Transitioning into adulthood is a formidable challenge for autistic youth. Though they face all the same challenges as their neurotypical peers, they may also contend with obstacles that their typically developing peers rarely must consider. Poor outcomes in independent living, education, and employment are consistently evidenced in this population, with only 20% of individuals described as having “good/very good” outcomes in these domains as defined by the measure of overall outcome (OO) of individuals on the spectrum (Henninger & Taylor, 2013; Howlin et al., 2000; Steinhausen et al., 2016). Furthermore, services that autistic children and teenagers receive through government and school supports, such as speech and language therapy, occupational therapy, behavioral therapy, and other similar supports, abruptly cease at age 18 (Laxman et al., 2019). This phenomenon, known as the “services cliff”, makes the transition to young adulthood especially difficult for this population (Laxman et al., 2019). Not only are they expected to move from a supported environment into a new world with lessened support, but many resources they are used to receiving are cut off, with little infrastructure to pick up the slack. Research focusing on the transition from high school into adult life is of the utmost importance in aiding positive outcomes in adulthood for this population. Despite the value of this work, there is a dearth of research focusing on autistic adults (Howlin & Magiati, 2017). Without understanding their experiences during this transition, it is difficult to identify and target the areas of need. Therefore, this review focuses on the experiences of autistic individuals navigating this transition.

Conceptual Framework

The framework through which most legislature and autism-related research are conducted is the medical model of disability. This model conceptualizes two states of being: normal and pathological (Hardman et al., 1996). “Normal” is defined as the absence of any biological problem in the individual. “Pathological” is defined as abnormal, diseased, or functioning in a maladaptive matter. This model differentiates “healthy” from “sick”, and values “healthy” or “normal” above any deviation from that norm. This is the model from which most psychiatric diagnoses are created, and the model through which most autism language, research, and legislature are understood (Baglieri, 2022). However, in recent years, many have turned towards social models of disability to better understand the lives of disabled individuals in the world (Oliver, 2013). Social models of disability consider disability as a construct, considering the way our culturally based economic, social, and value structures can define “disabilities”, and how these facets of our culture can shift to accommodate differences in individuals without pathologizing them.

From the shift towards social models of disability emerged the Neurodiversity movement. Neurodiversity is the idea that neurological differences can be considered part of the natural range of human development (Singer, 2017). Activists of the Neurodiversity movement, many of whom are autistic, advocate for neurological differences such as autism to be viewed as ways of being, rather than a disorder that needs to be cured. Following the Neurodiversity and social models of disability perspective, providing accommodations and environments for autistic individuals to succeed as they are is the best way to promote positive outcomes in this population.

Historical Context

In the last decade or so, rates of autistic young adults enrolling in college have significantly increased (Bakker et al., 2019; Nuske et al., 2019). Despite this increase, the postsecondary graduation rate as of 2020 for autistic students is only 41%, significantly lower than the US national college graduation rate of 62.3% (Causey et al., 2022; White et al., 2016). While there are many more recent factors affecting this increased enrollment, such as the increase in valuing neurodiversity as part of academic communities (Keenan et al., 2019), the door was opened to students with disabilities and learning differences pursuing degrees with the implementation of Title II of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973, which provides protection for college students with disabilities, including protections from discrimination and entitlement to accommodations. These acts require colleges and postsecondary educations to be equipped with appropriate aides and services unless doing so would result in fundamental alteration of the college program or undue financial or administrative burdens to the college. However, these guidelines leave significant maneuverability in what the college is required to provide due to the ambiguity inherent in the language. For instance, “undue burdens” is a difficult landmark to clearly demarcate. They also dictate that postsecondary schools may not discriminate against qualified individuals needing accommodations in the admissions process. These laws allow for increased college attendance by individuals needing accommodations. While services allowing their participation are available, certain restrictions are placed on the scope of services made available to these students.

While the Americans with Disabilities Act (ADA) provides support to college students with documented disabilities through student disability centers and despite the increase in enrolled students, structural supports to meet the growing need lags behind (Zeedyk et al., 2019), leaving many autistic college students without adequate resources to succeed. The result of this legislature is increased opportunity for individuals with disabilities (for example, autistic individuals) to attend college and to receive services. However, a secondary result of these laws is that autistic individuals who attend college education and require accommodations must undergo large amounts of bureaucratic barriers to obtain services through disability service offices, many of which only offer a limited selection of services. Furthermore, the ADA legislature operates within the medical model of disability, meaning that documentation of a diagnosed disability is required in order to obtain accommodations, even if an individual self-identifies as autistic and is aware of the accommodations they may need to succeed. This barrier may place additional steps between the individual and obtaining necessary services, as diagnoses can be difficult to obtain due to a variety of factors, from expense to providers having difficulty recognizing autism in females or gender diverse individuals (de Broize et al., 2022). It is important to note that college completion does substantially increase the chances of autistic adults to gain competitive employment, a protective factor against poor quality of life outcomes (Walsh et al., 2014), making barriers to obtaining necessary services a larger risk factor for this population than for typically developing college students.

The Current State of College for Autistic Students

College students on the autism spectrum can have a variety of needs that go unaddressed by college curriculum designed for neurotypical students. For instance, many autistic individuals struggle with executive functioning, or difficulty engaging in goal-directed behavior (Friedman & Sterling, 2019). Executive functioning (EF) can be understood as the ability to create goals, maintain focus and motivation to follow through with plans, and flexibly alter goals and plans in response to changing circumstances (Suchy, 2009). College students with poor EF may have difficulty with skills such as remembering deadlines, writing down assignments, and completing daily living tasks.

