Neurodiversity 101: Hidden Costs: Career Challenges for Parents and Carers of Neurodivergent Children
Prof. Amanda Kirby MBBS MRCGP PhD FCGI
Honorary/Emeritus Professor; Doctor | PhD, Multi award winning;Neurodivergent; CEO of tech/good company
Workplace conversations about equity and inclusion often focus on individuals with disabilities or neurodivergence, but we rarely talk about the impact on their parents and carers who are in workplaces.
The reality is that many parents of neurodivergent children face significant career barriers—lost earnings, stalled progression, and increased workplace discrimination—simply because they are fulfilling their caregiving responsibilities.
This seems like a double whammy as many will also be neurodivergent themselves.
A recent study (2024) examined the economic case for services, therapies and supports for autistic individuals and their families, and highlighted the implications for national policy and spending decisions.
Autism, like other neurodivergent traits impacts communication, interaction, and quality of life, with significant economic consequences, including lost income, reduced productivity, and public sector costs.
The UK’s annual economic impact of autism is estimated at over £32 billion (2011 prices), yet existing services often fail to meet autistic individuals' needs effectively. This can also be said for other neurodivergent conditions and traits too. This recent study specifically evaluated the economic case for autism-related services, highlighting interventions that improve outcomes while being cost-effective.
Key findings included:
Putting in place early interventions like Paediatric Autism Communication Therapy (PACT) yield long-term savings.
Supported employment programmes which could potentially save £900 million–£1.5 billion annually.
Mental Health Support Teams and anti-bullying programmes in schools.
Specialist autism teams and health checks improving well-being and reducing costs.
While this report focused on autism, it calls for government investment in scaling effective services, embedding autism priorities in policy, and expanding research. I see this needing to be extended not only for Autism alone ( as it hardly ever presents alone) but widening this call.
Prioritising Neurodivergent traits in policy reform is both an economic opportunity and a social responsibility, improving lives while optimising public spending.
What about the career penalty for caregiving ND Children?
Juggling work and caregiving is complex. Parents of neurodivergent children often face layers of the impact of this both at home ( and with school) and at work:
🔹 Unpredictable demands – Frequent medical appointments, therapy sessions, and school meetings can disrupt work schedules.
🔹 Lack of flexibility – Rigid workplace structures make it difficult to balance responsibilities, leading to unpaid leave or reduced hours, or choosing jobs that are less demanding and not always matching the abilities of the parent/carer.
🔹 Career stagnation – Fewer opportunities for progression due to time off, missed networking opportunities, or negative perceptions about commitment. It can be hard to go to 'after work' events where networking happens when you need to be home for your child when they get back from a 'bad day' at school.
🔹 Financial strain – The additional costs of assessments, therapies, and specialist support can make it harder to take career risks or move into higher-paying roles. There are also hidden costs such as broken or different toys, more clothing and washing, and specialist tools.
This ‘career penalty’ is disproportionately felt by women, who are more likely to take on primary caregiving roles. Research suggests that mothers of disabled children are less likely to be in full-time employment and often earn less than their peers.
City and Guild Neurodiversity Index 2025
In this year's City and Guilds Neurodiversity Index we once again asked more about parent/carer experiences of being in employment and what the barriers were for them in progressing.
•46% of respondents had a child with a diagnosis and another.
•7% were waiting for an assessment.
•26% also thought their child/children may be neurodivergent.
What did parents want to stay in work?
•24% said they need flexible working arrangements
•18% of parents said they need to work from home
•16% said they need the opportunity for hybrid working
What are some of the hidden costs of parenting ND children?
Children with ADHD
Xheng et al ( 2019) showed that on average, participants with ADHD incurred a total economic burden over the course of child development that was more than five times greater compared to youths without ADHD (ADHD = $15,036 per child, Control = $2,848 per child), and this difference remained significant after controlling for intellectual functioning, oppositional defiant symptoms, or conduct problems. Parents of participants with ADHD were more likely to have changed their job responsibilities or been fired and reported lower work efficiency. The current evaluation of economic burden to individual families extends previous estimates of annual societal cost of illness (COI) of ADHD. Our rough annual estimate of COI for ADHD in children and adolescents is $124.5 billion (2017 US Dollars).
