Bioecological Model Applied To Autistic Students’ Transition To Higher Education

Bronfenbrenner’s bioecological theory provides a valuable framework for understanding the complex experiences of autistic students transitioning to higher education.

This model considers the interactions between various environmental systems that influence an individual’s development. For autistic students, these systems include:

• Individual: Personal characteristics and ASD-related traits
• Microsystem: Immediate relationships (family, peers, educators)
• Mesosystem: Interactions between microsystems
• Exosystem: Indirect environmental influences (institutional policies)
• Macrosystem: Broader societal attitudes and cultural contexts
• Chronosystem: Changes over time

By examining these interconnected levels, we can better comprehend the multifaceted challenges and supports that shape autistic students’ transition experiences, informing more effective and holistic support strategies.

Nuske, A., Rillotta, F., Bellon, M., & Richdale, A. (2019). Transition to higher education for students with autism: A systematic literature review. Journal of Diversity in Higher Education, 12(3), 280–295. https://doi.org/10.1037/dhe0000108

Key Points

• The primary challenges for autistic students transitioning to higher education include social communication difficulties, sensory processing issues, need for structure/routine, executive functioning challenges, and independent living skills deficits.
• Factors like self-awareness, willingness to disclose ASD diagnosis, mental health/wellbeing, family support, and collaboration between stakeholders significantly affect transition experiences and outcomes for students with ASD.
• While transition planning and support programs exist, experiences vary widely, with inconsistent implementation even where mandated by law. More individualized, flexible approaches are needed.
• The research illuminates the complex, multi-level factors impacting transition but has limitations in sample sizes, diversity, and longitudinal data on outcomes.
• Supporting successful transitions to higher education for the increasing population of students with ASD is critically important for promoting educational access, inclusion, and positive life outcomes for these individuals.

Rationale

This systematic literature review was conducted to provide an updated synthesis of research on the experiences of students with autism spectrum disorder (ASD) and their family members during the transition to higher education.

The rationale for this study stems from several key factors:

1. Increasing prevalence of ASD and enrollment in higher education: Recent prevalence estimates suggest approximately 1 in 68 children have ASD, with prevalence increasing over the past few decades (Christensen et al., 2016). Consequently, the number of individuals with ASD enrolling in higher education has also been rising (Barnhill, 2016; Bell et al., 2017).
2. Challenges associated with ASD in educational settings: The core characteristics of ASD, including social communication difficulties, restricted interests, and sensory sensitivities, can create significant challenges in educational environments (Fleury et al., 2014). These challenges may be exacerbated in higher education settings, which often lack structure and require increased self-advocacy (Adreon & Durocher, 2007; Knott & Taylor, 2014).
3. Limited research on transition experiences: While literature exists on barriers and facilitators for individuals with ASD in higher education broadly (Barnhill, 2016; Brown & Coomes, 2016; Knott & Taylor, 2014), there is a paucity of research specifically focused on the transition period. Additionally, few studies have directly explored the experiences of individuals with ASD in higher education (Alverson et al., 2015; Anderson & Butt, 2017; Cai & Richdale, 2016).
4. Need for updated synthesis: Previous systematic reviews have examined experiences of students with ASD in higher education (Anderson et al., 2017; Gelbar et al., 2014; Toor et al., 2016), but an updated review incorporating recent studies and specifically focusing on transition experiences was warranted.
5. Importance of family perspectives: Research exploring the experiences of parents and family members during the transition to higher education for students with ASD is lacking (Anderson & Butt, 2017; Bell et al., 2017; Cai & Richdale, 2016). Including these perspectives is crucial for understanding the full context of transition experiences.
6. Theoretical framework: Applying the bioecological theory model (Bronfenbrenner, 1979) as a framework for examining transition experiences provides a novel approach to understanding the complex interactions between various systems impacting students with ASD during this period.

By addressing these gaps in the literature and providing an updated synthesis of research on transition experiences, this review aims to inform best practices for supporting students with ASD as they enter higher education.

The next step is to use this synthesized knowledge to develop more effective, individualized transition support strategies and policies.

Method

This systematic literature review followed the PRISMA guidelines (Moher et al., 2009) to ensure a comprehensive and transparent search and analysis process.

Databases searched

Six databases were systematically searched in August 2017: Medline, CINAHL, ProQuest (limited to articles only), PsycINFO, Scopus, and Informit.

