The Neurodiversity Decisions a Founder Makes Before HR Exists
Key Takeaways
- Most workplace neurodiversity failures happen in hiring design, not in hiring intent. The interview format screens for interview performance rather than job performance.
- Job descriptions written in traits rather than tasks act as filters against candidates who could do the work.
- Accommodations that must be requested carry a disclosure cost, which is why default accommodations reach more people than available ones.
- Neurodivergent employees frequently need more structure rather than more flexibility, which is the opposite of how most inclusion policies are written.
- In a company small enough that the founder still designs the work, these are founder decisions rather than HR decisions, and they are cheapest to make early.
- Dr. Deena Moustafa runs a multi-state clinical business and a direct-to-consumer apparel brand off one team, which has made the operational version of these questions unavoidable rather than theoretical.
Dr. Deena Moustafa is a Board Certified Behavior Analyst, an associate professor, and the founder of two companies that have almost nothing in common on paper.
The first, Go Behavioral, delivers behavioural health services for children and young people with autism and ADHD across California and Florida, in homes, schools, clinics, community settings, and virtually. The second, Cozyino, is a direct-to-consumer apparel brand making sensory-friendly and adaptive clothing, sold online at consumer price points.
One is a clinical services organisation operating under payer contracts and licensure requirements. The other is a retail business competing on product, margin, and fulfilment. They share a founder, largely one team, and a multilingual staff working across two continents.
Running both has forced a set of operational questions that most founders encounter years later, if at all, and that Moustafa argues are considerably cheaper to answer at the beginning.
The Interview Is The First Design Decision
Her starting position is that the standard hiring process does not measure what employers think it measures.
A conventional interview is an unstructured verbal exchange under time pressure with an unfamiliar person, assessed partly on eye contact, conversational rhythm and the ability to improvise a narrative. Almost none of those are requirements of most jobs. They are requirements of interviews.
The practical consequence is that a process designed to identify capability instead identifies fluency in a particular social format, and screens out candidates whose capability is real but whose fluency in that format is not. The result reads to the employer as a shortage of qualified applicants.
Speaking to Insights Care about entry into her own field, she has framed the first requirement as establishing a strong educational foundation in behaviour analysis. The observation cuts both ways. A sector that asks candidates to build that foundation and then screens them on conversational fluency is discarding the thing it asked for.
Her fixes are unglamorous and cost nothing. Send the questions in advance, which improves the quality of every answer from every candidate and removes an arbitrary memory task. Replace the hypothetical question with a work sample. State the format and duration of the interview beforehand, including who will be in the room. Allow written responses where the job itself is written.
None of this is an accommodation in the legal sense. It is a better assessment, and it happens to remove a barrier.
Traits Are Filters, Tasks Are Requirements
The second decision sits upstream, in how roles are written.
Job descriptions across most sectors are assembled from trait language. Strong communicator. Thrives in a fast-paced environment. Comfortable with ambiguity. Culture fit. Each of these reads as a requirement and functions as a filter, and in most cases none of them describes anything the job actually involves.
Moustafa’s argument is that a description written as tasks rather than dispositions is both more useful to the hiring manager and dramatically more accessible. A role that requires someone to write clear documentation should say that. A role that requires someone to handle unpredictable interruptions should say that too, because a candidate for whom that is genuinely difficult deserves to know before applying, and a candidate for whom it is fine will not be filtered out by a proxy.
The trait-language habit is also where a small company inherits assumptions from larger ones without examining them, usually by copying a template.
Default Beats Available
The most consequential distinction she draws is between accommodations that exist and accommodations that must be asked for.
An employee who has to request a change has to first disclose something about themselves to a manager, early in a working relationship, with no guarantee about how the information travels. That disclosure has a cost, and the cost falls hardest on the people least confident of their standing, which is usually the newest and most junior employees.
Anything that can be made a default therefore reaches more people than the same thing offered on request. Agendas circulated before meetings. Written summaries after them. Decisions recorded rather than communicated verbally in passing. Predictable start times. A quiet space that is bookable by anyone for any reason and requires no explanation.
Every item on that list is also, straightforwardly, better management. That is the argument, and it is a stronger one than the moral case because it does not depend on anyone’s goodwill surviving a difficult quarter.
Structure Is The Accommodation, Not Flexibility
The point she makes that most often surprises other founders is that inclusive workplace design is frequently written backwards.
The default assumption is that neurodivergent employees need flexibility. Often what they need is the opposite: clearer expectations, explicit success criteria, defined scope, and communication that does not rely on inference. Ambiguity is not freedom when the unwritten rules are the hard part.
A workplace that says “we’re flexible, just figure out what works” has not removed a barrier. It has moved the work of figuring out the rules onto the employee and made it invisible, and it will then read the resulting struggle as a performance problem.
Specificity costs a manager very little, and it is the single most portable practice in this list.
Why This Lands With Founders Specifically
The reason Moustafa frames these as founder decisions rather than HR decisions is structural. In a company small enough that the person who designs the work is also the person doing the hiring, these defaults are still choices. Once an organisation is large enough to have inherited processes, changing them becomes a policy project with a budget and a timeline.
The window in which a founder can set them by simply deciding is short, and it closes quietly.
There is also a reason this argument tends to arrive through women founders more often than the reverse. Moustafa’s own clinical interest has long included women on the autism spectrum, and the pattern she describes there is late identification, sustained masking, and difficulties that get read as personality rather than as unmet need. That pattern does not stop at the office door. A leader who recognises it is more likely to look at a workplace and see design decisions where others see individual shortcomings.
The autism prevalence figures underline the scale. The Centers for Disease Control and Prevention’s most recent estimate, published in April 2025 and covering surveillance year 2022, put prevalence among 8-year-olds at 1 in 31. Those children are entering the workforce over the next decade and a half, and they will be hired by companies that are being designed now.
The founders making those design decisions are, in most cases, not thinking about them at all.
Frequently Asked Questions
What Is The Common Mistake Companies Make On Neurodiversity Hiring?
Treating it as an intent problem rather than a design problem. The interview format itself screens for social fluency rather than job capability, and no amount of goodwill in the room corrects for that.
How Much Do These Changes Cost?
Most cost nothing. Sending interview questions in advance, writing job descriptions as tasks, circulating agendas, and recording decisions are process changes rather than budget items.
Why Default Accommodations Rather Than Accommodations On Request?
Because requesting one requires disclosing something personal to a manager early in a working relationship. That cost falls hardest on the newest and most junior employees, so an available accommodation reaches fewer people than a default one.
Do Neurodivergent Employees Need More Flexibility?
Frequently, the opposite. Clear expectations, explicit success criteria, and defined scope tend to matter more than loose arrangements, because ambiguity shifts the work of decoding unwritten rules onto the employee.
Who Is Dr. Deena Moustafa?
A Board Certified Behavior Analyst and associate professor, and the founder of Go Behavioral, a behavioural health provider operating in California and Florida, and Cozyino, a sensory-friendly and adaptive apparel brand. She is also the author of four books published between 2009 and 2011, including You Are Not Alone: A Message to Parents of Children With Autism.
Disclaimer: This article is provided for general informational purposes only and does not constitute legal, medical, employment, or human resources advice. Workplace requirements and accommodation obligations vary by jurisdiction and individual circumstances. Employers and employees should consult qualified professionals regarding their specific needs and responsibilities.
