Realist Evaluation of Specialist Peer Mentoring for University Students with ASD

Background: While many adults with Autism Spectrum Disorder (ASD) have average to high intellectual capabilities they still experience numerous challenges impacting their ability to negotiate everyday life. Post-secondary education has been identified as a means of improving outcomes in adulthood. Despite recognition of the benefits of education and intellectual abilities of many adults with ASD, the rate of those completing post-secondary education remains below those of others with and without disabilities. Specialist peer mentoring for adults with ASD has been proposed as an intervention that may enable success at university.

Objectives: This study aimed to identify the contexts, mechanisms and outcomes; and the relationship between these components of a specialist peer mentor program for university students with ASD.

Methods: Semi-structured interviews were explored a specialist peer mentor intervention for university students with ASD. The Realist Evaluation (RE) method provided a structured approach allowing for exploration of the contexts, mechanisms and outcomes of the program. RE facilitated the exploration of how the program worked, under what conditions, and what outcomes occurred as a result.

A total of 28 (23 female and 5 male; mean age=28.6; SD=6.9) peer mentors supporting university students with ASD completed semi-structured interviews ranging in duration from 30 to 90 minutes. Interviews were transcribed verbatim and systematically coded using the context, mechanism and outcome framework. The context of the program was considered circumstances present prior to the peer mentoring program, including aspects of the person, available services and the environment. The mechanisms were the components of the peer mentoring program; and the outcomes were the expected or unexpected consequences of mechanisms in a particular context. Following broad coding into categories of context, mechanism and outcomethematic coding was undertaken within each category.

Results: A total of 312 contexts, 961 mechanisms and 283 outcomes were identified. Within the context category thematic analysis revealed the themes of university services, university course demands, environmental conditions and individual differences. Themes within the mechanisms were problem solving, the mentor, the structured program, and social interactions. While the themes of identifying positive mentor outcomes, identifying personal strengths, achieving goals, increased independence and mentor-mentee relationshipwere identified within the outcomes.

Conclusions: The mechanisms of particular interest within the intervention were problem solving and the mentor. It is particularly interesting that even though ASD is a condition characterised by social communication difficulties several of the most pertinent mechanisms of the present intervention were forms of communication and social interaction. These findings indicate that to work effectively with university students with ASD mentors need to utilise therapeutic use-of-self and modelling to foster social communication and participation at university. It is also suggests that adults with ASD are able to effectively model social behaviours from their peer mentors. Modelling of appropriate and effective communication strategies by peer mentors is a powerful intervention to increase self-efficacy in social-communication for university students with ASD. Further research is required to describe the dynamics of the peer mentoring relationship and the impact of this intervention on ASD symptomatology.