Anxiety in Pupils with Autism Spectrum Disorder Primary to Secondary School Transition Dr. Beth Hannah Director, Transformative Change: Educational and Life Transitions (TCELT) Research Centre, University of Dundee

Autism Spectrum Disorder(ASD) Lifelong developmental disability Impairments in social interaction, communication and imagination Leads to… difficulty in dealing with social situations problems coping with changes find transition process more difficult (Dillon & Underwood, 2012) Results in… enhanced anxiety levels (clinical feature)

What do we know about anxiety in individuals with ASD? Two types of studies Compare anxiety levels of individuals with ASD with community samples (Kim et al., 2000; Kuusikko et al., 2008) Employ cross-sectional designs to compare matched groups (Gillot et al., 2001; Green et al.,2000) More anxiety and depression problems

Transition and Anxiety Following transfer to secondary school, levels of anxiety and stress are short-term feature during the first months (Graham & Hill, 2003; Tobbell, 2003) Levels of anxiety decrease for the majority of students during their first year at secondary school No studies exploring the anxiety levels of students with ASD during this transition

Study Research Questions How do the self-reported anxiety levels of a sample of students with ASD compare with those of the standardised sample prior to the transfer to secondary school? How do the self-reported anxiety levels of a sample of students with ASD compare with those of the standardised sample following the transfer to secondary school? How do the self-reported anxiety levels of a sample of students with ASD prior to the transfer to secondary school compare with those of the same students following transfer?

Study Setting- study took place in a large, inner city in Scotland Participants Sample- from south-side of city Inclusion criteria Have diagnosis of ASD In final year of education in a mainstream primary school Transfer to a mainstream secondary school anticipated. 8 male students with diagnosis of AS; aged 11 yrs 3 m to 12 yrs 4 m (M 􏰀 11 yrs 8.9 m; SD 􏰀 4.6 m)

Study Measure Adapted version of Spence Children’s Anxiety Scale (SCAS; Spence, 1997) 4 sub-scales panic attack and agoraphobia (PAA), separation anxiety (SA), physical injury fears (PI), obsessive compulsive (OC) (6 in original version) These sub-scales found to discriminate the HFA children from the other two matched groups in the Gillott et al. (2001) study 4-point scale response set (never, sometimes, often, and always) retained Cronbach alpha coefficients in current study with Spence et al.(2003) figures in brackets: PAA .72 (.80); SA .53 (.71); PI .75 (.60); and OC .66 (.75)

Study Procedure Adapted SCAS administered at two time points immediately prior to move to secondary school (early June to mid-July) approximately 6 months following transfer (late February to early April) Data analysis Wilcoxon Signed Rank (WSR) test employed to compare the group mean scores on each of the 26 items at time points 1 & 2 SCAS sub-scale scores at individual level compared to those of the standardization sample at time points 1 & 2 (Spence 1997; Spence et al., 2003).

Study Results- pre-post analysis at group level Decrease in scores for 4 of the 9 items in the Panic Attack and Agoraphobia (PAA) sub-scale but in 2 items the scores increased Decrease in 3 of the 6 items in the Separation Anxiety (SA) sub-scale Decrease in 2 of the 6 items in the Obsessive-compulsive (OC) sub-scale but in 3 items the scores increased Decrease in the score for 1 of the 5 items in the Physical Injury Fears (PI) sub-scale but in 3 items the scores increased Effect sizes calculated given the small sample size

Study Results-pre-post analysis at individual level Comparison of individual sub-scale scores with community sample on which test standardised A score of more than one standard deviation from the standardised mean was defined as substantial 5 out of 8 respondents had substantial scores in 1 sub-scale at time point1and this reduced to 4 respondents at time point2.

Study Results-pre-post analysis at individual level PAA- 1 respondent had substantial score at time point 1 but not at time point 2 SA- 2 respondents had substantial scores at time point 1; both figures lower at time point 2 with only 1 remaining substantial OC- 1 respondent had substantial score at time point 1 but not at time point 2; another respondent’s score increased at time point 2 reaching a substantial level PI - 1 respondent had substantial score at time point 1; at time point 2, 3 respondents had substantial scores.

Study Conclusions and Recommendations Individual differences in anxiety levels as students transition to a new school Limitations-use of self-report measure; acceptance of children’s diagnoses without reassessment; sample size Longitudinal research would enable tracking of anxiety levels over a longer time period and at various time points and provide greater insight into changes over time Use of additional measures (e.g. parent questionnaire)for triangulation Teachers and other professionals should take cognizance of individual variability in anxiety levels and responses to moving schools Support strategies-induction days, orientation visits, familiarity with timetables, maps of school, meeting school staff and other pupils, buddy system, relaxation techniques, support for parents and other family members

References Dillon, G. V. and Underwood, J. D. M. (2012) Parental perspectives of students with autism spectrum disorders transitioning from primary to secondary school in the United Kingdom. Focus on Autism and Other Developmental Disabilities, 27, 2, 111–121. Gillott, A., Furniss, F., & Walter, A. (2001). Anxiety in high functioning children with autism. Autism, 5, 277–286. Retrieved from http://aut.sagepub.com/ Graham, C., & Hill, M. (2003). Spotlight 89: Negotiating the transition to secondary school. University of Glasgow, SCRE Centre. Green, J., Gilchrist, A., Burton, D., & Cox, A. (2000). Social and psychiatric functioning in adolescents with Asperger Syndrome compared with conduct disorder. Journal of Autism and Developmental Disorders, 30, 279 –293. Retrieved from http://www.springer.com/psychology/child􏰂+%26􏰂+school􏰂+psychology/journal/ Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger Syndrome. Autism, 4 (2), 117–132. Retrieved from http://aut.sagepub.com/

References Kuusikko, S, Pollock-Wurman, R., Jussila, K., Carter, A. S., Matilla, M-L, Ebeling, H., . . . Moilanen, I. (2008). Social anxiety in high functioning chil- dren and adolescents with autism and Asperger Syndrome, Journal of Autism and Developmental Dis- orders, 38, 1697-1709. doi:10.1007/s10803-008- 0555-9 Spence, S. H. (1997). The Spence Children’s Anxiety Scale. In I. Sclare (Ed.) Child psychology portfolio. Windsor, England: NFER-Nelson. Spence, S. H., Barrett, P. M., & Turner, C. M. (2003). Psychometric properties of the Spence children’ anxiety scale with young adolescents [Electronic version]. Journal of Anxiety Disorders, 17, 605– 625. Retrieved from http://www.elsevier. com/wps/find/journaldescription.cws_home/ 801/description Tobbell, J. (2003). Students’ experiences of the transition from primary to secondary school. Educational and Child Psychology, 20(4) 4–14.