In addition to EF difficulties, autistic individuals often have difficulties with sensory overload, navigating certain social situations, and often require accommodations in the classroom (Test et al., 2014). However, accommodations are often difficult to receive. Obtaining accommodations can require paperwork, contact with disability offices, and disclosure of diagnoses and accommodations to each new instructor. In addition to navigating these systems, obtaining and utilizing accommodations can also require an understanding of one’s own diagnosis and needs in changing situations. The combination of EF struggles and the necessity of navigating disability accommodations may prove particularly challenging for this population, as an individual with EF difficulties may find navigating the paperwork and accompanying additional tasks to obtain and disclose disability accommodations difficult or impossible.

Up until graduation from high school, autistic students are provided with disability accommodations through school. Furthermore, their parents are allowed and encouraged to advocate for them in the pursuit of receiving services, obtaining IEPs (Individualized Education Plans provided through public schools that determine what services a student is eligible to receive, as well as what classroom would be the best fit for that child given their disabilities), and are generally present as supports. Appropriate parental involvement can act as a mediating factor in the deleterious effects of weak executive functioning skills (Taylor et al., 2017). However, by the time an individual turns 18 and is enrolled in college, parents are not permitted to view their school records unless the student gives permission or pursue disability accommodations for their children. One of the purposes of these college regulations around protections of school records and requiring self-advocacy on the part of the student when pursuing disability accommodations is to protect the privacy of college students who are over the age of 18. However, for autistic individuals who struggle with EF or other special needs, the inability of parents to assist them with obtaining disability services or navigating other needed supports within the context of college can be a daunting obstacle.

Autistic college students are, for the first time, on their own in an unfamiliar environment, with additional needs for accommodations that neurotypical college students may not have to navigate and may be ill-equipped to pursue necessary services without support. As autistic individuals often struggle with social interactions, being placed suddenly in an intensely social environment with no familiar social support can pose a serious hurdle to completing a degree, or even to having positive, growth-promoting experiences in college. Furthermore, with reduced independent living skills, autistic college students are faced with an additional obstacle compared with their typically developing peers; a greater burden of work, time, and energy, with a lower capacity for shouldering it.

Purpose of this Review

In the wake of increased college enrollment by autistic individuals in recent years ((Bakker et al., 2019; Nuske et al., 2019), an examination of the state of research around the experiences of autistic students in postsecondary education is necessary to understand the effects of national policies and to improve outcomes for this population. The purpose of this literature review is to provide an overview of autistic college students’ characteristics, service receipt, and experiences with various aspects of their college life. Following the social model of disability, this review will seek to center the needs and experiences of the autistic individuals, with the aim of discovering how their environment could be better shaped to fit their needs.

During childhood, parents, educators, researchers, and other stakeholders may be consulted in making executive decisions on how resources should be spent in benefiting the child. However, for adults with their own voices, it is considered critical to thoroughly explore and involve members of the community before designing interventions or other research intended to change outcomes for this population (e.g., Hoekstra et al., 2018). This review aims not only to center autism research surrounding this underserved and under-researched population, but to elevate the voices, opinions, interests, and needs of the individuals in the community.

Methods

This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR; Tricco et al., 2018).

Conceptualization of Terms

As defined by The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013), Autism Spectrum Disorder (ASD) is defined by persistent deficits in three areas of social communication and interaction, and at least two of four types of restrictive and repetitive behaviors. In recent years, a Neurodiversity movement has gained strength and voice as neurodivergent individuals turn away from the diagnostic label of “ASD”, and increasingly self-identify with the label of “autistic”. In an attempt to align the language of this research paper with the preferences of the community, this review will refer to individuals with a diagnosis of ASD as autistic, as well as individuals who have not received a diagnosis but self-identify as autistic. While not all autistic individuals align with the Neurodiversity movement’s preferred language, the language used in this review is intended to be as inclusive and respectful of the preferences of as many autistic individuals as possible. Individuals who are not autistic and do not identify with any other developmental disability throughout the course of this article will be referred to as “neurotypical”, meaning typically developing. Lastly, the term “stakeholder” will be used to refer to anyone who has a vested interest in the welfare of the autistic college student, but is not the student themselves (e.g., parents, educators, or clinicians working with the individuals).

Selection Criteria

Articles included in this review focus on the experiences of autistic college students as they navigate the transition into college or attended college, and the struggles they reported experiencing. Articles included recruited participants who were autistic and were at least 16 years of age, the average age in high school in the USA where transition planning begins to take place (IDEA; Individuals with Disabilities Education Act, 2004). The article review did not contain an upper limit for age, as the goal was to include autistic college students who did not follow the traditional path from high school into higher education, as well as those that took additional time to graduate or took time off from school to pursue other opportunities. Although age 16 is younger than the average age autistic young adults begin college, this review aimed to include community college students transferring out of high school early, as other studies including community college students have done (e.g., Porchea et al., 2010). This review included autistic college students who experienced co-occurring disabilities such as learning disabilities, as well as those who experienced mental or physical health issues. Studies included focus on service receipt or other avenues of promoting college success for this population. To meet inclusion criteria, studies had to be published in a peer reviewed journal, written in English, and were either surveys, qualitative interviews, or mixed method studies. Studies were excluded from consideration if they were published prior to 2013, not published in the USA, case studies, review articles, or experimental designs testing an intervention.

