School refusal and bullying in children with autism spectrum disorder

Chou W., Hsiao R., Ni H., Liang S., Lin C., Chan H., Hsieh Y., Wang L., Lee M., Hu H., Yen C.

The aim of this study was to examine the prevalence of self-reported and parent-reported bullying victimization, perpetration, and victimization-perpetration and the associations of autistic social impairment and attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms with bullying involvement in adolescents with high functioning autism spectrum disorder (ASD). A total of 219 adolescents with high functioning ASD participated in this study. The associations of sociodemographic characteristics, parent-reported autistic social impairment, and parent-reported ADHD and ODD symptoms with self-reported and parent-reported bullying victimization, perpetration, and victimization-perpetration were examined using logistic regression analysis. The results found that the agreement between self-reported and parent-reported bullying involvement was low. Compared with bullying involvement experiences reported by adolescents themselves, parents reported higher rates of pure bullying victimization (23.7% vs. 17.8%) and victimization-perpetration (28.8% vs. 9.1%) but a lower rate of pure bullying perpetration (5.9% vs. 9.1%). Deficit in socio-communication increases the risk of being pure victims and victim-perpetrators. Parent-reported victim-perpetrators had more severe ODD symptoms than did parent-reported pure victims.

Paul A., Gallot C., Lelouche C., Bouvard M.P., Amestoy A.

Children and youths with autism spectrum disorder (ASD) have behavioural characteristics and severe social disabilities that make them vulnerable to victimisation. The current study explores the prevalence of peer victimisation in this population in France. We used the Juvenile Victimization Questionnaire—Screener Sum Version in a French sample of 39 children and youths with ASD and 53 typically developing (TD) children and youths and tested the association of the victimisation with socio-demographic factors and clinical factors of anxiety and post-traumatic stress. The results indicate that 72% of the subjects with ASD had been victimised during the previous year and 94.9% during their entire lifetime. Of all students victimised at least once over the course of their lives, 75% had been victimised at school. Their peer victimisation score was significantly higher than in the TD group and was correlated to clinical factors such as a deficit in social skills and the severity of post-traumatic symptoms. Symptoms of anxiety were reported by parents of children and youths with ASD in 80% of cases. Children and youths with ASD are particularly vulnerable to victimisation at school. Discussion focuses on the importance of considering the impacts and needs of school integration of this population in France in order to prevent these phenomena and their consequences.

Sobba K.N.

School avoidance has increasingly become a major issue among adolescents. Research shows that students who avoid school are significantly more likely to experience numerous problems including schoo...

Madipakkam A.R., Rothkirch M., Dziobek I., Sterzer P.

Atypical responses to direct gaze are one of the most characteristic hallmarks of autism spectrum disorder (ASD). The cause and mechanism underlying this phenomenon, however, have remained unknown. Here we investigated whether the atypical responses to eye gaze in autism spectrum disorder is dependent on the conscious perception of others’ faces. Face stimuli with direct and averted gaze were rendered invisible by interocular suppression and eye movements were recorded from participants with ASD and an age and sex matched control group. Despite complete unawareness of the stimuli, the two groups differed significantly in their eye movements to the face stimuli. In contrast to the significant positive saccadic index observed in the TD group, indicating an unconscious preference to the face with direct gaze, the ASD group had no such preference towards direct gaze and instead showed a tendency to prefer the face with averted gaze, suggesting an unconscious avoidance of eye contact. These results provide the first evidence that the atypical response to eye contact in ASD is an unconscious and involuntary response. They provide a better understanding of the mechanism of gaze avoidance in autism and might lead to new diagnostic and therapeutic interventions.

Hwang S., Kim Y.S., Koh Y., Leventhal B.L.

