studies. For better systematization, the analysis is organized into thematic subcategories. Among others, it examines risks associated with the role of job coaches and supported employment programs (understood as a form of assistance aimed at helping people with disabilities obtain and maintain paid employment by providing guidance and on-site support [22,23]), challenges in digital or technology-mediated environments, and emerging issues related to requesting reasonable accommodations. This approach facilitates an understanding of the range of conditions that may affect the safety of autistic individuals.

In some of the studies included in the review, no hazardous situations in the workplace were identified [8,9,11,13,16,24,25,26,27,28,29,30]. Among the studies that did report such conditions, the number of hazardous situations varied considerably, with an average of approximately eight situations per article.

3.1. Identification of Occupational Risk Factors in Autistic Individuals in Conventional and Supported Work Environments

A significant portion of the studies analyzed focus on experiences within supported employment. While primarily aimed at evaluating the implementation and outcomes of such programs, many of these studies also provide insight into occupational risk factors present in regular workplace environments where autistic individuals are placed. In addition, the review included studies that describe employment experiences in conventional settings without specialized support.

In the study by Hedlund and Jordal [19], conducted with nurses diagnosed with autism and/or ADHD, three key psychosocial risk factors were identified using the COPSOQ III (Copenhagen Psychosocial Questionnaire, version III): high quantitative demands (refer to workload situations characterized by uneven distribution of tasks, difficulties in completing assigned duties, and falling behind in work), low sense of social community at work, and lack of support from supervisors.

Schwartz and Rogers [17], for their part, explored the employment experiences of young adults with developmental disabilities, including individuals with ASD, through interviews and focus groups with support professionals. The study identified several frequent psychosocial risk factors, such as sensory overload, difficulty transitioning between tasks, the need to multitask across different duties, and anxiety when asking for help. Support professionals also highlighted challenges related to difficulties in following workplace social norms and understanding interpersonal boundaries.

Petty, Eccles et al. [12] conducted a survey in the United Kingdom to explore perceived workplace difficulties among both autistic and non-autistic employees. Ambient noise was the only risk factor that generated consensus between the two groups. However, from the perspective of autistic employees, several additional risk factors were identified: the absence of adequate spaces for taking breaks, limited social support leading to negative judgments from colleagues, communicative differences, frequent misunderstandings, difficulty attending large meetings, lack of concentration during lengthy discussions, challenges speaking concisely, ambiguity in written information, and difficulties adapting to unexpected changes. Non-autistic employees, on the other hand, highlighted their autistic coworkers’ resistance to changes in routine or task assignments as a source of workplace conflict.

Another relevant contribution comes from the study by Taylor et al. [31], which explored the reasons for unemployment among adults with ASD. The autistic participants themselves identified several occupational risk factors, including workplace discrimination, environment-specific challenges related to their condition, and the perception that the work environment would be too demanding factors that directly influenced their decision not to seek or maintain employment.

In the Swedish context, Bertilsdotter Rosqvist et al. [4] analyzed the experiences of autistic young adults in vocational programs, highlighting risk factors such as excessively high work pace, deadline pressure, lack of control over workload, and the absence of structured and coordinated support from supervisors. Additionally, the study documented experiences of stigma, discrimination, lack of understanding of neurodivergence, disconnect between personal interests and assigned tasks, and rigid scheduling. The authors emphasized that individualized support must be complemented by workplace adaptations.

Along similar lines, Brighenti et al. [1], drawing on previous studies, identified barriers related to social communication skills in autistic individuals, such as difficulties initiating conversations, expressing needs, or interpreting facial expressions. Complementing this, Rampton et al. [7] reported additional risk factors including difficulty adjusting to new work routines, managers’ lack of preparedness to provide accommodations, and unclear job expectations, all of which limit the possibility of adequate performance.

Di Francesco et al. [32] identified workplace barriers that included lack of employer support, difficulties understanding autistic individuals, negative biases, and lack of awareness among coworkers.

In the study by Hedley et al. [5], autistic participants in a specialized employment program reported that insufficient training during the onboarding process led to feelings of unpreparedness and frustration, and that the training provided did not match their specific needs. The lack of autism awareness among coworkers and managers was also identified as a factor negatively affecting their work experience. The study discussion also referenced previous research findings that highlight common workplace challenges such as difficulties understanding figurative language, social communication, acquiring new skills, and adapting to new routines.

In the Project SEARCH program implemented in the United Kingdom, Romualdez et al. [33] documented risk factors emerging during job internships. The supported internship program involved interns with developmental and learning conditions, including autism, Down syndrome, specific language impairment, and intellectual disabilities. Interns reported difficulties with social interaction, challenges in understanding customers, and pressure or shouting from them, as well as unfamiliarity with basic workplace norms. Job coaches also pointed to obstacles such as ineffective communication, problematic relationships with managers, underestimation of abilities due to prejudice from some managers and colleagues who underestimated the abilities of the interns, lack of institutional support, and widespread misinformation about autism among coworkers and the broader work environment.

In the information technology sector, Nicholas and Lau [3] identified major barriers such as stereotypes and inaccurate assumptions about autistic individuals, both in the workplace and in broader society. These factors contribute to a hostile environment, limiting active participation, access to support, and opportunities for professional development.

Baker-Ericzen et al. [34] evaluated a vocational program focused on strengthening cognitive and social skills, and identified limitations in attention, working memory, planning, problem-solving, cognitive flexibility, and social competence as key barriers to employment inclusion. The study emphasized that, in the absence of adequate support, these challenges can negatively impact both job acquisition and retention.

Similarly, Hillier et al. [35], through observations and interviews with autistic adults in a vocational program, documented several risk factors: difficulties forming professional relationships, exclusion from social events, inability to understand abstract concepts, taking on tasks without recognition, being blamed for others’ mistakes, and challenges in forming friendships. Inappropriate behaviors were also reported, including constant interruptions, inappropriate comments, difficulty understanding one’s role, and practical difficulties such as lateness, poor break management, difficulty accepting criticism, and crossing personal boundaries with colleagues. Employers also noted low initiative in seeking help and limited participation in social activities.

