College Students’ Openness Toward Autism Spectrum Disorders: Improving Peer Acceptance
One probable consequence of rising rates of autism spectrum disorder diagnosis in individuals without co-occurring intellectual disability is that more young adults with diagnoses or traits of ASD will attend college and require appropriate supports. This study sought to explore college students’ openness to peers who demonstrate ASD-characteristic behaviors. Results showed a significant difference in openness between students who had a first-degree relative with an ASD (n = 18) and a gender-matched comparison group of students without such experience (F = 4.85, p = .035). Engineering and physical science majors did not demonstrate more overall openness. Universities should make efforts to prevent social isolation of students with ASD, such as programs to educate students about ASD and supports to ease college transition.
KeywordsAutism College student Adult Openness Acceptance College transition
It has recently been reported that approximately 1 in 110 children has an Autism Spectrum Disorder (ASD) (Centers for Disease Control 2009). Given the chronic nature of these disorders and associated long-term negative sequelae (Billstedt et al. 2007; Kelly et al. 2008; Sterling et al. 2008; White et al. 2009), more scientific attention on ASD in adulthood is warranted. Heightened public and scientific attention on autism and related conditions have contributed to methods for improved identification and diagnosis as well as effective methods of treatment, such as applied behavior analysis, pivotal response training, and school-based accommodations, to name a few (Naoi 2009; Ho 2008; Lerman et al. 2008). Most of the available intervention programs target children and occasionally adolescents, but very rarely do they target adults on the spectrum.
Colleges awarded federal aid toward TPSID programs (U.S. Secretary of Education 2010)
University of Massachusetts-Boston (TPSID Coordinating Center)
University of Alaska-Anchorage
University of Arizona
Stephanie Z. C. MacFarland
California State University-Fresno
University of California
Carlos O. Cortez
West Kern Community College District
Jeffrey G. Ross
Colorado State University
Catherine L Schelly
University of Delaware
Laura T. Eisenman
University of South Florida-St. Petersburg
Jordan T. Knab
University of Hawaii
Robert A. Stodden
David M. Mank
University of Iowa
University of Kentucky
Louisiana State University
K. Alisa Lowrey
Central Lakes College
University of Rochester
Bergen Community College
College of New Jersey
Jerry G. Petroff
Western Carolina University
David L. Westling
Minot State University
Ohio State University
Margo V. Izzo
Kent State University
College of Charleston
University of Tennessee
Houston Community College
University of Vermont and State Agricultural College
Virginia Commonwealth University
Elizabeth E. Getzel
Highline Community College
Such opportunities, however, come with certain challenges for students with ASD. Experiencing success at the undergraduate and graduate levels calls for an individual’s ability to demonstrate advanced social skills (Carneiro 2010), as well as communicative and adaptive skills. Impairments in these domains, however, are the hallmarks of ASD (American Psychiatric Association 2000). Furthermore, though postsecondary education is not the only means through which a higher income can be attained, having a higher income and better quality of life have been frequently attributed to having a professional degree (Bureau of Labor Statistics 2010; Gilmore et al. 2002; Grigal 2009; Migliore et al. 2009). Impaired social and communicative skills during young adulthood can decrease opportunities to find life partners and form support networks outside of one’s family, as friendships which are shorter in duration and increased loneliness are directly correlated to the degree of ASD characteristics a student displays (Jobe and White 2007; Howlin et al. 2004). Such impairments are also capable of negatively impacting one’s self-concept and hindering academic success (Howlin et al. 2000), counteracting the increases in self-esteem and sense of belonging that arise from being part of a college community (Hart et al. 2010). ASD has also been linked to the development of other psychiatric disorders. In a large sample (n = 122) of high-functioning adults with autism, Hofvander et al. (2009) found that 80% met criteria for one or more Axis I diagnoses, including mood, anxiety, and psychotic disorders.
One potential moderator of academic and social success for college students with ASD is the attitudes held by their peers displaying typical development. Peers’ level of openness and acceptance towards behaviors that are characteristic of ASD may affect the degree of social connectedness, or isolation, experienced by the student displaying such behavior. There is evidence that, for children, the peer group has an impact on one’s formation of social skills, self-esteem, academic achievement and motivation, and future outcomes (Wertsch 1985). A fair amount of research has been conducted to understand the influences of peers in a pre- and elementary school environment on children diagnosed with ASD (Campbell et al. 2005; Morton and Campbell 2008; Swaim and Morgan 2001). Through this research, primary school teachers and school administrators may be better prepared to meet the needs of students on the spectrum. There has unfortunately been minimal empirical study of potential peer influence on college students who have ASD.