While a growing number of studies indicate associations between experiences of bullying and autism spectrum disorder (ASD), it is not clear what roles comorbid behavioral problems may play. We investigated the experiences of children with ASD as victims and/or perpetrators of bullying. Children with ASD epidemiologically ascertained participated in a cross-sectional study. Although children with ASD showed significantly increased risk for bullying involvement compared to community children, after controlling for comorbid psychopathology and other demographic factors, increased risks for being perpetrators or victim-perpetrators disappeared while risk for being bullied/teased continued to be significantly elevated. This finding will help guide medical, educational and community personnel to effectively identify children with ASD at risk for school bullying and develop interventions.

Munkhaugen E.K., Gjevik E., Pripp A.H., Sponheim E., Diseth T.H.

School refusal behaviour in students with autism spectrum disorder (ASD) is poorly studied despite being considered a serious problem. This study assessed the frequency, duration, and expression of school refusal behaviour in students with ASD, aged 9–16 years, without intellectual disability. Further, the associations between school refusal behaviour and sociodemographic factors were explored. Teachers and parents assessed this behaviour over 20 days in a cross-sectional study of 216 students, including 78 students with ASD and 138 typically developing (TD) students. School refusal behaviour was significantly higher in students with ASD as compared to TD students. Significant associations were found between school refusal behaviour and illness of other family members. The study concludes that school refusal behaviour is pervasive in students with ASD.

Wang S., Deng H., You C., Chen K., Li J., Tang C., Ceng C., Zou Y., Zou X.

The aim of this study was to explore the differences between boys and girls in the diagnosis and clinical phenotypes of autism spectrum disorder (ASD) in China's mainland. Children diagnosed with ASD (n = 1064, 228 females) were retrospectively included in the analysis. All children were assessed using the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS). The results showed that girls scored significantly higher in ADI-R socio-emotional reciprocity than boys, and also scored lower in ADI-R and ADOS restricted and repetitive behaviors (RRBs). Meanwhile, the proportions of girls who satisfied the diagnostic cut-off scores in the ADI-R RRBs domain were lower than in boys (P < 0.05). Our results indicated that girls with ASD show greater socio-emotional reciprocity than boys. Girls also tended to show fewer RRBs than boys, and the type of RRBs in girls differ from those in boys. The ADI-R was found to be less sensitive in girls, particularly for assessment in the RRBs domain.

Lai M., Lerch J.P., Floris D.L., Ruigrok A.N., Pohl A., Lombardo M.V., Baron-Cohen S.

The male preponderance in autism prevalence has brought together the disparate topics of sex/gender and autism research. Two directions of neuroimaging studies on the relationships between sex/gender and autism may inform male-specific risk mechanisms and female-specific protective mechanisms of autism. First, we review how sex/gender moderates autism-related brain changes and how this informs general models of autism etiology. Better-powered human neuroimaging studies suggest that the brain characteristics of autism are qualitatively, rather than simply quantitatively, different between males and females. However, age and comorbidities might substantially moderate the pattern of differences. Second, we review how the relationship between autism-related brain changes (separately in males and females) and normative brain sex/gender differences informs specific etiological-developmental mechanisms. Both human and animal studies converge to indicate that the brain characteristics of autism are partly associated with normative brain sex/gender differences, suggesting convergence or overlap between the mechanisms leading to and modifying the development of autism and the mechanisms underlying sex differentiation and/or gender socialization. Future animal work needs to investigate sex differences in rodent mutants modeling autism-relevant genes and environmental exposures. Future human work needs to address the substantial phenotypic and etiological heterogeneity of autism and to focus on longitudinal neuroimaging studies (from early development) on the developmental trajectories of sex/gender-differential neural characteristics of autism. Combining animal and human work links up the causal chain from etiological factors, brain and physical development, to phenotypes. These together help delineate the different roles of sex and gender in relation to risk vs. protective mechanisms. © 2016 Wiley Periodicals, Inc.

Dillon G.V., Underwood J.D., Freemantle L.J.

