Understanding, Experiences, and Reactions to Bullying Experiences ...

J Dev Phys Disabil (2014) 26:747–761 DOI 10.1007/s10882-014-9393-1 O R I G I N A L A RT I C L E

Understanding, Experiences, and Reactions to Bullying Experiences in Boys with an Autism Spectrum Disorder Vicki Bitsika & Christopher F. Sharpley

Published online: 15 July 2014 # Springer Science+Business Media New York 2014

Abstract Most previous studies of bullying in young people with an Autism Spectrum Disorder (ASD) have relied on data from adults’ rather than the person with an ASD themselves, thus limiting our understanding of the bullying experience from the child’s perspective. To investigate this issue, 48 high-functioning boys with an ASD, and their mothers, completed an online questionnaire about various aspects of bullying. There were some minor discrepancies between mothers’ and their sons’ reported frequency of bullying. Boys demonstrated an understanding of the behaviour that constitutes bullying that was consistent with the wider literature, enhancing the validity of their responses about their experiences. Sources of bullying included friends, and bullying mostly occurred in the playground. These boys had ineffective coping strategies for bullying, and many reported significant physical and emotional negative reactions. Many boys found that telling adults made their bullying experiences worse, and most kept their bullying experiences to themselves until they reached home, then adopting a range of negative (tantrums) and positive (staying alone to calm down) behaviours. Unfortunately, over half of these boys sought to absent themselves from school as their preferred method for coping with their bullying experiences. These findings have major implications for interventions within schools to reduce bullying and to provide access to learning and social activities. Keywords ASD . Boys . School . Bullying

Introduction Being bullied at school adversely affects many thousands of students around the world, increasing their risk of physical and mental health problems (Due et al. 2005). Some of V. Bitsika : C. F. Sharpley Centre for Autism Spectrum Disorders, Bond University, Gold Coast, QLD, Australia C. F. Sharpley (*) Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia e-mail: [email protected]

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J Dev Phys Disabil (2014) 26:747–761

the psychological consequences of bullying include depression and suicidal ideation, which may also persevere into adulthood in the bullied person (Sweeting and West 1998). One of the more long-term damaging consequences of bullying is the absence from school of the child who has been bullied, leading to permanent dropout from school (Fried and Fried 1996), which in turn may impair employment and financial prospects in adulthood. Among school-age children, boys report being bullied more than girls (Due et al. 2005) and bullying appears to most often occur when some members of the peer group seek to achieve social dominance (Atlas and Pepler 1997). Children with a disability are frequently targets of bullying at school (Taylor and Spratt 2010), perhaps because of their generally lower social status due to physical or behavioural differences (Pepler and Craig 2002). Children with an Autism Spectrum Disorder (ASD) may be at a particular disadvantage in this respect because of their comparative difficulties in socialization, communication and their tendency to engage in rigid behaviour (APA 2013). These difficulties in understanding the complexities of verbal and nonverbal interactions may result in children with an ASD appearing as if they do not wish to engage with other children, followed by the exhibition of rigid or repetitive behaviour which may be judged as bizarre by their non-ASD peers (Haq and Le Couteur 2004). However, despite this hypothetical propensity of children with an ASD to be the targets of bullying from their peers, Zablotsky et al. (2012), p. 179) commented that there had been relatively “little empirical research” into the incidence, nature and effects of bullying upon children with an ASD, suggesting that these aspects of being bullied might be valuable future research foci in this group of children. Certainly, there are data suggesting a high incidence of bullying experiences in children who exhibit ASD-like behavioural difficulties arising from impairments in communication and socialization, at least from the perspective of their parents. For example, children who showed even subtle autistic behaviour patterns were found to be at a particularly high risk of bullying (Bejerot and Mortberg 2009) and 94 % of parents of children with Asperger’s Disorder (who commonly engage in rigid interactional patterns) reported that their 4- to 17-year old children were bullied (Little 2002). Another study by Carter (2009) also used parents’ reports of the bullying experiences of their child with Asperger’s Disorder to describe this issue but relatively few studies have been reported using data collected directly from children with an ASD themselves. That is, most of the studies reported above were either confined to parents’ reports of their children’s experiences of bullying or else focused upon school-based socio-demographic and educational predictors of bullying. However, some studies have collected self-reports from young people with an ASD about aspects of bullying. For example, van Roekel et al. (2010) surveyed adolescents with an ASD who attended special schools regarding their experiences of being bullied and bullying others. Teachers reported significantly higher levels of bullying than adolescents with an ASD, although Roekel and colleagues argued that the ASD adolescents were able to recognize bullying behaviour and report accurately upon its frequency. Significantly higher rates of bullying were also reported by parents compared to those from their children with an ASD by Rowley et al. (2012), who found that social impairment was inversely correlated with the frequency of bullying experiences in children with an ASD. Another study reported that ASD children (who were bullied more often than non-ASD children) had lower scores on a measure of social support (Symes and Humphrey 2010), and Rieffe et al (2012) found that ASD