Using a longitudinal approach, Howlin et al. [36] evaluated the NAS Prospects program and identified numerous risks reported by autistic participants, including serious workplace bullying, insomnia, depression, and difficulties establishing social connections. Managers acknowledged their lack of prior training on autism, which initially posed a barrier to inclusion—although the training and support provided by the program helped address this issue. Program staff also noted structural limitations such as the constant support required from employers and persistent difficulties understanding autism. Recurrent challenges among autistic workers included problems with organization, time management, communication, low productivity, inappropriate social behavior, and resistance to change.

Finally, Mawhood and Howlin [37], in their study on a supported employment project for adults with high-functioning autism or Asperger’s syndrome, documented various problematic working conditions. Practical difficulties included role ambiguity, work overload, social misunderstandings, lack of respect for personal space, and absence of timely feedback. Additional individual challenges were reported, such as speaking excessively or too little, excessive dependence on supervisors, tardiness, anxiety, slow task performance, rigidity in routines, and inappropriate personal habits or attire, all of which interfered with workplace adaptation.

Table 2. Occupational risk factors identified in conventional and supported work settings.

Study	Associated Risk Factors
[1,5,12,17,33,35,36,37]	Communication difficulties: Misunderstandings, difficulty with non-literal language, lack of concise communication, problems expressing needs, verbal/non-verbal issues.
[4,5,7,12,19,32,33,34,36,37]	Lack of support: Low supervisor and peer support, lack of autism awareness, insufficient institutional mechanisms.
[4,17,19,31,37]	Workload and pressure: High quantitative demands, deadline pressure, excessive pace, lack of control, inflexible scheduling.
[3,4,12,31,32,33,35,36]	Discrimination and stigma: Hostile environments, negative judgment, stigma, underestimation of abilities, unfair blame, workplace bullying.
[5,7,12,17,35,36,37]	Difficulty with routines: Trouble adapting to new routines, resistance to change, rigid behaviors.
[12,17,34,35,36,37]	Cognitive challenges: Issues with attention, memory, planning, problem-solving, cognitive flexibility.
[1,5,12,17,33,35,36,37]	Social interaction issues: Poor teamwork, social exclusion, inappropriate social behavior, misunderstanding of norms.
[12,17]	Sensory/environmental stress: Noise, bright lights, lack of rest areas, poor cleanliness, sensory overload.
[4,5,7,33,35]	Training/job mismatch: Unclear job expectations, insufficient onboarding, mismatch between tasks and interests, low recognition.

summarizes the occupational risk factors identified in the studies analyzed in this section.

3.1.1. Challenges Arising from Supported Employment Programs and Their Professionals

In addition to the challenges faced by autistic individuals in regular workplace environments, several of the reviewed studies highlight that supported employment programs and their professional teams can themselves become a significant source of occupational risk when organizational or methodological limitations are present.

The study by Dachez et al. [6], which focused on the experiences of autistic individuals in supported employment programs in France, identified a series of difficulties related to the role of job coaches, which acted as risk factors for both inclusion and job stability. The study was conducted with 19 autistic participants, 12 women and 7 men, aged between 20 and 54 years, all with a formal diagnosis. Among the most critical problems reported by participants were poor communication with coaches, lack of active listening, and limited ability to adapt to individual needs. Some participants described situations where coaches acted against their will, for example, contacting the employer directly or disclosing confidential information.

Autistic participants reported feeling overwhelmed by having to repeatedly explain their needs to new professionals and the lack of specific training on the autism spectrum among job coaches. This often-forced autistic workers themselves to educate their coaches about their difficulties, such as disorganization or mental overload. Some participants reported being asked to carry out tasks they found particularly challenging—such as making phone calls to companies—and feeling that their abilities were underestimated or that coaches overstepped by interfering in personal matters.

High turnover among coaches was also identified as a problematic issue, as it created a constant need for readjustment. Participants reported a lack of communication between outgoing and incoming professionals, which forced employees to restart the process from scratch each time a change occurred. Finally, work overload, poor coordination, and limited resources within support teams were cited as factors compromising the quality of assistance provided.

One of the most critical difficulties in supported employment programs is the lack of alignment between the individual characteristics of autistic workers and the tasks they are assigned, which generates multiple occupational risks related to person–job mismatch. As Nouf-Latif et al. [38] point out, each autistic individual has unique motivations, aspirations, and abilities that should be considered before implementing support measures. However, this individualized recognition is often ignored by standardized practices that assign tasks that are either insignificant or poorly matched to the autistic person’s profile. In that study, several autistic participants reported being placed in low-skilled roles that did not reflect their capabilities or interests. One participant described her experience as a “fake job,” noting that the tasks were neither meaningful nor appropriate for her skill level. Another expressed that holding a position with no real value led to feelings of uselessness, loss of motivation, and a diminished sense of purpose at work.

The study highlights that job coaches’ lack of understanding of the diversity within the autism spectrum contributes to the underestimation of workers’ capabilities and the implementation of poorly tailored support strategies. As also noted by Scott et al. [39], employment support services tend to apply generalized approaches that fail to account for the range of profiles and needs that exist within the spectrum.

These mismatches not only affect emotional well-being but also prevent autistic individuals from realizing their potential and achieving a sense of professional self-fulfillment. According to Nouf-Latif et al. [38], labor support policies are often designed using a one-size-fits-all approach that disregards the individual aspirations of autistic people, creating constant tension between autistic workers’ personal expectations and the rigidity of program structures.

This conflict is also addressed by Howlin et al. [36], who document how staff in a supported employment program faced ethical and operational dilemmas when pressured to place autistic participants quickly into any available position, even when such roles did not align with their interests or potential. In these cases, programs prioritized institutional demands over the well-being and goals of autistic participants, perpetuating a structural mismatch that undermines the very purpose of supported employment. Such practices, although not always intentional, verge on capacity-based workplace discrimination. Denying opportunities to demonstrate skills, assigning menial tasks, omitting paths for growth, or excluding autistic participants from relevant projects forms a subtle yet persistent pattern of occupational exclusion.

