Hilltop, what are you wanting to make happen? My ds is only 9, but I can tell you I was at this awkward stage too where it was like how do you tell someone they're broken, why would I do that, would the word mean anything. That's probably not what you're thinking with an 18 yo. You've said things about him not getting it together. Maybe this is kind of normal in your family and everyone else kinda pulled themselves up by the bootstraps and got it to work by 18? But he's clearly not.
My ds does a similar thing, where he's totally annoyed by a behavior that HE does also. But because his self-awareness is very poor, he has no clue that he does the very thing that annoys him about other people. So he'll be with other spectrum kids in public settings (sports, church, whatever) and say they're so WEIRD. LOL I can laugh. But to me, that means it's time and that he's ready for that explanation. You might get the Kathy Hoopmann books. Like just go ahead and get all of them. She has one each on anxiety and ADHD and two on ASD/aspergers. Just go ahead and get them. As I'm reading them to my ds he's going oh I'm like that! He doesn't do that on every page, but he does it on enough pages that it's helpful. He's 9. He's not gonna click as fast as your ds 18. But yeah, Amazon prime and you could have those books in 2 days. I just ask him hey do you know anybody from your sports like that, anybody from your church like that... It's kind of fun.
Another data piece for you. Social Thinking is a major place to look when you're wanting resources, books, therapies, whatever. They have a referral list for people who have been trained by them to do their Social Communication Profiles Dynamic Assessment. If someone on that list *happens* to be near you, like within 3-5 hours, they would be an invaluable resource.
Michelle Garcia Winner, the person behind Social Thinking, spends a lot of time in her workshops talking about her experience, unfortunately, with these really bright bright kids like ours. She says parents think getting them through college will solve everything, and then they get to the end with degrees and are unemployable. And when she brings these young adults into her clinic, obviously she starts teaching them about Social Thinking, starts them going through materials, but they get really straightforward jobs. Like Target or Walmart. Like just a job.
So I'm looking at what you're saying, and with my own dd a freshman this year at a university, using supports for her ADHD and having that tension of keeping her scholarship, I'm with you that it's concerning. My observation is that you're only a freshman once. Why screw that up when he needs a little more bake time? He's on the cusp of self-discovery and more self-awareness. He's about to get a diagnosis that could/should rock his world. He's going to need time to adjust, time to connect with resources. He could take a year, WORK A JOB, get services, THEN apply to college.
A lot of college is social. All of life involves social. There is no rush. He could apply to all these places, accept, and then defer for a year. He could take some time to get some services and be on-track to have a better experience.
If you want services, you could talk more about what he's struggling with. In our house we've used a variety of people. We have a behaviorist (BCBA) who comes in and gives us inhome analysis and help. We've used a licensed social worker/phd counselor who has significant experience with autism who does CBT and can address stress relief, emotional regulation, making choices. And we've used a phd psychologist who specializes in autism who leads a support group and is very in the loop. That person is really good at saying it straight and cutting to the chase on what's going on with the autism and how the person with autism thinks.
Autism, at its core, involves deficits in self-awareness. So when you surround him with people that he's ready to receive who can talk straight with him about his deficits and help him understand himself better, he can grow in these areas.
You're seeing him, so you know what he needs and what you could help him have access to. I guess the one thing I think *won't* probably work is self-reform. You sound really hopeless and discouraged right now, and I'm just saying self-reform, where you tell him to get his (whatever) together, probably isn't going to get him there. And if this pdoc is pussyfooting around the autism thing and really not an expert in it, move on. Has he been to an autism support group? Is there anything like that in your community?
Are you considering meds for the depression? I lost that in the thread. That could be on the table. If he's having aggression, treatment for that could be on the table. With my ds, we're using a very aggressive dosing of niacin to get him stable.
The thing about being in despair is that you're just one step, the right step, from maybe starting to turn things around. What other resources do you have or who else could you bring in to make a team to get him some help?