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and non-ASD children who bullied others were likely to report less guilt and more anger on standardised tests than children from both groups who did not bully others. These studies contribute to our understanding of the antecedents of being bullied and bullying others in young people with an ASD, but they leave several key questions unanswered. For example, the finding that parents and teachers reported significantly higher rates of bullying than children with an ASD themselves suggests that data from each of these sources might be best considered to represent different aspects of bullying rather than different reports on the same datum. Further, although van Roekel et al (2010) argued that the adolescents (12 to 19 years) with an ASD in their study were able to accurately understand a definition of bullying and apply it to report on their experiences, they cued their sample by a printed definition of bullying and a video segment depicting bullying behaviour, thereby leaving the non-tutored accuracy of the understanding of bullying by these young people to be further investigated. Finally, none of the studies reported to date has specifically focused upon the nature of the bullying behaviour as it is experienced by children with an ASD themselves, nor upon how they react to bullying in terms of their own psychological, physiological and behavioural responses at the time of being bullied or later. These factors are vital in understanding the bullying experience from the perspective of the child with an ASD who is bullied because they are the basis for an ideographic construction of an antecedent-behaviour-consequence model of bullying for these children in clinical settings. That is, while the identification of common environmental (e.g., school placement) factors, plus personality (e.g., anger, guilt) factors are valuable in understanding bullying as it occurs in young people with an ASD, these findings do not necessarily inform everyday clinical practice that requires data on (i) how children with an ASD perceive bullying (i.e., what it is to them when it occurs), (ii) exactly what form their bullying takes and how they react immediately to those perceived bullying experiences, and (iii) the longer-term effects of bullying upon their behaviour that may become confused with the general behavioural difficulties exhibited by these children. Additionally, a focus upon these matters within a younger age group than adolescence (as in most previous studies) enables data to be collected that can be of use in developing more effective responses to bullying at an earlier age, thus potentially avoiding the entrenchment of behaviour patterns that are not adaptive for the overall goals that these children hold for their lives. Therefore, this study had several aims. First, to test the previously-reported discrepancy between parents’ and children’s reports of the frequency of bullying, children’s own reports of the frequency of being bullied were compared to reports from their parents about the frequency of the children’s bullying experiences. Second, to determine if children had an accurate understanding of what constituted bullying (without cuing), the children’s own definitions of bullying were compared to those from the literature. Third, the children’s descriptions of the environmental antecedents of their bullying experiences were investigated to develop a more detailed model of how these unfortunate incidents occurred and who initiated them. Fourth, the kinds of bullying these children received were described. Fifth, in order to understand the immediate impact of being bullied, children were asked to describe how they felt emotionally, physically, and what they did in response to those bullying experiences. Finally, to describe the longer term effects of bullying upon the behaviour of these children, they were

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asked how being bullied at school later influenced their behaviour at home. High-functioning children with an ASD were chosen as the sample to be studied so as to maximize the opportunity to collect data that were valid and reliable for further research into these issues. The initial sample was restricted to male children because more boys than girls report being bullied. In order to ensure that the survey questions included in this research were comprehensible to a sample of high-functioning boys with an ASD, a pilot interview study was conducted on a small sample of boys with an ASD. During that pilot study, it became apparent that anonymity of respondents would enhance the chances of collecting accurate data, and so the main study used an online questionnaire format.

