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Read the following 3 articles and synthesize (Combine the ideas of all three sources into one overall point – DO NOT SUMMARIZE)  them into 1 and a half page word document. Also, write a well-elaborated question from each reading. Keep in mind the following points when working on this task:

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*Follow APA Rules

*Use proper citations

*Use  PAST TENSE when discussing the articles  (Research already took place)

*DO NOT USE the following words: Me, you, I, we, prove, proof.

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*DO NOT SUMMARIZE!!!

***MUST FOLLOW THE ATTACHED SAMPLE

Educators’ Challenges of Including Children with Autism Spectrum
Disorder in Mainstream Classrooms

Sally Lindsay*, Meghann Proulx, Nicole Thomson and Helen Scott

Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital,
The University of Toronto, Toronto, ON, Canada

Although children with autism spectrum disorder (ASD) are increasingly being
placed within mainstream classes, little is known about the challenges that teachers
encounter with including them as full participants in the class. This qualitative study
draws on a purposive sample of 13 educators who have experience teaching children
with ASD within two cities in Ontario, Canada. Through in-depth interviews we
asked about teachers’ challenges regarding creating an inclusive environment within
their classroom. Teachers reported several challenges, including: understanding and
managing behaviour; socio-structural barriers (i.e., school policy, lack of training and
resources); and creating an inclusive environment (i.e., lack of understanding from
other teachers, students and parents). Teachers recommend that more resources,
training and support are needed to enhance the education and inclusion of children
with ASD.

Keywords: Asperger’s; autism spectrum disorder; children; inclusive education;
mainstream classroom; qualitative research; social inclusion; teachers

Introduction

Educators have reported a notable increase in students with autism over the past few years
(Geneva Centre for Autism, 2010; Lindsay et al., 2013). Autism spectrum disorder (ASD)
is one of the most common childhood neurological disorders (Autism Society Canada,
2010), which is characterised by problems in communication (i.e., delay or lack of lan-
guage development), social development (i.e., lack of development of peer relationships,
impaired non-verbal behaviour), ritualistic behaviour and resistance to change (American
Psychiatric Association, 2012). With more students with ASD in mainstream classrooms,
educators are expected to create an inclusive educational environment, often with few or
no guidelines on how to do so (Horrocks, White, & Roberts, 2008; Lindsay et al., 2013).
Researchers have also highlighted that many schools are struggling to keep pace in meet-
ing the needs of students with ASD (Humphrey & Lewis, 2008; Symes & Humphrey,
2010). Many teachers and parents agree that more needs to be done to create inclusive
social environments within classrooms (Hinton, Sofronoff, & Sheffield, 2008; McGregor
& Campbell, 2001; Smith & Brown, 2000). Despite these obstacles, very little is known
about educators’ challenges with teaching children with ASD.

Evidence on inclusive education shows that successful implementation of inclusive
principles can lead to increased student engagement in social interaction, higher levels

*Corresponding author. Email: [email protected]

International Journal of Disability, Development and Education, 2013
Vol. 60, No. 4, 347–362, http://dx.doi.org/10.1080/1034912X.2013.846470

� 2013 Taylor & Francis

of social support, social networks and advanced education goals compared with their
counterparts in segregated settings (Bredekamp & Copple, 1997; Chandler-Olcott &
Kluth, 2009; Eldar, Talmor, & Wolf-Zukerman, 2010; Vakil, O’Connor, & Kline, 2009).
Despite these potential benefits, the inclusion of children with ASD in the mainstream
classroom can be challenging for teachers.

Given the social and behavioural impairments of children with ASD, teachers often
face considerable obstacles in appropriately managing their needs (Bowe, 2004;
Wilmhurst & Brue, 2010; Lindsay et al., 2013). Evidence consistently shows that many
teachers feel unprepared to support students with ASD socially, academically, and
behaviourally (Hinton et al., 2008; Horrocks et al., 2008; Symes & Humphrey, 2010).
Indeed, one of the most important challenges in working with students with autism in
integrated classrooms is inadequate knowledge about ASD and lacking access to con-
sultation support and advice (De Boer & Simpson, 2009). For example, one UK-based
study found that only 5% of teachers received training about autism even though the
majority of teachers had a child with autism in their class (McGregor & Campbell,
2001). Such gaps in training can leave teachers feeling discouraged while students with
ASD may miss opportunities to reach their full potential (Allen & Cowdery, 2005; War-
nock, 2005). Past research has typically focused on the challenges of managing individ-
ual behaviours in attempting to include children with ASD in the classroom. This study
addresses an important gap in the literature by also exploring the socio-structural factors
influencing the inclusion of these children. As a first step in building a more inclusive
environment where children are all considered an equally valued member of the class
(Eldar et al., 2010), it is critical to understand the challenges educators may encounter
when creating inclusive classroom environments, particularly for children with ASD.

In Ontario, Canada, where this study was conducted, school boards are required to
provide students with exceptionalities (i.e., behavioural, communication, intellectual,
physical or multiple) with appropriate special education programmes and services to
best meet their educational needs (Lindsay, Proulx, Scott, & Thomson, 2013; Ontario
Ministry of Education, 2012). Such students may receive these services once an
Identification, Placement and Review Committee have formally identified them (Ontario
Ministry of Education, 2012; Lindsay et al., 2013).

Within Ontario, Canada, the Ministry of Education has identified the inclusion of
students with ASD in school environments as an area of priority for action (Lindsay
et al., 2013; Minister’s ASD Reference Group, 2007). Other researchers also highlight
the need to develop a better understanding of educators’ challenges in working with
children who have ASD (Davis & Florian, 2004; Humphrey & Parkinson, 2006;
National Autism Society, 2003). The Ontario Ministry of Education (2012) has sup-
ported this inclusive approach with the Education Act and a commitment to support
children with disabilities in the Ontario school curriculum (Lindsay et al., 2013).

Theoretical Perspective: Inclusive education

The provision of inclusive and accepting social climates within schools is necessary to
help children reach their full potential and for them to feel important, welcome, and
appreciated (De Winter, Baeveldlt, & Kooistra, 1999). The United Nations Convention
on the Rights of the Child (1989) stipulates that all children, “should enjoy a full and
decent life, in conditions which ensure dignity, promote self-reliance and facilitate the
child’s active participation in the community” (Article 23). We draw on Lipsky and
Gartner’s (1997) model on the essential elements of inclusion to inform our analysis.

348 S. Lindsay et al.

Their model outlines seven essential elements that can be used to guide an inclusive
education programme. These elements include: visionary leadership, collaboration, refo-
cused use of assessment, support for staff and students, funding, effective parental
involvement as well as curricular adaptation and effective instructional practices. This
model offers a framework by which inclusion can be achieved (Lynch & Irvine, 2009),
and is consistent with Ferguson’s (1995) concept of authentic inclusion where organ-
ising an education programme based on these elements can meet the needs of all stu-
dents. We argue that applying best-practice elements of inclusion may be difficult for
teachers who are including students with high-functioning autism within their class.

Methods

This qualitative design explored educators’ challenges in and strategies for including
children with ASD in mainstream classrooms (see Lindsay et al. [2013] for methods
and findings on strategies) while applying Lipsky and Gartner’s (1997) model of essen-
tial elements of inclusion. Ethical approval was obtained from the ethics review boards
at a children’s hospital and two local district school boards.

Sample

This study drew on a purposive sample of educators to gain a better understanding of
the challenges they experience when including children with ASD in their classrooms.
Teachers were recruited through contacts with a local district school board. Information
letters were given to contacts of designated schools. Once the school board approved
the project, information letters were sent to teachers who were thought to meet the
inclusion criteria (see below). Participants who were interested in taking part contacted
the research team to set up a convenient time to be interviewed. Each participant was
screened by telephone to determine eligibility prior to the interview. Participants were
included if they met the following criteria: they had at least two years of teaching expe-
rience in an integrated class; they are currently an educator within an elementary school
within a local district school board; and/or they have experience teaching a student with
ASD within a mainstream class (Lindsay et al., 2013).

Our sample consisted of 13 educators (10 females, three males) who taught a wide
range of classes (see Table 1) (Lindsay et al., 2013). While current teaching roles may
not necessarily have been within a “regular” classroom (i.e., one teacher was currently
employed in a developmental disability programme, and six teachers were working in a
special education room), each educator interviewed was asked to draw on their previous
experiences, ranging from three to 22 years, teaching in a mainstream classroom. Satu-
ration was reached when no new or relevant data emerged (Strauss & Corbin, 1998).
Five of the teachers were based at a school in a rural area while eight were at an urban
school setting. Twelve of the teachers had earned additional qualifications in special
education (Lindsay et al., 2013).

Data Gathering

The interviews followed an in-depth, semi-structured format exploring teachers’
challenges on including children with ASD in mainstream classrooms. The first two
authors conducted the interviews between June 2011 and February 2012—these lasted
an average of 38 minutes (Lindsay et al., 2013). Informed consent was obtained from

Educators’ Challenges of Including Children with ASD 349

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Educators’ Challenges of Including Children with ASD 351

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Educators’ Challenges of Including Children with ASD 353

each participant prior to the interview. Demographic information was also collected,
including number of years taught, grades taught, type of school (rural/urban) and addi-
tional qualifications (refer to Table 1).

