The objective was to examine the frequency, correlates, and overlap of school disciplinary actions, psychiatric hospitalizations, and police contact among children and adolescents with autism. Survey results from 2525 caregivers of individuals with autism in elementary through high school were examined. Logistic regression was used to examine predictors of each outcome. Youth with autism most frequently experienced school disciplinary action (15.0%), followed by police contact (7.9%) and hospitalization (7.8%). Experiencing any one of the three events increased risk of experiencing either of the other events. Strong associations between traumatic experiences such as police contact and hospitalizations (OR 9.2), need to be explored to determine risk factors for potential intervention. Further research is needed to determine the temporal ordering of these outcomes.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Association, A. P. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.
Barnert, E. S., Perry, R., & Morris, R. E. (2016). Juvenile Incarceration and Health. Academic Pediatrics, 16(2), 99–109. doi:10.1016/j.acap.2015.09.004.
Bauminger, N., Solomon, M., & Rogers, S. J. (2010). Externalizing and internalizing behaviors in ASD. Autism Research, 3(3), 101–112. doi:10.1002/aur.131/abstract.
Browning, A., & Caulfield, L. (2011). The prevalence and treatment of people with Asperger’s Syndrome in the criminal justice system. Criminology and Criminal Justice, 11(2), 165–180.
Cashin, A., & Newman, C. (2009). Autism in the criminal justice detention system: A review of the literature. Journal of Forensic Nursing, 5(2), 70–75. doi:10.1111/j.1939-3938.2009.01037.x.
Christensen, D. B., Jr., Braun, K. V., Bilder, D., Charles, J., Constantino, J. N., Daniels, J., Durkin, M. S., Fitzgerald, R. T., Kurzius-Spencer, M., Lee, L. C., Pettygrove, S., Robinson, C., Schulz, E., Wells, C., Wingate, M., Zahorodny, W., Yeargin-Allsopp, M. (2016). Prevalence and characteristics of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 Sites, United States, 2012. MMWR. Surveillance summaries: Morbidity and mortality weekly report. Surveillance summaries/CDC, 65(No. SS-3), 1–23.
Chun, T. H., Katz, E. R., & Duffy, S. J. (2013). Pediatric mental health emergencies and special health care needs. Pediatric Clinics of North America, 60(5), 1185–1201. doi:10.1016/j.pcl.2013.06.006.
Croen, L. A., Najjar, D. V., Ray, G. T., Lotspeich, L., & Bernal, P. (2006). A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics, 118(4), e1203-1211. doi:10.1542/peds.2006-0127.
Eith, C. D., & Matthew. (2011). Contacts Between Police and the Public, 2008. Retrieved from.
Farrington, D. P., Gaffney, H., Lösel, F., & Ttofi, M. M. (2017). Systematic reviews of the effectiveness of developmental prevention programs in reducing delinquency, aggression, and bullying. Aggression and Violent Behavior, 33, 91–106. doi:10.1016/j.avb.2016.11.003.
Fazio, R. L., Pietz, C. A., & Denny, R. L. (2012). An estimate of the prevalence of autism spectrum disorders in an incarcerated population. Journal of Forensic Psychology, 4, 69–80.
Gray, K., Keating, C., Taffe, J., Brereton, A., Einfeld, S., & Tonge, B. (2012). Trajectory of behavior and emotional problems in autism. American Journal on Intellectual and Developmental Disabilities 117(2), 121–133. doi:10.1352/1944-7588-117-2.121.
Hartley, S. L., Sikora, D. M., & McCoy, R. (2008). Prevalence and risk factors of maladaptive behaviour in young children with Autistic Disorder. Journal of Intellectual Disability Research: JIDR, 52(10), 819–829. doi:10.1111/j.1365-2788.2008.01065.x.
Hassiotis, A., Gazizova, D., Akinlonu, L., Bebbington, P., Meltzer, H., & Strydom, A. (2011). Psychiatric morbidity in prisoners with intellectual disabilities: Analysis of prison survey data for England and Wales. The British Journal of Psychiatry: The Journal of Mental Science, 199(2), 156–157. doi:10.1192/bjp.bp.110.088039.
Kalb, L. G., Stuart, E. A., Freedman, B., Zablotsky, B., & Vasa, R. (2012). Psychiatric-related emergency department visits among children with an autism spectrum disorder. Pediatric Emergency Care, 28(12), 1269–1276. doi:10.1097/PEC.0b013e3182767d96.
Kanne, S. M., & Mazurek, M. O. (2011). Aggression in children and adolescents with ASD: Prevalence and risk factors. Journal of Autism and Developmental Disorders, 41(7), 926–937. doi:10.1007/s10803-010-1118-4.
King, C., & Murphy, G. H. (2014). A systematic review of people with autism spectrum disorder and the criminal justice system. Journal of Autism and Developmental Disorders, 44(11), 2717–2733. doi:10.1007/s10803-014-2046-5.
Krezmien, M. P., Leone, P. E., & Achilles, G. M. (2006). Suspension, race, and disability: Analysis of statewide practices and reporting. Journal of Emotional and Behavioral Disorders, 14(4), 217–226.
Law, G. C., Neihart, M., & Dutt, A. (2017). The use of behavior modeling training in a mobile app parent training program to improve functional communication of young children with autism spectrum disorder. Autism: The International Journal of Research and Practice. doi:10.1177/1362361316683887.
Losen, D. J., & Gillespie, J. (2012). Opportunities suspended: The disparate impact of disciplinary exclusion from school. UCLA: The Civil Rights Project.