While these inclusion criteria limited the range of studies that can be reviewed, the increase in individuals diagnosed with autism spectrum disorder and the fact that 84% of autistic teenagers report intentions to pursue a postsecondary education, alongside the constantly changing college landscape (Wei et al., 2016), indicate that examining more recent literature on the topic offers a more realistic picture of what transition-age autistic youth are experiencing as they transition to college today. The purpose of excluding intervention studies is that this review aims to capture a more general experience of autistic adults navigating in college, and interventions are specific by nature to the individuals involved and the setting in which they were performed. As so little research in autism is focused on this population, specifically on autistic college students and their experiences, it seemed prudent at this stage to center on research studies that took an exploratory stance, broadly gathering the experiences of participants, rather than limiting the scope of investigation to more specific phenomena, as is more common in randomized controlled trials (RCTs).

Articles were excluded if their primary focus was on employment rather than college experiences, or if the primary focus was on peer acceptance from neurotypical students. While social life is undoubtedly a critical aspect of a college experience and success/acclimation to college, this review is focused on a more holistic and academic view of college acclimatization. This criterion also acknowledges that not every student’s priority is to associate with peers or make friends in a college setting. Finally, articles were excluded if the perspectives in the article were solely those of stakeholders, for instance, parents, family members, professors, or service providers. The purpose of this choice was to center the views and experiences of the individuals themselves.

Search Methods

An electronic data search was conducted in the PsycInfo, PubMed, Google Scholar, and Web of Science databases using the following keyword search: (autism) OR (Asperger) OR (Autism Spectrum Disorders) OR (Autism Spectrum Disorder) AND (college) OR (postsecondary education). These databases were chosen for their frequency of use in other similar reviews as well as following the search criteria set out by PRISMA (e.g., Flegenheimer & Scherf, 2022, PRISMA-ScR; Tricco et al., 2018).

Literature searches of each database ceased only when 120 articles with no relevance to the topic (no mention of both college or postsecondary education and autism) had been consecutively viewed. In addition to the electronic data search, literature trails were conducted with each article found that met inclusion criteria.

The initial search resulted in 31,468 articles. Subsequently, 31,400 articles were excluded for irrelevance, leaving 68 viable articles on the topic of autistic college students’ experiences in college. After screening all 68 articles, 28 articles were removed for not being published in the USA, not written in English, case studies, or other baseline inclusion criteria. Of the remaining 40 articles, 20 articles were removed because participants were not young autistic adults, but were stakeholders such as parents, teachers, service providers, or other neurotypical students providing their perspectives on autistic students and their college experiences. After the 20 articles were removed, the remaining 20 articles were scanned for literature trails, which yielded two additional articles meeting inclusion criteria, leaving a final 22 articles meeting inclusion criteria and used in this review (see Fig. 1).

Fig. 1
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Article inclusion decision tree

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Coding and Interrater Reliability

Data analysis followed the guidelines for thematic analysis proposed by Braun and Clarke (2006), utilizing an iterative and inductive approach to identify recurring themes within and across the articles. The primary coder read through each of the articles several times and created preliminary codes based on the emergent themes (Syed & Nelson, 2015). Subsequently, the primary coder created a codebook with examples and definitions of each code, returning iteratively to this document to create edits and updates as needed. A secondary coder independently coded 20% of articles. The two coders reached a minimum of 80% agreement on each of themes (Syed & Nelson, 2015). This threshold was chosen to ensure a high level of consistency and reliability in the interpretation of the data.

Results

Review of Literature

The articles presented in this review cover a wide array of the experiences and characteristics of autistic college students (see Table 1). The main recurring themes in the 22 articles reviewed below are: Social environment and supports, available services and service gaps, mental and physical health, individual characteristics, strategies for success, and identity and disclosure. For frequency of code occurrence and corresponding articles, please refer to Table 2.

Table 1 Experiences of autistic college students*
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Table 2 Frequency of code occurrence
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Social Environment and Supports

In addition to the academic challenges autistic college students face upon beginning college, autistic students also encounter unprecedented social challenges. Bailey et al. (2020) conducted a survey and a series of interviews focused on the relationship between college social experience and subjective well-being. The results of the survey indicated that students spend most of their time doing hobbies by themselves, and that immediate family, friends, relatives, and school personnel were the main sources of social support. Furthermore, social connectedness and perceived social support were positively correlated with subjective well-being. In the interviews, students discussed that it was difficult to navigate the new social environment due to changes in social expectation, as well as the sheer increased volume of social interaction that is expected of college students. Students described anxiety around the number of new people they met on a regular basis, a decreased sense of privacy, and lack of alone time, due to the social nature of dorm life and classes. Additionally, students reported struggling to form new, meaningful relationships.

Similar to their neurotypical peers, students reported difficulty with the balance between academics and social interaction, yet reported positives about their college social experience, specifically the ability to connect with people with similar interests through clubs and special activities (Bolourian et al., 2018). One student reported, “I would say about 50% of [the science fiction/fantasy club] was on the spectrum, so we all tended to get along very well because we were able to bond over common interests” (Bolourian et al., 2018, p. 3336). Friends and families from prior to college were considered to be positive social support in navigating the new environment. However, professors were found to be both a positive and a negative social support, with some professors sitting down with students and providing them with extra guidance, and others creating negative experiences through lack of understanding of accommodation policies and failure to accommodate students who have disability services.

Jackson et al. (2018) report similar findings of social discontent among participants on the autism spectrum in college, with students reporting having an average of one to two close friends at school, but 39.3% of the sample reported having no close friends. Over a third of participants reported being slightly to very dissatisfied with their social group. The majority of study participants reported no romantic relationships while at school (58.9%), and 75% of participants reported loneliness as a significant issue for them: feeling left out, isolated, or a lack of companionship. Bullying was less common than isolation, with 35.7% of the sample experiencing some form of bullying in college.