Interview questions asked the following: Can you please describe how long you
have been teaching for and your training background?; Can you describe the types of
children that you have experience teaching (probe for autism)?; What is your approach
to teaching children with autism spectrum disorder?; Have you encountered any
challenges in educating children with autism within mainstream classes? If so, can you
give an example? (probe for essential elements of inclusion according to Lipsky and
Gartner’s model); and, Is there anything else that you would like to add that we did not
get a chance to talk about? These questions are consistent with Lindsay et al.’s (2013)
study.

Data Analysis

The interviews were recorded and professionally transcribed verbatim. The analysis
began with the first two authors independently reading through each interview several
times and noting key emerging themes. We drew on Lipsky and Gartner’s (1997) model
on the essential elements of inclusion (i.e., visionary leadership, collaboration, refocused
use of assessment, support for staff and students, funding, effective parental involve-
ment, curricular adaptation and effective instructional practices) to inform our analysis.
Codes with similar meanings were developed, examined and re-defined as necessary. A
constant comparative approach of organising the data with continual adjustment and
discussion amongst the research team was used throughout the analysis (Grbich, 2007;
Lindsay et al., 2013). Quotes that were reflective of each theme were extracted. Code–
recode and peer examination helped to establish the trustworthiness of the findings
(Grbich, 2007). An audit trail of analytical decisions regarding the themes was kept.

Results

Challenges in including children with ASD, as reported by the teachers interviewed, are
as follows: understanding and managing behaviour; socio-structural barriers (i.e., school
policy, lack of training and resources); and creating an inclusive environment (i.e., lack
of understanding from other teachers, students and parents). Table 1 provides an over-
view of the challenges reported by each educator. We did not notice any patterns
regarding the type of school (rural versus urban), the number of years taught, or the
grade levels taught and the number or types of challenges that were reported.

Understanding and Managing Behaviour

Understanding and managing student behaviour was a challenge to fully including
children with ASD. Teachers felt they lacked adequate information about ASD, particu-
larly with respect to specific ways to work with a child in the classroom and how to
appropriately manage a child when a behavioural outburst occurs. One teacher gives an
example:

There are days where you may have a student with autism who has a meltdown and you
can’t deal with it right then and there … You just can’t always work with just one child.
(Teacher 12)

354 S. Lindsay et al.

Another behavioural management concern was around how to handle unstructured
time such as recesses or field trips, occasions where routines might be broken causing
distress in a child with ASD. As one teacher shared:

When we have something like the play day or something that’s not structured, let’s say
they’re shooting hoops and [the student] misses three, he gets mad and screams and goes
and sits in the corner … He doesn’t know how to have fun if he’s not winning … The chal-
lenges are when there’s an outbreak what do you do with the rest of the kids? (Teacher 3)

With multiple children to supervise, this type of situation makes it difficult for teachers,
as one teacher said it best: “The biggest challenge is explaining to the other children
that [the student with ASD] needs more time or care” (Teacher 10).

Some teachers found it difficult to engage students with ASD in lessons, noting that
they often have specific interests and become frustrated when asked to do something
else. For example, a teacher said, “It’s difficult to involve my kids with autism into my
lessons where they’re engaged and participating in a way that isn’t distracting, yet pro-
ductive for them” (Teacher 13). Another teacher also spoke about the challenge of
expanding their specific interests:

One student was quite defiant and quite loud and oppositional towards the general class-
room structure. He did get along well with at least one other student but it was a constant
challenge with his behaviour and trying to include him within the lessons and the class-
room because he had his mind set on working on the computer and doing his own thing
versus a specific lesson. So inclusion was much more difficult. (Teacher 11)

Establishing a rapport with a student was noted by teachers as being an important
element for helping a child in distress to calm down. This was often a difficult task for
some teachers, making it challenging to include students with their peers. For example,
one teacher describes:

I think the biggest challenge is when they shut down and you don’t know how to get
through to them. Like in the primary grade they might get underneath a table, not talk to
you and refuse to do what you want. (Teacher 5)

In sum, teachers often felt unprepared to manage the behaviour of a child with ASD.

Socio-structural Barriers

A second challenge with including a child who has ASD involved socio-structural
barriers such as lack of training, availability of resources and school policies. Ten teach-
ers felt they lacked training and continuing education opportunities on how to work
with children with ASD. For example: “There’s a lot of kids who enter the classroom
and the teachers don’t know what to do. So these kids are underserviced. If we don’t
really understand the core problems with the kids, you can’t really teach them” (Teacher
1). Other teachers described how more support is needed to be able to fully include
children with ASD. For instance:

There is very little support for teachers in doing the planning [for students with ASD].
Unless you have Special Education qualifications there really isn’t time or attention given
to working on those practices of planning for inclusivity. (Teacher 9)

Educators’ Challenges of Including Children with ASD 355

Some teachers advocated for a more consistent process in training and supporting
teachers. For example, in regards to the special education additional qualification
courses: “I think the additional qualifications courses in Special Education have to have
an autism component. I think boards have a responsibility to in-service their teachers
on meaningful professional development for autism” (Teacher 9). Others commented:
“We need more teachers especially trained in autism” (Teacher 10). Some teachers said
that although training is available on understanding the basics of ASD behaviour, it is
not helpful for learning specific teaching methods to work with students. One teacher
commented, “There’s a lot about working with students with autism and tracking their
behaviors but there’s not a lot of workshops on how to teach them, different strategies”
(Teacher 12).

Another teacher noted that approaches to working with children with ASD could be
more proactive rather than reactive. For example: “most of the energy is spent on cor-
recting difficulties as opposed to making things that are going ok better” (Teacher 4).

Another structural barrier mentioned by eight teachers involved lacking appropriate
resources (i.e., financial resources, access to training opportunities, funding for an edu-
cation assistant) and equipment (i.e., computer software, assistive technology, “fidget
toys”) for students with ASD. One teacher explains:

Access to resources is a problem. For example, you know, I had a boy with autism and it
was quite a challenge to get that resource because he was in a regular program. There
wasn’t any money assigned to buying the equipment that he would need … assistive equip-
ment for example a whoopee cushion … or a weighted vest. Or even, you know took me a
long time, even you know the [software]. I had to go to other schools with special needs
programs to use their [software]. How is it you are able to program for the student if you
don’t have the necessary things to help the student? (Teacher 1)

Teachers found this frustrating and often had to advocate on the child’s behalf on their
own time to access these helpful resources. They noted that it was a particular challenge
for children with Asperger’s syndrome or high-functioning autism because most of the
resources tend to go towards children with lower-functioning autism. For example, one
teacher explains:

Even if he just has Asperger’s he’s still on the spectrum but there’s really not a lot of
human resource time or financial resource time given to him because, well, it’s just
Asperger’s. You know, it’s not like he’s a runner or a hitter or non-verbal or anything like
that so kind of “just deal with it” sort of thing. I think it’s really more of the Asperger’s
end that I would say is under-funded or under-supported. (Teacher 4)

In addition to lacking resources for equipment and teaching materials, teachers also
mentioned there was a lack of funding for education assistants. For example: “There’s
very little support in terms of EA [education assistant] time unless the child is a threat
to themselves or others in a physical way” (Teacher 7). Another teacher agreed: “It
would be nice if they [school board] stopped cutting EAs” (Teacher 2). Seven teachers
felt quite strongly about having an education assistant in the classroom to integrate the
students with ASD.

Barriers were also found at the school policy level, where teachers described the
difficulties in meeting the Ministry of Education standards on test scores despite
having children with diverse needs in their classroom. One teacher shared her
example:

356 S. Lindsay et al.

With special needs students it makes it really hard because there’s an expectation from the
Ministry [of Education] that a certain percentage of kids will get to a certain level and it’s
hard when you have those needs in the class and that’s not something they’re going to be
able to achieve. (Teacher 4)

Teachers especially felt this pressure when there were students with ASD in their class-
room.

Teachers lacked time to provide additional help to children with ASD, especially in
older grades where there are larger class sizes. Five of the teachers mentioned that class
sizes were a challenge for being able to successfully include a child with ASD. For
example, one teacher commented:

For some of these ASD kids when they get into Grade 4 where all of a sudden there are
30 kids in their class, double to what they’re used to having, then the attention from their
teacher probably gets cut in half. (Teacher 6)

The increased class sizes contribute to the teachers’ workload, which “can make it diffi-
cult to give proper consideration to the way we can support students with special
needs” (Teacher 9). Teachers explained that integrated classrooms can be very over-
whelming for children with ASD, especially with the class sizes and the noise they can
produce. For example: “In an integrated environment they’re lost. There’s too much
stimulus, too much everything. The noise, the kids, the class, the desk, the chairs” (Tea-
cher 8). In summary, teachers encountered many socio-structural challenges affecting
their ability to successfully include children with ASD in their mainstream class.

Challenges in Creating an Inclusive Environment

A third challenge teachers encountered was with creating an inclusive environment for
children with ASD within their class as well as the school. A common theme that six
teachers mentioned included a lack of awareness and understanding of the disorder
amongst other staff, students and parents. Teachers told us it is sometimes difficult for
other school staff to understand the behaviour of a child with ASD. Teachers also
suggested some staff may be nervous and have misperceptions about children with
ASD. Teachers described having to educate and bring awareness of ASD to their peers,
a role they felt to be challenging.

Parental Engagement

Another barrier that 11 teachers encountered was with engaging parents and maintaining
an open communication system. This was difficult, teachers reported, when parents
chose not to identify their child’s condition. For instance: “Kids that aren’t identified
but they have ASD, and the parents kind of don’t want to hear it” (Teacher 6). Teachers
shared with us how a lack of a formal identification of ASD led to children not being
eligible to receive resources and supports that could help to enhance their education
experience. One teacher describes her experience: “The parents are at different levels of
acceptance … We’ve got to get them to the point where they contact agencies that can
help them … Certainly rapport with the parents is sometimes a challenge” (Teacher 3).
Another teacher explained: “The most frustrating part is the parents … if they’re not on
board the success is limited” (Teacher 8).

