Youth with Autism Spectrum Disorder (ASD) experience high rates of bullying, which are associated with a higher incidence of mental health issues, according to a study in the Journal of Autism and Developmental Disorders this month by York researchers.
“Very little research has been done to assess the relationship between bullying and mental health in youth with ASD. It’s always been suspected there was a link, but this study confirms that,” says York Psychology Professor Jonathan Weiss, lead researcher 
of the study and co-author of the article, along with Debra Pepler, Distinguished Research Professor in Psychology, and first author M. Catherine Cappadocia, PhD candidate in clinical-developmental psychology.
M. Catherine Cappadocia
“In the study, those youth with ASD who experienced little or no victimization, less than two or three times in the past month, compared to those victimized at least once a week, exhibited less anxiety, self-injury and over-sensitive behaviours,” says Cappadocia. She, Weiss and Pepler, who is scientific co-director of the Promoting Relationships & Eliminating Violence Network (PREVNet), are all members of York’s Faculty of Health.
In “Bullying Experiences Among Children and Youth with Autism Spectrum Disorders”, the researchers surveyed 192 parents whose children, between the ages of five and 21 and enrolled in elementary or secondary school up to Grade 12, had been diagnosed with ASD. The authors examined the parents’ reports of victimization, along with the association between the rate of victimization experienced and mental health issues. Seventy-five per cent reported their child with ASD had been bullied within the last month at school, 23 per cent reported victimization two or three times, 13 per cent reported victimization once a week and 30 per cent two or more time a week. Fifty per cent of the youth with ASD had experienced victimization for more than a 
year, and that can lead to anxiety, depression, self-injury, hyperactivity, over-sensitivity and a lower self-concept, says Cappadocia.
Jonathan Weiss
“It’s one of the first studies to look at bullying in youth with ASD. It’s important as it shines a light on youth with ASD and victimization,” says Weiss. “I think it really highlights that chronic victimization is common for some of these youth. A large percentage of the youth in this study experience chronic victimization. Those are the youth that have significantly more mental health concerns.” In addition, he says, one in 110 children has been diagnosed with ASD. “It’s one of the most common identifications in the school system.”
One factor that puts youth with ASD at risk for victimization is when they have more difficulty being assertive and making friends at school. They often lack social and pragmatic skills, and their parents may be less empowered to effect change as a result of the number of major stresses in their lives. “These are a lot of the same factors that are found in the general population of kids that are bullied,” says Weiss. “What really stands out in this study is the association with these risk factors.”
A lack of friends is a significant risk factor for bullying even in the general population and leaves these children unprotected by their peers. That means no one is going to stand up for them when someone starts to bully them. “Eighty-five per cent of the 
time when bullying happens, peers are watching,” says Cappadocia. “If a peer stands up, 50 per cent of the time the bullying stops. Peer support makes a huge difference and represents a robust protective factor these kids are missing.”
Debra Pepler
Youth with ASD may also be more vulnerable because they lack the skills needed to react effectively to victimization when it does occur. “When children with ASD are targeted, there can be a more intense behavioural reaction, which may encourage the child who is bullying to continue,” she says. “If a child with ASD has a strong emotional or behavioural reaction, the bullying can become chronic, especially if peers tend to jump in and encourage the child who is bullying. It can keep escalating.”
Weiss, Pepler and Cappadocia all do clinical work in addition to research. In her clinical work, Cappadocia frequently sees youth with ASD who have been bullied. “Part of the interest in pursuing this particular research came from being interested clinically in how to help these children.”
The next step is to find interventions to help these children and their classmates, which would then translate to the general population, says Weiss. He is looking to run groups at York next year for youth with ASD who experience bullying, which will look at all facets of the problem, from peers, the school, their family, as well as the child.
He is also interested in looking at what makes some youth with ASD, who’ve been victimized, resilient. He’ll be examining what the peer, family and school relations are like, and why they may buffer the potential mental health impact of victimization.
Cappadocia received support through the Provincial Centre of Excellence for Child & Youth Mental Health at CHEO Graduate Award and the Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarships Doctoral Award. Weiss was supported by a New Investigator Fellowship from the Ontario Mental Health Foundation, while Pepler was supported by Networks of Centres of Excellence through its support of PREVNet.
For more information, visit the Journal of Autism and Developmental Disorders website.
By Sandra McLean, YFile writer