While autistic college students routinely struggle to make friends in a college setting, there are several aspects to college life, such as clubs, special interest groups, and extracurricular activities that can bolster the chances of finding like-minded peers. In a series of interviews with 13 autistic university students, Bolourian et al. (2018) found that students reported being very aware of the differences between themselves and their typically developing peers in both academic and social settings. When asked about peer interactions, students reported difficulty making friends, but also indicated that social opportunities on campus and student organizations help them to find like-minded peers and bond with new people. This sample was divided based on living situation; 40% of autistic students lived away from home. Students who lived on campus described being around peers all the time as overwhelming, but also experienced isolation without roommates. Both overstimulation and loneliness were commonly expressed. Lastly, autistic students were concerned about the social aspect of finding jobs after college, noting certain social skills they lack may be important in pursuing employment and making a good first impression. One student reported, “I’ve noticed, when I did my search in the job market, that if you weren’t very good at social skills, you wouldn’t get a job. It just didn’t happen” (Bolourian et al., 2018, p. 3337).

However, to some autistic college students, making friends and integrating themselves into peer groups is not a priority. Cullen (2015) used survey questionnaires, qualitative interviews, and focus groups to explore the academic, social, and daily living needs of autistic college students, and how those needs are met. Social needs of the study participants varied greatly on an individual basis, with several participants reporting that they did not feel a need to meet new people or expand their social circle, while others emphasized that the difficulty in meeting new people troubled them. The most common academic and social struggle students reported was feeling challenged with social interactions during group work, with some students reporting that they were scapegoated whenever anything went wrong with the group project and speaking about anxiety they experienced with the necessity of small talk and other social niceties surrounding this type of academically motivated interpersonal social interaction. One student explained, “every time I am placed into a group, slowly everyone starts to act distant and angry with me, leaving me to become the scapegoat and take the blame for anything that goes wrong, despite being a straight A student. When I contact instructors about my concerns, I am often told to talk it out with my group, which goes nowhere” (Cullen, 2015, p. 95). The majority of students reported that family helped to satisfy their social needs, with some students reporting social satisfaction found through friends they had made through special interest clubs, or through social media.

Some self-reported college experiences from autistic students are promising. Hendrickson et al. (2017) used the College Adjustment Program Evaluation Scales (CAPES) to collect student (N = 8) and parent ratings across several dimensions of student experiences in college, including student life, emotional adjustment, independent living skills, interpersonal relationships, and self-advocacy. On average, both students and parents rated the transition to college from special education high school positively, although parents rated the transition slightly more positively than students did. A caveat to these findings is that the eight students who participated were enrolled in full-time two-year certificate programs for students with intellectual and developmental disabilities, which is not necessarily representative of autistic college students attending schools without specific programs of this sort. These findings are nevertheless promising in that they demonstrate the potential to create positive college experiences for autistic individuals with structural changes to the curriculum and better disability support.

Available Services and Service Gaps

A predominant area of need when investigating the experiences of autistic college students in navigating their academic lives is to understand the state of services and accommodations they are provided. Sarrett (2018) examined autistic college students’ experiences and suggestions on making college and disability services more “autism friendly” through a survey and online focus groups. Of the participants who received disability accommodations (62% of the total sample), 68% reported that the accommodations met their expectations. The most received accommodations were extended test time, note takers, distraction free test areas, flexible due dates for assignments, and more permissive use of technology in the classroom.

While many participants had positive experiences with accommodations, several reported that persuading professors to abide by the accommodations was difficult or impossible (Sarrett, 2018). One participant reported, “accommodations are good if the professor complies. Sometimes the professor does not comply and there is nothing that can be done” (Sarrett, 2018, p. 685). Still others felt that the accommodations did not address the sensory, social, academic, or psychiatric needs. When asked what accommodations students would prefer that were not offered, the most frequently cited answer was increased autism awareness on campus. Participating students felt as though professors and peers were not adequately aware of the autistic “experiences and needs” profile. Participants also reported desiring sensory friendly spaces, educational practices designed for multiple learning preferences, disability support groups, and more acceptance of self-stimulatory behavior (“stimming”; repetitive motions intended to soothe, a common behavior in the autistic community; Kapp et al., 2019). It is notable that many of these requested accommodations are not academic in nature but serve to educate people in their immediate environment about their needs, and to provide social and emotional support.

In an online survey of 56 autistic adult college students, Jackson et al. (2018) examined the academic experiences, social experiences, and mental well-being of this population. Most participants reported utilizing some support services at school, averaging two to three support services per individual. Additionally, 30.4% indicated that they would appreciate additional or improved services beyond what they were already receiving or what was offered at their school. The most frequently desired services were increased social support groups, more accommodating housing options, and better counseling and psychological services. The authors found a significant correlation between degree type and comfort level, with those in the social sciences reporting the highest average of academic comfort, and those in the sciences reporting the least academic comfort.

In a survey examination of academic support that enables academic success in current and former autistic college students, Gelbar et al. (2015) found that their sample reported high academic success, along with a high level of comfort in disclosing their disability in academic settings, particularly to disability service coordinators. The most frequently utilized services were extended time on tests (63%), regular meetings with a disability counselor (49%), taking tests in a distraction free environment (43%), and utilizing notetakers (43%). Critically, about half the sample reported that these accommodations were similar to those that they received in high school, potentially indicating that consistency in service receipt between high school and college may be advantageous when transitioning to the next step of postsecondary education.

In another investigation of accommodations and support services preferred by autistic college students, Accardo and colleagues (Accardo, Bean, et al., 2019) asked 23 students to participate in semi-structured interviews and surveys on their experiences with service receipt on their college campus. The authors found that more than 50% of students preferred extra time on tests (83%), receiving a copy of the instructor’s notes (70%) and priority registration (65%). The two accommodations identified as “most helpful” were extra time on tests and housing accommodations. The accommodations identified by the students as “least helpful” were reader-scribes, the ability to audio-record lectures, and taking tests in the disability center rather than the classroom.