Search strategy and terms

The search strategy employed a combination of free text and subject heading terms (e.g., MeSH terms) combined using Boolean operators.

Examples of subject heading terms included:

Medline:

1. Exp Autistic Disorder/
2. Exp Autism Spectrum Disorder/ or exp Asperger Syndrome/
3. (autis* or asperger* or ASD or ASC).tw.
4. Universities/
5. Vocational Education/

PsycINFO:

1. Exp Autism Spectrum Disorders/
2. (autis* or asperger* or ASD or ASC).tw.
3. Exp COMMUNITY COLLEGES/ or exp COLLEGES/
4. exp Higher Education/

Free text search terms included synonyms for each keyword, such as:

• Autism spectrum disorder OR Asperger*
• Higher education OR further education OR tertiary education OR postsecondary education OR university OR college
• Transition

Inclusion and exclusion criteria

Inclusion criteria:

• Primary research studies
• Qualitative or mixed-methods design with at least 10% qualitative data
• Focus on experiences of individuals with ASD or their family members during transition to higher education
• At least 10% of participants with ASD or family members of individuals with ASD
• At least 10% of data describing transition experiences (commencing in higher education, first year of higher education)

Exclusion criteria:

• Not primary research
• Not focused on transition to higher education
• No or less than 10% qualitative component
• No or less than 10% inclusion of individual or family perspectives
• Wrong population (less than 10% of participants were individuals with ASD or family members)
• Focus on pre-transition expectations only

Statistical measures

As this was a qualitative systematic review, no statistical analyses were conducted. The quality of included studies was assessed using the McMasters Critical Review form: Qualitative Studies (Letts et al., 2007).

Two independent reviewers (AN and MB) conducted the quality assessment, with scores ranging from 11 to 19 points out of a possible 21.

Results

The systematic search identified 587 studies after duplicate removal. An additional 10 studies were identified by hand-searching reference lists and journal indexes.

After title and abstract screening, 526 articles were excluded. Full-text review of the remaining 71 articles resulted in 60 exclusions. The final review included 11 articles meeting all inclusion criteria.

Study Characteristics:

• Publication years: 2010-2017
• Geographic distribution: 4 USA, 2 UK, 2 Sweden, 1 Belgium, 1 Republic of Ireland, 1 Australia
• Study designs: Grounded theory (3), phenomenology (2), naturalistic inquiry (1), case study (1), unspecified (4)
• Data collection: Interviews (10 studies), focus groups (1 study)

Participant Characteristics:

• Total participants: 180 (158 individuals with ASD or family members)
• Individuals with ASD: 92 (71 male, 21 female)
• Parents: 64 (across 10 studies)
• Siblings: 2 (in 2 studies)

Key Findings

Results were categorized according to the bioecological theory model:

Individual Level:

1. Challenges related to ASD characteristics: Social communication difficulties, Sensory processing challenges, Need for structure and routine, Executive functioning difficulties, Independent living skills deficits
2. Self-awareness and disclosure: Varied levels of self-awareness, Reluctance or delay in disclosing ASD diagnosis, Difficulty with self-advocacy and help-seeking
3. Mental health and emotional wellbeing: Increased stress and anxiety during transition, Need for early preparation and timely support to minimize negative impacts

Microsystem Level:

1. Family support: Significant role of parents in providing emotional and practical support, Parents often involved in disclosure and accessing support services
2. Professional support: Positive experiences with knowledgeable, understanding professionals, Importance of clear communication and ASD-specific knowledge

Mesosystem Level:

• Collaboration: Importance of effective collaboration between secondary schools, families, and higher education staff

Exosystem Level:

1. Impact of legislation and policies: Varied experiences with mandated transition planning (e.g., IDEA in the US), Challenges related to privacy legislation and institutional policies
2. Transition programs: Inconsistent implementation and effectiveness of formal transition support programs

Macrosystem and Chronosystem Levels:

• Limited discussion of these levels in the reviewed studies

Insight

This systematic review provides valuable insights into the complex, multi-level factors influencing the experiences of students with ASD and their families during the transition to higher education.

