Abstract | Summary | Original Article

Bullying among adolescents with Autism Spectrum Disorders: Prevalence and perception

Van Roekel E, Scholte RHF, Didden R.

Journal of Autism and Developmental Disorders. 2010; 40: 63-73.

Question:

1. What percentage of adolescents with ASD are involved in bullying as either a victim or a bully?
2. Do adolescents with ASD accurately perceive bullying and victimization?
3. Do deficits of Theory of Mind in adolescents with ASD influence their perceptions?

Background: Bullying is a kind of aggression that is about abuse of power. Both the victims and perpetrators can suffer as a result of bullying, developing both behavioural and emotional problems as they grow up. Children who have special needs, such as physical, emotional, language, social, or learning problems are more likely to be bullied. Children with these same problems, but particularly those with behavioural problems, also bully other children. Like other special needs children and adolescents, those with ASD may be more prone to both being a victim of bullying and of bullying others because they have poor social skills, including the ability to understand the behaviour of other people, and fewer friends than their typically developing peers.

Participants: Two hundred and thirty adolescents with ASD and 24 adolescents without ASD, who formed a control group, took part.

Setting: Three special education schools located in the Netherlands.

Study Design: This study consisted of questionnaires administered to the adolescent with and without ASD and their teachers, and through examining the participants’ evaluation of videotaped segments focusing on social interactions.

Method: Children with a diagnosis of autism were located through computerized records, disability registers and by contacting local pediatricians, local child psychiatrists, and special schools to help ensure that all children with autism were located. Computerized lists of children's diagnostic records, immunization records, and health history records were examined to verify the diagnosis of autism, to find any reports of regression noted in the charts, and the reasons for the regression that were cited by the children's parents. The records were linked to determine first mention of "autism," any mention of "regression" and the date of MMR immunization. After finding all the records of children in whom regression was reported, the researchers looked for the parents' opinion as to the cause of their child's condition.

Outcome Measures: Participants rated each of their classmates according to a description of bullying behaviour and victimization, and were asked the number of incidents of bullying they had witnessed. A computerized Theory of Mind (ToM) test was administered to all participants. Teachers were asked to fill in a similar questionnaire on every child in the class. All participants rated themselves on their own behaviour. All participants rated video clips of social interaction to measure their ability to recognize bullying behaviour.

• Main results: The teachers’ perception of bullying and victimization differed from the adolescents perceptions. Teachers reported more bullying than the adolescents reported about their peers and themselves.
• Adolescents with ASD were as able to perceive and report on bullying as were those without ASD.
• The more teens with ASD were bullied, the more they perceived non-bullying situations as bullying. That is, they believe neutral or even positive experiences as negative.
• The more teens with ASD engaged in bullying, and the less developed were their Theory of Mind skills. In addition, those with poor ToM were more likely to identify bullying situations as nonbullying.
• About one quarter of teens with ASD in this study engaged in bullying.

Conclusions: Adolescents with ASD misperceive both bullying and victimization and need interventions to help them understand what constitutes appropriate behaviour. This could help reduce both victimization and bullying, both by other others and themselves.

Bottom Line Teenagers with ASD are often both the victims of bullying and inadvertent perpetrators of bullying. They need help to understand what is appropriate social behaviour and what is not. They were also accurate reporters of bullying, but were very sensitive to others’ behaviour.