Systematic Review of Articles Describing Experience and Supports of Individuals with Autism Enrolled in College and University Programs
Nicholas W. Gelbar • Isaac Smith • Brian Reichow
Published online: 11 May 2014
� Springer Science+Business Media New York 2014
Abstract The increase in the number of higher-func-
tioning individuals with autism spectrum disorders (ASD)
is likely to lead to an increased interest in postsecondary
opportunities including degree-granting college and uni-
versity programs. To provide an understanding of the
current evidence-base for supporting individuals with ASD
in higher education, this article reports the results of a
systematic review of the literature concerning college
students with ASD. Overall, 20 articles describing 69
individuals met the inclusion criteria. This small number of
articles and participants indicates the scarcity of research
on this topic and only two of these studies were experi-
mental in nature. These studies described a video-self
modeling intervention and a counseling intervention
respectively. Eighteen ‘‘case studies’’ were also present in
the literature that described difficulties ranging from anx-
iety to housing concerns. This review deliniates the limi-
tation of our understanding of effective college
programming for individuals with ASD.
Keywords Autism spectrum disorder � ASD � Asperger � College � University
Autism spectrum disorders (ASD) are a family of complex
neurodevelopmental disorders characterized by behavioral
symptoms in two broad domains: difficulties with social
communication and the presence of restricted and/or
repetitive behaviors (American Psychiatric Association
2013). Overall, ASD affects 1 out of 88 people (CDC 2012)
and this prevalence rate indicates an significant increase in
the number of individuals diagnosed with ASD over the
past 10 years (Schieve et al. 2012; Volkmar et al. 2004).
Many factors have contributed to the increasing prevalence
rates of ASD including an increase in the number of
individuals who are described as higher-functioning (CDC
2012). However, although individuals might be described
as higher-functioning, the developmental trajectory of each
individual is unique and the severity of symptom presen-
tation may vary over time (Eaves and Ho 2008; Fein et al.
While the number of higher-functioning individuals
with ASD is increasing, most of the research has focused
on individuals who are lower-functioning (Van Bergeijk
et al. 2008) and younger children (e.g., Reichow and
Volkmar 2010). While the efficacy of early-intervention is
well established (e.g., National Research Council 2001;
Reichow 2012; Rogers and Vismara 2008), the paucity of
research on older individuals has caused the Interagency
Autism Coordinating Committee (IACC) to target transi-
tion programs for adolescence with ASD as a priority for
research (IACC 2012). This emphasis on transition coupled
with data on the poor post-school outcomes for individuals
with ASD (Billstedt et al. 2005; Henninger and Taylor
2013) indicate the importance of research exploring expe-
riences of higher-functioning individuals as they exit the
K-12 education system.
Trends in recent research point to increased knowledge,
awareness, and acceptance of individuals with ASD on
college campuses (Gardiner and Iarocci 2013; Neville and
White 2011; Tipton and Blacher 2013). In a survey with
over 1,000 respondents, the majority indicated they were
N. W. Gelbar (&) � I. Smith � B. Reichow AJ Pappanikou Center for Excellence in Developmental
Disabilities, University of Connecticut Health Center, 263
Farmington Avenue, MC 6222, Farmington, CT 06030, USA
J Autism Dev Disord (2014) 44:2593–2601
aware of the increase in prevalence of ASD, though they
mistakenly attributed the increase to vaccinations (Tipton
and Blacher 2013). This finding may reflect a broader trend
in which campus communities are knowledgeable about
the increased prevalence of ASD and trends in treatment,
but remain less informed about etiology and outcomes
(Gardiner and Iarocci 2013; Tipton and Blacher 2013).