Among the risk factors identified in Nouf-Latif et al. [38] are: feelings of dispensability, a perception of meaningless work, assignment to tasks misaligned with abilities, lack of opportunities for professional development, and the presence of discouraging institutional practices. Some autistic participants even reported feeling economically exploited, as they were asked to perform skilled tasks without receiving fair compensation.

The study by Nicholas and Lau [3], focused on the influence of employment support on the experiences of autistic employees in the technology sector, reported both positive aspects and significant challenges in the provision of such support. Among the difficulties identified by autistic participants were interruptions in support services during periods of unemployment, which led to loss of motivation and a sense of institutional abandonment.

In a complementary line, Nicholas et al. [40] evaluated the functioning of a supported employment agency dedicated to the labor integration of individuals with ASD. Reported risks included the lack of ongoing workplace support, which resulted in job loss and worker demoralization. Autistic participants reported difficulties taking on more complex roles, such as supervisory positions, as well as sensory challenges, difficulties in social interaction, and a work environment marked by negative attitudes—including bullying, gossip, prolonged unnecessary conversations, inadequate supervision, overstimulating workspaces, lack of inter-institutional collaboration, and non-consensual disclosure of diagnoses, which led to dis-criminatory treatment.

Similarly, the study by Howlin et al. [36], which assessed the NAS Prospects supported employment program, documented several hazardous situations linked to structural limitations within the support system. Interviews with managers revealed risks such as the use of replacement advisors, which caused disruptions in support continuity, and difficulties reaching support staff during critical moments. Some support workers were unfamiliar with the specific requirements of job roles, hindering effective guidance, and personalized assistance was sometimes insufficient due to limited staff availability. The lack of coverage during the staff sick leave was also identified as a vulnerability.

Program staff acknowledged failures in collaboration with external institutions, often attributed to a lack of understanding about autism and the program’s role. Conflicts also arose when autistic individuals were placed in jobs that did not match their aspirations, prioritizing operational efficiency over personal goals. Additional structural issues reported by staff included administrative overload, lack of resources, limited career mobility, time constraints, and funding limitations.

The study by Petty, Tunstall et al. [15] explores the perceived barriers reported by employees and employers that hinder the implementation of reasonable accommodations in the workplace, including several conditions that directly affect autistic individuals. Among the main identified risk factors are rigid or chaotic workplace structures that prevent the personalization of environments; the inability to reduce adverse sensory stimuli due to noisy, busy physical spaces; and the lack of resources to implement accommodations, stemming from concerns about limited time, budget, and materials. Additionally, staff overload was identified as a further barrier, limiting the capacity to provide sustained and individualized support to workers with ASD.

Table 3. Occupational risk factors emerging directly from supported employment programs and their professionals.

Study	Occupational Risk Factors Identified
[6,15,36,38,40]	Lack of individualized support: Programs poorly adapted to personal needs; absence of tailored accommodations; tasks misaligned with capabilities or goals; ineffective guidance; rigid support systems.
[3,6,15,36,40]	Institutional and inter-agency failures: Poor collaboration between entities; administrative overload; lack of resources or time; discontinuity of support during unemployment.
[6,36,38]	Insufficient staff training: Lack of autism-specific training for job coaches or support staff; unawareness of job-specific demands; underestimation of capabilities.
[6,36,40]	Communication problems: Poor communication with job coaches; lack of active listening; prolonged unnecessary conversations; difficulty contacting support during critical moments.
[3,6,38,40]	Emotional and motivational impact: Job loss; demotivation; fatigue from repeatedly explaining needs; sense of institutional abandonment; perception of work as meaningless or exploitative.
[6,40]	Privacy and autonomy: Non-consensual disclosure of diagnosis or personal information; interference in private matters.
[6,15,36,40]	Instability of support staff: High staff turnover; understaffing; lack of continuity in support.
[15,40]	Environmental and sensory issues: Chaotic or overstimulating work environments; inability to reduce sensory input; lack of physical or material resources to adapt the workplace.

summarizes the occupational risk factors identified in the studies analyzed in this section. Taken together, these studies suggest that many of the risks faced by autistic individuals in supported employment settings do not stem from their individual characteristics, but rather from organizational decisions, programmatic rigidity, and institutional unawareness of the diversity within the autism spectrum.

3.1.2. Difficulties in the Context of Requesting Workplace Accommodations

This section analyzes the occupational risks that may arise when autistic individuals request reasonable accommodation in the workplace. These risks, although often invisible, can result in exposure to unfair conditions.

The study by Davies et al. [18] examines the barriers faced by autistic individuals when requesting workplace accommodations. Many autistic employees reported difficulties expressing their needs to employers, which constitutes a direct risk associated with social communication challenges.

The study also warns of the stigmatization that may be associated with requesting accommodation, as well as the fear of being perceived as problematic by colleagues or supervisors, factors that may discourage individuals from voicing genuine needs.

Complementing this, Rampton et al. [7] emphasize that job satisfaction among autistic individuals depends, among other factors, on the implementation of accommodations and supports in a way that is sensitive and avoids creating uncomfortable visibility or negative reactions among co-workers.

The study by Dachez et al. [6] documents various experiences of autistic individuals related to requesting accommodations in the workplace, identifying risks associated both with the lack of effective support from job coaches and with the complexity of the procedures involved in managing these requests. Among the most significant difficulties reported was the lack of knowledge about the official channels for submitting accommodation requests. These barriers can result in occupational burnout, especially when the employee is left to manage their needs independently without adequate support.

Similarly, Rampton et al. [7] emphasize that the acceptance and proper implementation of workplace accommodations by managers largely depends on their level of training and the support they receive from the organization. The study shows that managers who do not feel sufficiently prepared or supported tend to perceive accommodation as less justified, which may lead to a reduced willingness to implement them.