This research investigated the self-reported mainstream school experiences of those diagnosed on the autistic spectrum compared with the typically developing school population. Existing literature identifies four key areas that affect the quality of the school experience for students with autism: social skills, perceived relationships with teaching staff, general school functioning, and interpersonal strengths of the young person. These areas were explored in a mainstream U.K. secondary school with 14 students with autism and 14 age and gender matched students without autism, using self-report questionnaires and semi-structured interviews. Quantitative analyses showed consistent school experiences for both groups, although content analysis of interview data highlighted some differences in the ways in which the groups perceive group work, peers, and teaching staff within school. Implications for school inclusion are discussed, drawing attention to how staff awareness of autism could improve school experience and success for students with autism attending mainstream schools.

Vidourek R.A., King K.A., Merianos A.L.

Bullying is a significant problem in U.S. schools. The purpose of the present study is to examine the impact student bullying has on avoidance behaviors and fear at school among youth nationwide. Data from the School Crime and Safety Survey was analyzed. Participants included 5,784 U.S. students in grades 5 through 12. Almost one-third of students reported being bullied in the past year. Females, junior high school students, and public school students were significantly more likely to report being bullied than their counterparts. Students who were bullied were significantly more likely than students who had not been bullied to report fear and avoidance. Prevention and intervention programs are needed to reduce bullying and negative consequences associated with the behavior.

Maïano C., Normand C.L., Salvas M., Moullec G., Aimé A.

The true extent of school bullying among youth with autism spectrum disorders (ASD) remains an underexplored area. The purpose of this meta-analysis is to: (a) assess the proportion of school-aged youth with ASD involved in school bullying as perpetrators, victims or both; (b) examine whether the observed prevalence estimates vary when different sources of heterogeneity related to the participants' characteristics and to the assessment methods are considered; and (c) compare the risk of school bullying between youth with ASD and their typically developing (TD) peers. A systematic literature search was performed and 17 studies met the inclusion criteria. The resulting pooled prevalence estimate for general school bullying perpetration, victimization and both was 10%, 44%, and 16%, respectively. Pooled prevalence was also estimated for physical, verbal, and relational school victimization and was 33%, 50%, and 31%, respectively. Moreover, subgroup analyses showed significant variations in the pooled prevalence by geographic location, school setting, information source, type of measures, assessment time frame, and bullying frequency criterion. Finally, school-aged youth with ASD were found to be at greater risk of school victimization in general, as well as verbal bullying, than their TD peers. Autism Res 2016, 9: 601-615. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Weiss J.A., Cappadocia M.C., Tint A., Pepler D.

Bullying victimization is commonly associated with anxiety among individuals with and without Autism Spectrum Disorder (ASD), and both bullying victimization and anxiety are more prevalent among youth with ASD than in the general population. We explored individual and contextual factors that relate to anxiety in adolescents and young adults with ASD who also experience bullying victimization. Participants included 101 mothers of adolescents and young adults diagnosed with ASD. Hierarchical multiple regression analyses were conducted to investigate the relationship between bullying victimization and anxiety in children with ASD, as well as parenting stress as a potential moderator of that relationship. Findings indicate that parenting stress moderates the association between bullying victimization and anxiety. The severity of anxiety was most strongly associated with bullying victimization when mothers reported high levels of stress. Implications for interventions that assist parents with coping and address bullying victimization are discussed.

Idring S., Lundberg M., Sturm H., Dalman C., Gumpert C., Rai D., Lee B.K., Magnusson C.

In a record-linkage study in Stockholm, Sweden, the year 2011 prevalence of diagnosed autism spectrum disorders (ASD) was found to be 0.40, 1.74, 2.46, and 1.76 % among 0–5, 6–12, 13–17, and 18–27 year olds, respectively. The corresponding proportion of cases with a recorded diagnosis of intellectual disability was 17.4, 22.1, 26.1 and 29.4 %. Between 2001 and 2011, ASD prevalence increased almost 3.5 fold among children aged 2–17 years. The increase was mainly accounted for by an eightfold increase of ASD without intellectual disability (from 0.14 to 1.10 %), while the prevalence of ASD with intellectual disability increased only slightly (from 0.28 to 0.34 %). The increase in ASD prevalence is likely contributed to by extrinsic factors such as increased awareness and diagnostics.

