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A Comparison Between Caregiver-Reported Anxiety and Other Emotional and Behavioral Difficulties in Children and Adolescents with Autism Spectrum Disorders Attending Specialist or Mainstream Schools

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Abstract

Increasing numbers of students with Autism Spectrum Disorder (ASD) are attending mainstream schools. Nonetheless, concerns about their emotional well-being and mental health in these settings have also been raised. This study sought to compare caregiver-reported anxiety and other emotional and behavioural problems in youth with ASD attending mainstream or specialist schools. Caregivers of 27 youth with ASD in mainstream schools (age 10.91 ± 3.44 years) and 69 youth with ASD in special schools (age 10.93 ± 2.81 years) matched for gender, age, adaptive functioning and autism symptom severity scores participated. Caregivers completed the Spence Children’s Anxiety Scale–Parent, a measure of adaptive functioning, and a checklist of other emotional and behavioral difficulties. Students with ASD attending mainstream schools experienced higher levels of social anxiety symptoms compared to their specialist school counterparts. No other statistically significant differences were found in other aspects of emotional and behavioural functioning examined, but some differences emerged in item-level analyses. Uncertainties in navigating more complex social environments and increased social relating difficulties in mainstream schools are discussed as probable environmental triggers for increased social phobia related symptomatology, although other explanations for this small effect size difference are also considered. Limitations of the present study and recommendations for future research focusing on exploring environmental socio-ecological factors influencing anxiety and mental health in young people with ASD are also discussed.

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Notes

  1. It should be noted that the majority of the children and adolescents with ASD in Singapore are diagnosed in the country’s two leading public child development units (0–7 years) or at the Child Guidance Clinic for 7–18 year olds (see Table 1). These are staffed by qualified and trained multi-disciplinary teams employing DSM-IV-TR (American Psychiatric Association 2000), DSM-5 (American Psychiatric Association 2013), or ICD-10 (World Health Organization 2011) diagnostic criteria and adhering to evidence-based ASD assessment practices (i.e. Ministry of Health 2010; Moh and Magiati 2012).

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Acknowledgments

This research was supported by Start-up Grant from the Department of Psychology at NUS awarded to the second author. We are grateful to the caregivers of the youth with ASD who participated in this study, to the specialist school and teachers who facilitated recruitment, and to Ms. Julianne Wen-Li Tan who helped to organize the workshop on supporting parents of children with ASD attending mainstream schools.

Author Contributions

HZ participated in the design of the study, carried out the data collection, performed the statistical analyses, participated in the interpretation of the data and drafted the manuscript. IM conceived the study, participated in its design, coordination and interpretation of the data and helped to draft the manuscript. All authors read and approved the final manuscript.

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  1. Hani Zainal

    Present address: Department of Psychology, The Pennsylvania State University, 310 Moore Building, University Park, PA, 16802-3103, USA

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  1. Department of Psychology, National University of Singapore, Block AS4, #02-07, 9 Arts Link, Singapore, 117570, Singapore

    Hani Zainal & Iliana Magiati

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Zainal, H., Magiati, I. A Comparison Between Caregiver-Reported Anxiety and Other Emotional and Behavioral Difficulties in Children and Adolescents with Autism Spectrum Disorders Attending Specialist or Mainstream Schools. J Autism Dev Disord 49, 2653–2663 (2019). https://doi.org/10.1007/s10803-016-2792-7

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