Methods Pilot Study Ten children with an ASD participated in face-to-face interviews which aimed to extract descriptions of their personal experiences of bullying. This semistructured interview explored five topic areas: friendships and social interactions at school (3 questions), recognition of specific bullying behaviours (5 questions), strategies for reporting bullying incidents to another person (4 questions), immediate- and long-term responses to being bullied (4 questions), and emotional plus physiological impacts of being bullied (4 questions). Children were guided to respond to interview questions by discussing their personal experiences in their own words. Responses were audiotaped and submitted to thematic analysis in order to establish key themes which represented those experiences common across all ten children. Those themes became the basis for developing questions which asked about bullying experiences for the online questionnaire package. Participants A total of 48 boys with an ASD (M age = 9.9 years, SD = 2.0 year, range=7 years to 12 years), plus their mothers, completed an online questionnaire during the first 6 months of 2013. These boys were all high-functioning and were recruited from the Gold Coast area in Queensland, Australia. They were in grades 2 to 7, and four of them attended a special school, with the remainder attending mainstream schools. All the participants with an ASD had received their diagnosis from a 2-hour clinical interview with their parents and based upon DSM-V criteria for ASD, plus family history. These interviews were conducted by either a state-registered paediatrician or psychiatrist, all of whom were specialists in the diagnosis and treatment of ASD in children and adolescents. These diagnoses were confirmed by a suitably qualified and state-registered clinical psychologist who had a PhD in the assessment and treatment of ASD and who had several decades’ experience in diagnosis and treatment of ASD in children and adolescents. Interview protocols focussed upon developmental history, symptoms of an ASD (from DSM-V criteria), including the presence of impairments in social interaction and social communication, plus the presence of repetitive and restricted behaviour and interests. Symptoms of ASD were referenced to the developmental history of the participants and the social context in which their ASD symptoms occurred. All diagnoses were confirmed by behavioural observation. This diagnostic process is the accepted and required standard for identification of


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autism conditions in Australia, where the use of the ADOS and ADI-R is recommended only when there is uncertainty regarding the relevance of an autism diagnosis (there was no such uncertainty for any of the ASD participants for this study). Mothers reported that the official diagnoses for these boys were: ASD = 12 (25.0 %), Asperger’s Disorder = 33 (68.8 %), Pervasive Developmental Disorder Not Otherwise Specified (PD-NOS) = 2 (4.2 %). Fig. 1 presents the summaries of parent-reports on the major ASD-related difficulties that their sons suffered and indicates that those difficulties which were most severe were concerned with their ability to socialize and control rigid behaviour. By contrast, poor or atypical communication was not rated by these parents as being a severe problem for their sons. Measures The questionnaire package consisted of two parts, comprising open-ended questions, multiple-choice questions, and questions that used Likert scales. First, a section asked the boys’ mothers about their sons’ age, grade, type of schooling (special vs mainstream) and official diagnosis (ASD, Aspergers, PD-NOS), plus a rating of their level of difficulty in the three areas of Socialising, Communicating, and Rigid behaviour on a 5-point scale (Minimal, Slight, Moderate, Severe, Very severe), whether their son had reported being bullied (yes/no), how often they had been bullied (open-ended) and who bullied them (open-ended). Second, the boys were asked their age, and school grade (both open-ended), plus whether they had friends at school (yes/no), how many friends they had (open-ended) and whether they had a special friend (yes/no), what they did during recess and lunchtimes (open-ended), their definition of bullying (openended), whether they had been bullied (yes/no) and the source (one other student, a group of students, a student who is sometimes my friend), frequency (not often, sometimes, nearly every day) and site of that bullying (classroom, playground, corridor in school, toilet). Then they were asked about their experiences of bullying, including how they had been bullied (verbally, physically), if they had told anyone about being bullied (yes/no) and how reporting the bullying made them feel (always better, sometimes better, sometimes worse, always worse), what their immediate response to being bullied was (ignore it, smile, reply, hit/punch/kick, chase the bullies away, walk away from them), whether that response was successful (never, sometimes, usually, 50 45 40 35 30 25 20 15 10 5 0

Socialising CommunicaƟng Rigid behaviour

Minimal

Slight

Moderate

Severe

Very severe

Fig. 1 Parents’ ratings of the severity of their sons’ ASD-related behaviours

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always), the emotional (sad, nervous, scared, angry, lonely) and physiological (headaches, stomach butterflies, stomach pains, feel like vomiting) impacts of being bullied and what they did several hours after being bullied (spent time alone, talked to someone, tried to forget it, cry, had a tantrum, had difficulty sleeping, asked if they could stay away from school). All of these alternatives were derived from the pilot study of 10 boys with and ASD described above. Procedure Ethical approval was obtained for this study from the Bond University Human Research Ethics Committee (BUHREC). Mothers of participants were recruited from ASD associations on the Gold Coast, Qld, Australia, via information sessions conducted by the first author. All participants were informed that the responses they and their sons gave would be kept confidential, and they were given an online address to access the questionnaire. Data were downloaded from the online data-collection service and analysed by SPSS version 20.