Lai M., Lombardo M.V., Baron-Cohen S.

Autism is a set of heterogeneous neurodevelopmental conditions, characterised by early-onset difficulties in social communication and unusually restricted, repetitive behaviour and interests. The worldwide population prevalence is about 1%. Autism affects more male than female individuals, and comorbidity is common (>70% have concurrent conditions). Individuals with autism have atypical cognitive profiles, such as impaired social cognition and social perception, executive dysfunction, and atypical perceptual and information processing. These profiles are underpinned by atypical neural development at the systems level. Genetics has a key role in the aetiology of autism, in conjunction with developmentally early environmental factors. Large-effect rare mutations and small-effect common variants contribute to risk. Assessment needs to be multidisciplinary and developmental, and early detection is essential for early intervention. Early comprehensive and targeted behavioural interventions can improve social communication and reduce anxiety and aggression. Drugs can reduce comorbid symptoms, but do not directly improve social communication. Creation of a supportive environment that accepts and respects that the individual is different is crucial.

Jensen C.M., Steinhausen H., Lauritsen M.B.

This study investigated time trends and associated factors of incidence rates of diagnosed autism spectrum disorders (ASD) across the lifespan from 1995 to 2010, using data from the Danish Psychiatric Central Research Registry. First time diagnosis of childhood autism, atypical autism, Asperger’s syndrome, or pervasive developmental disorder—unspecified (PDD-NOS) were identified, incidence rates were calculated, and data were fitted using non-linear least squares methods. A total of 14.997 patients were identified and incidence rates for ASD increased from 9.0 to 38.6 per 100,000 person years during the 16-year period. The increases were most pronounced in females, adolescents, adults, and patients with Asperger’s syndrome and PDD-NOS.

Cappe É., Despax J., Ridremont D., Boujut E.

ABSTRACTTeachers working with autistic children are at a great risk of stress and burnout, particularly in mainstream classrooms. To identify the general relationship between including a child with a mental disability and teachers' burnout and stress, as well as to discern any autism spectrum disorder (ASD)‐specific associations, this study compared teachers' experiences with children with ASD, attention‐deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) and typical children (control group). Two comparisons with a total sample of 907 teachers were conducted: one involving mainstream teachers (three groups: ASD, ADHD, and control) and one with specialized teachers (two groups: ASD and CD). Participants completed scales measuring perceived stress, self‐efficacy, perceived social support, coping, and burnout. The hypothesis that autism is specifically associated with teachers' burnout was chiefly rejected based on the results; instead, the intensity of behavioral problems appeared to be central. Clinical implications and research perspectives are discussed, particularly regarding the importance of training teachers in children's specific needs and inclusive pedagogy.

Bowden N., Anns F., Vu H., Dacombe J., Muir C., Russell J., van der Meer L., Williams J., Clendon S.

ABSTRACTBackgroundExtant literature indicates autistic students have lower school attendance compared to the general population. However, there remains considerable heterogeneity between studies, a lack of large population‐based studies beyond the UK and US, and insufficient consideration of age and sex differences in attendance rates. The aim of this study was to examine school attendance among autistic compared with non‐autistic students including stratification by age and sex.MethodsThis was a national retrospective cohort study using population‐level data on students aged 5 to 16 years in 2018. Autism was identified using diagnostic information contained within multiple health datasets. Regular attendance was defined as attending 90% or more of school half days. The association between autism and attendance was estimated using complete‐case 2‐level random intercept modified Poisson regression.ResultsAmong 654 438 students, 8427 (1.3%) were autistic. In adjusted analyses, autism was associated with significantly decreased likelihood of regular attendance (incident rate ratio [IRR] 0.88; 95% CI, 0.86–0.90). Age and sex stratification revealed significant age differences with likelihood of regular school attendance lower for younger autistic students (5–11 years) (IRR 0.85; 95% CI, 0.83–0.87) while sex differences were marginal. The most frequent type of non‐attendance among autistic students was justified (including medical) absence (8.2% of recorded attendance hours for autistic students vs. 5.0% for non‐autistic students).ConclusionThis study provides further, whole‐population evidence of the significant disparities experienced by Autistic students. To improve attendance of autistic students, comprehensive and targeted supports are required to help the student, family and school.