Quality of previous interactions with individuals with ASD
have been shown to predict acceptance and willingness to
volunteer to work with individuals with ASD, with females
and social science majors particularly likely to volunteer
and show acceptance (Gardiner and Iarocci 2013). A con-
tradictory finding, however, indicated that social science
majors were less comfortable interacting with individuals
with ASD than engineering majors or students who had
first-degree family members with ASD (Neville and White
Despite the increased awareness and acceptance of
college students with ASD, their relatives have expressed
concerns that these students were bullied, easily distracted,
unable to prioritize, and lacked the ability to structure their
schedules without the proper accommodations (Fleischer
2012). Relatives were further frustrated by their inability to
play a role in the collaborative relationship between stu-
dents and the disability services coordinators responsible
for securing supports (Fleischer 2012). Additional work has
described many of the academic challenges faced by
individuals with ASD as they transition to postsecondary
education. People have suggested that college counselors
should act as the primary facilitators in coordinating sup-
ports among faculty, disability services offices, peer men-
tors and parents (Graetz and Spampinato 2008; Pillay and
Bhat 2012). Although counseling and support services
geared specifically towards students with ASD are rare, one
exemplar program provided a first-year experience course
unique to individuals with ASD consisting of an environ-
ment in which students can express concerns with their
transition to college, practice social skills to facilitate
improved peer interactions, and become familiar with
campus facilities, procedures, and services (Smith 2007;
Wenzel and Rowley 2010).
The difficulties with executive functioning and critical
thinking faced by individuals with ASD can be addressed
by using a variety of instructional strategies including
breaking tasks into smaller pieces, providing clear expec-
tations for submitted work, and helping students to make
plans and stay organized (Shmulsky and Gobbo 2013).
Additional academic accommodations that have been
suggested include extended deadlines, extra time on exams,
and alternatives to group projects and assignments
involving public speaking (Gobbo and Shmulsky 2012).
These types of supports allow students with ASD to dem-
onstrate their knowledge of course material in a format
with which they are more comfortable. Difficulties with
loosely structured courses and abstract language used by
peers and professors have been addressed by providing
detailed syllabi and using concrete language in lectures
(Gobbo and Shmulsky 2012). Further, taking a reduced
course load or scheduling classes only on certain days of
the week has been suggested as a way to free students from
the pressure of busy class days (Adreon and Durocher
2007). Finally, to address the hypersensitivities of many
students with ASD, research has proposed the elimination
of as many distracting environmental stimuli as possible
(Gobbo and Shmulsky 2012).
In addition to academics, college students with ASD are
likely to face issues with socialization, independent living
skills (including housing and roommate concerns), self-
advocacy, and structuring their time (Adreon and Durocher
2007; Fleischer 2012; Pillay and Bhat 2012). To address
these concerns, utilization of independent agencies that
provide services above and beyond those legally required
by the Americans with Disabilities Act (ADAAA 2008)
such as mentorship programs and weekly support group
meetings has been proposed (Dillon 2007). Interventions
designed to improve peer communication by developing
scripted responses and practicing (role-playing) conversa-
tional skills have been described in the literature (Harrison
1998; Zager and Alpern 2010). Commuting from home to
avoid the stresses of dorm life has also been proposed as a
way to ease the transition to postsecondary education
(Pillay and Bhat 2012).
As the number of individuals with higher-functioning
ASD has risen (CDC 2012), the number of individuals with
ASD seeking to attend degree-granting institutions of
higher education is also likely to increase. Thus, it is
essential to understand the current research base docu-
menting the challenges and supports faced by college stu-
dents with ASD to develop effective programs for high-
functioning individuals with ASD in order to increase the
post-school outcomes for this group. Unfortunately, the
literature describing the intersection of ASD and post-
secondary education has been limited. A review summa-
rizing the available evidence does not current exist so the
purpose of this article is provide a systemic review of the
published literature on the firsthand experiences of indi-
viduals with ASD attending degree-granting colleges and
We included articles in our review meeting the following
inclusion criteria. First, the article contained individuals
2594 J Autism Dev Disord (2014) 44:2593–2601
with ASD who were attending a degree-granting college or
university. Second, the article included a first-hand
description of the services, supports, or experiences of one
or more individuals. Third, the article was published in
English in a peer-reviewed journal. Included and excluded
studies were collected following the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses
(PRISMA; Moher et al. 2009).
We conducted an electronic database search of Medline,
Embase, and PsycINFO in October 2013 using the fol-
lowing text word search strategy: (exp child development
disorders, pervasive/OR autis* OR (pervasive develop-
ment* disorder* OR PDD or PDDs) OR Asperger*) AND
(undergraduate* OR college* OR university* OR (graduate
adj student*) OR postsecondary). Two authors screened all
titles and abstracts independently in order to exclude
clearly irrelevant articles. The full papers of the remaining
articles were then examined to determine which articles
met all inclusion criteria. After the database search, we
examined the reference lists of the included articles for
possible articles that were not located in the database
Variable Definitions and Coding
For all articles, we attempted to code nine variables related
to participant characteristics, college experiences, and
services and supports received. We coded six variables
related to the participants of the articles. First, we coded
the location of the institution the participants were
attending (United States, Canada, Great Britain, or other).