Results Research question 1: Agreement between parents’ vs boys’ reports of bullying. Table 1 presents the percentages reported affirmatively by parents and boys for several questions about frequency and source of bullying. Taken at first glance, these data suggest a high level of agreement between parents and their sons about these variables, apart from the source of bullying (single child or group of children). These data are in contrast to those reported by van Roekel et al (2010), who noted that teachers reported that 30 % of adolescents were bullied but only 17 % of adolescents confirmed that report. Although teachers were not sampled in this study, it may be that parents’ opinions of whether their child is being bullied are more likely to agree with the opinions of the children themselves than are the observations of their teachers. However, despite the apparently high level of agreement between parents and their sons shown in Table 1 for whether they had been bullied or not (i.e., over 80 % in both sources), plus agreement regarding the frequency of bullying, the parents’ reports on the source of bullying appear to be quite Table 1 Parents’ vs boys’ reports of frequency and source of being bullied

Parents (%)

Son (%)

Bullied

83.3

81.3

Bullied each day

39.6

41.7

Bullied by a single child

20.8

50.0

Bullied by a group of children

39.6

52.1

2.1

39.6

Bullied by a friend


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different to the responses given by their sons, particularly as to whether the boy had been bullied by a friend. Further examination of the raw data for bullying frequency also indicated that the level of agreement was not as comprehensive as appears from those initial figures. For example, although 40 parents said that their son had been bullied, only 34 (85.0 %) of the sons of those 40 parents also reported that they had been bullied, with one boy reporting that he had not been bullied and 5 who did not respond to this question. Conversely, of the 39 boys who reported being bullied, 34 (87.2 %) of their parents agreed with them and 5 reported that their sons had not been bullied. That is, nearly 15 % of parents were overestimating the presence of bullying and over 10 % were underestimating it, according to their sons’ own reports. Research question 2: Boys’ accuracy of understanding of what constitutes bullying. The boys were asked to describe their understanding of bullying behaviour, and every boy made a response to this question with only one boy answering that he did not know what bullying was. Table 2 presents a representative sample (selected blind by each of the two authors from the total responses) of the descriptions made by the 47 boys (97.9 %) who gave definitions of bullying. From the wider literature, bullying is often defined as “deliberate, repeated or long-term Table 2 Boys’ definitions of bullying It’s when someone attacks you, annoys you and makes you cry. When people are mean to me with words or hurt me by hitting or poking and saying they want to kill me Where people hurt other with words or hit you Bullying is when people tease you and be mean to you even sometimes hurt you Bullying is when somebody teases you over, over and over. When people are mean to me Hitting, name calling Saying mean things and not letting me play When someone teases you and make fun of you!! When they push and hit u! People hurting other people, physically, emotionally or verbally When people are mean for no reason Bullying is where people being mean to you keep on going and they think it’s fun. If people are being mean to a person Someone who teases you When someone constantly picks on you or pesters you, pushes you People who tease you, hit you and never stop annoying you It’s when people try to hurt your feelings or in extreme cases try to attack you, they think it’s funny When kids say you can’t play with us you smell People hitting other people and taking their stuff