Eaves and Ho (2008) conducted a longitudinal study of a sample who had received ASD diagnoses as children, to examine outcomes in young adulthood. Results showed that at the age of 24, approximately half of their sample had positive outcomes, while 46% showed comorbid mental illness diagnoses, obesity, and/or use of prescription medications, along with continued struggles in social settings. The authors concluded that the adults in this study were faring better than previous studies had reported (e.g., Howlin et al. 2000), perhaps owing to their birth after the movement towards community-based services and their participation in targeted intervention programs following early identification (Eaves and Ho 2008). Mahoney (2008) surveyed college students to assess their attitudes towards individuals with autism via measures of knowledge on the disorder, quality of previous interactions with individuals who have autism, and their views of appropriate social behaviors. Students reported relatively positive views and acceptance levels, which were positively correlated to the participants’ knowledge of ASD and the number of previous encounters with individuals who have autism. The question remains, however, of the consistency between students’ self-reported levels of openness and their openness in a lifelike setting. Self-reports of being open to peers who have ASD may not translate into a willingness to spend free time with that peer or consider him a friend, for example. As found in studies of children with ASD, peer rejection can lead to aggression, depression, and school dropout (Harnum et al. 2007), making it necessary to explore such variables as peer openness and acceptance.
Having a first-degree relative with ASD may increase exposure to, and understanding of, the disorder. Depending on how often the relatives interact, opportunities may be provided to become accustomed to ASD-characteristic behaviors (e.g., stimming, posturing, social oddities) that the person would otherwise not encounter (Petalas et al. 2009). Such first-hand experience may contribute to less uncertainty toward, and increased acceptance of, such behaviors when meeting individuals outside one’s family.
Field of study in college may also influence peers’ openness towards ASD. In developing the Autism-Spectrum Quotient (AQ), Baron-Cohen and colleagues (2001) compared the degree of ASD characteristics self-reported by college students with typical development majoring in mathematics, physical sciences, humanities, and social sciences, as well as UK Mathematics Olympiad winners. Physical science students and UK Mathematics Olympiad winners reported having significantly more ASD characteristics. More specifically, computer science and mathematics students showed higher levels of ASD characteristics than biology, engineering, medicine, and other physical science students (Baron-Cohen et al. 2001). Indeed, as computer scientists and mathematicians are stereotypically more reclusive and internalizing by nature of their studies (Kokosh 1976; Baron-Cohen et al. 1998), they may be more open to ASD-characteristic behaviors when compared to social science and humanities scholars.
The purpose of this study was to assess college students’ openness (i.e., acceptance, tolerance) to ASD characteristics in peers. In order to assess openness in this population, a vignette developed by Harnum and colleagues (2007) to assess elementary school children’s perceptions of a child with an ASD or ADHD was modified for college students. We sought to determine if the scale structure would replicate when used with adults, hypothesizing that, similar to the initial study, a two-factor model would be derived. It was hypothesized that students who reported having a first-degree relative with an ASD would be more open to a peer’s ASD-characteristic behaviors than would students without a first-degree relative with ASD. Peers majoring in engineering and physical sciences were also anticipated to be more readily accepting of behaviors characteristic of ASD than peers whose majors are based on social interaction, such as social sciences.
Data for this study came from a two-phase project on the prevalence and risks of ASD symptoms among college students. The study took place at a large public university located in the Southeast United States, and was approved by the institution’s Internal Review Board for human subject research. Data collection for the present study occurred electronically via a secure server, with all undergraduate students at the university invited to participate. Participant recruitment involved utilization of the university psychology department’s online experimental database through which student participation earned class credit, email distribution lists in other academic departments and student groups, and posted flyers around campus, including on- and off-campus counseling centers. Modest honoraria in the form of a raffle for gift certificates to local restaurants were offered as incentive for participation.
From the full sample (n = 685) of undergraduate students, analyses are based on participants who had complete data on Harnum et al.’s (2007) modified openness scale and the Autism Spectrum Quotient (Baron-Cohen et al. 2001), n = 652. Demographic data are presented in Table 1. The sample was predominantly female (66%), and fairly diverse in terms of college major—Social Sciences (e.g., Psychology, Sociology), 32%; Engineering, 28%; and Physical Sciences (e.g., Biology, Mathematics), 20%.