Educators’ Challenges of Including Children with ASD 357

In addition to communicating with the parents of the child with ASD, teachers also
highlighted they had to manage concerns from other parents. For instance, they had to,
“Help other parents understand that this child is not bad but is just as important as your
child but has other needs … but I can’t break privacy and say, he’s got autism so give
him a break” (Teacher 6). In sum, interactions with parents of children with ASD and
parents of students’ peers presented to be challenging amongst teachers.

Peer Understanding and Acceptance

Ten teachers mentioned the challenges in creating an atmosphere of understanding and
peer acceptance to include the child with ASD. Children often realise there may be
something different about a child with ASD, but are unaware of the official diagnosis
(due to privacy laws) or are unaware of how these differences manifest as behaviours.
This makes it difficult for teachers to create an understanding and empathetic climate
within their class. The consequence, as teachers report, is that children with ASD are
often excluded from peer activities. One teacher recalls:

Another huge challenge is getting people to understand that the behavior of [a person with
ASD] is communication. When they are behaving poorly they are trying to tell us some-
thing … it’s hard to get people to understand they’re not acting out just to be a pain.
They’re acting out because they don’t have a way of telling you what’s bugging them.
(Teacher 8)

Most of the teachers, even those with extensive teaching experience, reported strug-
gling with how to promote peer interaction for children with social, communication and
behavioural impairments. Eight teachers described challenges in creating social and peer
groups for the child with ASD. For example, one teacher described, “In integrated clas-
ses if they’re anxious they can’t function which causes maladaptive social behaviors,
which makes them not have friends, essentially” (Teacher 13). Another teacher had a
similar example: “One of the big challenges is the fact that they’re ostracized or they
don’t have that circle of friends because they have a hard time keeping friends”
(Teacher 4).

Teachers mentioned difficulty with getting other children in the class to understand
why a peer behaves differently and to accept them for who they are. For instance: “I
find in Grade 5/6 they have a hard time understanding why somebody may not be the
same as them and unfortunately, I think that’s the time those children might get a little
targeted” (Teacher 5). In sum, a lack of peer understanding and acceptance made it
difficult for teachers to successfully include the child with ASD in the class.

Discussion

This study explored educators’ challenges with including children with ASD in main-
stream classes. Improving social inclusion of children with ASD is important not only
for their social and academic development but also to provide typically developing chil-
dren with an opportunity to develop a tolerance and appreciation for others who are
“different” (Lindsay & McPherson, 2012a).

Our findings suggest that teachers found it difficult to apply best practices of inclu-
sion (as defined by Lipsky & Gartner, 1997) when there was a child with ASD within
their mainstream classroom. Teachers reported difficulty in understanding and managing

358 S. Lindsay et al.

the behaviour of children with ASD and enhancing social and communication skills to
help them to develop peer relationships. This is consistent with past research showing
that teachers often face considerable difficulty addressing the needs of children with
ASD (Wilmhurst & Brue, 2010), probably due to a lack of training. Teachers also
discussed how it was often difficult to tailor lessons while still engaging all of the
children. Indeed, curricular adaptation and effective instructional practices are deemed
as best practice for inclusive classrooms (Lipsky & Gartner, 1997); however, our find-
ings suggest that this was difficult for teachers to achieve.

Second, teachers encountered several socio-structural barriers in the school environ-
ment, such as a lack of training and resources in addition to restrictive school policies.
These are viewed as key elements for achieving inclusion in mainstream classes (Lipsky
& Gartner, 1997). Our findings are similar to previous research showing that teachers
need specific training and support, understanding and collaboration from their col-
leagues and the school board to facilitate the full inclusion of children with ASD (Eldar
et al., 2010). Indeed, continuing efforts for staff development are needed (such as work-
shops or professional development) for the successful inclusion of students (Lipsky &
Gartner, 1997). Evidence shows that students must receive the necessary funding to
ensure they are properly supported (Lindsay et al., 2013; Lipsky & Gartner, 1997).

A third challenge that teachers encountered was creating an inclusive environment
within the class and school. Our findings showed that there was a lack of understanding
of or familiarity with the disorder among other teachers, students and parents, which
inhibited the full inclusion of children with ASD. Collaborating in a multi-disciplinary
team to ensure children receive services tailored to their needs is an essential element
of a successful inclusive classroom according to Lipsky and Gartner’s (1997) model of
inclusive education. Yet educators in our sample found it difficult to work with others
within the school to enhance the dignity and respect of all students, a key aspect of
inclusive pedagogy. Consistent evidence shows that such support from others (i.e., edu-
cators, students and parents) is critical because it can benefit students with ASD and
can enhance the processes associated with inclusive education (Lindsay et al., 2013;
Lipsky & Gartner, 1997; Timmons & Breitenbach, 2004).

Teachers also reported challenges with parental involvement in the child’s schooling,
which inhibited their access to the supports that could have helped their progress. Past
studies show that parental involvement is a key element of successful inclusion of a
child with a disability in a mainstream classroom (Lindsay et al., 2013; Lipsky &
Gartner, 1997).

One best practice of inclusion according to Lipsky and Gartner’s (1997) model that
we did not encounter in our findings was visionary leadership, which involves guiding
the inclusion movement towards its goal. It could be because teachers were struggling
to gain the basic training and necessary resources for the child that the overarching goal
of inclusion within the school was not a priority. Other recent studies highlight the
importance of disability awareness programmes to improve inclusion and attitudes
towards children with disabilities (Lindsay & Edwards, 2013). Perhaps more of a
whole-school approach is needed to help support and guide teachers on how to best
include children with ASD within their classes.

Having the proper mechanisms in place in a child’s social environment is essential
for them to thrive and to be treated as a valued member of the class (Humphrey, 2008).
For example, past research shows that a lack of social inclusion among children is often
the result of typically developing children not being taught to value diversity,

Educators’ Challenges of Including Children with ASD 359

acceptance and peer belonging within inclusive classrooms (Lindsay & McPherson,
2012a, 2012b; Maich & Belcher, 2012).

In aligning our findings with Lipsky and Gartner’s (1997) model of essential ele-
ments of inclusion, we argue that applying best practices to enhance inclusion may
be difficult for teachers who are educating children with ASD. There appear to be
several larger, systemic issues that may be challenging for teachers to address on
their own. For instance, the additional qualification courses are generally quite short
and tend to address generic issues of disability. Thus, there is perhaps a need for
longer or more focused training on specific conditions. Teachers in this study also
noted that when workshops or training are provided around children with ASD it is
often focused on tracking their behaviour, while more time should be focused on
how to teach children with ASD and offering solutions on how to successfully
include them with their peers within the class. Further, some teachers suggested that
more resources should be directed to hiring education assistants to help students
with ASD within the class. However, this is somewhat of a contentious issue
because some evidence shows that having an education assistant in the class can
isolate students from their peers and increase their risk of bullying (Lindsay &
McPherson, 2012a). A final recommendation in relation to our findings is that
school boards should consider the diversity of students when setting standards for
testing and also class sizes.

A limitation in this study is its small sample size, and the findings are not
generalisable to all teachers (Lindsay et al., 2013). Our aim, however, was to provide
an in-depth understanding of teachers’ challenges of including children with ASD in
mainstream classes. Further, our study drew on educators’ experiences of including
children with ASD and some of the teachers were now in different roles within the
school. This may have influenced their perception of the inclusion of children with
ASD. Nevertheless, our findings are consistent across current roles and are also similar
with past research on challenges in educating children with ASD (Lindsay et al., 2013).
Another limitation is that many of the teachers in our sample had special education
qualifications. Although this is common for the location where our sample was drawn,
it may not be typical of all countries. Thus, further research is needed to explore the
strategies that teachers use in different locations. Future research should explore how
inclusion is enhanced or inhibited by the design of the classroom and school.

Conclusion

Teachers who work with children with ASD in mainstream classes encounter several
challenges in including them as full members of the class. These challenges include
understanding and managing behaviour; socio-structural barriers (training, resources,
policies); and creating an inclusive environment within the classroom. More resources,
supports and training are needed for teachers so they can provide an inclusive environ-
ment for students with ASD. Based on the findings in this study we recommend that
more information and support are provided to teachers so students with ASD can be
included as full members of the class. This can be done through both formal and infor-
mal training such as workshops and disability awareness resources. Schools should also
emphasise teamwork to address the needs of children with ASD to develop effective
solutions of enhancing their inclusion.

360 S. Lindsay et al.

Key Messages

• Many teachers lack training and resources to successfully include children with
ASD in mainstream classrooms.

• Teachers encounter challenges in creating an inclusive classroom environment for
children with ASD.

• A lack of understanding of the nature of ASD from school staff, students and
parents can inhibit the successful inclusion of children with ASD.

• Teachers need more support in understanding and managing the behaviour of
students with ASD.

Acknowledgements
The findings reported here are based on research conducted as part of the “Exploring Educators’
Successes and Challenges of Including Children with ASD in Mainstream Classes” project. The
content of this publication does not necessarily reflect the views or policies of Holland Bloorview
Kids Rehabilitation Hospital nor this journal. Opinions reflect those of the authors and do not
necessarily reflect those of the funding agency. The authors had no financial or other conflicts of
interest.

