Challenges, support, and progression for students with autism in university: a systematic review

Abstract

© 2025 Smith M et al. This is an open access work published in Routledge Open Research and distributed under a creative commons licence.Background An increasing number of students with autism are entering Higher Education (HE), yet they continue to face significant challenges, including elevated rates of mental health difficulties and limited access to appropriate support. These students are also less likely to achieve academic success or graduate compared to their neurotypical peers. Despite growing awareness, there is limited synthesis of university-based initiatives aimed at supporting the mental health and wellbeing (MHWB) of autistic students. This systematic review explores barriers to engagement and identifies effective MHWB support practices within HE settings. Methods A systematic search of seven academic databases was conducted to identify studies published between 2015 and 2025 that focused on MHWB support for autistic university students. Following a multi-stage screening process, eligible studies were analysed using reflexive thematic analysis. Results Nineteen studies met the inclusion criteria. Three overarching themes were identified: (1) Barriers and challenges experienced by autistic students; (2) The relationship between autism and higher dropout rates in HE; and (3) MHWB support initiatives targeting autistic students. While several promising interventions were noted, findings highlighted pervasive psychosocial barriers, inconsistent implementation of support, and a general lack of institutional understanding and preparedness. Conclusion The review underscores an urgent need for autismspecific and autism-informed MHWB strategies in higher education. Universities must adopt inclusive, evidence-based approaches to reduce barriers and enhance long-term wellbeing and academic outcomes for autistic students