Mandell, D. S. (2008). Psychiatric hospitalization among children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(6), 1059–1065. doi:10.1007/s10803-007-0481-2.
Mandell, D. S., Xie, M., Morales, K. H., Lawer, L., McCarthy, M., & Marcus, S. C. (2012). The interplay of outpatient services and psychiatric hospitalization among Medicaid-enrolled children with autism spectrum disorders. Archives of Pediatrics and Adolescent Medicine, 166(1), 68–73. doi:10.1001/archpediatrics.2011.714.
Matson, J. L., & Cervantes, P. E. (2014). Assessing aggression in persons with autism spectrum disorders: An overview. Research in Developmental Disabilities, 35(12), 3269–3275. doi:10.1016/j.ridd.2014.08.004.
Micallef, L., & Rodgers, P. (2014). EulerAPE: Drawing area-proportional 3-venn diagrams using ellipses. PLoS ONE, 9(7), e101717. doi:10.1371/journal.pone.0101717.
Moskowitz, L. J., Walsh, C. E., Mulder, E., McLaughlin, D. M., Hajcak, G., Carr, E. G., & Zarcone, J. R. (2017). Intervention for anxiety and problem behavior in children with autism spectrum disorder and intellectual disability. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-017-3070-z.
Nayfack, A. M., Huffman, L. C., Feldman, H. M., Chan, J., Saynina, O., & Wise, P. H. (2014). Hospitalizations of children with autism increased from 1999 to 2009. Journal of Autism and Developmental Disorders, 44(5), 1087–1094. doi:10.1007/s10803-013-1965-x.
Prins, S. J. (2014). Prevalence of mental illnesses in US State prisons: A systematic review. Psychiatric Services, 65(7), 862–872. doi:10.1176/appi.ps.201300166.
PHLP. (2014). Getting Medical Assistance for a Child (under 18) with a Severe Disability, Behavioral, or Autism Spectrum Disorder under the PH-95 Category (“loophole”). In P. H. L. Project (Ed.).
Rava, J., Shattuck, P., Rast, J., & Roux, A. (2017). The prevalence and correlates of involvement in the criminal justice system among youth on the autism spectrum. Journal of Autism and Developmental Disorders, 47(2), 340–346. doi:10.1007/s10803-016-2958-3.
SAS. (2016). SAS Institute Inc. Cary NC.
Schlenz, A. M., Carpenter, L. A., Bradley, C., Charles, J., & Boan, A. (2015). Age differences in emergency department visits and inpatient hospitalizations in preadolescent and adolescent youth with autism spectrum disorders. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-015-2405-x.
Schwartz-Watts, D. M. (2005). Asperger’s disorder and murder. The Journal of the American Academy of Psychiatry and the Law, 33(3), 390–393.
Sheryl, A. H., Stephanie, M. P., Herrenkohl, T. I., Toumbourou, J. W., & Catalano, R. F. (2014). Student and school factors associated with school suspension: A multilevel analysis of students in Victoria, Australia and Washington State, United States. Children and Youth Services Review, 36(1), 187–194. doi:10.1016/j.childyouth.2013.11.022.
Sickmund, M., Sladky, A., & Kang, W. (2017). Easy access to juvenile court statistics: 1985–2014.
Siegel, M., & Gabriels, R. L. (2014). Psychiatric hospital treatment of children with autism and serious behavioral disturbance. Child and Adolescent Psychiatric Clinics of North America, 23(1), 125–142. doi:10.1016/j.chc.2013.07.004.
Soltis, S. L., Probst, J., Xirasagar, S., Martin, A. B., & Smith, B. H. (2013). Diagnostic and demographic differences between incarcerated and nonincarcerated youth (Ages 6–15) with ADHD in South Carolina. Journal of Attention Disorders. doi:10.1177/1087054713506746.
Sullivan, A. L., Van Norman, E. R., & Klingbeil, D. A. (2014). Exclusionary discipline of students with disabilities: Student and School characteristics predicting suspension. Remedial and Special Education, 0741932513519825.
U.S. Census. (2014). Pennsylvania Quick Facts. Retrieved from http://quickfacts.census.gov/qfd/states/42000.html.
Whalon, K. J., Conroy, M. A., Martinez, J. R., & Werch, B. L. (2015). School-based peer-related social competence interventions for children with autism spectrum disorder: A meta-analysis and descriptive review of single case research design studies. Journal of Autism and Developmental Disorders, 45(6), 1513–1531. doi:10.1007/s10803-015-2373-1.
Young, S., & Thome, J. (2011). ADHD and offenders. The World Journal of Biological Psychiatry: The Official Journal of the World Federation of Societies of Biological Psychiatry, 12(Suppl 1), 124–128. doi:10.3109/15622975.2011.600319.
Zhang, D., Katsiyannis, A., & Herbst, M. (2004). Disciplinary exclusions in special education: A 4-year analysis. Behavioral Disorders, 29(4), 337–347.
This study was funded through the Autism Services, Education, Resources, and Training (ASERT) Collaboration, under the Bureau of Autism Services, Office of Developmental Programs, Pennsylvania Department of Human Services.
Conflict of interest
The authors declare that they have no competing interests.
About this article
Cite this article
Turcotte, P., Shea, L.L. & Mandell, D. School Discipline, Hospitalization, and Police Contact Overlap Among Individuals with Autism Spectrum Disorder. J Autism Dev Disord 48, 883–891 (2018). https://doi.org/10.1007/s10803-017-3359-y