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

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.