Table 4. Occupational risk factors that may emerge when requesting workplace accommodations.

Study	Occupational Risk Factors Identified
[18]	Difficulty expressing needs to employers, communication barriers, lack of support, hostile work environment, fear of stigmatization, perception of being problematic.
[7]	Discomfort due to the visibility of accommodations, negatively impacting workplace integration, reduced willingness to implement adjustments.
[6]	Lack of support from job coaches, complex procedures for requesting accommodation, lack of knowledge about official channels, uncertainty, managing needs individually without support.

provides a summary of the occupational risk factors that may emerge when the process of requesting and implementing reasonable accommodation is not managed appropriately.

3.1.3. Occupational Risk Factors Associated with Digital or Technology-Mediated Work Environments

The digitalization of the workplace has opened new possibilities for the inclusion of individuals with ASD, whether through remote work, electronic communication tools, or technological interventions such as virtual reality simulators. However, according to the evidence from the reviewed studies, these environments can also pose specific occupational risks that need to be identified and addressed through preventive measures.

The study by Tomczak et al. [41] analyzes the benefits and challenges of teleworking for individuals with ASD, highlighting both its advantages and the new occupational risks that may emerge in such settings. Many participants reported a preference for remote work, as it allows them to avoid common risk factors in traditional office environments, such as sensory overload (auditory, visual, or olfactory), rigid schedules, and intense or forced interpersonal interactions. Teleworking eliminates small talk, large meetings, prolonged activities, and the obligation to engage in informal conversations.

Nevertheless, the study also warns of several specific challenges associated with this modality. Identified risks include reduced access to desired social interactions, limited peer learning opportunities, and difficulty participating in electronic communications, such as using webcams or joining video calls. Some autistic individuals also encountered barriers in answering phone calls, reporting emerging issues, or requesting assistance during the workday. Another significant risk was the difficulty in setting task priorities and maintaining a clear boundary between work and personal life, particularly in loosely structured schedules. This situation can lead to excessive dedication to work, potentially resulting in long-term negative effects on mental health.

The study by Tomczak et al. [2] explores how to improve communication processes throughout the employment cycle of individuals with ASD, identifying intense verbal contact as a major source of difficulty. As an alternative, the authors propose using indirect, electronically mediated communication, recommending tools such as email, instant messaging, chatbots, online communicators, or digital platforms—which could help reduce the stress associated with direct interactions. They also suggest organizing meetings in small groups and combining face to face and virtual formats to enhance the communicative experience.

However, the study does not delve into the potential risks that may arise from intensive use of digital tools in remote work settings. While it focuses on the potential benefits of technological mediation, it does not address problems stemming from electronic communication itself, such as the overuse of emails or chatbots, difficulties in conveying nuances, interpreting ambiguous responses, or dealing with technical interruptions.

On the other hand, in the study by Tomczak et al. [2], both in their introduction and in the section on employment retention, the authors mention several problematic situations in face-to-face contexts. These include the need for clear instructions and difficulties in social communication with supervisors and co-workers. Specific problems, such as difficulty interpreting social norms, recognizing facial expressions or tone of voice, expressing affection, asking questions appropriately, and understanding implied meanings, were reported in previous research [42,43,44].

The study by Petty, Tunstall et al. [15] analyzes the effects of teleworking during the COVID-19 pandemic in the United Kingdom, reporting a mixed impact on autistic individuals. On the one hand, several neurotypical participants noted that this modality allowed some employees with ASD to better regulate their environment, which helped reduce exposure to sensory stimuli and limit unwanted social interactions, enhancing concentration and promoting a general sense of relaxation.

However, the study also identifies a series of emerging risks associated with remote work. These include social isolation, difficulties in maintaining effective communication through digital means, and lack of structure. In addition, it is noted that many autistic individuals may require additional support in remote settings, as they do not always feel comfortable expressing their needs or requesting assistance.

The descriptive study by Bisher [45] examines the use of digital technologies to facilitate remote work for individuals with autism in the telecommunications sector in Jordan. It reports high levels of participation in telework among individuals with ASD and identifies a positive correlation between the use of technology and work performance effectiveness. The study emphasizes the perceived benefits of teleworking and offers general recommendations for its improvement, such as the need for adequate technological infrastructure and continuous training programs. However, the study does not explore the potential risks associated with remote work for this population.

Amat et al. [14] evaluate the virtual reality simulator VIRCAS, a technological tool designed to enhance teamwork skills in both autistic and neurotypical individuals. The use of this virtual environment aims to mitigate challenges related to social communication, integration into group dynamics, and the need to adapt to typically neurotypical interaction codes. While such interventions may help reduce certain occupational risks, it is important not to overlook the challenges that can arise from the use of assistive technologies.

During the initial phases of the study, participants reported cognitive overload due to the complexity of the virtual tasks and the difficulty in interpreting objects and required actions within the simulated environment. Some expressed uncertainty about what actions to take, highlighting the need for more intuitive interfaces. The report also mentions technical issues and difficulties with unfamiliar devices such as haptic tools, which can become barriers if not accompanied by adequate support. Moreover, the intensive use of virtual environments could reduce opportunities to develop face-to-face social skills, posing a risk of technological dependency if not balanced with real-world interaction contexts.

Table 5. Risk factors mitigated through remote work and digital technologies.

Study	Occupational Risk Factors Identified
[41]	Reduction in sensory overload (noise, lighting, smells); flexible scheduling; reduced exposure to forced social interactions; elimination of informal conversations and multi-person meetings; increased autonomy to structure the workday and avoid prolonged activities.
[2]	Reduction in stress associated with direct verbal communication using written channels (emails, messaging, platforms); improved communication experience through small meetings and virtual environments.
[15]	Reduction in adverse sensory stimuli in the physical environment; decreased exposure to unwanted social interactions; improved concentration and a greater sense of relaxation while working.
[14]	Mitigation of social communication difficulties, facilitation of team integration, and reduction in barriers associated with neurotypical social codes through controlled virtual environments.

summarizes how digital solutions can help mitigate occupational risk factors in in-person work environments for individuals with ASD.