Funding
The research project was funded by a Bloorview Research Institute start-up grant, from the
Holland Bloorview Kids Rehabilitation Hospital Foundation.

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Research in Autism Spectrum Disorders 6 (2012) 1156–1167

Contents lists available at SciVerse ScienceDirect

Research in Autism Spectrum Disorders

J o u r n a l h o m e p a g e : h t t p : / / e e s . e l s e v i e r . c o m / R A S D / d e f a u l t . a s p

Factors relating to education professionals’ classroom practices for the
inclusion of students with autism spectrum disorders

Matthew J. Segall a,1,*, Jonathan M. Campbell b

a Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia, United States
b University of Georgia, Department of Educational Psychology and Instructional Technology, Athens, Georgia, United States

A R T I C L E I N F O

Article history:

Received 29 January 2012

Accepted 28 February 2012

Keywords:

Autism

Inclusion

Teacher attitudes

Knowledge

A B S T R A C T

It is essential to understand the current practices used to foster inclusive education for

students with autism spectrum disorders (ASDs) as well as factors related to the

implementation of classroom interventions. In the current study authors assess the

experience, knowledge, attitudes and current practices of education professionals

regarding ASD. Results suggest that special education teachers and school psychologists

hold higher levels of experience, training, and knowledge as compared to general

education teachers and administrators. Attitudes towards inclusive education for students

with ASD were positive, in general, although attitudes were not a significant predictor of

awareness or use of empirically supported interventions. Implications and future

directions are discussed.

� 2012 Elsevier Ltd. All rights reserved.

1. Introduction

Educating students with autism spectrum disorder (ASD) in public schools is a significant challenge (Robertson,
Chamberlain, & Kasari, 2003; Yell, Katsiyannis, Drasgow, & Herbst, 2003), due in large part to core features, substantial
heterogeneity of symptom presentation, and an array of associated behaviors and challenges (Eaves & Ho, 1997; Hendren,
2003). In recent years, more students with ASD have been educated in general education settings rather than in segregated
environments, a practice generally referred to as inclusion (White, Scahill, Klin, Koenig, & Volkmar, 2007).

A growing body of research has documented the experiences of students with ASD in inclusion settings. For example,
Boutot and Bryant (2005) reported on the peer nomination ratings of 177 elementary school students, including ten students
with ASD who were educated in regular education classrooms. Results suggested that there were no significant differences
between students with ASD and their typically developing peers on measures of social preference, social impact, or social
network affiliation. Whereas similar findings have been reported elsewhere (Robertson et al., 2003), other research has
suggested that peer attitudes towards a child with autism viewed on videotape were significantly less positive than attitudes
towards a typical peer (Campbell, Ferguson, Herzinger, Jackson, & Marino, 2004; Swaim & Morgan, 2001). Still other research
using peer nomination methods indicates that, although children with ASD are part of the larger social network, their
involvement in that network is less than typical peers, particularly in terms of reciprocity, companionship, and acceptance
(Chamberlain, Kasari, & Rotheram-Fuller, 2007).

Ochs, Kremer-Sadlik, Solomon, and Sirota (2001) used ethnographic observation methods and video recordings to
qualitatively explore the experiences of 16 students with ASD in inclusion settings. Their findings suggest that, across the

* Corresponding author. Tel.: +1 404 727 8350.

E-mail addresses: [email protected] (M.J. Segall), [email protected] (J.M. Campbell).
1 Previously a graduate student at the University of Georgia.

1750-9467/$ – see front matter � 2012 Elsevier Ltd. All rights reserved.
doi:10.1016/j.rasd.2012.02.007

M.J. Segall, J.M. Campbell / Research in Autism Spectrum Disorders 6 (2012) 1156–1167 1157

classrooms observed, there exist both positive inclusion practices, such as peers patiently helping students with ASD or
providing corrective feedback, and negative inclusion practices, such as ignoring students with ASD or displaying open
disrespect.

In order to assist teachers in educating students with ASD in inclusive settings, authors have summarized inclusion
practices for students with autism (e.g., Harrower & Dunlap, 2001), recommended guidelines for the inclusion of students
with Asperger’s syndrome (e.g., Jordan, 2005; Williams, 1995), and summarized empirically evaluated treatments for
persons with ASD (e.g., Simpson et al., 2005). These recommendations are numerous, and it is beyond the scope of this paper
to review the various interventions appropriate for inclusive classrooms (e.g., environmental adaptations, instructional
techniques, social skills interventions, general behavior management strategies). Given the focus of the present
investigation, teacher variables, which are identified in the summary works as important to successful inclusion, will be
explored in depth.

1.1. Teacher variables

Teacher disposition and behavior are identified consistently as important to successful inclusion (e.g., Burack, Root, &
Zigler, 1997). Beyond generally accepted personality traits, such as kindness and patience, experts suggest that teachers be
predictable, consistent and concerned with social development in addition to academic gains to create a successful inclusion
experience for students with ASD (Safran & Safran, 2001). Due to difficulties with general social competence (Gutstein &
Whitney, 2002), teachers should be vigilant in protecting their students with ASD from teasing and bullying (Griffin, Griffin,
Fitch, Albera, & Gingras, 2006; Williams, 1995) and should act as social translators in the classroom (Safran, 2002). It may
also be necessary for teachers to both prompt students with ASD to engage in appropriate behavior and prompt peers to
initiate social interactions with students with ASD (Odom & Watts, 1991).

Consistent with these suggestions is the recommendation that teachers of students with ASD be knowledgeable about the
disorder itself (Jordan, 2005) and the various practice options and strategies that will facilitate inclusion for the individual
student (Dahle, 2003; Fisher, Frey, & Thousand, 2003). Indeed, recent education laws suggest that teachers receive
specialized training so that they are highly qualified to educate students with ASD (Yell, Drasgow, & Lowrey, 2005; Yell et al.,
2003). Some efforts have been made to assess the knowledge base of teachers and other education professionals about ASD.
Early research suggested that teachers held incorrect beliefs about ASD, particularly in the realm of cognitive abilities,
compared to autism specialists (Stone & Rosenbaum, 1988). Similarly, researchers have indicated that speech–language
pathologists report inadequate knowledge of strategies for inclusion (Cascella & Colella, 2004) and require additional
training (Schwartz & Drager, 2008). Other studies suggest that education professionals, such as administrators, special
education teachers, and general education teachers, demonstrate a significant lack of knowledge about ASD, as opposed to
incorrect information (Segall, 2007). Further, researchers have found a positive relationship between teacher knowledge,
experience with disabilities, and teacher self-efficacy (Buell, Hallam, Gamel-McCormick, & Scheer, 1999).

A fundamental assumption held by many educators and researchers is that the attitude educators hold toward the
practice of inclusion is an important determinant of the success of inclusive education for students with ASD (Burack et al.,
1997; Segall, 2007). Ajzen’s theory of planned behavior (2001) stresses the importance of attitudes and their relationship
with other variables such as behavioral intentions, perception of control, and awareness of the beliefs of influential others.
Stanovich and Jordan (1998) used Ajzen’s model to investigate inclusion practices of teachers and found that administrators’
beliefs about inclusion were the strongest predictors of teacher behavior. Interestingly, teacher attitudes did not mediate
this relationship.

Prior research has focused on assessing educator attitudes towards inclusion (see Avramidis & Norwich, 2002; Scruggs &
Mastropieri, 1996 for reviews). In general, findings from this body of research reveal that educators hold positive attitudes
towards the general concept of inclusion (Ward, Center, & Bochner, 1994). There are, however, several variables which
influence the opinions of teachers and other education professionals, including type and severity of disability; training and
knowledge of disabilities; and contact and experience with disabilities (Avramidis & Norwich; Hannah & Pilner, 1983).
Additionally, there are conflicting results within the literature, particularly in their application regarding attitudes towards
inclusion for students with ASD.

For example, researchers have demonstrated that type of disability and the presence of a label in a short vignette about a
student with disabilities did not affect teachers’ decisions of whether or not to include the student in general education
classrooms (Myles & Simpson, 1989). Likewise, Brubaker, Bundy, Winslow, and Belcher (2010) found that, with the
exception of visual supports, school psychologists were equally likely to recommend interventions for a child described as
having autism or a child with the same behaviors but no diagnostic label.

Both school psychologists (Center & Ward, 1989) and principals (Praisner, 2003) have endorsed that some disabilities are
more suitable for inclusion than others. For example, Barnett and Monda-Amaya (1998) found that less than one-third of
principals recommended inclusive practices for students with severe disabilities and cognitive disabilities. Other research
indicates that principals are more optimistic than special education teachers that students with mild disabilities may benefit
from inclusion (Cook, Semmel, & Gerber, 1999), suggesting that views about amenability for inclusion may differ across
education professionals, which may be related to training and knowledge of disabilities.

One readily replicated finding is that teachers with special education qualifications report more favorable attitudes
towards inclusion than those without special education qualification (Avramidis, Bayliss, & Burden, 2000; Center & Ward,

M.J. Segall, J.M. Campbell / Research in Autism Spectrum Disorders 6 (2012) 1156–11671158

1987; Villa, Thousand, Meyers, & Nevin, 1996). Accordingly, general education teachers report more need for training on
inclusion practices than special education teachers, who also report high self-efficacy related to educating students with
disabilities (Buell et al., 1999). Similarly, studies have demonstrated that teachers with greater knowledge of behavioral
principles and higher self-efficacy reported more adaptive reactions to the stress of students with challenging behavior
(Hastings & Brown, 2002).

