College and High Functioning Autism

It's that time of year when campus starts to buzz again.  Schedules are reviewed, sometimes tweaked, social relationships renewed or sought and if we're lucky here in Atlanta, there's a small hint of autumn in the morning air filling us with a promise freshness and clarity that can be brought to the academic setting.  For the college student with High Functioning Autism (HFA), it can also bring with it anxiety of academic challenges past.  So here's a list, in no particular order, of topics and issues I've seen and possible solutions/suggestions as to how to cope with them.

First, a word about coping.  Coping is what we do in this world.  Most folks get that pretty naturally. Coping for a person with HFA can be a huge challenge, however.  Anxiety, poor organizational skills, lack of support from others, ADHD, depression and even psychosis can inhibit our ability to cope. Not to mention dysfunctional family dynamics, the challenges of an unrecognized or untreated learning disability and so many more variables.  The key, the point to focus upon is finding a balance in how we manage the stress we have.  There are things we can effect and things over which we have absolutely no power.  Understanding that is key (speak to any successful recovering alcoholic about the versatility of "The Serenity Prayer.")

Every college has their version of a student support center.  It's a place where there's coaching, support, tutoring around the challenges students face with organizational skills, self advocacy, remediation, social and sometimes mental health resources all geared to help the student achieve both academic and personal success.  These services, in my experience, are underutilized by the HFA community.  Remember, in High School there are IEP's (Individual Education Plans.)  Because the state is obligated to teach all students, even those with special needs, there are federal laws proscribing how to do so.  In college there's still requirements, but the big difference is that the student must self identify and bring their requests for reasonable accommodations to the attention of the school.  The school is not obligated to initiate, unlike in High School.  

Mental Health services are increasingly ubiquitous on college campuses.  Many students have the need for mental health services ranging from psychotherapy to crises intervention, psychiatric services (for diagnosis and medication management) as well as support groups and more.  Because there is a high incidence of anxiety, depression, ADHD (among other diagnoses) in the HFA community, utilizing these services is critical.  If you needed these services in High School, you probably need them in college.  Freshman year's a bad time to experiment living life without them.

The academic load in college can be daunting.  Again, there is often a stark contrast between the expectations in High School and those in college.  In High School it is quite common for teachers and other staff to be well aware of the needs of the student with special needs (reference the IEP comments above) and to be quite understanding and solicitous of students.   Second chances (or more) may be quite common.  Not so much in college.  I tell my clients who are in college that the professors simply don't care about your personal issues or challenges.  College is a place for grown ups.  If the assignment was due yesterday, coming today with your hat in your hand may not cut it at all.  This does not mean that professors are mean or unsympathetic, but unless there's a real extenuating circumstance, they may not be at all inclined to give a break.  I also recommend to all but the most highly academically gifted student that they consider taking less than a full academic load for the first semester to get their feet wet.  Being academically overwhelmed as a college freshman is a recipe for disaster.

College is a hotbed of social interaction.  Many people find romance, spouses, business partners and lifelong business acquaintances and friends in college.  For people on the autistic spectrum, social relationships are often the holy grail of challenges.  So many HFA folks in college have great strengths academically, but struggle with social basics like eye contact or how to have a simple spontaneous chat while waiting on line.  In an atmosphere where fraternities and sororities bind pledges in lifelong emotional connection, the person on the spectrum can be left to the sidelines without a clue as to how to form more than a passing friendship.  This can lead to a great deal of personal pain and depression in the realization that their toolbox just seems to be missing some of the equipment that everyone else seems to have readily available.  This is where the basics of social skills (which many kids on the spectrum are bludgeoned with throughout their childhood and adolescence) come into play and it may be time for a refresher on how to acquire and use these necessary skills. Again, the  student support center is likely a good resource for these challenges.

Accountability and personal responsibility are cornerstones of independent college life.  Even if living at home, the relationship between student and college doesn't usually include parents, the default source of structure and support for high schoolers.  As a result, basics like attendance and completion of assignments fall entirely on the student.  I've seen many HFA kids go away to college only to come home with their tails between their legs having spent the first semester isolated in their dorm room spending the bulk of their time surfing the net or playing video games to the exclusion of their academic responsibilities.  Parents send them away in the hopes that their children's wings will fully extend and allow for flight, but they often need more support before they can fly on their own. This is why I almost always recommend that students live at home at least for the first year of college and that they include their parents in their academic lives in order to have some accountability.  This is even more important if the student is not engaged in the school's student support center.   Many HFA students can get the hang of college life, but they often need extended support from home to do so.  On campus housing can still be an option, but I recommend the student show independence in a more supervised environment before doing so.   The emotional hit for not succeeding independently in college is not to be underestimated - and this is on top of the ongoing burden that kids on the spectrum may have living with autism.

Common to most college campuses are the broad use of alcohol and drugs.  College is where many students are first exposed to these substances and for people on (and off) the spectrum they can be a tempting social lubricant.  Remember that alcohol and drugs dis-inhibit our brains.   Thus we are more likely to say and do things we certainly might not have done sober.  This can include engaging in "consensual" (in quotes due to the role the substances may play in one's consent) sexual activity for which the individual is not emotionally prepared, not to mention the concerns for sexually transmitted diseases and pregnancy.  Horrifyingly, up to 20% of women and 5% of men report being sexually assaulted in college, one study showed that 15% of freshman women were raped while under the influence of alcohol.  The devastation this can create is far beyond the scope of this discussion, but the destructive results (whether or not the victim is on the spectrum) cannot be underestimated. Beyond description in their potential for destruction is the continued availability of hallucinogens and narcotics raising these concerns.  The toxic formulations of narcotics laced with fentanyl explonentially skyrocket the danger to levels that we struggle to comprehend.  

College is a place where many people with high functioning autism can flourish with support and thoughtfulness.  It's easy for individuals on the spectrum and their families to hope that the college experience will be a fresh start.  And there may well be something to that, however it's critical to remember that we are who we are.  Whatever our histories and challenges, they don't disappear just because we want them to.  Forge ahead into college, but do it smartly.  Insulate with support and realism.