Labor market inclusion of autistic adults in Brazil: bridging functional assessment, clinical practice, and public policy.

Autism spectrum disorder (ASD) is increasingly recognized in adulthood, yet unemployment and underemployment remain disproportionately high among autistic adults worldwide. Although Brazil has developed a comprehensive legal framework grounded in the biopsychosocial model of disability, including Law No. 12,764/2012, the Brazilian Inclusion Law (13,146/2015), and employment quota legislation, these advances have not consistently translated into sustainable workplace inclusion. This narrative review critically examines the Brazilian legal framework for labor inclusion of autistic adults, the limitations of current functional assessment instruments, particularly the Brazilian Functionality Index (IF-Br), and the implementation of reasonable accommodations from an International Classification of Functioning, Disability and Health (ICF) perspective, drawing on international policy experiences for comparison. Results indicate that Brazilian policy remains predominantly oriented toward quota-based hiring, with functional assessment instruments that inadequately capture context-dependent difficulties-such as sensory processing, executive functioning, and implicit social demands-particularly among individuals requiring level 1 support. This mismatch between formal inclusion and workplace accessibility may generate a self-reinforcing cycle of psychological distress, reduced occupational performance, and job loss. International models combining legal protections with individualized functional assessment and structured workplace support demonstrate more sustainable outcomes. The findings underscore the strategic role of psychiatrists in bridging clinical evaluation and public policy through workplace-oriented functional assessments and concrete recommendations for reasonable accommodations. Improving labor inclusion for autistic adults in Brazil depends less on new legislation and more on refining clinical and evaluative practices capable of translating formal rights into meaningful, sustainable occupational participation.