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Sunday, June 21, 2020

The Health of Autistic College Students

In The Politics of Autism, I discuss the growing number of college students on the spectrum.

Jane D McLeod, Amelia Hawbaker, Emily Meanwell have an article at Autism titled "The Health of College Students on the Autism Spectrum as Compared to Their Neurotypical Peers." The lay abstract:
Studies have shown that children and older adults on the autism spectrum experience more physical and mental health problems than their neurotypical peers. Less is known about the physical and mental health of college students on the spectrum. Studying college students is important because young adults on the spectrum are enrolling in college at increasing rates and because health problems can be a barrier to succeeding in college. We collected data from 2820 students at 14 colleges and universities using an online survey, some of whom had registered for accommodations based on autism and others of whom had not. We used the data to compare the physical and mental health of students on the spectrum to their neurotypical peers. Because students with autism often report other disabilities that also affect health, we accounted for whether they experienced a learning disability, attention deficit hyperactivity disorder, sensory impairment, mobility impairment, mental health disorder, or any other disabilities. We assessed health using self-reports of how healthy they were physically and mentally, and reports of depressive symptoms, symptoms of anxiety, sleep deprivation, and binge drinking. We found that students with autism reported poorer physical and mental health, more depressive symptoms, and more symptoms of anxiety even after taking into account other disabilities they may have experienced. They were also less likely to report sleep deprivation and binge drinking. Our results argue for developing specialized services to address the physical and mental health challenges of college students on the spectrum.
From the article:
Focusing on college students allowed us to engage the question of whether the health disadvantages associated with autism extend to a relatively advantaged subgroup of the larger autism population. Because intellectual disabilities heighten the risk of poor health among adults on the autism spectrum (Bishop-Fitzpatrick & Rubenstein, 2019), we might have expected to observe a relatively weak association of autism with health in this sample. In contrast, though, even in this select group and even after taking comorbid conditions into account, we find that autism continues to place young adults at risk of poor health outcomes. Why the health disadvantages of autism remain strong in this subgroup deserves additional attention.

Our results for college students also encourage consideration of how the services that colleges and universities provide could be improved. The high levels of anxiety and depression we observed among students with autism are especially concerning for both their general well-being and their success in college. Both types of mental health problems reduce the likelihood of academic success in college populations (e.g. Eisenberg et al., 2009). College students on the spectrum themselves identify comorbid anxiety and depression as one of the major challenges they face (Cai & Richdale, 2016; Nuske et al., 2019). Importantly, the elevated levels of anxiety and depression we observed among students on the spectrum were independent of reports of mental health diagnoses. This implies that they are not simply a function of comorbid, diagnosed mental health conditions. When assessing the needs of students on the spectrum and designing mental health support programs, colleges and universities should give special attention to undiagnosed and subclinical mental health problems.