(AQ; Baron-Cohen et al. 2001) A 50-item questionnaire with four-point response options (definitely disagree, slightly disagree, slightly agree, definitely agree), the AQ was developed as a self-report measure of autistic characteristics in adults. It is typically scored in a binary manner, so that a response is scored as a 1 if it is in the direction of autistic and 0 if in the opposite direction, to yield a total score that ranges from 0 to 50. Higher scores indicate more symptoms of ASD and, using this scoring approach, the optimal cutoff was determined as 32 or higher for identifying people with clinically significant levels of autistic traits (Baron-Cohen et al. 2001). The AQ can also be scored according to the four-point responses (Austin 2005) to yield a dimensional, and perhaps more sensitive, index of ASD severity. In this sample, internal consistency was acceptable for the total score, with an alpha of .80.
Demographic and descriptive data for total openness score (n = 652)
All analyses were conducted using SPSS Statistics 17.0. It was first sought to determine whether the two-factor model of openness (Harnum et al. 2007) would be replicated with the scale modified for use with college students via a principal components factor analysis. A series of one-way Analyses of Variance (ANOVA) were used to determine if openness to ASD varied based on gender, family history of ASD, college major, or severity of ASD symptoms. Bivariate correlations were also conducted to explore the degree to which openness was related to the degree to which one exhibited ASD-characteristic behaviors themselves.
Initial analyses showed no problems with out-of-range or non-random missing data. Each vignette item on the Openness scale was found to be significant (p < .05) on the Komogorov-Smirnov test of normality; however, such a result is common in large samples such as this (Tabachnick and Fidell 2001). Examination of histograms revealed the shape of data distribution approximated normality, and therefore no transformations were made.
In the principal component analysis of Openness Scale responses, communality values were all acceptably high (≥.789). One component emerged with an eigenvalue above one (eigenvalue = 3.09), which explained 44% of the variance. By lowering the critical eigenvalue to .9, a three-component model emerged, which explained a total of 71.15% variance. However, given that all seven variables loaded substantially onto the single component (loadings ranged from .339 to .813) and that the scree plot indicated a one-component solution to be most parsimonious, we arrived at a final one-component explanatory model.
Based on this single-component model of the scale, scores on the seven statements were summed to yield a total score (with total scores ranging from 7 to 35) for ‘openness to ASD.’ Lower scores on this index reflect less openness or acceptance of ASD-like behaviors. The scale was found to have acceptable internal consistency (α = .77). Only one item (2: “This person is as smart as I am”), if removed, would increase the internal consistency of the scale slightly (to .79). The mean summary score on the scale for the sample as a whole was 22.64 (±3.99). The item with the highest mean response, which reflected the most openness, was item one “This person makes me feel afraid,” whereas the lowest openness score was for item six, “This person is different from me.” On each of the scale items, scores ranged from one to five (Table 2).
There were few group differences in openness based on gender. Males reported significantly more openness than females to two of the vignette items: item 4 (hang out with person), F (1,650) = 3.94, p = .048, and item 5 (feel comfortable around this person), F (1,650) = 9.96 (1,650), p = .002. On these items (4 and 5), males obtained mean scores of 2.98 ± .99 and 3.32 ± .95, respectively, whereas female participants had scores of 2.83 ± .89 and 3.07 ± .95, respectively. There was not a significant male–female difference in total scores, F (1,650) = 2.56, ns.
Only four participants (<1% of sample) reported having ever been given an ASD diagnosis, preventing any analyses of openness based on self-reported ASD diagnosis of the participant. Eighteen participants (2.6% of sample), 14 of whom were male, reported having a first-degree relative with ASD. In terms of the relationship of the relative with ASD to the participant, for 10 participants it was a brother, step-brother, or half-brother; for six it was a sister, step-sister, or half-sister; one participant did not indicate relative type; and one reported having multiple relatives affected by ASD: a mother, father, and brother. A comparison group of 18 students was selected randomly from the full sample, excluding those who reported having a previous ASD diagnosis, matched for gender. Participants who reported having a relative with ASD obtained a mean openness score (M = 25.44 ± 4.48) which was significantly higher than that of the students without a relative with ASD (M = 22.50 ± 3.49), F (1,34) = 4.85, p = .035.