Second, we coded the sample size of individuals with ASD
in the article (individuals with developmental disorders
other than autism were excluded). Third, we coded the
participant’s reported diagnosis (e.g., autism, high func-
tioning autism, Asperger’s syndrome, PDD, PDD-NOS).
Fourth, we coded the gender (percent male) of participants.
Fifth, we coded the mean, standard deviation, and range for
the age of the participants. Finally, we coded the partici-
pant’s full scale IQ.
We also coded three variables related to the college
experiences and the supports and services described in each
article. First, we coded firsthand experiences of the par-
ticipants (e.g., depression, anxiety, difficulty making and
keeping friends) that were described in each article. Sec-
ond, we coded if the student received academic accom-
modations (e.g., note-taker, extended time on exams,
separate test location) and/or curricular modifications (e.g.,
assignment substitution). Accommodations included any
service provided by an instructor, peer, independent agency
or campus disability office that better allowed participants
to complete the same coursework as peers in the same
classes, whereas curricula modifications were changes in a
course’s syllabus that permitted a participant to complete
different assignments than peers in the same class. Finally,
we coded non-academic support services that were
described (e.g., social support groups, peer mentors).
We located 3,553 records; 2,565 remained after deduplica-
tion. Fifty-one articles remained after title and abstracts were
screened to ensure that the study focused on college students
with ASD. Most of the excluded studies described or
reviewed interventions or issues facing students in the K-12
education system. After examination of the full papers we
judged 15 articles to meet all inclusion criteria. Examination
of the reference lists of these 15 articles revealed an addi-
tional 52 articles for full paper examination, of which five
met inclusion criteria. Thus, the final sample of articles was
20. The primary reasons for exclusion are shown in the
PRISMA flow diagram shown in Fig. 1.
We located 20 articles published in peer-reviewed journals
describing collegiate experiences and/or supports of adults
with ASD. The articles were all published in or after 1999,
which was over 50 years after Kanner’s first description of
infantile autism (Kanner 1943) and Asperger’s initial
description of the condition named for him (Asperger
1944). With respect to date of publication, one-half of the
articles (50 %) were published since 2010. Of the 20 arti-
cles, all but one reported college experiences from the
United States (11 of 20, 55 %) or the United Kingdom (8 of
20, 40 %); the one article not from the US or UK reported
college experiences of one student from Japan (Yamamoto
and Nihei 2008). The largest sample size of an individual
article was 12 (Langford-Von Glahn et al. 2008). A
majority of articles contained fewer than five participants
(14 of 20 articles, 70 %). Two articles (Pugliese and White
2013; Mason et al. 2012) used experimental methods to
investigate interventions. The remaining 18 articles (90 %)
were essentially case studies of individuals with ASD in
Table 1 provides information on participant characteris-
tics, college experiences, and types of support services
J Autism Dev Disord (2014) 44:2593–2601 2595
across the articles included in this review. Collectively
there were 69 participants across the 20 articles included in
this review (there were the same eight participants in
Madriaga (2010) and Madriaga and Goodley (2010) and
the same single participant in Connor (2012, 2013) so they
were only included once in the total count). All (100 %)
articles provided diagnoses for participants, though one
(Lee et al. 1999) was speculative in nature. Asperger’s
syndrome (52 of 69, 75 %) was the most prevalent diag-
nostic category, followed by ASD (12 of 69, 17 %) and
PDD (5 of 69, 7 %). In articles that reported the gender of
participants (17 of 20, 85 %), the majority (41 of 60,
68 %) were male. Age information of participants was
included in five articles (25 of 69; 36 % of participants)
with a range across articles of 16- to 30-years-old
(M = 21.20, SD = 3.20). Full scale IQ information was
provided in one of 20 articles (5 %) for five participants
(M = 128, SD = 9.50).
Firsthand experiences of individuals with ASDs in college
settings were described in 17 of 20 (85 %) articles and are
shown by study in Table 1. Anxiety (12 of 17, 71 %) was
the most commonly reported experience, followed by
loneliness (9 of 17, 53 %) and depression (8 of 17, 47 %).