Fujii K., Idrizi K., Friedman C.A., Byrnes K.

Ullah K., Saeed S.

In this study, we examined the social and cultural factors causing bullying of children with special needs, particularly in the socio-cultural context of Pakistan. Despite the global attention on bullying, there remains a significant gap in understanding how cultural norms, social stigmas, and community attitudes affect bullying among children with special needs in Pakistan. This study aims to fill this gap. The study analyzed multiple research studies including research papers, academic articles, books, reports, and policy analyses to examine the different dimensions of bullying of children with special needs in Pakistan. The study findings reveal that embedded cultural norms and social stigmas contribute significantly to the increasing cases of bullying. Community attitudes, lack of awareness, and inadequate anti-bullying policies further aggravate this issue. The insights gained from this study can inform policies that focus on culturally sensitive and inclusive anti-bullying strategies to provide friendlier and more conducive learning environment for all children.

Sasso I., Sansour T.

AbstractSchool plays an important role in the development of a child. The impact of school absenteeism extends beyond academic achievement, affecting one's ability to participate in life successfully. In particular, children with difficulties in communication and interaction are at risk of developing school absences. This systematic review therefore focused on school absenteeism among children on the autism spectrum and examined the risk and influencing factors contributing to school absences. Eighteen studies were included, thirteen of which used a quantitative design, two of which were mixed-method studies, and three of which had a qualitative design. Different studies had varying definitions of school absenteeism and employed diverse study designs, prompting the need for a narrative synthesis. We evaluated the data regarding the factors of individual, parental, and school based on the KiTes bioecological systems framework for school attendance and absence by Melvin et al. (2019). We identified the majority of risks and influences in relation to the school factor and identified interacting factors contributing to school absenteeism in all factors. We recognised research gaps and provided guidance for further research.

Guo S., Huang N., Liu X., Zhang S., Guo J.

Students who are bullied not only affect academic performance, but also produce a range of psychological problems. The purpose of the present study was to investigate the association between school bullying and academic burnout among Chinese students, assuming school climate to play a moderating role in the aforementioned relationship. This study provides corresponding intervention strategies and reference data for the prevention and treatment of bullying in schools. The data was obtained by a cross-sectional survey of 20,730 Chinese students from 23rd May to 23rd June 2022. Multiple linear regressions and Latent Profile Analysis (LPA) were used to examine the hypotheses. This study revealed that all dimensions of school bullying and school bullying level (β = −0.09; 95 % CI, −4.946, −3.833) were associated with academic burnout. Verbal bullying (β = 0.15; 95 % CI, 1.689, 1.972) had the strongest association with academic burnout, followed by social (β = 0.14; 95 % CI, 1.496, 1.779) and physical bullying (β = 0.13; 95 % CI, 1.451, 1.734), while cyber bullying (β = 0.08; 95 % CI, 0.847, 1.127) had the weakest association with academic burnout. In addition, school climate can moderate the association between school bullying and academic burnout. Students who experienced school bullying and in bad school climate showed elevated levels of academic. This study used cross-sectional data, preventing us from drawing conclusions about causation. The findings suggested that creating a harmonious school climate and reducing school bullying may effectively alleviate academic burnout caused by school climate and school bullying.

Khamis E.M., AL Jabery M.A.

