1. 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

2. 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)

3. 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

4. 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

5. 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?

6. 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)

7. 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)

8. 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).

9. 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

10. 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.

11. 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.

12. 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

13. 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
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
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

14. 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, doi: /s
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 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.