Key findings highlight the need for:

1. Individualized approaches: Given the heterogeneity of ASD and varied manifestation of challenges, support strategies must be tailored to each student’s unique needs and strengths.
2. Early, comprehensive transition planning: Consistent, effective transition planning beginning in secondary school is crucial for preparing students with ASD for higher education.
3. Improved self-advocacy skills: Developing self-awareness, disclosure strategies, and self-advocacy skills is essential for students with ASD to access necessary supports in higher education.
4. Mental health support: Addressing increased stress and anxiety during transition through targeted interventions and timely access to support services is critical.
5. Family involvement: Recognizing and facilitating the important role of family support while balancing student independence and privacy considerations.
6. Professional development: Ensuring that staff in both secondary and higher education settings have adequate knowledge and understanding of ASD to provide effective support.
7. Systemic collaboration: Fostering better collaboration between secondary schools, families, and higher education institutions to create smoother transitions.
8. Policy implementation: Addressing gaps between legislative requirements for transition support and actual implementation in educational settings.

These findings extend previous research by providing a more comprehensive, theoretically-grounded understanding of transition experiences.

The application of the bioecological theory model highlights the interconnected nature of various factors influencing transition outcomes.

Further research is needed to:

• Conduct longitudinal studies tracking long-term outcomes for students with ASD in higher education
• Explore perspectives of a more diverse range of stakeholders (e.g., siblings, peers, faculty)
• Investigate the effectiveness of specific transition support strategies and interventions
• Examine the experiences of students with ASD who do not disclose their diagnosis or access formal supports
• Explore the impact of co-occurring conditions (e.g., anxiety, depression) on transition experiences and outcomes

Strengths

The study had several methodological strengths:

1. Comprehensive search strategy: Systematic searches across six databases and hand-searching of reference lists and key journals ensured a thorough literature review.
2. Adherence to PRISMA guidelines: Following established systematic review protocols enhanced the rigor and transparency of the review process.
3. Inclusion of mixed-methods studies: Considering qualitative data from mixed-methods studies expanded the pool of relevant research included in the review.
4. Theoretical framework: Applying the bioecological theory model provided a structured approach to analyzing and synthesizing findings across studies.
5. Quality assessment: Use of the McMasters Critical Review form to evaluate the methodological quality of included studies strengthened the review’s credibility.
6. Multiple reviewers: Independent screening and quality assessment by two reviewers enhanced the reliability of study selection and evaluation.
7. Focus on transition experiences: Specifically examining the transition period addressed an important gap in previous literature reviews on ASD in higher education.
8. Inclusion of family perspectives: Considering the experiences of both individuals with ASD and their family members provided a more comprehensive understanding of transition challenges and supports.

Limitations

Several limitations should be considered when interpreting the results of this review:

1. Small sample sizes: Most included studies had relatively small sample sizes, limiting the generalizability of findings.
2. Limited geographical and demographic diversity: Participants in many studies were from narrow demographic groups (e.g., White, high income, middle class), restricting the applicability of findings to more diverse populations.
3. Focus on formally diagnosed/registered students: Many studies only included participants with formal ASD diagnoses or those registered with disability services, potentially excluding the experiences of undiagnosed or non-disclosing students.
4. Lack of longitudinal data: The absence of long-term follow-up data limits understanding of transition outcomes and the effectiveness of support strategies over time.
5. Potential selection bias: Participants who volunteer for such studies may not be representative of the broader population of students with ASD in higher education.
6. Limited exploration of macrosystem and chronosystem factors: The reviewed studies provided minimal insight into broader societal and historical influences on transition experiences.
7. Exclusion of non-English language studies: The review may have missed relevant research published in other languages.
8. Focus on peer-reviewed literature: Excluding grey literature and unpublished studies may have resulted in publication bias.

These limitations highlight the need for larger, more diverse, and longitudinal studies to further validate and expand upon the findings of this review.

Implications

The findings of this systematic review have significant implications for practice, policy, and future research:

1. Individualized support: Higher education institutions should develop more flexible, personalized approaches to supporting students with ASD, recognizing the diverse needs and strengths within this population.
2. Transition planning: Secondary schools and higher education institutions should collaborate to implement comprehensive, early transition planning for students with ASD, beginning well before graduation.
3. Self-advocacy training: Developing programs to enhance self-awareness, disclosure strategies, and self-advocacy skills for students with ASD is crucial for successful transitions.
4. Mental health services: Targeted interventions to address increased stress and anxiety during transition should be integrated into support services for students with ASD.
5. Family involvement: Higher education institutions should explore ways to meaningfully involve families in the transition process while respecting student privacy and promoting independence.
6. Professional development: Both secondary and higher education staff require ongoing training to enhance their understanding of ASD and effective support strategies.
7. Policy implementation: Policymakers and educational administrators should address gaps between legislative requirements for transition support and actual implementation in educational settings.
8. Disclosure processes: Higher education institutions should review and potentially revise disclosure processes to make them more accessible and less intimidating for students with ASD.
9. Peer support: Developing peer mentoring or support programs may help address social challenges and promote inclusion for students with ASD.
10. Universal design: Implementing universal design principles in higher education could benefit students with ASD while promoting inclusivity for all students.
11. Research funding: Increased funding for larger-scale, longitudinal studies on transition experiences and outcomes for students with ASD is needed to inform evidence-based practices.
12. Intersectionality: Future research and practice should consider how factors such as gender, race, socioeconomic status, and co-occurring conditions interact with ASD to influence transition experiences.