Attitudes towards inclusion have improved as a result of an intervention that included a combination of information
about disabilities and supervised experience working with students with disabilities (Johnson & Cartwright, 1979), lending
support for the contact hypothesis. The contact hypothesis suggests that there is an inverse relationship between experience
with a person with disability and negative perceptions of such persons (Corrigan et al., 2001).

Indeed, whereas teachers from schools without inclusive practices report strong negative feelings about inclusion
(Vaughn, Schumm, Jallad, Slusher, & Saumell, 1996), teachers from inclusive schools report more positive attitudes towards
the practice (Avramidis et al., 2000). Among principals, contact has also been shown to be related to attitudes towards
inclusion. For example, Praisner (2003) found a significant positive correlation between experience with disabilities and
attitude towards inclusion.

From the current literature, several hypotheses can be made regarding educator attitudes towards inclusion and ASD. In
chief, as type and severity of disability have been shown to influence attitudes, it is likely that attitudes towards inclusion of
students with ASD would be less positive than other disabilities. Additionally, the relative infrequency of ASDs compared to
learning disabilities, for example, may lead educators to report less desirable attitudes. As educators may have had fewer
contact with students with ASD, contact theory predicts less positive attitudes towards including them in the general
education setting. On the other hand, educators who have special education training and/or specific experience with
students with ASD (Robertson et al., 2003) will likely demonstrate stronger positive opinions about inclusion for such
students than educators without such training and experience.

Indeed, with respect to ASD, there is a growing body of research evaluating these hypotheses. Cook (2001), for
example, assessed teachers’ opinions about students with obvious disabilities (e.g., autism) and hidden disabilities (e.g.,
attention deficit–hyperactivity disorder). Cook found that teachers were more likely to report feeling indifferent (versus
rejection, concern, or attachment) to students with obvious disabilities. Research also suggests that teachers may be
unprepared to provide instruction to students with autism (Cook, Tankersley, Cook, & Landrum, 2000; Stoiber, Gettinger,
& Geotz, 1998), which may explain the reported indifference. On the other hand, school psychologists with a high level of
knowledge of ASD reported neutral opinions about a variety of potential interventions for these students (Brubaker et al.,
2010). Similar to other findings, special education teachers in the Stoiber et al. (1998) study reported being significantly
more prepared to work with students with ASD than general education teachers. However, across educator types,
teachers indicated that autism, as compared to other disabilities such as learning disabilities, will need the greatest
degree of accommodations (Stoiber et al., 1998). One study of elementary school principals, the majority of whom had no
experience with students with ASD, suggests that these administrators would place students with ASD in general
education infrequently and were more likely to place such students in the most restrictive settings at their school
(Praisner, 2003).

Other research has presented more optimistic results. In a small study of general education teachers from 12 elementary
school classrooms which contained a student with autism, participants reported generally positive relationships with these
students (Robertson et al., 2003). Further analysis indicated that this relationship was moderated by the target students’ peer
status, such that students with higher status were viewed more positively.

In a study by McGregor and Campbell (2001) both regular education and specialist staff were surveyed about their
attitudes towards inclusion of students with ASD. Teachers who reported having experience with a student with autism
reported positive attitudes towards the practice, independent of teacher type. In this study, participants indicated that the
severity of autism was in important factor for inclusion. Additional research investigating teacher opinions about potential
outcomes for persons with ASD suggests that success in school is both an important and likely outcome, yet attaining the
highest education possible is viewed as more important than likely (Ivey, 2007).

In efforts to extend this line of research, Segall (2007) sampled administrators, special education teachers, and general
education teachers. The results supported the assertion that educators report generally positive attitudes towards inclusive
education for students with ASD. Interestingly, whereas attitudes towards inclusion were not found to significantly correlate
with other relevant variables (e.g., knowledge of autism), attitude of the staff was identified consistently as the most
important factor for successful inclusion. Furthermore, analysis of the knowledge items indicated that education
professionals lack a substantial amount of accurate information about autism.

1.2. Purpose of the current study

Results suggest that while attitudes towards the practice of inclusion for students with ASD may be positive, a variety of
factors related to both student (e.g., severity) and teacher (e.g., experience) affect the strength of these opinions. The aims of
the present study are to (a) further assess education professionals’ backgrounds and perspectives in the areas of prior
experience working with children with ASD, knowledge of ASD, attitudes towards inclusive education, and classroom
practices, and (b) extend the literature specifically regarding school psychologists’ knowledge and attitudes towards
inclusion for students with ASD.

M.J. Segall, J.M. Campbell / Research in Autism Spectrum Disorders 6 (2012) 1156–1167 1159

The following hypotheses are posed:

(a) D

Tab

Des

De

Pr

Fe

Et

Ag

Hi

Ti

Tr

a

oes the experience, training, knowledge and attitudes of education professionals relate to the use of more effective
classroom strategies for inclusion? Investigators hypothesize that more experience, more training, greater knowledge,
and positive attitudes will relate to the use of more effective classroom strategies.

(b) D

o education professionals (e.g., administrators, general education teachers, special education teachers, and school
psychologists) differ in their knowledge of ASD and their awareness of classroom strategies? Investigators predict that
special education teachers and school psychologists will demonstrate higher knowledge when compared to other
professionals.

(c) D

o attitudes differ between groups of education professionals? Investigators predict that general education teachers will
hold less positive attitudes towards the inclusion of students with ASD than special education teachers, administrators,
or school psychologists.

2. Methods

2.1. Participants

Forty-five schools across the state of Georgia were recruited to participate in the study with elementary, middle and high
schools recruited in equal numbers. In addition, the department of special education was contacted from each county in
which schools have participated, in order to recruit a sample of school psychologists serving the same locations. Seventy-five
psychologists were invited to participate in the study. The sample included 33 schools (73% participation rate) located within
15 counties throughout the state of Georgia. Participation within schools ranged from 10% to 100%, with the median
participation rate at 50%. Sixty-two questionnaires (41.3% response rate) were completed by elementary school educators;
38 by middle school educators (25.3%); 67 by high school educators (44.6%). In addition, 33 school psychologists participated
in the study (44.0% response rate).

In total, 196 (out of 525; 37.3% response rate) education professionals completed the survey. Prior research suggests that
this rate of response is acceptable for survey research (Chafouleas, Riley-Tillman, & Sassu, 2006; Warwick & Lininger, 1975).
Thirty-nine questionnaires were completed by administrators; 53 by general education teachers; 71 by special education
teachers; and 33 by school psychologists. Respondents were primarily women (84%) and Caucasian (91%). Many participants
had earned master’s degrees or higher; however, administrators and school psychologists were significantly more likely than
general education and special education teachers to hold higher educational degrees, F(3, 191) = 25.6, p < .001. Additional
demographic information is presented in Table 1.

2.2. Measure

The Autism Inclusion Questionnaire (AIQ; Segall & Campbell, 2007) was utilized in the present investigation and contains
six sections. Items for the Demographic Information section were adapted from the surveys developed by Praisner (2003)
and McGregor and Campbell (2001). Three forms of the AIQ, an Administrator Form, a Teacher Form and a Psychologist Form,

le 1

cription of participants.

mographic variables % or M (SD) n

ofessional type

Administrator 19.9 39

General education teacher 27.0 53

Special education teacher 36.2 71

School psychologist 16.8 33

male 84.4 162

hnicity

Caucasian 91.3 178

African American 7.7 15

e (in years) 42.6 (10.4) 181a

ghest degree earned

Bachelor’s 18.5 36

Master’s 26.7 52

Specialist’s 44.1 86

Doctorate 10.3 20

me in current position (in years) 7.7 (7.0) 195

aining and experience

Certified in special education or school psychology 54.1 106

Specific ASD training 33.8 66

Specific ASD experience 56.7 110

Student with ASD currently in classroom 25.0 49

181 participants reported their age.

M.J. Segall, J.M. Campbell / Research in Autism Spectrum Disorders 6 (2012) 1156–11671160

were created to allow different questions to be posed in the Demographic Information section and appropriate wording and
instructions throughout the survey.

The second section, Knowledge of Autism Spectrum Disorders, contains 15 items proposed to measure one’s
knowledge of ASD in three areas: diagnosis and symptomatology; treatment; and etiology. Knowledge items were
adapted from Stone (1987), Shah (2001), and Furnham and Buck (2003). The questions in this section are presented as
True/False statements; in addition, a ‘Don’t Know’ option was included and respondents were instructed to select this
response rather than guess.

Section three, Opinions about Inclusive Education, contains Likert-type scale items. Six response choices range from
Strongly Agree to Strongly Disagree, and a seventh option, ‘‘No opinion or neutral,’’ is available. On 11 items,
respondents evaluate whether various factors (e.g., the severity of disability) are important for successful inclusion.
Seven statements measure participants’ attitudes towards inclusion in general and inclusion of students with ASD in
particular. Items in this section were adapted from McGregor and Campbell (2001), Furnham and Buck (2003), Praisner
(2003), and Stone (1987).

The fourth section, Classroom Behaviors, presents 20 behaviors related to ASD. Participants are asked to rate how
disruptive, ranging from Highly Disruptive to Not At All Disruptive, each behavior would be if exhibited by any student in
their classroom. Items in this section were adopted from the DSM-IV-TR (American Psychiatric Association, 2000), CARS
(Schopler, Reichler, & Renner, 1988), and McGregor and Campbell (2001).

