“School distress” rates are elevated among those with autism

Rates of “school distress”—or significant emotional distress related to attending school—are significantly elevated in children with autism spectrum disorders (ASD), according to a new study from the United Kingdom.

Sophie Connolly and colleagues compared questionnaire responses from 947 parents of children and young people who experienced school distress to responses from 149 parents of an age-matched control group. They report, “Notably, 92.1 percent of children and young people currently experiencing school distress were described as neurodivergent and 83.4 percent as autistic.” In comparison, only 16.8 percent of individuals in the “no school distress” group were autistic. Moreover, autistic individuals who displayed school distress exhibited distress at a significantly earlier age than nonautistic children, and this distress was more enduring.

The researchers add that sensory processing difficulties and attention-deficit/ hyperactivity disorder (ADHD) were also linked to higher rates of school distress. In addition, they say that “clinically significant anxiety symptomology and elevated demand avoidance were also pervasive.” 

They also note, “The majority of children and young people experiencing school distress either currently or previously attended a mainstream provision… posing the question of whether mainstream settings are suitable for all children and young people, and if not, which provisions may be more appropriate.” 

The researchers note that their study included individuals currently undergoing or awaiting assessments for ASD as well as those with official diagnoses. They say that because research typically shows no significant difference in ASD characteristics between adults with a confirmed ASD diagnosis and those awaiting diagnosis, and because waiting times for diagnosis are lengthy in the United Kingdom, “broader inclusion criteria are likely to provide a more accurate estimation of the prevalence of autism among children and young people with school distress.” However, they note that their study population was of limited diversity, which may influence their findings. 

The researchers conclude, “Further research, ideally co-produced with autistic and otherwise neurodivergent individuals, is needed to determine best practices in education, and to ensure appropriate understanding of how neurodivergent pupils best learn.”

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“School distress and the school attendance crisis: a story dominated by neurodivergence and unmet need,” Sophie E. Connolly, Hannah L. Constable, and Sinéad L. Mullally, Frontiers in Psychiatry, September 22, 2023 (free online). Address: Sinéad L. Mullally, sinead.mullally@ newcastle.ac.uk.

This article originally appeared in Autism Research Review International, Vol. 37, No. 4, 2023