College as a Developmental Context for Emerging Adulthood in Autism: A Systematic Review of What We Know and Where We Go from Here.
Chaia Flegenheimer, K Suzanne Scherf
PMID 34060001WHAT IT FOUND
Autistic college students report feeling academically prepared but struggle with time management, sensory overload, and social isolation.
Interventions exist but are multi-component and often lack control groups, making it hard to know which specific supports actually help students stay enrolled.
Key findings
01Autistic students generally report having the academic skills to succeed, with 65% reporting good grades compared to 68% of typically developing peers.
02The most consistent challenges involve daily living skills, specifically time management and adapting to changes in routine, with 67% to 87% of students reporting difficulties in these areas.
03Most interventions target social skills but are multi-component programs, making it difficult to determine which specific elements improve college retention or adaptation.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The review is narrative rather than a meta-analysis, so it does not provide pooled effect sizes. Most included studies relied on self-report, and autistic individuals may have limited insight into their own social skills. Intervention studies often lacked control groups or were underpowered, making it difficult to determine if improvements were due to the intervention or natural development. The interventions reviewed were multi-component, so it is unclear which specific parts (e.g., mentorship vs. skills training) were effective. Only published, peer-reviewed studies were included, which may introduce publication bias.
The easy way to misread this
Do not assume that existing social skills interventions are proven to improve college graduation rates. The review highlights that most interventions are multi-component and lack rigorous control groups, meaning the specific contribution of any single therapeutic technique to student retention cannot be separated from other factors like mentorship or general support.