Among children with special needs, those with autism spectrum disorder (ASD) are more susceptible to school bullying, due to communication challenges. In this study, the severity and types of school bullying, mainly physical, verbal, and social, experienced by children with ASD were identified and assessed from their mothers’ perspectives in Jordan. Additionally, the mothers’ levels of agreement with a set of anti-bullying interventions targeted at preventing bullying or attenuating its adverse consequences on children with ASD were evaluated. The results revealed that verbal and physical bullying were the most common types of school bullying experienced by children with ASD. Furthermore, the frequency of bullying has not been correlated to gender or school type; however, children in primary school experienced a higher frequency of school bullying. The results also revealed a set of proposed anti-bullying interventions that received a high level of agreement from the mothers. These interventions include arranging for various training sessions and programs targeted to children with ASD and their mothers to guide them on handling bullying and assigning specialists at schools to evaluate, monitor, and prevent bullying behaviors and support bullied students. Such interventions are considered promising opportunities for addressing school bullying among children with ASD.

Lindblad V., Ravn R.L., Gaardsted P.S., Hansen L.E., Lauritzen F.F., Melgaard D.

AbstractIntroductionIn the fields of labor market and education research, there is a vast interest in mental health factors affecting unsuccessful school‐to‐work transitions, dropout from school and labor market disconnections for young people. Young people who are not in employment, education or training are conceived of as NEET.AimTo get an overview we conducted a systematic review of the present literature on the influence of mental health on the likelihood of becoming NEET in Europe.MethodA Systematic literature search was conducted in four databases on February 21, 2023, with an update on January 15, 2024.Results33,314 articles were screened whereas 41 studies involving 8,914,123 individuals were included. Poor mental health such as attention deficit hyperactive disorder, autism, depression, borderline, and psychosis during childhood and adolescence is strongly associated with becoming NEET.ConclusionMental health issues, whether mild or severe, heighten significant the risk of adverse education and employment outcomes in early adulthood, extending to young individuals with personality disorders, borderline personality disorder, and psychoses. These observations inform early intervention strategies for children and young people grappling with mental health challenges. Timely treatment is essential. Future research should focus on the gap in research like specific disorders such as eating disorders and anxiety.

Di Vincenzo C., Pontillo M., Bellantoni D., Di Luzio M., Lala M.R., Villa M., Demaria F., Vicari S.

AbstractThe aim of the study was to explore the clinical significance of school refusal behavior, its negative impact on psychological well-being of children and adolescents and its relationship with the most common psychopathological conditions during childhood and adolescence (e.g. neurodevelopmental disorders, psychiatric disorders). School refusal behavior refers to a distressing condition experienced by children and adolescents that compromise regular school attendance and determine negative consequences on mental health and adaptive functioning. A narrative review of the literature published between January 2019 and March 2023 was conducted. Ten studies (n = 10) were included from a literature search of the electronic databases PubMed, CINAHL, PsycInfo, MedLine, and Cochrane Library. The results indicate that school refusal is highly present in neurodevelopmental disorders such as autism and attention-deficit/hyperactivity disorder due to the presence of behavioral problems and deficits in communication skills. As for psychiatric disorders, school refusal appears to be highly common in anxiety disorders, depressive disorders, and somatic symptoms. We also found that school refusal behavior may be associated with various emotional and behavioral conditions that act as risk factors. Especially, but are not limited to, it may be associated with a diminished self-concept, exposure to cyberbullying, specific affective profiles and excessive technology usage. Our results indicate that school refusal is a condition with many clinical facets. It can be attributed to both vulnerability factors, both temperamental and relational, and to various psychopathological conditions that differ significantly from each other, such as neurodevelopmental disorders and psychiatric disorders. Recognizing these aspects can improve the implementation of patient-tailored therapeutic interventions that are consequently more likely to produce effective outcomes. The therapeutic intervention should facilitate the recognition of cognitive biases regarding school as a threatening environment, while regulating negative emotions associated with school attendance. Additionally, therapeutic intervention programs linked to social skill training and problem-solving training, conducted directly within the school setting, can enhance children’s abilities to cope with academic performance and social relationships, ultimately preventing school refusal.