Openness scale: items and descriptive data
% of sample at each response option
1. This person makes me feel afraid
2. This person is probably as smart as I am
3. I would not mind Jamie living in my hallway or apartment building
4. I would hang out with Jamie in my free time
5. I would feel comfortable around this person
6. This person is different from me
7. Overall, I think I would like Jamie as a person
Openness scale scores across college majors
Engineering (n = 165)
Social science (n = 164)
Physical science (n = 131)
Other (n = 192)
1. This person makes me feel afraida
3.69 ± 1.00
4.01 ± .84
3.73 ± .99
3.86 ± .91
2. This person is probably as smart as I am
3.61 ± .86
3.54 ± .82
3.64 ± .75
3.52 ± .86
3. I would not mind Jamie living in my hallway or apartment building
3.85 ± .91
3.90 ± .84
3.85 ± .82
3.71 ± .91
4. I would hang out with Jamie in my free time
3.00 ± .89
2.80 ± .95
3.03 ± .91
2.74 ± .94
5. I would feel comfortable around this person
3.24 ± .92
3.20 ± .95
3.15 ± 1.01
3.04 ± .95
6. This person is different from mea
2.03 ± .88
1.82 ± .80
1.95 ± .86
1.80 ± .82
7. Overall, I think I would like Jamie as a person
3.52 ± .70
3.48 ± .80
3.55 ± .74
3.43 ± .76
22.94 ± 3.86
22.74 ± 3.83
22.90 ± 4.11
22.10 ± 4.12
Thirteen participants (eight females) scored above the clinical cutoff of 32 on the AQ, with scores ranging from 32 to 39. To compare their level of openness to participants who scored below the AQ cutoff, a random, gender-matched sample was selected from the full sample. There was no group difference in overall openness based on the sum scores, F (1,24) = .53, ns. The group with high-AQ scores obtained a mean openness score of 25.54 (±4.65), compared to those below the cutoff (24.46 ± 2.67). There was, however, a significant group difference on item 6 (person is different from me), F (1,24) = 4.65, p = .04. The high-AQ group reported a mean openness score on this item of 3.08 ± 1.26, compared to the low-AQ group’s mean of 2.15 ± .90, indicating the high-AQ participants felt the vignette character to be more similar to themselves than did the participants with lower AQ scores. For the full sample, the correlation between ASD symptoms (based on the continuous total score on the AQ) and openness was not significant (r = .15).
Students who reported having a first-degree relative on the spectrum obtained significantly higher openness scores, which may be the function of having increased exposure and an understanding of ASD through interactions with their relative. Eighteen students reported having such a relative, with most students reporting a sibling. A limitation of this finding, however, is that we neither determined the degree of exposure these students had to their relative nor measured of the students’ knowledge or understanding of ASD. Though first-degree relatives may imply closeness, a family member with a developmental disability may spend a fair amount of time in treatment and support programs, thus limiting actual contact between relatives. Further research is needed to explore this relationship.
Differences across college majors were found. Engineering students indicated the most comfort, yet also most fear, around peers with ASD. Since engineering students typically present behavioral similarities to students with ASD (e.g., Kokosh 1976; Baron-Cohen et al. 1998), in being reclusive and studious, they may experience a higher comfort level around such peers than social science and other majors. Though the comfort level may be higher as a consequence, their higher degree of social withdrawal (Jobe and White 2007) may also result in the experience of fear towards any possible interactions with peers, regardless of the peers’ possible ASD characteristics or any similarities with their peers. Physical science students indicated the highest willingness to spend their free time with a peer with ASD, and the strongest belief that the person would be likeable and possesses an equal level of intelligence to themselves. These findings concur with those of Baron-Cohen et al. (2001), who demonstrated that mathematics and engineering students of a university student sample were more likely to display ASD phenotypes than students with more socially-based majors, such as theatre arts and social sciences. Social science majors received the lowest fearfulness score, and indicated the least concern about having the peer live in the same hallway or building, while those in the ‘other major’ category received the highest score on the belief that the student with ASD is different from themselves. Social science curriculums emphasize the study and understanding of diversity and varying personality attributes, in order to build an understanding of one’s social environment. As a result students in these fields may show more acceptance toward others, regardless of their background, and may show the least concern or discomfort over a peer with ASD living in one’s vicinity. Lastly, males showed higher openness than females. Males have been found to be more introverted in their emotional and social expressiveness (Shields 1995), which may result in more behavioral similarities between themselves and the peer, as females have been found to be typically more emotionally expressive and socially-oriented, and as a result males may display the least fearfulness (Brody 1985).