Children with ASD
More than £215 extra-a-month to raise a child with autism has been cited.The research, by Dr Chloe Blackwell, from the Centre for Research in Social Policy (CRSP) at Loughborough University, and leading children’s disability charity, Family Fund, looked at the higher cost of everyday, non-specialist, household and play items like furniture, clothes and toys, which need to be commonly replaced and of higher quality, for neurodiverse children’s needs.
Parents and carers raising children with autism need to spend at least 60% more for higher quality items, replaced more regularly, due to how their children use them.
Children with DCD
I wrote with colleagues about this in 2019. See https://journals.sagepub.com/doi/abs/10.1177/0308022619866642?journalCode=bjod for full report.Mean direct healthcare costs were approximately £700 in the 6 months prior to the survey. Almost all children were in mainstream education, but many received additional support. Among children who received therapy/intervention, the average indirect cost was £574 in the 6 months prior to the survey. However, this did not include changes to employment made to accommodate caring for the child. Notably, respondents commented that they frequently struggled to access services for their children. Parents reported not applying for advancement opportunities or choosing jobs where they could work part time or flexibly reducing their chances of earning more as well.
Workplace Bias and Stigma
Even when parents manage to balance work and caregiving, they often face subtle (or not-so-subtle) biases. Assumptions about their availability, reliability, or ability to ‘fully commit’ can lead to missed promotions and fewer leadership opportunities. Some parents even fear disclosing their caregiving role due to concerns about discrimination or job security.
What Can Workplaces Do?
Employers must recognise that supporting caregivers is an essential part of an inclusive workplace.
Practical steps include:
✅ Flexible working – Offering remote or hybrid options and flexible hours can make a huge difference.
✅ Carer-friendly policies – Paid leave for medical appointments, workplace adjustments, and additional support can reduce stress.
✅ Challenging bias – Training managers to understand and support employees with caregiving responsibilities.
✅ Creating a culture of inclusion – Encouraging open conversations and recognising the value parents bring to the workplace.
The Equality Act 2010 protects carers from discrimination and harassment because of their caring responsibilities.
Why does this matter?
By supporting parents and carers of neurodivergent children, workplaces don’t just help individuals—they create stronger, more resilient, and more diverse teams. Retaining experienced employees, reducing burnout, and fostering loyalty are all business benefits. It’s time we recognise that workplace inclusion isn’t just about individuals—it’s about families too. This has an impact for all in society.
Blog Author
I am Amanda Kirby, CEO of Do-IT Solutions a tech-for-good company that delivers consultancy and guidance, consultancy, training and web-based screening tools that have helped 10s of 1000s of people. Contact us and we can discuss how we can help.
We strive to deliver person-centered solutions relating to neurodiversity and wellbeing.I am a mixed bag of experiences and skills and have 25+ years of working in the field of neurodiversity.
I am a medical doctor, Professor, and have a Ph.D. in the field of neurodiversity; most important of all I am a parent and grandparent to neurodivergent wonderful kids and am neurodivergent myself.
I have written 10 books so far.Theo Smith and I wrote the UK award-winning book Neurodiversity at Work Drive Innovation, Performance, and Productivity with a Neurodiverse Workforce. My 11th book came out in 2023 Neurodiversity and Education.
(*Thoughts and ideas are all my own)
Chair Cadarn Housing Group, Member National Youth Work Strategy Implementation Board, Lay member Bridgend CBC audit and risk , practice solutions associate
3moThanks for sharing . This very much resonates with me . The continued juggling and the expectations to meet competing needs are very real as is the feeling of doing all these badly !
#Allyship #Advocacy #AntiRacism #NDChampion #Neurodiversity #Inclusion #SEND Educator | Former Headteacher | Inclusion Consultant | Anti-Racism Coach | Author “Be an Ally, Not a Bystander”| Art Advocate | Mentor | Coach
4moI have been supporting a parent who is facing some significant challenges with their child. Job insecurity and not having an understanding employer who allows a parent/carer to work flexibly is such a massive area of stress for parents/carers of disabled and/or neurodivergent children. Thankyou for highlighting this.
Mental Health & Wellbeing Specialist & Autism Trainer
4moSuch an important discussion point.
Adult nurse
4moFrom my own experience, l felt l had to work twice as hard to prove l could still be effective at work whilst being a single mum to my child as l fought to get them diagnosis and support but i would do it all again in a heartbeat
We feel so passionate about this! Thanks for highlighting the issue in such an articulate & thoughtful way