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exposure to negative acts performed by a person or persons” and may include “threats, insults, nicknames or physical acts such as assault or theft (plus) exclusion from the peer group” (Due et al. 2005, p. 128). It is clear from Table 2 that, as a sample, these boys did have an understanding of bullying that is similar to that shared by the wider community and the extant literature and which includes name-calling, hitting and kicking, rumours and social exclusion (Hoover et al. 1992), which are repeated hostile actions that take place within a relationship characterised by a power differential (Olweus 1993), plus threats, insults or nicknames or physical acts such as assault or theft (Due et al. 2005). This verification of the understanding that the boys’ with an ASD had of bullying with the wider literature allows for the remaining data to be considered as referring to a meaningful and reliable definition of bullying that is common to non-ASD persons. Of interest, the definitions offered by these boys and shown in Table 2 include personal definitions (e.g., “When people are mean to me with words or hurt me by hitting or poking and saying they want to kill me”, “When people are mean to me”, “Someone who teases you”, “When kids say you can’t play with us, you smell”) and more abstract definitions (e.g., “People hurting other people, physically, emotionally or verbally”, “People hurting other people and taking their stuff”). Research question 3: Environmental antecedents of boys’ bullying experiences. To get an understanding of the antecedents to bullying, boys were first asked about their friends and where they spent their free time at school. Nearly three-quarters (72.9 %) of the boys reported that they had friends at school and the number of friends varied from 1 to 28, with a mean of 5.7 friends; 54.2 % said that they had a best friend at school and 52.1 % of those best friends were in the same grade as the boy with an ASD. However, despite the large proportion of boys who reported having friends at school, 60.4 % said that they spent their lunchtimes alone. Somewhat sadly, 39.6 % of these boys reported that they had been bullied by “someone who is sometimes my friend”. Boys reported being bullied in their classrooms (45.1 %), in the corridor waiting to enter a classroom (35.2 %), in the playground (69.0 %) and in the toilet (15.5 %). Research question 4: What kind of bullying do these boys receive? The most widespread verbal and physical forms of bullying that these boys experienced are shown in Table 3. The most common verbal bullying was being made the butt of jokes, being called mean names or sworn at, having rude things said about how they acted, being excluded from playing activities, and being reported to their teachers even if their behaviour did not warrant that. The most common form of physical bullying


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Table 3 Five most common forms of verbal and physical bullying experienced by sample and percent of sample who reported these Verbal bullying

Percent Physical bullying

Percent

Make jokes about me and laugh at me

62.5

Being hit, pushed or kicked

58.3

Call me mean names and swear at me

60.4

Have ganged up on me

45.8

Say rude things about the way I act

52.1

Ignore me

43.8

Tell me I can’t play with them or be in their group 47.9

Taken something that belongs to me

41.7

Tell the teacher on me even when I haven’t done anything wrong

Tried to take my friends away from me 37.5

47.9

was being hit, pushed or kicked, followed by being “ganged up on”, being ignored, having something taken from them, and interference with their friendships. Research question 5: Immediate, short term and longer term responses to being bullied. Boys had several immediate and short-term responses to being bullied. The most common immediate responses were to: walk away from the bullies (56.3 %), ignore them (54.2 %), followed by saying something back to them (43.8 %) or making sure they were not near the bullies (39.6 %). Only 33.3 % of boys responded in kind by hitting, pushing, punching or kicking the bullies, and the comparative inability of these boys to adopt a superior role was reflected in the finding that only 18.8 % were able chase the bullies away and 16.7 % were able to smile at the bullies to show them that they were not affected. Most boys listed several of these ways in which they responded to bullies, but the relative effectiveness of these strategies was variable and generally unsuccessful, as shown in Fig. 2. As well as trying to cope with the bullying as it occurred, boys also were asked if they told anyone about being bullied. Reflecting their perceptions of who might be able to help them deal with the bullying, 75.6 % told their parents, 52.1 % told their teacher, principal or school counselor, while only 10.4 % told their siblings; 14.6 % told no-one, “trying to keep the bullying a secret”. Unfortunately, telling these people was not very successful in reducing the distress which arose from being bullied, with only 6.3 % of boys reporting that it always made them feel better to tell someone, 25.0 % usually feeling better, 37.5 % sometimes feeling better, and 16.7 % never feeling better. To add to this ineffectiveness in feeling better by telling someone about being bullied, 37.5 % reported that telling someone made the bullying worse either sometimes or always, with only 14.6 % reporting that telling someone never made the bullying worse.

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100 80 60 40 20 0 Never

SomeƟmes

Usually

Always

Fig. 2 Success rates for boys’ strategies to cope with bullying

Following these immediate or short-term responses to being bullied, the boys had several longer-term reactions which were classified according to the emotional and physiological effects the bullying had upon them. Table 4 presents these data, showing the percent of the sample who reported each reaction. Although the most common emotion these boys reported feeling to being bullied was anger, it was very closely followed by sadness, suggesting that the emotional reactions experienced by these boys were complex and not simply feeling frightened, nervous or lonely. Physiological reactions of the kind listed in Table 4 are significant because they are not necessary concomitants of mild or moderate psychological stress but usually only occur when that stress is intense or chronic, particularly after being bullied (Hansen et al. 2006). Although tension headache is a common first response to stressors, three of the four most common physiological responses were associated with irritation of the digestive system,

Table 4 Emotional and physiological reactions to being bullied and percent reporting these Emotional reactions