Participants also described experiences of isolation/mar-
ginalization (e.g., peer rejection of participant’s repeated
social overtures, peers starting a petition to have a partic-
ipant removed from a dormitory) in 4 of 17 articles (24 %).
Housing and roommate concerns were reported in 3 of 17
articles (18 %).
Academic Supports and Services
The majority of articles (12 of 20, 60 %) described aca-
demic supports and services for the students with ASD and
Fig. 1 Article inclusion decision tree (adopted PRISMA flow diagram)
2596 J Autism Dev Disord (2014) 44:2593–2601
Table 1 College experience and supports for students with autism
Study Location N Diagnosis Gender
Age (years) First hand
Academic supports Non-academic
1:0 Not reported None reported Lecture notes, extra
time on exams
1:0 19 Loneliness,
Separate location and
extra time on exams
1:0 19 Loneliness,
None reported None reported
4:0 Not reported Stress, housing/
Professor facilitation of
5:1 Not reported Loneliness Lecture notes, extra
time on exams,
Jones et al.
6:3 Range 16–21 Bullying,
None reported None reported
1:0 Not reported Difficulty writing
for an audience
None reported None reported
7:5 Not reported Loneliness,
difficulty, lack of
Lecture notes and
Lee et al.
1:0 21 Loneliness,
None reported None reported
2:0 Not reported Anxiety, bullying Tutor Peer mentor,
3:3 Not reported Marginalization None reported None reported
5:3 M = 21.1
(SD = 3.9;
dislike of crowds,
extra time for exams,
J Autism Dev Disord (2014) 44:2593–2601 2597
are described by study in Table 1. Accommodations were
described in 9 of 12 articles (75 %) and included extra time
on exams (6 of 9, 67 %), lecture notes from instructors (5
of 9, 56 %), use of a separate testing location (3 of 9,
33 %), extended deadlines on assignments (2 of 9, 22 %),
lecture notes from peers (2 of 9, 22 %), oral exams (1 of 9,
11 %), and professor facilitation of group projects (1 of 9,
11 %). Course curricula modifications were described in 3
of 12 (25 %) articles (Langford-Von Glahn et al. 2008;
Taylor 2005; Taylor et al. 2008) describing individualized
supports. In all three cases, the modifications included
individual projects in lieu of group projects. In two articles,
participants were permitted to give presentations one-on-
one with an instructor rather than in front of a large group
(Taylor 2005; Taylor et al. 2008).
Non-academic Supports and Services
Nine of 20 (45 %) studies described non-academic support
services provided to college students with ASDs which are
shown by study in Table 1. The majority of these supports
took the form of peer mentorship programs (5 of 9, 56 %)
or assigned counselors, aides, or liaisons (5 of 9, 56 %).
Three of 9 (33 %) articles described parental involvement.
Single instances of the use of Social Stories (Glennon
2001), disability teams (MacLeod and Green 2009), social
Table 1 continued
Study Location N Diagnosis Gender
Age (years) First hand
Academic supports Non-academic
5:3 M = 21.1
(SD = 3.9;
Separate location and
extra time for exams
2:0 M = 22.5
(SD = 3.5;
Loneliness, anxiety None reported Video modeling,
Oda (2010) United
0:1 Not reported Anxiety Tutor None reported
5:0 M = 21.27
(SD = 1.88,
None reported None reported Cognitive
Not reported None reported Coursework/
for classes missed
Not reported Anxiety, disruptive
alternatives to group
for classes missed
1:0 Not reported Loneliness,
Tutor Peer mentor
Japan 4 PDD
Not reported Loneliness,
None reported None reported
2598 J Autism Dev Disord (2014) 44:2593–2601
support groups (MacLeod and Green 2009), video model-
ing (Mason et al. 2012) and cognitive behavioral inter-
ventions (Pugliese and White 2013) were also reported.
Overall, the major finding of this review is the scarcity of
research concerning the experiences of college students
with ASD. Only 20 articles describing 69 individuals met
the inclusion criteria for this review, which were pur-
posefully broad in order to capture as many articles as
possible. Specifically, the current literature base contains
fragmented descriptions of programs, experiences, and
theoretical suggestions for effective programs. As shown in
Fig. 1, the majority of articles (n = 39) were excluded
because they did not describe firsthand accounts of college
experiences, supports, and services. While many of these
articles contained suggested practices that are likely to be
effective and helpful, it is time to move past theoretical
suggestions and into empirically-based recommendations.