Morales-Hidalgo P., Voltas N., Canals J.

Autistic individuals are at increased risk of experiencing various forms of victimization during their lifespan. This study analyses the self-reported prevalence of bullying victimization in autistic pre-adolescents and those with subthreshold autistic traits in comparison with peers without neurodevelopmental conditions. The sample was comprised of 323 participants (11 and 12 years old; 45 with autism or subthreshold autistic traits) from Spanish general education schools. The assessment protocol included psychopathological (autism characteristics and co-occurrent problems), cognitive and academic characteristics. Bullying victimization was self-reported by the pre-adolescents themselves using the Bullying and School Violence Questionnaire ( Acoso y violencia escolar). Autistic participants (57.9%) and those with subthreshold autistic traits (26.9%) showed a higher rate of bullying victimization in comparison with their peers (18.3%). Bullying rates were more frequent and severe and were characterized by intimidation and social exclusion behaviours. These problems were associated with greater intensity of restrictive and repetitive behaviours and with more co-occurring behavioural and emotional problems. We did not find any association with other individual or family factors. Our data reveal the greater risk of bullying behaviours among autistic young people and those with subthreshold autistic traits, which implies the need for detection and establishment of protocols to prevent consequences for their mental health and quality of life. Lay abstract Autistic individuals face a higher risk of various forms of victimization throughout their lives, with bullying being especially prevalent during their school years. Previous studies indicate that autistic children are 2.4 times more likely to be bullied than their typically developing peers and twice as vulnerable as those with other disabilities. However, the extent of this issue among Spanish schoolchildren with autism remains unexplored. In addition, there is no information regarding the presence of bullying victimization in children with marked but undiagnosed autistic traits (i.e. subthreshold autistic traits). This study examines the self-reported prevalence of bullying victimization in autistic pre-adolescents and those with subthreshold autistic traits, comparing them with peers without neurodevelopmental conditions. The study involved 323 participants (11 and 12 years old; 45 with autism or subthreshold autistic traits) from Spanish general education schools. The results revealed a higher rate of bullying victimization among autistic participants (58%; 3.1 times higher risk) and those with subthreshold autistic traits (27%; 1.5 times higher risk) compared with their peers without neurodevelopmental conditions (18.3%). Victimization was linked to more intense restrictive behaviours and increased behavioural and emotional problems. No significant associations were found with other individual or family factors. Our findings underscore the heightened risk of bullying faced by autistic pre-adolescents and those with subthreshold autistic traits at school, emphasizing the need to identify and implement preventive measures to mitigate bullying and its detrimental impact on their mental well-being and overall quality of life.

Abdullah M.

AbstractThe physical, social, emotional, intellectual, and mental health of students with Autism Spectrum Disorder (ASD) can be affected negatively if a problem occurs in an inclusive classroom setting.The purpose of this study is to investigate how bullying affects students with ASD. This thorough literature review looks at how bullying affects students with ASD including social development, academic performance, and school participation. Bullied children who grow up to be adults have anxiety and despair that affect their school engagement. Students with ASD are unable to get along with typically abled students due to bullying. The paper highlighted the importance for educators to prevent and treat bullying of students with ASD. However, the study has severe drawbacks such as a lack of empirical research conducted in the UAE. The study recommends releasing further studies in the UAE carrying out more research on other factors that impact bullying of kids with ASD to raise awareness of this issue.

Ulaş S., Seçer İ.

AbstractConsidering the problems associated with school attendance, school refusal is an adjustment problem that tends to become increasingly prevalent. The present study identifies the patterns reported in the literature on school refusal and outlines the structure and sub-components of school refusal. Therefore, the systematic review method was selected as the research method for this study. The data sources of this study consist of 40 research articles that fell within the purview of WoS and were either included or excluded according to predetermined inclusion and exclusion criteria. Using MAXQDA 2020, both content and descriptive analyses were conducted in synthesizing the data sources. As a result of the analysis, the study year, method, data collection tool, data collection procedure, data analysis, and sample were examined as descriptive characteristics. Analyzing the content characteristics, five themes were identified: risk factors for school refusal, school refusal symptoms, school refusal protective factors, approaches, and techniques for intervention in school refusal, and consequences of school refusal. The findings are provided by discussing the related literature.