Percent

Physiological reactions

Percent

Angry Sad

62.5

Stomach butterflies

41.7

60.4

Headaches

Lonely

35.4

37.5

Stomach pains

31.3

Nervous

37.5

Feel like vomiting

27.1

Scared

31.3


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suggesting more intense reactions to the stressor of being bullied (Walker et al. 2001). Research question 6: Effects of being bullied at school upon behaviour at home. Another aspect of reactions to bullying is the transfer of the emotional responses to home environments. This may occur because school is perceived by these boys as a non-accepting situation due to the presence of bullies or because they see it as too filled with the everyday activities of school life to allow them time and opportunity to report their bullying experience. For whatever reason, 52.1 % of the sample reported that they kept their feelings about being bullied “inside” until they got home. When they did reach home, they responded in different ways. Of these, several were withdrawal responses (56.3 % asked their parents to keep them home from school the next day, 35.4 % tried to forget about being bullied), some were positive responses (37.5 % spent time by themselves to calm down, 37.5 % talked to someone at home about being bullied) and some were negative (45.8 % had a tantrum because they found it too difficult to control their feelings, 35.4 % found it hard to sleep, and 22.9 % cried because they felt sad).

Discussion As in previous studies, both the parents (Little 2002; Cappadocia et al. 2012) and the boys themselves reported high frequencies of bullying. Although there was a strong level of agreement between parents and their sons about the latter’s bullying experiences, sufficient discrepancies existed to warrant collection of more detailed bullying data from both sources and then exploration of any disagreements that may exist between those sources. Those findings did not necessarily negate either the selfreports of boys with an ASD or their parents’ observations of them but more likely suggest that some boys did not tell their parents that they had been bullied and/or that parents may have considered their son had been bullied although the sons did not think so. Further research is needed to clarify the exact sources of these discrepancies, but one possible explanation may be eliminated. That is, Table 2 data dispel the hypothesis that boys did not understand what bullying was and that they were not able to accurately report it. In fact, Table 2 lends validity to the remaining data collected in this study and is consistent with some other previous findings on the validity of selfreported bullying experiences of boys with an ASD (e.g., van Roekel et al. 2010). In order to help children with an ASD develop effective avoidance of bullying situations, it is necessary to identify the environmental antecedents of those bullying experiences. While some previous studies of bullying among young people with an ASD have focused upon the associations between parents’ reports of their child’s disability, communication, externalization of anxiety (e.g., Cappadocia et al. 2012), the present study collected data from both parents and their sons, and found that the friends which boys with an ASD had at school sometimes did not act as friends, but

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were reported as instigating bullying. This finding about the inconsistency of those friendships reflects a potentially very disturbing phenomenon for children with an ASD and would be likely to contribute to their overall uncertainty about their peers and therefore their anxiety about school in general. Further, the finding that bullying appeared to occur across most areas of the school environment is consistent with previous reports about children with disabilities in general (Taylor and Spratt 2010), and suggests that there were few safe havens for the boys in this study. The fact that nearly half of the sample reported being bullied in the classroom could be a potential inhibitor of concentration within lessons and consequent academic achievement. The boys in the sample were bullied in a variety of ways but all were most unpleasant experiences for any healthy human being and would constitute a major source of confusion for these boys who already had diminished abilities to comprehend the (anti-) social behaviours of their peers. The coping responses used by these boys were relatively ineffective, and it is apparent that the boys in this sample had few effective coping responses or respites from being bullied, and that the usual sources of support available to children were also mostly ineffective and often actively detrimental. Therefore, it is not surprising that many of these boys had negative emotional and psychophysiological responses to being bullied and that the longer-term psychological sequalae of being repeatedly angry, sad, lonely and nervous (all reported by over onethird of the sample) are considerable and may be expected to bias these boys against their school experience, perhaps leading to dropout and consequent reduced chances of gainful employment. The reactions reported by these boys in Table 4 are common stress responses to chronic and uncontrollable stressors in the environment which have been linked with significant psychological (Tennant 2002) and physical disease (Thoits 2010) in adults. Bearing in mind the ineffective coping strategies shown by these boys, plus their significant emotional and physical responses to being bullied, the fact that over half of them did not speak of their feelings until they reached home after school is understandable. However, when they were in a more familiar and secure environment at home, nearly half “had tantrums” (in the words of the pilot sample), over one third could not sleep, almost a quarter were tearful because they felt sad and over half asked if they could be excused from school, the latter finding being also reported previously (Fried and Fried 1996). These findings for the six research questions addressed in this study have several important implications for clinical practice. It would be reasonable to expect that, in the absence of telling an adult about being bullied, children with an ASD might instead communicate their distress through withdrawal and challenging behaviour. Therefore, in cases where such behaviour begins to occur or escalates, it would be appropriate for adults to consider that bullying and other adverse social experiences might be possible antecedents for that behaviour. Since the classroom is a common site for bullying, it is important that teachers to identify any bullying events and remediate these as one means of assisting the child with an ASD to re-engage with learning. The ASD children in this study reported that they had a group of friends but that they also remained isolated in social situations which commonly involved peer interaction (e.g., break times). Therefore, the question of what constitutes friendship from the perspective of children with an ASD is worthy of consideration. Gallagher et al (2000)


