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

ImportanceSocial 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.ObjectiveTo 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.DesignMixed-methods convergent parallel design integrating quantitative survey data and qualitative content analysis.SettingA mid-sized, private university in the southeastern United States.ParticipantsA convenience sample of undergraduate students living on campus (N = 49; 23 autistic, 26 non-autistic).Outcomes and MeasuresAn 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.ResultsGroups 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 RelevanceComparable 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.