Table 6. Risk factors present in digital or technology-mediated environments.

Study	Occupational Risk Factors Identified
[41]	Reduction in desired social interactions; limited opportunities for peer learning; difficulties with electronic communication (videocalls, emails, phone calls); challenges in seeking help during emerging issues; difficulty in setting priorities; lack of separation between work and personal life; risk of work overload.
[15]	Social isolation; difficulty with digital communication; lack of structure; prolonged uncertainty; need for additional support to express needs or request help.
[14]	Cognitive overload due to the complexity of the virtual environment; difficulty interpreting tasks; uncertainty about required actions; technical issues and problems with haptic devices.

summarizes the risk factors identified in technology-mediated work environments. Overall, the studies show that these environments require specific risk assessments. For digital settings to become facilitators of inclusion, it is essential to consider not only the opportunities they offer but also the challenges they present.

3.1.4. Challenging Behaviors in Non-Adaptive Work Environments

In the case of individuals with ASD, certain neurological characteristics or behaviors associated with the condition can lead to hazardous situations if the work environment is not properly adapted.

One of the most relevant studies in this area is that of Schall [10], which focuses on the application of positive behavioral supports in the workplace. The study identifies a series of problematic behaviors in an employee with ASD that emerged in response to inadequately adapted working conditions. These behaviors included making loud noises that were uncomfortable for customers and staff, pushing others when feeling upset, speaking loudly at inappropriate times, repeatedly taking out the trash after checking the bins, and insisting on maintaining a strict routine. The functional analysis conducted by the team revealed that these behaviors were triggered by situations such as making mistakes or receiving corrections. This insight made it possible to adjust tasks and support systems to prevent incidents and enhance workplace inclusion.

In a complementary study, Ham et al. [46] present two cases of young adults with ASD enrolled in supported employment programs, in which behavioral interventions were implemented to address various challenging behaviors in the workplace. In the first case, reported difficulties included failure to follow instructions, refusal to work or adhere to the schedule, asking for help unnecessarily, refusing to move or speak, claiming to have completed incomplete tasks, resistance to routine changes and task transitions, ignoring corrections, perseverating on preferred tasks, taking excessively long lunch breaks, and disruptive behaviors such as crying, shouting, and throwing objects. In the second case, the participant exhibited agitation, verbal refusal to follow instructions, walking away, making comments about cartoons, jumping and rapid rocking, as well as physically aggressive behaviors such as throwing medication on the floor, punching, tearing papers, and rocking toward others. To address these challenges, intervention plans and staff training were implemented, resulting in a significant reduction in problematic behaviors and sustained employment.

Similarly, Wehman and Kregel [22] document two cases of individuals with autism and severe intellectual disability who participated in a supported employment program. Among the challenging behaviors observed were failure to respond to the supervisor, a tendency to take lunch and breaks outside of scheduled times, lack of attention to assigned tasks, making inappropriate noises, and having an appearance deemed unacceptable by workplace standards. Following the implementation of intensive supports and intervention strategies, improvements were noted in both participants’ work and social behavior.

Table 7. Challenging behaviors in non-adaptive work environments.

Study	Challenging Behaviors
[10]	Loud noises, pushing, speaking loudly, compulsive checking of containers, insistence on rigid routines; triggered by mistakes or corrections at work.
[46]	Refusal to follow instructions, resistance to schedules, excessive and unnecessary help-seeking, refusal to move or speak, resistance to routine changes, insistence on preferred tasks, ignoring corrections, crying, shouting, throwing objects, agitation, walking away, inappropriate comments, repetitive movements, aggressive behaviors (hitting, throwing objects, tearing papers, and rocking toward others).
[22]	Lack of response to the supervisor, unscheduled breaks, inattention, inappropriate noises, appearance not aligned with workplace standards.

summarizes behaviors that may initially appear disruptive but are, in fact, responses to non-adaptive work environments. Collectively, these studies highlight the potential of autistic individuals to succeed in the workplace when provided with appropriate training and the necessary resources.

3.2. Classification of Occupational Risks in Individuals with Autism Spectrum Disorder

The risk factors identified in the studies were classified into nine thematic categories, ensuring that all cases could be included within one or more of these categories. In total, 215 risk situations were identified: (1) harassment, including aggression, and discrimination; (2) communication, encompassing difficulties in expressing oneself and understanding others; (3) changes or routine, related to disruptions in routines and lack of predictability; (4) cognitive load, involving excessive mental demands; (5) social isolation, referring to exclusion and lack of social connections; (6) lack of support, where the environment fails to provide necessary resources; (7) sensory overload, including noisy and visually overstimulating environments; (8) person–job mismatch, where tasks are not aligned with the individual’s profile; and (9) dysregulated behaviors, stemming from impulsive or aggressive actions.

Figure 2 shows the frequency of inclusion of risk factors according to thematic categories. Each of these categories represents a set of factors that can significantly impact the well-being of autistic individuals. Of the total 215 risk factors identified, some were included in more than one thematic classification due to their content. The most frequent categories are communication and lack of support, with 27.18% and 13.94% of occurrences, respectively. Cognitive load also emerges as a critical factor (11.50%), indicating that excessive mental demands can be a significant challenge, along with changes or routine, which account for 11.15% of the cases.

Table 8. Classification of psychosocial risk factors by thematic categories.