Limitations of this study stem from its population base. In selecting from a technical university, the sample was drawn from a more science and engineering-oriented community. Results may consequently be different if the study were to be replicated in a typical liberal arts school. The university’s student population, being predominantly male (approximately 57%), may have increased, and therefore normalized, students’ exposure to masculine-typical behaviors that are also associated with ASD, such as introversion and emotional reclusiveness. It is plausible that the participants in this sample reported greater openness compared to some other college student populations, because of increased exposure to such behaviors. Additionally, with participants in this sample being predominantly female, the sample may have presented a higher prevalence of ASD characteristics had there been gender-matched sampling, since ASD is more common among males (Fombonne 1999). Investigating peer openness toward ASD using a sample drawn from multiple universities would yield more representative results. The effect of having a first-degree relative with ASD on one’s openness towards peers exhibiting ASD phenotypes requires further investigation. In this study, there was no measure of intimacy between the participant and the relative. Acceptance of ASD behaviors in peers may be more directly related to amount of previous exposure to individuals with ASD; having a relative with ASD is an imperfect proxy for amount of prior exposure. Discrepancies may also exist between self-reported levels of openness and behaviors of acceptance demonstrated in a real-life setting. Humans’ innate tendency towards a self-serving bias and the tendency to view oneself positively (Miller and Ross 1975) may have led participants to provide answers which would describe their behaviors as more open and accepting than they would necessarily manifest themselves in their actual behavior, should they face an interaction with a peer with ASD.
Increased public education on ASD has provided opportunities for more extensive etiological and treatment research; however, there still exists a lack of awareness across college campuses of the daily obstacles faced by adults on the spectrum (Huws and Jones 2010). Since the 1970s, the Autism Society of America has celebrated April as Autism Awareness Month, with the primary goal of educating the public on this disorder and the issues it currently faces within the community. University student organizations could use this month to provide increased information to student bodies on ASD and its increased prevalence. The provision of explanatory information on ASD to students on college campuses can help decrease negative evaluations and promote peer acceptance. There is evidence for the positive impact of such programs with children (Campbell et al. 2005). The Organization for Autism Research (OAR) has created an informational DVD, Understanding Asperger Syndrome: A College Professor’s Guide, targeted towards the college professor and teacher audience, which provides information on the perspective of a student on the spectrum and specifies steps professors can take towards helping such students succeed in the classroom. Websites have also been created, such as http://www.thinkcollege.net, http://www.transitiontocollege.net, and http://www.throughthesamedoor.com, which provide information on college transition for students with intellectual and developmental considering postsecondary education (Hart et al. 2010).
University preparation for the transition of students with ASD into their communities calls for substantial work, especially due to the unique needs of this population (Lurie and Gurian 2010). Since social agencies and school guidance counselors frequently work with students to assist them in adjusting and excelling throughout their elementary and secondary school years, there is a call for providing continued assistance to these students as they are increasingly entering the college environment (Stodden and Zucker 2004). Campus Americans with Disabilities Act (ADA) offices can offer summer transition programs for students with ASD prior to entering college, similar to Upward Bound programs held for non-disabled high school students, in providing skill-building workshops and the assignment of a campus-based counselor to act as secondary advisor to the student throughout his or her college career.
An emphasis on acceptance of new students with ASD by the student body can be demonstrated by the institution’s administration through emphasizing inclusion during freshmen orientation meetings and beginning-of-year student activities. Within the classroom setting, as students with physical, learning, or sensory disabilities receive accommodations such as interpreters or extended time for test completion. Likewise, students with ASD can benefit from additional accommodations such as social coaches who would assist in the comprehension of verbal and nonverbal interactions, coping with the stress of overstimulating environments, and in the development of skills for peer interactions and future employment opportunities. Students already benefit from the use of technological devices such as personal digital assistance and palm pilots to help organize schedules and task lists; these devices can further be used as means to communicate with counselors and peer mentors throughout the day when assistance is needed (Robertson and Ne’eman 2008; Hart et al. 2010; Welkowitz and Baker 2005). Tracking of students’ academic success may also enable university officials to facilitate the provision of support, when necessary. Information on autism may also be included in appropriate academic courses (e.g., introductory psychology) to enhance understanding and openness. Peer mentoring programs can be implemented to help students develop social, academic, and daily living skills (e.g., time management), all of which may be impaired by their ASD symptoms. Lastly, peer support groups for students with ASD or related disabilities can be established to enable students with similar experiences to connect. Physical science and engineering students self-reported more openness in this study, suggesting the benefit of forming peer support groups across these majors, especially since students with ASD characteristics are more likely to be drawn to these areas of study (Baron-Cohen et al. 2001). TPSIDs, implementing a comprehensive transition program model, prove beneficial to students with ASD due to the number of aforementioned services they cover with their key components: academic enrichment programs, the provision of information on and preparation for college admissions, financial aid assistance, mentoring through both adults and peers, and social enrichment activities (United States Department of Education 2003). As a result, post-secondary institutions must continue to capitalize on the extension of the federal support to comprehensive transition services for students with disabilities and continue to explore opportunities to enhance peer openness and ultimately social integration of students with ASD.
The authors wish to thank the students of Virginia Tech and the administrative staff who enabled us to conduct this study.
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