Bullying causes significant short-term emotional and physical consequences for children with autism

This study was led by researchers from the Interactive Autism Network, a project of the Kennedy Krieger Institute that is the nation's first online autism registry with participants from 47 states, making it the largest collection of autism data in the world.

"Recent research indicates that children receiving special education services are at risk of being victimized at higher rates than regular education students," says Dr. Paul Law, senior study author and director of the Interactive Autism Network at Kennedy Krieger. "Our findings show that not only are these children being bullied more, but they are also experiencing significant short-term, and likely long-term, effects of being bullied."

Participants in the study included parents of 1,221 children with ASD recruited through an online questionnaire. Researchers utilized the Bullying and School Experiences of Children with ASD Survey, a 63-item questionnaire, to collect key data from parents regarding their child's school environment, involvement in bullying, and the child's educational and psychological functioning. Additionally, researchers used the Parent Observation of Child Adaptation (POCA) to reflect parents' ratings of their child's behaviors and level of psychological distress after a bullying incident. The study's findings on the characteristics and psychiatric comorbidities most associated with bullying are below.

Characteristics of Children with ASD Involved in Bullying

• Over a one month period, 38 percent of children with ASD were bullied, with 28 percent frequently bullied.
• Immediate consequences of being bullied included emotional trauma (69 percent) and physical injuries (8 percent).
• Nearly 14 percent of children who were bullied reported being scared for their own safety.
• Eighteen percent of children were reported to have been triggered into fighting back, with 40 percent having an emotional meltdown or outburst that resulted in disciplinary action from school staff.
• Nine percent of children with ASD acted as bullies, with five percent identified as frequent perpetrators of bullying.

Psychiatric Comorbidity and Bullying Behaviors

• Children with ASD who also presented with ADHD and depression were more likely to be bullied.
• Children with ASD who also presented with conduct disorder or oppositional defiant disorder were more likely to be bullies.
• Children with ASD who also presented with ADHD, conduct disorder or oppositional defiant disorder were most likely to be bully-victims, characterized as being both victims of bullying and behaving as bullies.

According to Dr. Law, it is well documented that short-term consequences of bullying include poor mental and physical health outcomes. The long-term consequences can also have a serious effect on the well-being of an individual with ASD. In many cases, the effects of bullying can extend into adulthood with an increased risk for later psychiatric illness.

"Our results provide insights that will help teachers and school staff identify children with autism who may be at the greatest risk for bullying involvement, either as victims or perpetrators," says Dr. Law. "Outside of school, parents should be encouraged to talk to their child about bullying, particularly if they are concerned their child may be a victim. Parents should also set up appointments to talk to the staff or teachers at their child's school to learn more about how they can work to prevent bullying and help children involved in bullying cope with the consequences."

Future research is needed to clinically validate the correlation between a child's psychiatric diagnosis and bullying behavior. Longitudinal study designs will also help to provide insight into the sequence of events related to bullying behaviors and psychological and physical issues. Researchers hope that with greater information on the bullying behaviors and the consequences of bullying on children with ASD, parents, school staff, teachers and health care providers can better protect this particularly vulnerable population.

Other researchers who contributed to the study were Benjamin Zablotsky, PhD and Catherine Bradshaw, PhD, MEd, of the Johns Hopkins Bloomberg School of Public Health; and Connie Anderson, PhD, of Kennedy Krieger Institute.

The Interactive Autism Network is supported by grants from the Simons Foundation, Autism Speaks and the National Institute of Mental Health (NIMH).