Primary Risk	Secondary Risk	Associated Factors
Harassment	Discrimination	Social stigma; negative judgment from colleagues; underestimation due to stereotypes; incorrect assumptions about abilities.
	Interpersonal hostility	Gossip; unfair blame; lack of respect for personal space; negative social attitudes.
	Conflicts	Bullying; interpersonal conflicts; verbal aggression (including from customers).
	Adverse work environment	Unsustainable environment; lack of measures against harassment.
Communication	Difficulties in expressing and understanding needs	Difficulties requesting help; problems expressing needs and being heard; burden of having to explain needs to new interlocutors; verbal and nonverbal communication challenges; difficulty speaking concisely; lack of understanding of workplace rules.
	Interpersonal communication problems	Communication problems with coworkers, supervisors, job coaches, or managers; misunderstandings and difficulties in social interactions; lack of teamwork skills; difficulties related to intensive interpersonal contact.
	Lack of understanding of language and social cues	Problems interpreting non-literal communication (sarcasm, humor, metaphors); issues interpreting ambiguous information; difficulty interpreting facial expressions and tone of voice; trouble understanding customers.
	Atypical communicative behaviors	Inappropriate behaviors in social communication (excessive questioning, interruptions, inappropriate statements, not knowing when to ask questions); physically aggressive or agitated behavior resulting from communication frustration; refusal to follow any supervisor instructions.
	Deficits in emotional interaction	Problems maintaining small talk and excessive trivial conversations; difficulties understanding affection.
Changes or routine	Difficulty with changes and transitions	Difficulties with task switching and transitions; challenges adapting to unexpected changes, new work routines, and new roles.
	Preference for routine	Inflexible work environment; insistence on maintaining preferred routines; perseveration on preferred tasks; rigidity.
	Problems with time management	Problems with punctuality and time management; difficulties completing daily schedules; issues with break times.
	Workplace adaptation challenges	Difficulty starting from scratch with a new job coach; challenges separating work and home life.
Social isolation	Lack of integration	Low sense of social belonging; reduced or lack of informal social interactions; exclusion from social events.
	Difficulties establishing relationships	Difficulty socializing and making friends; lack of understanding from coworkers and managers.
	Social barriers	Difficulties following social norms; difficulties understanding social boundaries; lack of adaptation to neurotypical standards; issues with social perception.
	Personal appearance	Problems with personal habits, clothing, and socially unacceptable appearance that cause rejection or social prejudice.
Lack of support	Insufficient support from the work environment	Low social support from managers and coworkers; insufficient training, knowledge, and understanding of autism among job coaches, supervisors, and peers; lack of time, resources, and coordination in workplace support; inadequate accommodations and lack of structured coordination; challenging work environment; lack of work preparation and work ethic; difficulty seeing the broader role perspective; lack of clarity in responsibilities.
	Limitations in professional development	High turnover and detachment from employment support; limited professional growth due to inflexibility; work environments that restrict professional advancement; training that is insufficient or poorly aligned with individual needs; challenges in remote training and skill acquisition.
	Workload burden	Educational burden of having to explain needs to new interlocutors; support teams with excessive workloads.
	Supervisory deficiencies	Lack of supervision; job coach disconnected from the workplace; lack of feedback and clear instructions.
Dysregulated behaviors	Challenging behavior	Refusal to follow instructions; inappropriate, socially immature, or challenging behaviors.
	Agitated behaviors	Physically aggressive or agitated behavior; throwing objects or materials; expressing frustration through disruptive behaviors (crying, shouting, swearing).
	Repetitive behaviors	Repetitive or self-stimulatory behaviors (rocking, swaying); making disturbing or inappropriate noises.

and

Table 9. Classification of ergonomic risks factors by thematic categories.

Primary Risk	Secondary Risk	Associated Factors
Cognitive load	Work position with excessive cognitive demands	High quantitative demands in work tasks; working under time pressure; problems with concentration and sustained attention caused by interruptions; difficulties interpreting and processing complex information due to poorly structured tasks; difficulty learning and performing new tasks due to lack of time; working memory issues due to excessive information load; prolonged activities.
	Executive functioning difficulties	Problems with cognitive flexibility, planning, and problem-solving; constant need for prompts and corrections due to lack of adaptations such as checklists and feedback; slowness in task execution caused by unrealistic time frames.
	Digital challenges	Challenges in managing non-intuitive digital tools; limited knowledge for operating complex digital platforms.
	Complex role demands	Difficulties in supervisory roles; problems managing multiple tasks simultaneously.
Sensory overload	Loud noises and intense stimuli	Exposure to noisy environments and intense sensory stimuli (auditory, olfactory, visual).
	Inadequate lighting	Lack or excess of lighting in the workplace.
	Lack of regulation spaces	Absence of appropriate spaces for sensory breaks.
	Overstimulating environments	Open spaces with excessive distractions; large meetings that hinder concentration; distractions due to lack of cleanliness.
Person–job mismatch	Mismatch between tasks and skills	Tasks not aligned with personal skills and competencies; inability to meet job demands; high workload disproportionate to the worker’s capacity.
	Insufficient recognition	Frequent assignment of tasks without proper recognition or compensation.
	Low autonomy	Low autonomy in task execution.

present the structured classification of the 215 identified risk factors according to psychosocial and ergonomic approaches, respectively. This organization was carried out by grouping related expressions, removing redundancies, and consolidating different wording with similar meanings found across the studies. The result is a representation of occupational risks for individuals with ASD, organized by primary risk, secondary risk, and associated risk factors.

The categorizations facilitated the analysis of the predominant preventive approaches in the literature. Interpretation of Figure 3 reveals a clear predominance of psychosocial risks, accounting for 76.66% of all 215 identified factors. Among the most frequent factors are a low sense of social belonging, limited social support from supervisors, lack of autism-related knowledge among coworkers, supervisors, and job coaches, and difficulties switching between tasks. On the other hand, although to a lesser extent, ergonomic factors were also reported, accounting for 23.34%. Among these, cognitive factors were the most represented, indicating that mental demands are among the main challenges, especially when linked to multiple tasks that are overly varied or difficult to complete without adequate support. It was also observed that physical and environmental ergonomic risks were the least addressed areas (sensory overload was not among the most discussed categories).

The classification based on the occupational risk prevention approach shows that most research in the field of autism and employment focuses on addressing psychosocial factors, placing ergonomic approaches in the background.