Ulaş S., Gonzálvez C., Seçer İ.

School refusal is considered a risk factor for academic, social, and personal situations, such as school dropouts. Studies have been carried out on school refusal for almost 50 years. However, general research trends have not been mapped yet. This study summarizes the bibliometric analysis of scientific collaborations and prevalence across locations by country and institution, leading researchers, journals, and trends (keywords) in school refusal research. The United States, Japan, Spain, and England are the countries that stand out in terms of school refusal. It can be said that the Journal of American Academy of Child and Adolescent Psychiatry, Cognitive and Behavioral Practice, and Frontiers in Psychology are important journals that publish on school refusal. Researchers named Christopher A. Kearney, Carolina Gonzálvez, Jose Manuel Garcia-Fernandez, David A. Heyne, and Brigit M. Van Widenfelt have been found to have more intensive studies and collaborations on school refusal. The authors keywords common use for school refusal; are truancy, school absenteeism, adolescence, school attendance, school phobia, autism spectrum disorder, and bullying. The findings show that school refusal is a current research area, and scientific collaborations continue to be established. The findings reveal all the details of the school refusal research.

Shiozu H., Kimura D., Iwanaga R., Kurasawa S.

Strategies are critical to promote child participation in important life activities. This study analyzed the participation strategies of the parents of children with neurodevelopmental disorders. Ninety-two Japanese elementary children with neurodevelopmental disorders and their parents were recruited. The parents completed the Participation and Environment Measure for Children and Youth (PEM-CY) questionnaire. Strategy text data obtained from the PEM-CY were analyzed with the co-occurrence network and correspondence analyses. The co-occurrence network analysis showed that the commonality of strategies to enable participation at home, school, and community settings was able to explain the child’s characteristics when involved in each setting. The correspondence analysis also suggested the need for specific strategies in each setting. The importance of strategies to improve the attitudinal environment and promote the participation of children with neurodevelopmental disorders was evident. Reducing stigma is important in all environments, especially in the public sphere. In addition, specific strategies are needed in each setting, suggesting the importance of context-specific approaches.

Li S., Chien W., Chung C., Tzeng N.

IntroductionChildren and adolescents with autism spectrum disorder (ASD) may be particularly vulnerable to the impact of traumatic events, yet the association between ASD and the risk of developing acute stress disorder and post-traumatic stress disorder (PTSD) remains uncertain. This study aims to investigate this association, addressing the gap in large-scale evidence on the subject.MethodsConducted as a retrospective and matched cohort study, data was sourced from the National Health Insurance Research Database (NHIRD) in Taiwan, spanning from January 1, 2000, to December 31, 2015. The study included patients aged 18 years or under newly diagnosed with ASD (n=15,200) and compared them with a matched control group (n=45,600). The Cox proportional regression model was employed to assess the risk of acute stress disorder and PTSD.ResultsOver the 15-year follow-up period, a total of 132 participants developed either acute stress disorder or PTSD. Among them, 105 cases (0.691% or 64.90 per 100,000 person-years) were in the ASD group, while 27 cases (0.059% or 5.38 per 100,000 person-years) were in the control group. The adjusted hazard ratio for the ASD group was significantly higher compared to the control group (25.661 with 95% CI = 15.913-41.232; P &lt; .001).DiscussionThis study provides compelling evidence that individuals with ASD face an elevated risk of developing acute stress disorder and PTSD. The findings underscore the importance of clinicians recognizing and addressing this vulnerability in ASD individuals exposed to traumatic events. This emphasizes the need for heightened attention to the risk of PTSD and acute stress disorder in the ASD population.