Kasey’s Workplace Questionnaire

Research Study

Hi, My name is Kasey McClelland and I am the mother of an Aspie 8 year old. I am also enrolled at Texas State University and I am writing a research paper of Autism in the workplace; however I reside in a rural community and am looking to send my anonymous and brief (less than 5 minutes) questionnaire to 30-50 autistic or Asperger’s individuals.

I’ve had no luck locating emails for individuals and have very few responses at this time.

I’ve attached the questionnaire and would appreciate any resources or responses from volunteers if you care to assist me.

Thank you for your time and if you chose to assist me, please respond with answers to the questionnaire within 7 days.

Respectfully, KM

Questionnaire for the Working Individuals
Beginning This Job
1. What is your current job title?_______________________________________________
2. What qualifications did you have that were associated with this position?
3. Did you have any assistance in acquiring this job (i.e. placement or temp agency, career coach, family member)? If Yes, please explain. Yes No _____________________________
Job Duration
1. How long have you been working in this position and are you a full-time, part-time, or seasonal employee? ____________________________________________________________________
2. What is the longest amount of time during your adulthood that you have been without a job?
3. What is the longest amount of time you have maintained the same job? __________________
Job Satisfaction
1. What do you enjoy most about your current position and/or company? __________________
2. What is the most disagreeable aspect of your current role and/or company?
3. What has been the most fulfilling moment in your career thus far?
4. What was the reason behind your last unemployment time or career change (i.e. reason for leaving or reason for termination)? ______________________________________________
Environment of employment
1. Do you work in an isolated space alone or with a few people? Please explain. ____________
2. On a scale of 1 (most disruptive)-10 (not disruptive at all), how disruptive is your work environment to you on an average day? ____________________________________
3. Are you easily distracted by your surroundings? If Yes, please explain Yes No
Relationships at Work
1. Do you have friends, enemies, acquaintances, or co-workers? Circle all that apply
2. Is your employer aware of your medical diagnosis of Autism/Asperger’s? Yes No N/A
3. Have you ever been harassed or discriminated against while at work? (If Yes, please proceed to the remaining questions in this section. If No or you chose not to disclose this information, no further actions are necessary for this questionnaire.) Yes No
4. Did you report this issue to a supervisor or Human Resources Dept? Yes No
5. Do you believe the issue was addressed appropriately? (If No, please explain). Yes No