The predominance of psychosocial risks in the reviewed studies can be explained by the inherent characteristics of ASD, such as difficulties in social communication, cognitive rigidity and social barriers. These traits make individuals particularly vulnerable to adverse social environments, which can have a direct impact on their mental health and emotional well-being. As a result, many studies have prioritized the analysis of psychosocial distress in the workplace.

On the other hand, it could be argued that there are barriers to identifying physical or environmental risks in this population. Unlike psychosocial risks, which are often explored through interviews or experiential narratives, ergonomic risks may require specific measurement and observation tools that are often not adapted for autistic individuals.

Focusing solely on psychosocial aspects without further exploring the redesign of the physical and environmental workplace contributes to placing the responsibility on the autistic individual to adapt, rather than transforming the work environment to make it accessible.

4. Discussion

The analysis of the reviewed studies allows the identification of a series of occupational risk factors that recurrently affect autistic individuals in the workplace. Although the approaches and contexts of the studies vary, commonalities among authors can be identified. The classification of occupational risks is synthesized in Figure 4, which serves as a conceptual framework for the discussion of the main findings.

One of the most widely documented factors is the lack of structured support from the work environment, which manifests in a wide range of hazardous situations such as the absence of coordinated managerial support, insufficient specialized training, a lack of clarity regarding job roles or expectations, and the absence of reasonable accommodations [4,5,6,7,18,33,35,37,40,41]. For example, Bertilsdotter Rosqvist et al. [4] identify the lack of structured and coordinated support from managers as a critical risk, while Dachez et al. [6] highlight the inadequate training of job coaches and their high turnover. Similarly, Hedley et al. [5] point to insufficient training and the failure to tailor it to individual needs as significant concerns. Rampton et al. [7] and Romualdez et al. [33] emphasize the unpreparedness of managers and the lack of autism knowledge within work teams. Furthermore, the absence of clear routines, precise instructions, and adequate accommodations—highlighted by Hillier et al. [35], Mawhood & Howlin, [37], Davies et al. [18] and Tomczak et al. [41], contributes to disorganized or misaligned work environments that do not meet the needs of autistic individuals.

Among the most recurrent risk factors are difficulties in social communication and interpersonal interaction. These are documented across multiple studies, both from the perspective of autistic workers themselves and that of their supervisors or coworkers. Reported barriers include initiating or maintaining conversations, interpreting facial expressions, understanding social boundaries, appropriately requesting help, as well as frequent misunderstandings in everyday interactions or socially inappropriate behaviors [1,2,4,5,6,7,10,12,14,17,18,22,33,35,36,37,40,41]. Studies such as those by Hillier et al. [35], Tomczak et al. [2], Baker-Ericzen et al. [34] and Howlin et al. [36] describe challenges in social perception, establishing professional relationships, understanding both explicit and implicit social norms, and participating fluently in group dynamics. These difficulties are often exacerbated by the lack of understanding, empathy, or communication skills among coworkers, supervisors, and managers, which increases the likelihood of misunderstandings, social isolation, or the perception of being negatively judged [4,5,14,15,36,37,40].

Excessive work pace also emerges as a significant occupational risk factor. Several studies report working conditions characterized by high quantitative demands [19], the need to perform tasks under time pressure and maintain an overly fast work rhythm [4], as well as the inability to control the assigned workload. Additionally, situations have been documented in which workers must face prolonged activities and sustained high workloads [37,41].

Difficulties in coping with change, adapting to new routines, or managing transitions also represent one of the most recurrent risk factors identified in the literature on autism and employment, as highlighted by numerous studies [5,7,10,12,17,35,36,37,46]. While a preference for routine and resistance to variability are inherent characteristics of the autistic profile, the way these traits become hazardous situations in the workplace largely depends on the structure of the job. The lack of support can amplify difficulties related to change, turning an internal vulnerability into a risk to occupational safety.

Ambiguity in roles and expectations also appears frequently. Participants report difficulties in understanding what is expected of them, what their responsibilities are, or how they should act in new situations, as a result of unclear job expectations [7], lack of role clarity [37], and the absence of clear instructions and rules [35]. This is further compounded by unfamiliarity with workplace norms [33] and the lack of immediate feedback on performance [37].

An additional set of identified risks is related to the sensory characteristics of the work environment. Among the most notable elements are noisy settings [12,18], inadequate lighting [18] and exposure to intense sensory stimuli—whether auditory, olfactory, or visual [41]. Likewise, excessively open workspaces [40], the absence of appropriate areas for taking breaks [12] and the lack of proper adjustments in the physical or sensory environment [18] make it difficult for autistic individuals to remain in their positions and negatively impact their well-being.

Mismatches between the worker’s profile and the characteristics of the job are also observed. Various studies have documented situations such as a disconnect between the individual’s interests and the job role [4], the assignment of tasks that are not aligned with the worker’s skills or aspirations, a perception of meaningless work, and the performance of qualified tasks without appropriate compensation, as well as stagnating and discouraging practices that hinder professional development [38]. This type of mismatch can act as a form of a covert workplace exclusion by limiting growth opportunities and diminishing the perceived value of the work performed. Within this broader issue, one underexplored dimension in the literature relates to the risks associated with a lack of professional recognition. This includes performing tasks with no added value, the absence of growth opportunities, or being assigned to underqualified roles issues highlighted by Nouf-Latif et al. [38] and Hillier et al. [35].

Another factor that is less addressed in the literature, though equally relevant, is explicit discrimination or workplace harassment. While documented in a smaller number of studies, it has significant consequences for the mental health and employability of autistic individuals [4,12,32,35,36,40].

