Published on in Health Tip of the Week
From the outside, children with high-functioning autism spectrum disorder (HF-ASD) look similar to other children – but, because of difficulties related to social skills and behavior, they often find it challenging to navigate certain social situations – leading them to stand out.
“Parents of children who think or learn differently, like those with autism spectrum disorder, often worry that their child will experience being the target of bullying, and parents ask us about ways to both manage those situations and develop the skills to prevent them,” says Sandhyaa Iyengar, MD, MPH, a board-certified pediatrician and attending physician with the Division of Developmental and Behavioral Pediatrics (DBP) at Children’s Hospital of Philadelphia (CHOP) who specializes in treating children with autism spectrum disorder (ASD).
According to a survey of DBP providers, conducted through CHOP’s Center for Violence Prevention (CVP), providers unanimously believe youth with HF-ASD are “often” victimized by peers at school. Bullying a person with disabilities can be considered a federal crime or a violation of their civil rights, Dr. Iyengar points out.
Providers in DBP say the most reported form of bullying is verbal, followed by relational and cyberbullying, with physical bullying being the least reported. However, all four types of bullying are viewed as “harmful to extremely harmful” for youth with high-functioning autism.
“Youth with high-functioning autism spectrum disorder benefit from supports to bring out their potential, and a safe space to be their unique self – including in the school environment,” says Dr. Iyengar. To help youth thrive, she suggests parents and caretakers increase their own awareness about bullying, paying close attention to their child’s behavior and any unexplained changes in mood or activities. She offers the following tips as a guide.
Why children with high-functioning autism are more vulnerable to bullying
Children with ASD have difficulty with social connections, back-and-forth play and communication, peer relationships, and using body language to communicate with others. They often show repetitive behavior including body movements and language, or restricted or unusual interests.
“When we refer to children with HF-ASD, we mean those with a mild level of symptoms who generally have at least average intelligence and language abilities,” Dr. Iyengar says. Children with HF-ASD are more likely to be in general education classrooms, exposed to typically developing peers (more than children in a special education setting), and therefore are at-risk for bullying.
According to CHOP’s DBP providers, the top five contributing factors to the bullying of children with HF-ASD are:
- Difficulties reading social cues
- Difficulty understanding common social conventions
- Not noticing or understanding the intentions of others
- Taking things too literally
- Trouble entering peer groups
“It is not always apparent to children with HF-ASD when they are bullied because they often have difficulty understanding social situations; they may even inadvertently respond in a way that encourages the behavior to continue or escalate,” Dr. Iyengar says.
She describes one story a family shared with her, in which an 8-year-old boy was repeatedly given bread and mud sandwiches to eat and in response would thank the bully for sharing their lunch. Her patient did not understand that the other children were laughing at him instead of being his friends. “With bullying, there is a power imbalance, which can be physical or social power, and the person who is more vulnerable is the victim of repeated insults,” Dr. Iyengar adds.
On the other side, because children with autism cannot always clearly communicate their thoughts and feelings, parents should be mindful that these same youth may inadvertently offend a friend or classmate without even knowing it. This can cause a backlash and increased acting out against the child with autism.
Effects of bullying on children with HF-ASD
Youth with high-functioning autism who are victims of bullying are also likely to experience or show these characteristics:
- Negative mood or self-image, i.e., feeling weird and different
- Change in their eating and sleeping patterns
- A decline in school performance; a refusal to go to school, or ride the school bus
- Shutting down; a loss of interest in activities they used to enjoy
- Outbursts of aggression, perhaps without a clear trigger
What parents can do to address bullying
Bullying of children with high-functioning autism spectrum disorder is unfortunately common. Dr. Iyengar recommends the following tips when addressing the topic with your child or on their behalf.
Support your child
Being the target of bullying is never your child’s fault. As parents, it’s your responsibility to help your child understand this and to encourage them to tell a teacher or staff member when others are purposely mean to them. You can help your child learn ways to manage bullying – and build their coping skills by:
- Teaching them to adjust their response according to the severity of what is happening (i.e., when a child is bothering them versus bullying them).
- Role-play how to speak up assertively: “Hey, stop. Leave me alone.”
- Practicing the words your child can use to get help from an adult.
You can also help your child build their self-advocacy skills by offering them scripted phrases they can use, such as:
- “Everyone’s mind works a little differently.”
- “I just get overwhelmed, but I’m working on it.”
- “These kinds of things take more time for me to figure out.”
Know when to intervene
Adult intervention is always needed when bullying occurs – especially for youth with ASD. Reach out to school leaders and keep your child’s educational team informed and involved.
Together, you can create a safety plan, which may include:
- In-service education for school staff to explain your child’s disability and vulnerability to bullying
- Peer education to help classmates better understand your child’s disability
- Positive bystander training for classmates
Formalize educational goals
Individualized Educational Plan (IEP) goals can be established to help your child cope with bullying or teasing they may encounter at school. A sample IEP goal could be to: identify and practice direct and indirect ways to react to, handle and lessen the effects of bullying behavior.
In an IEP, parents can request supplementary aids and services, program modifications or supports including:
- hallway or playground monitoring by staff;
- allowing your child to leave class early to avoid hallway encounters;
- using social stories to help your child understand difficult situations when they occur; and/or
- a “no-questions-asked” procedure for your child to remove themself from a situation where bullying behavior occurs
If the school does not respond appropriately to bullying reports, parents can write a letter reminding school administrators of their legal obligation to supply a Free and Appropriate Education (FAPE) for their child. For help, use this Word document template.
NOTE: Bullying a child with an IEP can be considered harassment, which is a crime. To better understand the law, view Rights and Policies from PACER’s National Bullying Prevention Center.
Resources for families
- Call the Pennsylvania Department of Education Bullying Prevention Consultation Line for advice at 866-716-0424
- Visit CHOP’s Center for Violence Prevention website to learn about bullying in schools and view violence prevention tools and free bullying prevention workshops
- Review the PA Department of Health’s Bullying Prevention website
- See Autism Speaks’ Combating Bullying toolkit, which includes a social story that can be personalized as an effective teaching tool for youth with ASD
- Read AbilityPath’s IEP resource: Addressing Bullying with a Child’s IEP
- Watch a video by PACER’s National Bullying Prevention Center: Using the IEP of 504 Plan to Help Address Bullying – Episode 12
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