Mental Health as a Key Mediator for Outcomes in Postsecondary Education, Employment, and Everyday Living in Autistic Adults.

Background: As the number of adults who identify as autistic increases, it is vital to understand factors that improve autonomy and achievement of a good life for autistic adults. Postsecondary education and employment may contribute to higher levels of independence but may also add stress and increase mental health concerns. This study aimed to explore interactions of mental health concerns with adaptive daily living (ADL) outcomes, defined for this study as postsecondary education and employment outcomes, in verbally fluent autistic adults. Methods: We surveyed 140 adults with confirmed ( Results: Autistic traits and camouflaging traits did not directly predict ADL outcomes. However, the mental health latent variable was a strong direct predictor of ADL outcomes in that worse mental health predicted better ADL; mental health also significantly mediated the relationships between autism traits and ADL and camouflaging traits and ADL. Conclusions: This sample self-reported substantial education and work experience, though not always at levels high enough to support independence. Nonetheless, overall success in adaptive daily activities remains a significant challenge. Importantly, success in school and work was predicted by poor mental health, an indicator of the high cost of fitting in with neurotypical expectations that highlights the need for neurotypical systems to better understand and accommodate unique strengths and support needs to facilitate success