By addressing these implications, stakeholders can work towards creating more inclusive, supportive higher education environments that promote successful transitions and positive outcomes for students with ASD.

References

Primary reference

Nuske, A., Rillotta, F., Bellon, M., & Richdale, A. (2019). Transition to higher education for students with autism: A systematic literature review. Journal of Diversity in Higher Education, 12(3), 280–295. https://doi.org/10.1037/dhe0000108

Other references

Adreon, D., & Durocher, J. S. (2007). Evaluating the college transition needs of individuals with high-functioning autism spectrum disorders. Intervention in school and clinic, 42(5), 271-279. https://doi.org/10.1177/10534512070420050201

Alverson, C. Y., Lindstrom, L. E., & Hirano, K. A. (2019). High school to college: Transition experiences of young adults with autism. Focus on autism and other developmental disabilities, 34(1), 52-64. https://doi.org/10.1177/1088357615611880

Anderson, A. H., Stephenson, J., & Carter, M. (2017). A systematic literature review of the experiences and supports of students with autism spectrum disorder in post-secondary education. Research in Autism Spectrum Disorders, 39, 33-53. https://doi.org/10.1016/j.rasd.2017.04.002

Anderson, C., & Butt, C. (2017). Young adults on the autism spectrum at college: Successes and stumbling blocks. Journal of Autism and Developmental Disorders, 47, 3029-3039. https://doi.org/10.1007/s10803-017-3218-x

Barnhill, G. P. (2016). Supporting students with Asperger syndrome on college campuses: Current practices. Focus on Autism and Other Developmental Disabilities, 31(1), 3-15. https://doi.org/10.1177/1088357614523121

Bell, S., Devecchi, C., Mc Guckin, C., & Shevlin, M. (2019). Making the transition to post-secondary education: opportunities and challenges experienced by students with ASD in the Republic of Ireland. Postsecondary educational opportunities for students with special education needs, 55-71.

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Brown, K. R., & Coomes, M. D. (2016). A spectrum of support: Current and best practices for students with autism spectrum disorder (ASD) at community colleges. Community College Journal of Research and Practice, 40(6), 465-479. https://doi.org/10.1080/10668926.2015.1067171

Cai, R. Y., & Richdale, A. L. (2016). Educational experiences and needs of higher education students with autism spectrum disorder. Journal of autism and developmental disorders, 46, 31-41. https://doi.org/10.1007/s10803-015-2535-1

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Keep Learning

Socratic questions for a college class to discuss this paper

1. How might the experiences of students with ASD transitioning to higher education differ in countries with varying educational systems and disability support policies?
2. In what ways could advances in technology potentially address some of the challenges faced by students with ASD during their transition to higher education?
3. How might the intersectionality of ASD with other factors such as gender, race, or socioeconomic status impact transition experiences? How could future research better address these intersections?
4. What ethical considerations arise when balancing the need for parental support with the privacy and independence of adult students with ASD in higher education settings?
5. How might the COVID-19 pandemic and the resulting shift to online learning have affected the transition experiences of students with ASD? What new challenges or opportunities might have emerged?
6. In what ways could the principles of universal design in higher education benefit not only students with ASD but also the broader student population?
7. How might peer mentoring programs be designed to effectively support students with ASD while also promoting greater understanding and inclusion among the general student body?
8. What role could self-advocacy training play in preparing students with ASD for the transition to higher education? How early should this training begin?
9. How might the experiences of students with ASD who choose not to disclose their diagnosis differ from those who do? What are the ethical implications of encouraging or discouraging disclosure?
10. In what ways could the bioecological systems theory be applied to develop more comprehensive transition support programs for students with ASD?