When asked what services students would prefer that they are not currently using, students indicated that they would like to participate in academic coaching (91%), summer transition programs (70%), tutoring (65%), and the writing center (57%). Students did not prefer to participate in peer mentorship or social skills groups. Academic coaching, which the vast majority of students indicated in both the survey and semi-structured interviews indicated that they would prefer, was explained as being a helpful tool for executive functioning weaknesses, with students stating that academic coaching helps them set goals, organize assignments, and receive support that is flexible and changes based on their needs.

Lastly, when asked what service students would like to be present that is not offered by their university, students requested access to faculty hours prior to course registration. While justification for this request is not provided in the findings, this extra time prior to the class beginning would likely give autistic students time to disclose their diagnosis to the professor and carefully review accommodations. Given the finding by Sarrett (2018) and others that professors are, at times, failing to give accommodations and are generally undereducated about autism and what autistic students might need from them in their classroom, this request seems appropriate.

Mental and Physical Health

Fernandes and colleagues (Fernandes et al., 2021) examined survey data from the National Autism Indicators Report (Roux et al., 2015) on the mental and physical health status of autistic college students. While it is already well-established that autistic individuals frequently contend with co-occurring psychiatric conditions, such as ADHD, anxiety, and depression, the study’s results established that autistic college students are likewise contending with more chronic illnesses compared with their typically developing peers. Their physical health was found to be significantly lower than their peers and the comparison group, which may be a contributing factor to low success rates in college, along with poor mental health outcomes. These findings are even more poignant when considered in conjunction with additional findings from the study that autistic college students performed similarly to comparison groups in academic achievement in high school, including comparable SAT verbal scores.

In a 2021 survey conducted by McLeod and colleagues, autistic college students reported significantly worse physical and mental health compared to neurotypical students, despite reporting higher than average levels of healthy behaviors, such as lower rates of binge drinking and sleep deprivation. While autistic individuals are more likely than typically developing individuals to have co-occurring disabilities, autistic students were approximately twice as likely to report poor mental health compared with neurotypical counterparts. Similarly, Jackson et al. (2018) found that over half their participants reported at least one co-occurring psychiatric diagnosis, depression being the most common, followed by anxiety, ADHD, OCD, and Bipolar Disorder. Articles that interviewed participants on the topic found that co-occurring mental health conditions were described as serious obstacles to success in college, with one student explaining that “[OCD] is a crippling disease and it takes a lot to handle… I didn’t really like the idea of sharing a room with somebody, just because of the obsession with having to be clean and everything” (Accardo, Kuder, & Woodruff, 2019, p. 4884). These findings are unsurprising, given that co-occurring mental health conditions are extremely common in this population (Hossain et al., 2020).

These results suggest that in addition to the external hardships autistic students face, and to the inherent hardships that autism-related difficulties may create, autistic college students contend with significantly poorer physical and mental health compared with their neurotypical peers. Given the number of factors working against them in their efforts to succeed in a competitive, stressful, and new environment, these results further emphasize the importance of providing strong structural support for autistic college students.

Individual Characteristics and Strategies for Success

These two themes were combined into one section due to their similarities and inherent interconnectedness, as reported individual characteristics often proved integral in students’ understanding of their own success and development of strategies to succeed. Gelbar et al. (2015) examined the relationship between individual characteristics of autistic college students and subsequent success in a college environment. They found that participants reported high levels of self-confidence in their academic abilities, with 80% agreeing with the statement, “I have the academic skills to succeed in college”. However, the majority of the sample found it difficult to some degree to follow lectures, manage their time effectively, and focus while studying. Despite the high levels of disclosure rates in the sample, only 50% endorsed comfortability disclosing their diagnosis on campus. Almost all participants in the sample preferred to spend their time in quiet places on campus, and half of the participants enjoyed living on campus. While the purpose of selecting a highly successful sample was to learn about the strategies and resources successful autistic college students used to navigate the challenges they may experience, the majority of the sample reported struggles with stress and anxiety, with a minority reporting disability discrimination from both peers and professors.

A study by White and colleagues (White et al., 2016) examined college students as well as other stakeholders through focus groups and an online survey to better understand the needs experienced by both current and incoming autistic college students. For both students and educators, the theme of interpersonal confidence was cited as the greatest area of need among autistic college students. Students reported difficulty with listening, cooperating, and communicating effectively. In the survey responses, students reported that reduction in social supports, academic stresses, and emotional regulation were the most challenging to them. Correspondingly, when students were asked what services they would prefer if cost was not an issue, they selected career counseling, weekly supportive therapy, and social interaction training.

Reis et al. (2021) used a strengths-based perspective to examine the success of academically talented autistic college students. In data from 40 semi-structured interviews, the 2e/ASD (academically talented and on the autism spectrum, or “twice exceptional”) participants reported being enrolled in advanced and accelerated classes through high school, as well as participating in many extracurricular activities, both in and out of the classroom. Although all participants were aware of their status as academically gifted and autistic, less than half reported feeling aware of their academic strengths and weaknesses, only gaining greater understanding after graduating from high school. Students discussed how their struggles to understand their weaknesses continued into their college experiences, with participants reporting weaknesses in organization and planning, as well as social difficulties that prove challenging in a college environment. One student reported, “I understand my strengths and weaknesses…Rather than let them go out of control, I handled them. For example, I knew that I was not good in social groups, so I would plan how to handle these before they happened” (Reis et al., 2021, p. 4434). Participants also reported using a variety of academic and metacognitive skills and strategies to keep up in college, most of which fell under the umbrella of time management and gaining understanding of their strengths and weaknesses in learning. For example, a student explained, “I chunk my time out carefully and make sure that if I know I am going to need ten hours to do something, I plan to spend two hours every day on that task and then give it five days” (Reis et al., 2021, p. 4435). Lastly, participants emphasized the importance of social support systems in understanding why they had difficulty with a class, or why a social interaction went awry. Academically successful college students learned to request accommodations even if it was difficult, and to advocate times for themselves in the new environment.