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suggested that the social interaction impairments inherent in autism disorder prevent children with an ASD from using meaningful and socially-sensitive cues to judge whether a friendship exists between them and a peer. Further Ochs et al (2001) indicated that children with an ASD are more likely to employ non-social (e.g., physical proximity) rather than social (e.g., frequency of interactions) criteria to judge whether a peer is their friend, leading them to over-estimate their friendships at school. Therefore, training children with an ASD to identify actual friendships could assist them in avoiding interactions with potential bullies. This training approach could also focus on helping the child with an ASD to become sensitized to those subtle behaviours from their peers which indicate that low-level bullying is occurring, plus a strategy for that child to remove him- or herself from the bullying situation. The desire for friendships paired with poor strategies for initiating and sustaining mutuallyrewarding interactions with peers are known to cause children with an ASD to become targets for bullying (Bauminger and Kasari 2000). Therefore, assisting children to learn age-appropriate and context-specific methods for engaging their peers as well as rehearsal of alternative responses to odd or idiosyncratic social behaviours could be at the centre of interventions aimed at building selfprotection against bullying in children on the autism spectrum. Finally, since children with an ASD are highly likely to produce long-term responses to being bullied which occur in the home with family members who might not be aware that a bullying incident has occurred, forming a strong school-home system to communicate about any outburst or withdrawal behaviour, emotional distress such as crying, and (most importantly) child requests to remain home from school, would assist in monitoring the child’s bullying experiences and development of a more inclusive (i.e., home and school) intervention approach. As in all research, this study has several limitations, first of which is the generalisability from this sample to others in different nations, cultures and settings. Similarly, only boys were included in this sample because they constitute the largest gender-defined subgroup of children with an ASD but the replication of this study with girls will provide some further information and test whether there are gender-specific experiences and effects of bullying. Although some previous studies had used adolescents as their participants, the inclusion of younger children in this study helped to provide some further data regarding the ways that bullying is experienced across childhood and adolescence, but direct comparison across age groups could further explicate those differences. Because the research questions investigated in this study are different to most of those used in previous studies, asking them of an adolescent sample in a future study would add to the understanding of how bullying influences young people with an ASD across the age range. This study did not attempt to test the longterm effects of bullying upon these children, but follow-up data collected over several years would help to clarify those effects, and a prospective study is underway to achieve that goal. The associations between bullying experiences and more serious psychological problems such as anxiety and depression are also vital to a complete understanding of bullying effects and that study is currently underway with the sample used here. Due to the fact that only 4 of the 48 boys sampled here attended special school, comparisons between mainstream and special school settings were not undertaken but could be investigated in future studies. Similarly, examination of the incidence and effects of bullying from boys across a range of ASD diagnostic severity

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might reveal differences that are specific to (for example) high- vs low-functioning boys with an ASD. In conclusion, a group of 48 boys responded to a series of questions that had been designed to tap their experience of bullying. Results indicated that the sources of bullying were sometimes friends, that the bullying took a range of verbal and physical forms, and that the boys did not possess effective coping strategies to help them deal with being bullied. Some of the emotional and physical consequences of being bullied that were reported are also potential antecedents of major psychological and physiological illness, arguing for focused interventions to teach these boys how to deal with bullying as well as educate their peers to refrain from doing so. Bullying emerges from this study as a major impediment to a sound education for boys with an ASD, one of the basic rights of all children.