Section five, Classroom Practices, contains a list of 37 strategies, interventions, and practices that may be useful in the
inclusion of a student with ASD in the general education setting. These practices were acquired from a variety of sources
including Simpson et al. (2005), Alberto and Troutman (2003), and guides for parents and teachers (e.g., Harrower & Dunlap,
2001; Williams, 1995). In particular, 19 interventions are summarized by Simpson et al. (2005) who has rated each practice
as ‘‘Scientifically Based,’’ ‘‘Promising,’’ ‘‘Limited Supporting Information,’’ or ‘‘Not Recommended.’’ For each practice in the
list, participants are asked to note whether they have heard of a particular practice, whether they have used the strategy, and
whether they think it could be effective in better including a student with ASD in the classroom. The final section of the AIQ
contains one item offering the participant an opportunity to participate in future research such as focus groups discussing
inclusive education for students with ASD.

2.3. Procedure

Packets of materials were mailed to consenting school administrators, containing an instructions sheet, two AIQ –
Administrator forms, and eight AIQ – Teacher forms; each AIQ was accompanied by a consent form and a stamped return
envelope. Administrators were asked to distribute materials to the appropriate school personnel. In addition, the department
of special education from each county from which schools participated was contacted, and sent study materials. In order to
increase return rates, three follow-up contacts were made, and four randomly selected participants received a small
monetary incentive.

2.4. Data reduction and analysis

Survey data were analyzed using SPSS software. The proposed hypotheses were evaluated using ANOVA and
multiple regression procedures. For the purpose of analysis, several total scores were created. An Experience Total
Score was calculated by summing a participant’s affirmative responses to having certification (i.e., special education or
school psychologist), specific autism training, specific autism experience, and currently having a student with autism
special education eligibility in the classroom. Thus, the Experience Total Score could range from 0 to 4. A Knowledge
Total Score (a = .83) was calculated by summing the number of correct responses to the 15 knowledge items. In addition,
the number of ‘Don’t Know’ responses were summed, and a Percent Correct Score was calculated by dividing
the Knowledge Total Score by the difference between 15 and the number of ‘Don’t Know’ responses [Percent Correct
Score = Knowledge Total Score/(15 � # of Don’t Know)]. Missing data from the Knowledge of ASD section were
recoded as ‘Don’t Know’ responses. From the Opinions about Inclusive Education section, seven items comprised an
Attitude toward ASD Inclusion Total Score (a = .68) with higher scores reflecting more positive attitudes. A Disruptive
Behavior Total Score (a = .93) was calculated by summing the responses to the 20 items in the Classroom Behaviors
section.

Finally, two total scores were calculated based on responses to the Classroom Practices section. An Awareness of Practice
Total Score (a = .91) was calculated by summing the number of strategies for which participants indicate awareness. A Use of
Practice Score (a = .81) was calculated by summing the number of strategies for which participants indicate current or prior
use. Only the 19 strategies discussed in the Simpson et al. (2005) treatment guide were included in this score, and strategies
were weighted according to Simpson’s categorization. Thus, use of Scientifically Based Practices was scored as 3; use of
Promising Practices was scored as 2; use of Limiting Supporting Information practices was scored as 1; and use of Not
Recommended practices was scored as 0.

Of the 196 participants who completed the survey, 19 participants did not complete the AIQ to produce all calculated
total scores. In the final data analysis, listwise deletion was used to account for these participants’ incomplete
responses.

M.J. Segall, J.M. Campbell / Research in Autism Spectrum Disorders 6 (2012) 1156–1167 1161

3. Results

3.1. Relationships between disruptive behaviors, experience, knowledge, attitudes, awareness of strategies, and use of strategies

Correlation analysis revealed significant positive relationships between all total scores except for educators’ perceptions
of behaviors (Table 2). That is, greater amounts of experience related to more correct responses to Knowledge items, more
positive attitudes, reported awareness of more strategies, and reported use of more effective strategies. All relationships
between experience, knowledge, attitudes, awareness of strategies and use of strategies were significant at the .01 level.

Additional analyses were conducted to determine if these relationships differed by educator type (Table 2). Differences in
correlations were tested across educator groups with family-wise error corrections, and no statistically significant
differences were noted. However, interesting trends emerged. The most striking finding was that attitudes were weakly
correlated with other areas for administrators, special education teachers and school psychologists, whereas for general
education teachers, attitudes towards inclusion for students with ASD were moderately correlated with knowledge,
awareness and use of strategies but not experience. In addition, for school psychologists only three domains were
significantly related: disruptive behaviors and knowledge (r = �.43, p < .05) experience and knowledge (r = .40, p < .05) and
awareness and use of strategies (r = .52, p < .01).

A multiple regression analysis, in which total scores for Disruptive Behaviors, Experience, Knowledge, and Attitudes
(independent variables) were hypothesized to predict Awareness of Practice (dependent variable), suggests that experience,
knowledge and attitudes each are significant predictors, accounting for 53% of the total variance. Knowledge alone
accounted for 43% of the variance, b = .66, p < .001. Due to the group differences shown in the original correlation analysis,
independent regression analyses were conducted for each educator group. For administrators, experience was the only
salient predictor of awareness of practice, accounting for 17% of the variance, b = .41, p = .012. For general education teachers,
knowledge and attitudes significantly predicted awareness of practice, accounting for 42% of the variance; knowledge alone
accounted for 33% of the variance, b = .58, p < .001. For special education teachers, knowledge and experience significantly
predicted awareness of practice, accounting for 56% of the variance; knowledge alone accounted for 47% of the variance,
b = .69, p < .001. Interestingly, there were no significant predictors of awareness of practice within the school psychologist
group.

A second multiple regression analysis, in which total scores for Disruptive Behaviors, Experience, Knowledge, and
Attitudes (independent variables) were hypothesized to predict Use of Practice (dependent variable). Results revealed that
Experience and Knowledge were significant predictors, accounting for 31% of the variance; experience alone accounted for
27% of the variance, b = .52, p < .001. As with awareness of practice as an outcome variable, these analyses were conducted
separately for each educator group, producing varied results. For administrators, experience was the only salient predictor of
use of strategies, accounting for 21% of the variance, b = .46, p = .005. For general education teachers, attitudes were the only
salient predictor of use of strategies, accounting for 18% of the variance, b = .42, p = .002. For special education teachers,
knowledge and experience significantly predicted awareness of practice, accounting for 30% of the variance; knowledge
alone accounted for 23% of the variance, b = .48, p < .001. Interestingly, there were no significant predictors of awareness of
practice within the school psychologist group.

3.2. Group differences in knowledge, awareness, and attitudes

Total scores for Autism Experience, Knowledge of ASD, Attitude towards Inclusion of students with ASD, Awareness of
Strategies for Inclusion of students with ASD, and Use of Strategies are reported in Table 3. Tukey–Kramer tests were used in
post hoc analyses to account for unequal group sizes. No significant group differences were found for disruptive behavior
total scores, F(3, 184) = .55, n.s.

For the Knowledge Total Score, general education teachers (M = 5.7, n = 53) and administrators (M = 5.5, n = 39) achieved
scores which were significantly lower (F(3, 191) = 25.3, p < .001) than both special education teachers (M = 8.2, n = 70) and
school psychologists (M = 10.8, n = 33); however, the scores of general education teachers and administrators did not differ.
School psychologists’ knowledge of autism was greater than special education teachers (p = .001). For the Awareness of
Strategies Total Score, general education teachers (M = 16.0, n = 52) and administrators (M = 17.3, n = 37) reporting having
heard of fewer strategies, F(3, 188) = 30.0, p < .001, relating to autism inclusion than both special education teachers
(M = 23.5, n = 70) and school psychologists (M = 26.4, n = 33).

In a pattern similar to the Knowledge Total Score, general education teachers (M = 6.8, n = 53) and administrators (M = 7.2,
n = 39) selected ‘‘Don’t Know’’ responses more frequently than either special education teachers (M = 3.6, n = 70) or school
psychologists (M = 1.5, n = 33), F(3, 191) = 19.4, p < .001. On average, the total sample selected ‘‘Don’t Know’’ to five items,
and with ‘‘Don’t Know’’ responses accounted for in the Percent Correct Score, participants answered 69% of the items
correctly, again with significant group differences, F(3, 191) = 7.9, p < .001. Table 4 presents summary data for correct
responses and ‘‘Don’t Know’’ responses for each Knowledge item.

Nearly all participants (n = 178, 92%) reported positive attitudes towards autism inclusion as measured by the Attitudes
towards Inclusion of students with ASD Total Score (i.e., scores 35 and above); the remaining participants reported attitudes
which were neither positive nor negative (i.e., scores between 22 and 34). Although participants viewed inclusive education
for students with ASD favorably, in general, group differences were observed, F(3, 185) = 7.0, p < .001. Special education

Table 2

Correlations between Total Scores for Disruptive Behaviors (DIS), Autism Experience (EXP), Knowledge of Autism Spectrum Disorders (KNOW), Attitude

towards Inclusion of Students with Autism Spectrum Disorders (ATT), Awareness of Practices to Include Students with Autism Spectrum Disorders

(AWARE), and Use of Practices (USE).

