Laurie Leventhal-Belfer - College on the Autism Spectrum: A Parents Guide to Students Mental Health and Wellbeing

College on the
Autism Spectrum

A Parents Guide to
Students Mental Health
and Wellbeing

Laurie Leventhal-Belfer

Foreword by Tony Attwood

Contents

Foreword

One of the diagnostic characteristics of autism is insistence on sameness, with considerable anxiety and distress when established routines are changed. Starting college inevitably involves new daily routines, expectations and social conventions.

There are clearly positive aspects of going to college; for example, the opportunity to make new friends, potentially a reduction in bullying and rejection by peers, the enjoyment of intellectual stimulation and accomplishments, and perceived freedom from parental micromanaging. However, there are potential challenges too, which are often of great concern for parents. These include coping with daily living skills, facing a range of temptations and distractions, adapting to new social and academic conventions, and managing stress and anxiety.

During the high school years, a parent may have provided considerable support in the areas of time management, nutrition, budgeting, personal hygiene, and sleep. That parent may have been so efficient in facilitating daily living skills that the student was not aware of their support needs, failing to recognize the cues that indicate a particular requirement, such as having a shower. A parent may have provided regular daily monitoring, prompts, guidance, and reassurance that are unavailable once the student leaves home for college. It is imperative, therefore, that increasing independence in daily living skills becomes a part of home life some years before going to college.

There are many temptations and distractions at college: for example, the opportunity to indulge in increasing, unsupervised screen time; the lure of intoxication by both legal (alcohol) and illegal drugs (e.g., marijuana); and the possibility of developing romantic and sexual relationships, inherently distracting and unsettling for a vulnerable young person. A typical student will have friends at college to provide advice and emotional support, but the student who has autism may not easily establish a trustworthy social network of people to whom they can disclose their thoughts and feelings.

While the student may tend towards reclusiveness, there is obvious advantage in having friends and acquaintances with whom to discuss assignments, provide support in potentially risky situations, and even develop romantic relationships. They should be encouraged, therefore, to initiate social interactions with fellow students on their course, and to seek out and join some of the many college groups and societies in areas of talent or interest, such as choral singing, music, or drama, to name but a few.

There will be new social conventions and expectations at college. These are often fairly obvious for a typical student, but less so for the student who has autism, who may need guidance in the social aspects of college life with fellow students and academic staff. They may be less aware of social conventions, sometimes appearing to be politically incorrect, or being perceived as having extreme political, social, or religious beliefs. There may also be a risk of their being recruited by extremist student groups.

Because of the many potential pitfalls in this unfamiliar student life, a number of colleges are developing a buddy system for students who have autism. The buddy may simply be a fellow student who wants to help someone who has autism, or perhaps a fellow senior student who has autism themselves. The intention is that they meet regularly to discuss and provide support on a range of college issues, from developing friendships to assignments and exam preparations. In Australia, several colleges are starting Neurodiversity Hubs, providing a meeting place and mutual support for neurodiverse students. In other colleges, a student who has autism is allocated a buddy who is a graduate student of clinical psychology at the college. The student psychologist can provide support with regard to friendships and social conventions, as well as emotional support. This can be in addition to the colleges disability support and mental health services.

There are also social conventions and protocols associated with academic college life. The student who has autism may have an intolerance of uncertainty and ambiguity, with difficulty accepting an alternative perspective, and during tutorials may talk too much or too little. There can also be a tendency for the student to correct publicly the professors errors, which will not endear them to the academic staff.

As much as the student who has autism will need guidance in the social culture and codes of behavior and conduct at college, the academic staff will also need training and guidance in how to facilitate the inclusion of a student who has autism in their classes and tutorials.

Another area that requires attention when a young person with autism starts college is that of stress and emotion management. During the high school years, parents would have been able to accurately read the subtle signs of increasing stress or mood disorder in their adolescent son or daughter, even when the young person may not have been cognitively aware of these signs. The parents would have been able to suggest strategies for stress and emotion management; but at college, where there may be no one to closely monitor stress levels and emotional wellbeing, the risk is that increasing stress may develop into or exacerbate an anxiety disorder, or the student may slowly sink into severe depression. Student support services will need to elicit from the student themselves (or the students parents) the personal indicators of increasing stress and worsening mood, as well as monitoring increasing social isolation and any interpersonal friction. The support services will need to have a regular and frequent schedule of meetings with the student to review stress and emotion levels, as well as academic progress.

A source of stress for a student who has autism can be the sensory and social aspects of college. There may be sensitivity to specific sounds, light intensity, and aromas. The college may need to recognize this characteristic of autism and make accommodations and compromises. Another source of stress is the sheer number of students in lecture halls and on campus, which can be overwhelming for the student with autism. A simple solution for this can be for the student to arrive at the lecture hall early, when it is still relatively quiet, and select a seat that is slightly more secluded and near the exit. A more extreme, but less satisfactory, solution is for the student with autism to complete the course externally on the Internet. While this enables the student to avoid lecture halls and crowded campuses entirely, the disadvantage is the lack of opportunity to meet fellow students on campus, make friends, and engage in face-to-face conversations with other students and lecturers.

There may need to be specific help with exams, which are a great source of anxiety for students who have autism. Accommodations can include avoiding a large examination hall by taking the exam in an adjacent small room; being able to type rather than write exam answers (autism is associated with dysgraphia); and, at the start of the examination, a member of staff being available to ensure the student has not taken a too literal interpretation of the exam question.

Another source of stress is the requirement to submit a group project or assignment. The student who has autism will need guidance and support in several aspects of group work. These may include identifying and joining a group; when and how to contribute to group discussion (not being dictatorial or subservient); coping with criticisms (and compliments); and recognition and acceptance of the possibility that there may be an uneven distribution of the workload between group members.