Supporting Autistic Adults in Postsecondary Settings: A Systematic Review of Peer Mentorship Programs.

Background: The number of autistic individuals attending college or university is increasing, yet graduation rates are low as postsecondary environments often fail to support autistic students' individual needs. Peer mentorship programs are emerging as a promising approach for providing individualized, one-on-one support to meet this service gap for autistic postsecondary students. However, no literature has systematically described these programs. Methods: We conducted a systematic review that described existing peer mentorship programs for autistic students in postsecondary education as well as their effectiveness. Results: Our search of five databases found nine unique programs that were evaluated in 11 peer-reviewed articles. Programs reported positive outcomes in various domains, which included social skills, academic performance, and sense of belonging. The evidence for these programs was primarily qualitative, sample sizes were small, and there was considerable heterogeneity in the format, provision, and goals of these programs, as well as the evaluation methods used. Conclusions: Overall, the state of the research related to the efficacy of peer mentorship programs for autistic students remains in its infancy, and further research is needed to quantify effectiveness and enable program comparisons. Lay summary: Why was this review done?: The number of autistic individuals attending college or university is increasing, yet graduation rates are low as most colleges and universities do not have the neccessary accommodations to support this population. Several peer mentorship programs now exist to provide individualized, one-on-one support for autistic students at college or university.What was the purpose of the review?: While several programs exist, it is unknown how effective these programs are in improving the academic experience for autistic students.What did the researchers do?: We systematically reviewed research describing existing peer mentorship programs for autistic university/college students and their effectiveness. Our search of five databases revealed nine unique programs that were evaluated in 11 peer-reviewed articles.What were the results of the review?: Most peer mentorship programs reported positive outcomes in various areas, including social skills, academic performance, and a sense of belonging. However, many of the studies were quite different in their approach and how they evaluated success, thus making it challenging to compare the programs with one another.What do these findings add to what was already known?: The findings from our systematic review highlight that only a few studies related to peer mentorship programs exist. We need more research to quantify the effectiveness of peer mentoring programs for autistic college/university students.What are potential weaknesses of this review?: There were evident inconsistencies between evaluation methods and types of measurement across studies, and studies often had a small number of participants, which limited our ability to make conclusions about the impact of such programs.How will these findings help autistic adults now or in the future?: This article provides a summary of the kinds of supports available to autistic adults within postsecondary settings, which may help autistic adults explore options for their own education. Advancing research in this area may improve the college/university experience for autistic adults in the future.

Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis.

BACKGROUND: Co-occurring mental health or psychiatric conditions are common in autism, impairing quality of life. Reported prevalences of co-occurring mental health or psychiatric conditions in people with autism range widely. Improved prevalence estimates and identification of moderators are needed to enhance recognition and care, and to guide future research. METHODS: In this systematic review and meta-analysis, we searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, and grey literature for publications between Jan 1, 1993, and Feb 1, 2019, in English or French, that reported original research using an observational design on the prevalence of co-occurring mental health conditions in people with autism and reported confirmed clinical diagnoses of the co-occurring conditions and autism using DSM or ICD criteria. For co-occurring mental health conditions reported with at least 15 datapoints (studies), we assessed risk of bias and we determined pooled estimates of prevalence for different co-occurring conditions in autism using random-effects models, and descriptively compared these with prevalence estimates for the general population from the literature (post hoc). We investigated heterogeneity in prevalence estimates using random-effects meta-regression models. This systematic review is registered with PROSPERO, CRD42018103176. FINDINGS: Of 9746 unique studies identified, 432 were selected for full-text review. 100 studies were eligible for inclusion in our qualitative synthesis, of which 96 were included in our meta-analyses. 11 categories of co-occurring conditions were investigated, of which eight conditions were included in the meta-analyses and three were descriptively synthesised (ie, trauma and stressor-related disorders, substance-related and addictive disorders, and gender dysphoria). From our meta-analyses, we found overall pooled prevalence estimates of 28% (95% CI 25-32) for attention-deficit hyperactivity disorder; 20% (17-23) for anxiety disorders; 13% (9-17) for sleep-wake disorders; 12% (10-15) for disruptive, impulse-control, and conduct disorders; 11% (9-13) for depressive disorders; 9% (7-10) for obsessive-compulsive disorder; 5% (3-6) for bipolar disorders; and 4% (3-5) for schizophrenia spectrum disorders. Estimates in clinical sample-based studies were higher than in population-based and registry-based studies, and these estimates were mostly higher than those in the general population (post hoc). Age, gender, intellectual functioning, and country of study were associated with heterogeneity in prevalence estimates, yet remaining heterogeneity not explained was still substantial (all I2 >95%). INTERPRETATION: Co-occurring mental health conditions are more prevalent in the autism population than in the general population. Careful assessment of mental health is an essential component of care for all people on the autism spectrum and should be integrated into clinical practice. FUNDING: Academic Scholars Awards, Department of Psychiatry, University of Toronto; O'Brien Scholars Program, Slaight Family Child and Youth Mental Health Innovation Fund, and The Catherine and Maxwell Meighen Foundation via the Centre for Addiction and Mental Health Foundation.

Increases in the autistic trait of attention to detail are associated with decreased multisensory temporal adaptation.

Recent empirical evidence suggests that autistic individuals perceive the world differently than their typically-developed peers. One theoretical account, the predictive coding hypothesis, posits that autistic individuals show a decreased reliance on previous perceptual experiences, which may relate to autism symptomatology. We tested this through a well-characterized, audiovisual statistical-learning paradigm in which typically-developed participants were first adapted to consistent temporal relationships between audiovisual stimulus pairs (audio-leading, synchronous, visual-leading) and then performed a simultaneity judgement task with audiovisual stimulus pairs varying in temporal offset from auditory-leading to visual-leading. Following exposure to the visual-leading adaptation phase, participants' perception of synchrony was biased towards visual-leading presentations, reflecting the statistical regularities of their previously experienced environment. Importantly, the strength of adaptation was significantly related to the level of autistic traits that the participant exhibited, measured by the Autism Quotient (AQ). This was specific to the Attention to Detail subscale of the AQ that assesses the perceptual propensity to focus on fine-grain aspects of sensory input at the expense of more integrative perceptions. More severe Attention to Detail was related to weaker adaptation. These results support the predictive coding framework, and suggest that changes in sensory perception commonly reported in autism may contribute to autistic symptomatology.