Entire sample (N = 183)

DIS EXP KNOW ATT AWARE

EXP .02 – – – –

KNOW �.08 .56** – – –
ATT �.10 .34** .33** – –
AWARE �.05 .58** .66** .41** –
USE .03 .52** .47** .30** .74**

Administrators (n = 35)

DIS EXP KNOW ATT AWARE

EXP �.30 – – – –
KNOW �.12 .45** – – –
ATT �.12 .29 .02 – –
AWARE �.28 .43* .33 .19 –
USE �.31 .44** .30 .31 .76**

General education teachers (n = 49)

DIS EXP KNOW ATT AWARE

EXP .03 – – – –

KNOW �.13 .40** – – –
ATT �.25 .14 .49** – –
AWARE �.05 .24 .58** .53** –
USE �.02 .29* .41** .43** .77**

Special education teachers (n = 68)

DIS EXP KNOW ATT AWARE

EXP .14 – – – –

KNOW �.12 .38** – – –
ATT �.04 .21 .17 – –
AWARE �.05 .53** .69** .29* –
USE .16 .44** .51** .17 .74**

School psychologists (n = 31)

DIS EXP KNOW ATT AWARE

EXP �.12 – – – –
KNOW �.43* .40* – – –
ATT �.21 .07 �.01 – –
AWARE �.11 .16 .29 �.02 –
USE �.02 .21 .03 �.21 .52**

* p < .05 (two-tailed).

** p < .01 (two-tailed); lower DIS scores suggest a perception of less disruptiveness.

M.J. Segall, J.M. Campbell / Research in Autism Spectrum Disorders 6 (2012) 1156–11671162

teachers’ attitudes (M = 42.2, n = 69) were more positive than either administrators (M = 39.9, n = 39) or general education
teachers (M = 38.9, n = 50). On the other hand, while school psychologists’ (M = 41.6, n = 31) and special education teachers’
attitudes did not differ, school psychologists’ attitudes were more favorable than general education teachers, but not
administrators. No differences were found between the attitudes of general education teachers and administrators.

Two additional results relating to educator attitudes should be noted. First, of 11 potential factors, participants were in
strongest agreement that the attitude of the staff was important for successful inclusion. No educator group differences were

Table 3

Total Scores for Autism Experience (EXP), Knowledge of Autism Spectrum Disorders (KNOW), Attitude towards Inclusion of Students with Autism Spectrum

Disorders (ATT), Awareness of Practices to Include Students with Autism Spectrum Disorders (AWARE), and Use of Practices (USE).

Total scores

EXP KNOW ATT AWARE USE

Administrators (n = 39) .64 (.7) 5.51 (3.5) 39.90 (4.7) 17.32 (6.2) 6.13 (4.2)

General education teachers (n = 53) .91 (1.0) 5.70 (3.7) 38.86 (4.8) 16.02 (6.3) 3.43 (4.1)

Special education teachers (n = 71) 2.59 (1.2) 8.21 (2.8) 42.16 (3.6) 23.46 (5.5) 10.06 (6.7)

School psychologists (n = 33) 2.55 (.8) 10.79 (1.7) 41.55 (3.3) 26.42 (5.9) 9.94 (6.4)

Total samplea (N = 196) 1.74 (1.3) 7.43 (3.6) 40.72 (4.4) 20.77 (7.2) 7.47 (6.3)

Note. Data is presented as mean (standard deviation).
a Group differences found for all five total scores, p < .001.

Table 4

Descriptive results for educators’ performance on the knowledge of ASD items (n = 195).

Knowledge of ASD items % correct % don’t know

Symptoms and diagnosis

The diagnostic criteria for Asperger’s syndrome are identical to high-functioning autism. 29.7 53.8

ASDs are developmental disorders. 39.5 37.9

ASDs only exist in childhood. 77.9 20.5

Children with ASDs are very similar to one another. 63.6 27.2

Most children with ASDs have cognitive abilities in the intellectually disabled range. 17.4 32.3

Most children with ASDs have special talents of abilities. 19.5 26.7

The core deficits in ASDs are Impaired Social Understanding, Language Abnormalities,

and Impaired Sensory Functioning.

2.6 26.7

Treatment and intervention

Behavior therapy is an intervention most likely to be effective for children with ASDs. 56.9 37.4

Early intervention demonstrates no additional benefit to children with an ASD. 76.9 20.0

If an intervention works for one child with an ASD, it will definitely work for another child with an ASD. 88.7 11.3

Medication can alleviate the core symptoms of ASDs. 46.2 44.6

With proper intervention, most children with an ASD will eventually ‘‘outgrow’’ the disorder. 70.3 27.7

Etiology

Genetic factors play an important role in the causes of ASDs. 43.6 43.1

In many cases, the cause of ASDs is unknown. 71.3 26.2

Traumatic experience very early in life can cause an ASD. 39.5 53.8

M.J. Segall, J.M. Campbell / Research in Autism Spectrum Disorders 6 (2012) 1156–1167 1163

found for this item, F(3, 191) = .65, n.s. Second, while marginal group differences were found, F(3, 191) = 2.9, p = .04, such that
special education teachers were more in agreement with the statement ‘‘All students with an ASD should be included in
general education settings’’ than general education teachers, the majority of participants felt neutral towards this statement
(M = 4.3, n = 195).

Finally, a mixed model analysis of variance was conducted to determine if educator groups rated potentially disruptive
behaviors differentially and if particular behaviors would emerge as more disruptive than others. Using a Huynh–Feldt
correction for violation of the sphericity assumption, the within-subjects analysis suggests a main effect for disruptive
behaviors, F(14.39, 2646.92) = 149.0, p < .001. Controlling for family-wise error rates, the level of disruptiveness of specific
behaviors was not rated differentially by educator groups. Screaming (M = 4.6) and aggression to others (M = 4.5) emerged as
two of the most disruptive behaviors across all professionals.

4. Discussion

Prior research has documented teacher attitudes towards students with special education needs and the practice of inclusive
education for students with special needs (Avramidis & Norwich, 2002). Only recently, however, have studies specifically
investigated attitudes as they apply to students with ASD (Horrocks, White, & Roberts, 2008; McGregor & Campbell, 2001;
Segall, 2007). Furthermore, there are a number of domains related to attitudes, such as knowledge, experience, and training,
which have not been fully explored in the literature for students with ASD. The purpose of the current study, therefore, was to
assess experience and training, knowledge of autism, and attitudes towards inclusive education for students with ASD across
various educational disciplines. In addition, the current investigation focused on education professionals’ awareness and use of
an extensive list of practices and strategies to promote inclusive education for students with ASD.

Overall, the sample reported favorable attitudes towards the practice of inclusive education for students with ASD, which
is consistent with previous research (Avramidis & Norwich, 2002). In contrast, however, participants varied on their
attitudes and a number of other related domains such as experience and training, knowledge of ASD, and awareness and use
of practice options. Specifically, general education teachers reported the least positive attitudes; although their opinions
generally favored inclusion, their ratings were less strong than special education teachers or school psychologists. The
difference is consistent with previous research on educator attitudes related to autism (McGregor & Campbell, 2001). As a
whole, the participants felt neutral that all students with ASD should be included in general education settings and felt
strongly that the attitude of the staff was an important factor in the successful inclusion of a student with ASD.

Differences were observed on measures of knowledge, awareness of practice, and use of strategies across educators. In
particular, school psychologists and special education teachers reported higher levels in each of these domains as compared
to general education teachers and administrators. The difference suggests a need for adaptations in educator training
modules, as administrators, special education teachers, general education teachers, and school psychologists are all charged
with effectively implementing the individualized education plans for students with ASD who are educated alongside their
typically developing peers.

The domains measured on the AIQ were all related in the direction to suggest increased experience and training relates to
more favorable attitudes and more favorable implementation of empirically supported practices. That is, participants with
higher levels of experience, knowledge, and awareness of practice options also reported more positive attitudes towards
inclusive education and more experience in using empirically validated treatments as outlined by Simpson et al. (2005).
While the causal relationship between these variables must be explored in greater depth, regression analyses suggest that

M.J. Segall, J.M. Campbell / Research in Autism Spectrum Disorders 6 (2012) 1156–11671164

knowledge of autism is a strong predictor of awareness of practice and experience in the area of autism is a strong predictor
of the use of empirically supported interventions.

Interesting patterns emerged across groups. Whereas knowledge, experience and attitudes were all positively correlated
in the combined sample, these relationships were weakened at the group level. For example, only for general education
teachers were relationships between attitudes and knowledge, awareness of practice and use of strategies significant. Also,
for school psychologists, only the relationships between behaviors and experience, experience and knowledge, and
awareness and use of strategies were significant. Similarly, correlation patterns amongst these domains were different for
special education teachers and administrators. One possible interpretation is that the nature of the roles of these education
professionals differs in ways that alter the nature of the relationships of these variables. Thus, it may be that for general
education teachers, who receive professional training geared towards educating typically developing students, one’s attitude
toward inclusive education is a more salient factor than for a special education teacher, in which case knowledge of autism
may be more relevant. Results in the current study suggest this may be the case. When awareness of practice and use of
empirically supported interventions were viewed as outcome measures, each educator group demonstrated a different
relationship among the variables. For example, in the administrator group, experience was predictive of awareness and use
of practice, whereas in the general education group, attitudes were the strongest predictors of these domains.

Regarding the relationship of the current study to educator training, it is also important to highlight that the current study
suggests that education professionals demonstrated a lack of knowledge and endorsed inaccurate beliefs. For example, general
education teachers and administrators responded that they did not know the answer to about seven out of 15 items assessing
current knowledge of autism. Moreover, on average, participants reporting having heard of just 21 out of 37 possible strategies
to support inclusive education for students with ASD. With ‘‘Don’t Know’’ responses on the knowledge section accounted for,
participants on average responded correctly to approximately 70% of the items, suggesting a large number of misconceptions.