Roux et al. (2015) drew upon survey data from the National Longitudinal Transition Study-2 (NLTS2) to examine the differences in individual characteristics in autistic college students who attended postsecondary education at 2-year and 4-year universities, as well as vocational or technical school. The authors found that 46% of students who attended college after high school attended a 2-year college only, while only 11.7% attended only a 4-year college, and 23.8% attended both 2 and 4-year colleges. In both college groups, students were primarily male and Caucasian, and half were from households with incomes in the range of $50,000–$75,000. More than half of the students who attended a 2-year college had high verbal ability, with little or no trouble holding a conversation, and the majority were able to navigate places outside the home compared to individuals who did not attend college. Two-year college students frequently disclosed their disability to the school and requested accommodations (48.6%), with the most common accommodations being human aids (62.5%), testing accommodations (56.4%), and physical adaptations in the classroom environment (34.3%). Interestingly, over 80% of students who attended a 2-year college reported feeling as though they had received enough services, although only 68% reported that the services are useful, potentially indicating that the quantity of services was sufficient, but the quality lacking.

In another large survey of over 3000 college students who were either on the autism spectrum, had other disabilities, or were neurotypical, McLeod et al. (2019) investigated self-reported outcomes on academic performance, social relationships and bullying, and physical and mental health. Autistic students were more likely to be male and to be younger than either the neurotypical group or the students with other disabilities. Parents of autistic students were found to be more likely to have a higher education than the parents of other groups of students. They were also less likely to be international students, and less likely to be enrolled full-time. Autistic students had lower GPAs, were more likely to fail a course or take a remedial course, and reported more academic challenges than their neurotypical peers, despite being equally or more likely to have contact with faculty and reporting similar levels of academic engagement in the classroom.

Autistic students were also less likely to participate in internships or other career-oriented academic extracurricular activities than both students with other disabilities and neurotypical students. Students with disabilities as well as autistic students reported lower quality of social relationships than their neurotypical peers, and were more likely to have experienced bullying, especially if they were a racial or ethnic minority. Autistic students were also less likely to have romantic relationships compared with both other groups of students. Unsurprisingly, both students with disabilities and autistic students reported worse physical and mental health compared to the neurotypical group.

Cox and colleagues (Cox et al., 2021) conducted a series of qualitative interviews with autistic college students to analyze the challenges they underwent and understand coping strategies that are intended to address and overcome challenges. In interviews, students frequently reported struggles with coursework due to the mismatch between EF and how material is presented in class, explaining that “it’s not fair to us autistic people. It’s not designed for us autistic people” (Cox et al., 2021, p. 262). Large lecture halls were noted as the most ineffective method of information delivery for this population. However, class discussion and group assignments were considered the most socially uncomfortable for the students. Participants described the difficulty of suppressing repetitive behaviors and following social cues in these academic social contexts. Although stress and anxiety were reportedly high in this population, participants were reluctant to seek support from instructors or staff, or found disclosure unhelpful, with faculty and staff unwilling to work with them to find solutions. Accessing disability accommodations was similarly difficult, with several students running into bureaucratic red tape involving paperwork.

Students also reported receiving support from other sources, including academic tutors, family members, counselors, understanding professors, and friends. Despite individual stories of positive experiences with support in an academic context, the students described these incidents as not indicative of the larger attitudes or systems of support for college students with autism. Lastly, when it came to how each student self-identified, individual participants varied in their acceptance of autism as a part of themselves, with some embracing the label, and others rejecting autism as an integral part of their self-conception.

Identity and Disclosure

Along with understanding how autistic college students contextualize their surroundings, there is a need to understand how they view their own disability status and identity. In addition to the difficulties obtaining services, physical and mental health struggles, and the many other burdens autistic college students face, students must contend with the fact that their identity can carry a certain stigma among their neurotypical peers. In a survey examining characteristics of autistic college students and self-perception of their skills and disability status, Shattuck et al. (2017) found that only two thirds of their sample characterized themselves as “having a disability or special need”. Being Black and having higher functioning skills were significantly correlated with lower likelihood of self-identifying as having a disability. While the reasoning behind this finding was not explored further through interviews or expanded survey questions, this may be a cultural difference that bears further exploration in future research. The authors also found that self-confidence and one’s ability to handle obstacles were higher among males and those with higher verbal abilities, although lower among STEM majors. Lastly, Black participants reported lower confidence in their ability to get people to listen to them compared to their white counterparts.

In another exploration of identity and disclosure practices among autistic college students, Frost et al. (2019) conducted 20 semi-structured interviews on how autistic students integrate autism into their identity, whether they pursue an autism community in college, as well as how and when they disclose their diagnosis. Interestingly, half of the participants said that autism is a substantial part of their identity, and half reported that autism is not a strong part of their identity. They reported both strengths of autism and negative feelings about autism, often mixed with other co-occurring health disorders. One participant explained, “I see it as a double-edged sword. It comes with challenges but also with gifts that make me who I am” (Frost et al., 2019, p. 271). The intersectionality of an autistic identity with race was also mentioned by one participant as an additional barrier to being understood by her peers: “I’m Black too, so people have certain stereotypes and certain types of ideals associated with that, so, all of a sudden when you also say you’re autistic, it’s like that’s another building block for them” (Frost et al., 2019, p. 271). The majority of participants reported not feeling a part of a broader autism community, some finding those communities stigmatizing, and others being concerned that being a part of an autistic community would only serve to emphasize stereotypes and subsequent judgment.