Several studies have documented that, in the absence of appropriate accommodations, challenging behaviors may emerge in the workplace among individuals with autism, such as loud vocalizations, pushing others, speaking out of turn, insistence on routines, refusal to follow instructions, fixation on preferred tasks, undue extension of breaks, crying, shouting, throwing objects, jumping, rapid rocking, aggression, or a lack of attention to tasks [10,22,46]. These behaviors, which hinder workplace coexistence, have been addressed through tailored behavioral interventions, intensive support, and individualized on-the-job training strategies. Although these actions may be perceived as challenging, the studies consistently emphasize that professional intervention, continuous support, and task adaptation not only reduce the occurrence of such behaviors but also promote job retention.

On the other hand, two critical areas stand out among the least addressed risks in the reviewed literature. These areas are often overlooked by traditional preventive approaches, yet they have a direct impact on the workplace experience of individuals with ASD. The first is the lack of continuity, time, and resources in supported employment programs, as highlighted by Dachez et al. [6], Nicholas et al. [40] and Howlin et al. [36]. These studies show that even when support systems are in place, their poor implementation can turn support into an additional source of vulnerability—whether due to high turnover among job coaches, lack of assistance at critical moments, insufficient training, overburdened support teams, or failures in inter-agency coordination [6]. Thus, the literature reveals that many of the risks encountered in supported employment frameworks do not stem from individual characteristics of autistic people, but rather from organizational shortcomings within the support system itself.

The second underdeveloped yet highly impactful area involves the risks associated with requesting reasonable accommodations. Although addressed by Davies et al. [18], Rampton et al. [7], Petty, Tunstall et al. [15] and Dachez et al. [6] this topic appears only tangentially in the literature. The review shows that many autistic individuals are afraid to request accommodations due to fear of retaliation or stigmatization [7,18], while others face complex institutional procedures, a lack of awareness of official channels, or ineffective responses from the organization [6].

In this same vein, an emerging dimension of occupational risk is associated with digital and technologically mediated environments. Digitalization has opened new opportunities, such as telework and the use of simulators, but it has also introduced new challenges. According to Tomczak et al. [41] and Petty, Tunstall et al. [15], telework can mitigate sensory overload and reduce forced interactions, but it may also increase social isolation, blur the boundaries between personal and professional life, and hinder effective communication. The intensive use of digital tools is not without risks: Amat et al. [14] identify cognitive overload in the use of virtual simulators, particularly during initial phases, as well as difficulties in interpreting tasks or virtual objects. Lastly, Bisher [45] highlights the benefits of remote work but fails to address the associated risks reflecting a common trend of focusing on technological advantages while overlooking the challenges they introduce. These latter issues are rarely addressed in current protocols, despite their growing prevalence.

Ultimately, the most extensively addressed risk factors in the reviewed literature, such as lack of structured support, organizational rigidity, limited understanding of autism, work pressure, and task ambiguity, are rooted in workplace conditions rather than in the individual characteristics of autistic people. Likewise, those less frequently discussed risks, such as those related to the physical and sensory environment, person–job mismatch, lack of professional recognition, or workplace harassment, also stem from external deficiencies. Far from being inherent problems of the autistic person, these risks emerge when environments are not designed or managed from an inclusive perspective. Added to this are risks derived from institutional shortcomings in supported employment programs, challenges posed by digital or technologically mediated environments, and the difficulties in requesting reasonable accommodations all of which reflect systemic barriers. Although some of the literature addresses individually originated challenging behaviors, the reviewed studies agree that such behaviors typically arise in the absence of adequate support, and that with adapted interventions, they can be effectively prevented and managed. Therefore, a preventive strategy for autistic workers must not focus solely on individual-level interventions but must also involve comprehensive transformations in on-site and remote workplaces, as well as in the regulatory frameworks that govern support and labor inclusion for autistic individuals.

Study Limitations and Future Recommendations

One limitation of this study is that the reviewed articles did not exclusively focus on occupational risks; instead, these risks were identified by interpreting various contexts and descriptions provided by the authors. This situation reflects the scarcity of studies specifically addressing occupational risk prevention in autistic workers and makes it necessary to infer risk factors from broader discussions. It also highlights the heterogeneity of the reviewed works, which vary widely in terms of methodologies, objectives, and workplace contexts, making comparison and synthesis more complex.

A further limitation concerns the process of data extraction and coding, which was carried out manually. The identification and categorization of occupational risk factors relied on the researchers’ interpretation, a process that, while systematic, may introduce a degree of subjectivity.

The literature search was also limited to three databases (Scopus, Web of Science, and PubMed), which may have excluded relevant studies published in other repositories. In addition, some potentially relevant records could not be retrieved in full text and were therefore excluded, which may have led to the omission of additional insights into occupational risks. The review was restricted to publications in English, as the search strategies were designed and executed using English terms. This language restriction may have limited the coverage of the review by excluding relevant studies published in other languages.

Furthermore, existing preventive tools, protocols, and technological solutions specifically designed for the autistic population in workplace contexts were not explicitly analyzed. Future research should aim to compare the occupational risks identified in this study with those addressed by current preventive solutions, to determine which risks remain unaddressed and justify the need to develop new, adapted preventive tools that respond to the multiple risk factors faced by autistic individuals.

5. Conclusions

The conclusions drawn from the state-of-the-art analysis reveal that individuals with Autism Spectrum Disorder primarily face psychosocial occupational risks, which mainly stem from external factors associated with work environments that lack appropriate adaptations to their neurological characteristics. Among the most recurrent risk factors are the absence of personalized support, significant difficulties in communication and social interaction, and challenges in adapting to unexpected changes or transitions. The research identifies multiple risk factors not currently addressed in traditional occupational risk prevention protocols. These conventional protocols tend to focus on standard workplace settings and often overlook key scenarios such as remote work or the processes for requesting reasonable accommodations. This omission highlights a gap that limits the effectiveness of current risk assessment systems.

The results of this study can contribute in practical terms to improving workplace environments for individuals with autism. They provide employers, human resources professionals, and occupational risk prevention specialists with a clearer understanding of the multiple risk factors affecting this population. Moreover, the detailed identification of these risks can serve as a foundation for adapting or developing specific assessment tools and preventive strategies.