Person–Environment–Occupation Fit in Autistic College Students: A Mixed-Methods Study of Social Participation

Abstract

Importance Social participation is a core occupation influencing health, identity, and belonging in college students. Limited research examines participation among autistic students within a person–environment–occupation (PEO) framework. Objective To examine social participation among autistic and non-autistic college students by comparing participation rates, satisfaction, motivations, and perceived barriers and exploring differences in lived experience and PEO fit. Design Mixed-methods convergent parallel design integrating quantitative survey data and qualitative content analysis. Setting A mid-sized, private university in the southeastern United States. Participants A convenience sample of undergraduate students living on campus (N = 49; 23 autistic, 26 non-autistic). Outcomes and Measures An anonymous survey of self-reported participation hours, satisfaction ratings, activity involvement, motivations, and barriers. Analyses included Welch's t-tests and a chi-square test; qualitative data were analyzed inductively and integrated. Results Groups reported similar activity types, participation rates (p = .14), satisfaction (p = .63), and barriers (p = .61). Overall, 62% reported at least one barrier, most commonly time. Qualitative findings revealed differences in experience: autistic students more often described internal barriers (e.g., anxiety, difficulty identifying activities), whereas non-autistic students emphasized interpersonal challenges. Both groups desired greater campus engagement. Conclusions and Relevance Comparable participation outcomes may mask differences in experience and PEO fit. Occupational therapy can support meaningful engagement through neurodiversity-affirming, contextually responsive approaches that enhance accessibility, fit, and a sense of belonging. Plain Language Summary This study was done to better understand how autistic and non-autistic college students take part in social activities and how those experiences feel. Social activities help students build friendships, feel included, and support well-being. The study found that both groups spent about the same amount of time in social activities and felt similarly satisfied. However, their experiences were different. Autistic students more often reported feeling anxious or having trouble finding activities that matched their interests. Other students more often described challenges with fitting into social groups. These results show that participation is not just about how often someone joins activities, but also how comfortable and meaningful those experiences are. Occupational therapists can use this information to design activities and environments that better match students’ needs. This can improve participation, increase belonging, and support more inclusive college communities.