More research in this area is needed to support effective
transition and post-secondary programming. Potential
avenues for this research include surveying and inter-
viewing college students with ASD to understand their
experiences in post-secondary education in order to inform
A secondary finding of this review involves the research
methodologies used in the research literature. Only two
studies (Mason et al. 2012; Pugliese and White 2013)
contained experimental manipulations; the remaining 18
articles amount to what would be best described as case
studies. It should be noted that this review used a liberal
definition of a case study as many of the articles provided
very brief descriptions of the individual’s experiences,
presented only one individual as a case study, and the case
presented often supported the researcher’s theoretical
positions on what constituted effective postsecondary
programming for individuals with ASD. Of the two
experimental studies, both used single subject experimental
designs. The first study investigated the effectiveness of
video-modeling to improve social communication in col-
lege students with ASD (Mason et al. 2012) and the second
examined effectiveness of a cognitive-behavioral therapy
(specifically a psycho-educational intervention designed to
improve problem-solving skills) (Pugliese and White
2013). The effectiveness of these two interventions that are
theoretically distinct does not provide any indication of
what effective post-secondary programming should entail.
In addition, the use of mostly case studies to support the-
oretical suppositions and two fragmented intervention
studies indicate that future research on the experiences of
college students with ASD is essential. It is crucial to
investigate the experiences of these students to understand
the nature of their reported skill deficits that informs future
These two findings coalesce and support other review
studies that the evidence-based supporting practices for
adolescence and adults is scant (Volkmar et al. 2014).
While the evidence supporting behavioral interventions is
overwhelming (Matson 2009; Reichow et al. 2012), it is
unclear if these interventions develop the broad and gen-
eralized skill sets that are required for competitive
employment or postsecondary success. Transporting these
interventions from early intervention to transition- and
postsecondary-aged youth especially for individuals who
are higher-functioning may not be the most effective
approach though further research is clearly necessary.
Overall, it is unclear which theoretical paradigms would
best serve these students when designing programming.
Currently, the K-12 system assumes given the academic
achievement of higher-functioning individuals with ASD
that they will be successful in postsecondary environments;
an assumption that is contraindicated by the literature on
their post-school outcomes (Billstedt et al. 2005; Hennin-
ger and Taylor 2013). This assumption is also contradicted
by the results of this literature review; the majority of the
articles included indications of depression, anxiety, and
loneliness. Obviously, further research is needed to explore
the prevalence rates of these concerns in college students
with ASD, but other research has indicated that adolescents
with ASD also have reported these issues (Berthoz et al.
2013; Skokauskas and Gallagher 2010; Strang et al. 2012).
Beyond the social and emotional difficulties faced by these
students, it is also important to understand the areas in
which they report that they are academically prepared and
the areas academically in which they struggle.
Given the increased prevalence rates of higher-functioning
individuals with ASD, it is likely that more individuals
with ASD will be entering higher education. This position
is supported by the increasing rate of publication on
experiences and supports for college students with ASD
seen in this review. These articles reported a systematic
review of the literature regarding the experiences and
support services reported in the peer-reviewed literature for
college students with ASD. We found 18 case studies and
two experimental intervention studies of individuals with
ASD in college. The case studies indicated the presence of
anxiety, loneliness, and depression and the need for aca-
demic and non-academic supports. One intervention study
investigated video-modeling using single-subject method-
ology; the other intervention study explored a cognitive-
J Autism Dev Disord (2014) 44:2593–2601 2599
behavior therapy focused on building problem-solving
skills. Overall, the current literature-base describing the
experiences of and programs for individuals with ASD in
college is fragmented and indicates that much research is
necessary to understand how to best serve this population
and to improve their post-school outcomes.
Acknowledgments This research was not funded by any grant. We would like to acknowledge Mary Beth Bruder, Director of the AJ
Pappanikou Center for Excellence in Developmental Disabilities at
the University of Connecticut Health Center, for her support and
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- Systematic Review of Articles Describing Experience and Supports of Individuals with Autism Enrolled in College and University Programs
- Selection Criteria
- Search Methods
- Variable Definitions and Coding
- Search Results
- Article Characteristics
- Participant Characteristics
- College Experiences
- Academic Supports and Services
- Non-academic Supports and Services