References APA. (2013). Diagnostic and statistical manual of mental disorders-V. Washington: American Psychiatric Association. Atlas, R., & Pepler, D. (1997). Observations of bullying in the classroom. LaMarch centre for research on violence and conflict resolution. York: York University. Bauminger, N., & Kasari, C. (2000). Loneliness and friendship in high-functioning children with autism. Child Development, 71, 447–456. Bejerot, S., & Mortberg, E. (2009). Do autistic traits play a role in the bullying of obsessive-compulsive disorder and social phobia sufferers? Psychopathology, 42, 170–176. Cappadocia, M., Weiss, J., & Pepler, D. (2012). Bullying experiences among children and youth with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 266–277. Carter, S. (2009). Bullying of students with asperger syndrome. Issues in Comprehensive Pediatric Nursing, 32, 145–154. Due, P., Holstein, B., Lynch, J., Diderichsen, F., Gabhain, S., Scheidt, P., et al. (2005). Bullying and symptoms among school-aged children: international cross secctional study in 28 countries. European Journal of Public Health, 15, 128–132. Fried, S., & Fried, P. (1996). Bullies & victims: helping your child survive the schoolyard battlefield. New York: M. EVans. Gallagher, P., Floyd, J., Stafford, A., Taber, T., Brozovic, S., & Alberto, P. (2000). Inclusion of students with moderate or severe disabilities in educational and community settings: Perspectives from parents and siblings. Education and Training in Mental Retardation and Developmental Disabilities, 35(2), 135–147. Hansen, A., Hogh, A., Persson, R., Karlson, B., Garde, A., & Orbaek, P. (2006). Bullying at work, health outcomes, and physiological stress response. Journal of Psychosomatic Research, 60, 63–72. Haq, I., & Le Couteur, A. (2004). Autism spectrum disorder. Medicine, 32, 61–63. Hoover, J., Oliver, R., & Hazler, R. (1992). Bullying: perceptions of adolescent victims in the midwestern USA. School Psychology International, 13, 5–16. Little, L. (2002). Middle-class mothers’ perceptions of peer and sibling victimization among children with Asperger’s syndrome and nonverbal learning disorders. Issues in Comprehensive Pediatric Nursing, 25, 43–57. Ochs, E., Kremer-Sadlik, T., Solomon, O., & Sirota, K. (2001). Inclusion as a social practice: views of children with autism. Social Development, 10(3), 399–419. Olweus, D. (1993). Bullying at school: what we know and what we can do. Oxford: Blackwell. Pepler, D., & Craig, W. (2002). What should we do about bullying: research into practice. Peacebuilder, 2, 9–10. Rieffe, C., Camodeca, M., Pouw, L., Lange, A., & Stockmann, L. (2012). Don’t anger me! Bullying, victimization, and emotion dysregulation in young adolescents with ASD. The European Journal of Developmental Psychology, 9, 351–370. Rowley, E., Chandler, S., Baird, G., Simonoff, E., Pickles, A., Loucas, T., et al. (2012). The experience of friendship, victimization and bullying in children with an autism spectrum disorder: associations with child characteristics and school placement. Research in Autism Spectrum Disorders, 6, 1126–1134.


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Sweeting, H., & West, P. (1998). Health at age 11: reports from schoolchildren and their parents. Archives of Disease in Childhood, 78, 427–434. Symes, W., & Humphrey, N. (2010). Peer-group indicators of social inlcusion among pupils with autistic spectrum disorders (ASD) in mainstream secondary schools: a comparative study. School Psychology International, 31, 478–494. Taylor, L., & Spratt, E. (2010). Bullying and ostracism experiences in children with special health care needs. Journal of Developmental and Behavioral Pediatrics, 31, 1–8. Tennant, C. (2002). Life events, stress and depression: a review of recent findings. Australian and New Zealand Journal of Psychiatry, 36, 173–182. Thoits, P. (2010). Stress and health: major findings and policy implications. Journal of Health and Social Behavior, 51, S41–S53. van Roekel, E., Scholte, R., & Didden, R. (2010). Bullying among adolescents with autism spectrum disorders: prevalence and perception. Journal of Autism and Developmental Disorders, 40, 63–73. Walker, L., Garber, J., Smith, C., Van Slyke, D., & Claar, R. (2001). The relation of daily stressors to somatic and emotional symptoms in children with and without recurrent abdominal pain. Journal of Consulting and Clinical Psychology, 69, 85–91. Zablotsky, B., Bradshaw, C., Anderson, C., & Law, P. (2012). Involvement in bullying among children with autism spectrum disorders: parents’ perspectives on the influence of school factors. Behavioral Disorders, 37, 179–191.