Lastly, the vast majority of participants reported preferring not to disclose their autism identity to other people, disclosing only to close friends and partners, or when strictly necessary to obtain accommodations. When asked what motivated this decision, most participants responded that they were concerned about being misunderstood, being seen as attention seeking, or being judged negatively and treated badly as a result. Conversely, the one participant that reported frequently disclosing his status as autistic explained that he did so to facilitate greater understanding among his peers, saying, “I just don’t really care about hiding it” (Frost et al., 2019, p. 272).

Fear of peer stigma is a commonly cited reason for not wanting to disclose one’s identity, especially among young adults in a new environment. Underhill et al. (2022) interviewed ten autistic college students to investigate and found that these students routinely engaged in masking behaviors, camouflaging their more “autistic” tendencies to prevent associations with negative or stigmatizing stereotypes. Participants reported preparing for social interactions to avoid seeming off-putting and reported being seen as neurotypical by their peers as a priority. Every participant reported spending high amounts of energy on self-monitoring during social information interactions, with one participant explaining, “it’s less of like a specific interaction and more of just a need to constantly be very vigilant about how I’m saying things” (Underhill et al., 2022, p. 6). Students also compared themselves favorably to others on the autism spectrum, seeing themselves as more “neurotypical” than other autistic students who are experiencing peer-instigated stigma, believing they can “hide in plain sight”. Participants also expressed that autistic students who could not hide their more “autistic” attributes were more deserving of stigma than themselves, expressing pity for those who could not control their own behaviors or who appeared awkward or unusual in social interactions while explicitly distancing themselves. They considered the autism label to be highly stigmatizing, and several participants limited disclosure to only close confidants as a result.

Cox et al. (2017) explored the identities and disclosure habits of nine autistic adults who currently or formerly attended college. Students reported awareness that they were different from their peers. In particular, participants who received their autism diagnosis earlier in life reported greater levels of self-acceptance and positive sense of identity. However, even among those who had a positive self-conception, disclosure was generally a topic of discomfort. Many participants were concerned with what others would think if they knew about the label of autism and had negative experiences disclosing to both faculty and students. Several students reported experiences of their confidences being weaponized against them. In general, participants reported using “pragmatic disclosure”, or only disclosing their diagnosis in specific times and places when it would be beneficial to do so. One participant explained, “I don’t know when or how to say it, so I would always wait for it to come up” (Cox et al., 2017, p. 78). Similarly, Bolourian et al. (2018) found that several students reported feeling pressured by faculty and their institution to perform at the same level as their neurotypical peers, feeling set up for failure by the universities’ lack of support for their limitations. Many students were afraid of disclosing their diagnoses to faculty for fear they would not be believed or would be negatively set apart from their peers.

A study by Zeedyk et al. (2019) illuminates some reasons why students might fear disclosing their autism status to faculty. The authors conducted a series of interviews with 13 autistic college students, as well as 18 college professors to investigate the experiences and needs of autistic college students. In semi-structured interviews, both students and professors identified a theme of “invisible disability”, or the idea that their disability was often undetectable without prior knowledge. Students shared difficulties in obtaining services since they did not present as obviously in need of them, or expressed concern that others would think they were lying if they asked for assistance. Students also reported that disability services were more concerned with physical disabilities than other disabilities, leading to students having to work with the available services even if they were not appropriately addressing their underlying needs. Furthermore, students reported working with professors to utilize “unofficial accommodations”, with professors going above and beyond what was required by the ADA. Both positive and negative interactions with other students and professors surrounding the disclosure of their disabilities were reported, with some faculty asking for information that is private and against the law to share, and other faculty refusing to honor disability accommodations provided through the University.

Discussion

Findings from the articles reviewed above indicate that while many autistic college students have positive experiences with campus life and certain services received through disability supports and other campus resources, there is still much to be desired in the college experiences of many autistic students. Across numerous studies, many students reported that the services they received were either inappropriate or inadequate to their needs. Furthermore, participants frequently reported professors’ unwillingness or inability to comply with the accommodations theoretically given to them through campus resources. Conversely, several professors provided support not officially offered through campus resources to bridge the gap between needs and service availability.

Limitations

Very few of the articles reviewed partnered with autistic individuals in their creation. Furthermore, the author of this review is not autistic. While working with autistic college students to learn more about their experience is an admirable step towards the inclusion necessary for community partnered research, the next step is to include both the autistic individuals themselves and stakeholders in designing and conducting research. Partnering with community members and stakeholders can yield richer and more useful results when learning more about individuals’ experiences or designing interventions to improve their lives, as even the interview questions and topics can be more targeted when designed by members of the community with lived experience as opposed to connected outsiders. The Neurodiversity movement has a saying that perfectly exemplifies the approach future research should take in exploring this underrepresented research field: “Nothing about us, without us” (Hoekstra et al., 2018).

Implications for Future Research

Part of the difficulty in generalizing this type of research is that different colleges and postsecondary environments may offer different services, accommodations, service landscapes, and inclusive culture. Future research may consider zeroing in on a location or a group of locations and potentially partnering with college disability service departments for a more in-depth examination of resources offered and experiences of autistic students. The knowledge of student experiences around these resources will be invaluable in moving forward in this area of research, providing a jumping off point for improving access to appropriate services, educating faculty and staff about the needs of autistic students, providing more support for faculty compliance (e.g., with disability accommodations), creating new avenues for increased social networking and support, and increasing the quality of services offered through campus disability offices.

