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As more autistic students pursue four-year degrees, many colleges have developed autism support programs (ASPs). However, limited research exists on what these programs offer, how decisions are made, and how impact is evaluated. This study used survey data (n = 52) and follow-up interviews (n = 6) with ASP administrators to examine available supports, decision-making factors, and perceived effectiveness. While academic and social supports are prioritized, areas like mental health, independent living, and career development receive less consistent attention. Decision-making is often informed by staff collaboration, student input, and professional networks. Despite ongoing barriers, such as funding and staffing, the findings offer practical insights to inform future research and improve support for autistic college students.