While mental and physical health was a frequently raised issue among autistic college students, very few of the articles reviewed in the study centered on health as a primary focus of their investigations. Future research may delve deeper into the experiences of autistic college students regarding both their mental and physical health, and investigations into campus resources to deal specifically with autism-related commonly co-occurring mental and physical health, such as the accessibility of on-campus healthcare, as well as the intersections of other autism-related stressors with health risks. As college-age students are prone to mental health crises, both through stressors and due to developmental stages (Pedrelli et al., 2015), and autistic college students have additional stressors that may contribute added risk, research into prevalence and prevention in this population is highly recommended.

It is unsurprising to find that students who are more successful academically in college tend to be those who were more successful academically in high school. However, the articles reviewed indicate additional strategies and resources used by this population that may be helpful for all autistic students. Learning from successful college students and understanding what they did to succeed may prove useful to those who are struggling.

Given the findings of negative reactions from faculty refusing accommodations, as well as the well-known existing stigma of an autism diagnosis, the hesitancy around disclosure reported by many participants is understandable. Despite this, disclosure was critical in obtaining services and support for many students. Increasing education on the part of faculty and staff, as well as equipping students with the tools they need to feel comfortable around disclosure and confidence in how they can explain their diagnosis to those uneducated about autism, can prove invaluable skills in navigating postsecondary schools successfully. Additionally, as students do not have to disclose their diagnoses to professors to obtain accommodations, arming students with the knowledge of what information they do and do not need to share may help empower students to feel comfortable advocating for themselves in the classroom.

The insight gleaned from these articles on the lived experience of autistic college students is varied and at times contradictory. Most students reported wanting or benefiting at least somewhat from a college social life. There is evidence outside of anecdotal accounts that friendships are beneficial and can be a protective factor for autistic adults (Mazurek, 2014). Promisingly, many participants in the articles reviewed above mention college as a fruitful environment for finding special interest clubs and bonding with other students with similar interests, indicating that college can be a conducive environment for expanding social horizons and finding social support. However, autistic college students were reported as less likely to seek out and participate in extracurricular and social activities. Future research could investigate the avenues autistic college students use to bond with other students of similar interests, while future intervention research might focus on designing interest based social skills groups (e.g., PEERS for Young Adults; Laugeson et al., 2015).

One finding that emerged from anecdotal accounts of autistic college students was the internalized stigma they frequently experienced towards other autistic college students displaying more outwardly neurodivergent behavior, such as self-stimulation or emotional dysregulation. Many participants reported doing their best to “mask” potentially socially unacceptable behavior, inwardly and outwardly distancing themselves from individuals who either chose not to mask or who masked less effectively than themselves. Similarly, many students reported preferring to bond with neurotypical individuals with similar interests than other autistic college students. While this internalized stigma is a commonly observed phenomenon among members of the autism community (Huang et al., 2023), there is little research examining inward stigmas and biases on the part of autistic individuals towards other members of the community. Further research could investigate this phenomenon more thoroughly.

Although friendship can be a protective factor against negative outcomes in autistic adults, many autistic college students report preferring fewer friends or to spend most of their time alone. Future research may investigate further into the reasoning behind these choices, investigating whether disinterest in making friends is due to sensory overstimulation, social anxiety, or to genuine preference for isolation.

The research reviewed above briefly touched upon the intersection between race and disability status, finding that Black participants were less likely to self-identify as autistic, and were less confident in their ability to get faculty and students to listen and believe them compared to their white counterparts. The intersection of race and autistic identity is largely unstudied and has enormous implications for the lives and experiences of many individuals. Black students in general are less likely to utilize mental health services on college campuses, as well as other services (Anderson, 2018). The intersection of race and autistic identity may have more important implications for underutilization of services. Additionally, these articles did not review any other racial or ethnic minority identity apart from Black students. Future research should investigate the effects of this intersectional identity at greater length, as well as a wider range of racial and ethnic intersectional identities. Students’ racial and ethnic identity can independently affect service receipt, mental and physical health, personal identity, and social experiences. Many of the reviewed articles did not report on participants’ race and ethnicity, or address intersectionality, leaving a significant gap in need of additional research.

Conclusion

With more autistic young adults heading to college than ever before, it is critical to understand the experiences of these students. First-hand accounts of their time at college can illuminate what remains to be improved and what areas of need should be targeted by future research and policies.

There are several actionable items found within these results for high schools and universities. Given the finding that students had difficulty navigating their accommodations with professors and disclosing their identity in professional settings, education about student rights to their accommodations and instruction on how to disclose an autistic identity to a professor could be a valuable pre-collegiate educational tool that could be incorporated into transition-related IEPs. Furthermore, faculty could be given mandatory training on speaking to students about disability, how to honor disability accommodations, and promote comfort and trust in the student-teacher relationship. Lastly, universities may consider the frequency with which each type of accommodation is used, and the preferences students expressed in these findings to shape their accommodation offerings in future years. Further research in this field could yield more useful and lasting steps towards improving college for autistic students.

College can be a gateway to successful employment and is a launchpad to an independent adulthood for many autistic individuals. Therefore, in the effort to improve quality of life outcomes for autistic young adults, illuminating conditions in which autistic college students can be successful and thrive is a top priority. The literature reviewed in this article represents a step forward in achieving that goal. However, researchers and educators are only at the beginning of understanding the successful roadmaps into and through the college years for this population. It is advisable that such professionals partner with members of the autistic community and relevant stakeholders to create a more accessible and positive college experience.