Other researchers have found that education professionals endorse a variety of misconceptions about autism, particularly
in terms of etiology (Brubaker et al., 2010; Schwartz & Drager, 2008; Stone, 1987). Several of these misconceptions may be
worth noting as they provide some commentary on the distinctions between the field of education and other related
disciplines. For example, over 70% of respondents reported that the core deficits of ASDs are impairments in social
understanding, language and communication, and sensory functioning. While psychiatric diagnosis does not consider
sensory abnormalities to be a core deficit of ASD, sensory abnormalities are taken into consideration in terms of assessment
for special education eligibility. In addition, about half of the participants in the current study reported beliefs that most
children with ASDs are not cognitively impaired and have special talents and abilities. While current studies suggest that the
proportions of individuals with both ASD and cognitive impairment are changing (Edelson, 2006), there is not yet consensus
that the majority of persons with ASD fall above the cognitive impairment classification. In addition, it is unclear whether the
endorsement that the majority of children with ASD have special talents and abilities reflects a strongly held belief of
optimism or a misconception that many individuals with ASD are also savants. A conservative conclusion of these findings is
that additional training would be advantageous to clarify education professionals’ understanding of these issues.

Content validity for the AIQ knowledge scale was evaluated in two primary ways. First, knowledge items were derived
from both previous studies assessing knowledge of ASD and are largely based on the DSM-IV-TR (APA, 2000) description of
pervasive developmental disorders. Second, an initial item tryout suggested that researchers and experts in the field of ASD
responded with high accuracy to knowledge items. Thus, efforts were made to create a knowledge measure which could
accurately assess one’s knowledge of ASD in terms of symptoms and diagnosis, treatment and intervention, and etiology, and
the measure appears to be internally reliable.

4.1. Implications

There are several important implications based on the results of the current study. In chief, the relationship between
experience, knowledge, and attitudes is a complex one and may differ for various educator groups. For example, while lower
levels of knowledge were reported by general education teachers and administrators, as compared to special education
teachers or school psychologists, knowledge was a salient predictor of awareness of practice for general and special
education teachers but not for administrators or school psychologists. Therefore, in order to maximize the effectiveness of
training module reform, the importance of these variables should be taken into account across training programs. In other
words, general education teachers may best be prepared to work with students with ASD by infusing additional coursework
expanding their knowledge of autism and addressing their opinions about inclusive education for these students; on the
other hand, increasing the experience of administrators, in terms of working with students with ASD, may have a more direct
effect on their awareness of strategies to support these students. Across all participants in this study, however, experience,
knowledge, attitudes were all interrelated, suggesting that the targeting of one area from a training module perspective may
indeed have an effect on other domains.

Given the higher levels of knowledge, experience and attitudes reported, both school psychologists and special education
teachers would likely be effective trainers of education professionals and consultants regarding inclusive education
(Brubaker et al., 2010; Williams, Johnson, & Sukhodolsky, 2005). Teacher training and personnel preparation are clearly
needed in the area of autism spectrum disorders (Addison & Lerman, 2009; Morrier, Hess, & Heflin, 2011). High levels of
favorable attitudes towards inclusive education for students with ASD in the current sample suggest that the challenge of
inclusion may more strongly relate to training models rather than to resistance; although this suggestion may not be true for

M.J. Segall, J.M. Campbell / Research in Autism Spectrum Disorders 6 (2012) 1156–1167 1165

school psychologists (Brubaker et al.). Further study of this hypothesis should be explored more fully as knowledge alone
does not fully predict behavior (Kennedy, Regehr, Rosenfield, Roberts, & Lingard, 2004).

4.2. Limitations and future directions

One important limitation of the current study is that while the overall sample is larger than the previous study using the
AIQ (Segall, 2007), specific group (e.g., administrators) samples were relatively small. Future investigations should increase
the sample sizes of educator groups in exploring the replication of these findings. Similarly, samples of additional
populations, such as paraprofessionals, student teachers, and parents, should be examined.

Generalization of the current findings is also limited by the regional nature of the sample. Education professionals
enrolled in the study may not represent all educators in the United States or in other countries. Further, while the response
rate of the current study is acceptable, it is plausible that a response bias exists such that education professionals who lack
interest in education of students with ASD or have negative beliefs about inclusive education for these students did not
participate in the study.

It cannot be understated that the responses on a questionnaire such as the AIQ cannot measure behavior; without
observational data to document teacher behavior and practice, the findings of the present study represent only an estimate
of teachers’ training, experience and beliefs. That is, educator report of awareness of practice and use of strategies may not
reflect precise understanding and implementation of these interventions and practices. In addition, it is possible that the AIQ
may not fully capture all aspects of training, experience and educator beliefs. Future investigations in the area of successful
inclusion for students with ASD should incorporate observational data along with measurement of domains assessed by the
AIQ in order to portray the most accurate picture of inclusion for students with ASD. Further, it is important to recognize that
the autism spectrum is broad and the AIQ lacks specificity in referencing varying profiles of students with ASD. Indeed,
analysis of the potentially disruptive behaviors associated with ASD suggests that educators perceive a number of these as
‘‘highly disruptive’’ (e.g., aggression to others). It is quite likely that opinions about inclusive education and the
implementation of this practice may be different for students with various profiles along the autism spectrum.

It is interesting that the initial study using the AIQ (Segall, 2007) did not find a significant correlation between attitudes
towards inclusion and awareness and use of practice. However, as the direction of the relationship between these constructs
was consistent, it is possible that the increased sample size in the present study illuminated the significant strength of these
relationships. On the other hand, this disparity in results may relate to the lower levels of internal consistency for the
attitudes scale as compared to the other scales generated by the AIQ; that is, it is possible that items on the AIQ are not
effectively measuring attitudes towards inclusive education.

Further support for this explanation is found in the high levels of positive attitudes reported by participants. Indeed, 92%
of the sample reported attitudes to suggest favorable opinions about inclusive education for students with ASD; no
participant reported unfavorable opinions. Accordingly, the lack of variability in response to statements about inclusion for
students with ASD may either suggest that education professionals are uniformly in favor of the practice of inclusion or that
the AIQ does not effectively measure this domain. Future study measuring the attitudes of education professionals towards
ASD appears warranted. In particular, measurement of domains such as affective, conative and cognitive attitudes towards
inclusion (Hannah & Pilner, 1983), self-efficacy (Ajzen, 2001) would capture educator beliefs more fully. Specifically
regarding the conative attitudes, or behavioral intentions, of an educator, teacher resistance to change and intervention
acceptability should be explored.

Alternatively, domains such as experience and knowledge demonstrated adequate levels of internal consistency on the
AIQ, and these domains significantly predicted outcomes such as awareness of strategies and use of effective strategies with
empirical support. Specifically, knowledge was most predictive of the number of inclusion practices of which education
professionals were aware; experience was most predictive of education professionals reported use of treatments categorized
by Simpson et al. (2005).

Accordingly, the AIQ represents a potential assessment tool for evaluating educator quality and expertise in the area of
ASD. Students with ASD will likely benefit from placement with education professionals who are experienced, are
knowledgeable, and report favorable attitudes about a particular student’s placement and potential. Administrators and
other educators in leadership positions may benefit from the use of an instrument which can validly assess these domains.
The creation and validation of such tools would be an important area for both research and practice.

Acknowledgments

This study was funded by a graduate student research grant from the Organization for Autism Research awarded to the
first author. The preparation of this manuscript was part of the first author’s doctoral dissertation.

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  • Factors relating to education professionals’ classroom practices for the inclusion of students with autism spectrum disorders
    • Introduction
      • Teacher variables
      • Purpose of the current study
    • Methods
      • Participants
      • Measure
      • Procedure
      • Data reduction and analysis
    • Results
      • Relationships between disruptive behaviors, experience, knowledge, attitudes, awareness of strategies, and use of strategies
      • Group differences in knowledge, awareness, and attitudes
    • Discussion
      • Implications
      • Limitations and future directions
    • Acknowledgments
    • References

O R I G I N A L P A P E R

Social Networks and Friendships at School: Comparing Children
With and Without ASD

Connie Kasari • Jill Locke • Amanda Gulsrud •

Erin Rotheram-Fuller

Published online: 30 July 2010

� The Author(s) 2010. This article is published with open access at Springerlink.com

Abstract Self, peer and teacher reports of social relation-

ships were examined for 60 high-functioning children with

ASD. Compared to a matched sample of typical children in

the same classroom, children with ASD were more often on

the periphery of their social networks, reported poorer

quality friendships and had fewer reciprocal friendships. On

the playground, children with ASD were mostly unengaged

but playground engagement was not associated with peer,

self, or teacher reports of social behavior. Twenty percent of

children with ASD had a reciprocated friendship and also

high social network status. Thus, while the majority of high

functioning children with ASD struggle with peer relation-

ships in general education classrooms, a small percentage of

them appear to have social success.

Keywords Social networks � Playground observations �
Friendships � Social skills

Introduction

Despite the well-documented peer difficulties of children

with autism spectrum disorders (ASD), parents and profes-

sionals increasingly prefer inclusion of their children in

general education classrooms (Kasari et al. 1999). The

rationale is that placement of children with ASD in general

educational settings increases the involvement of these

children in the mainstream, through the behavioral modeling

of typical peers, and others’ acceptance and appreciation of

people with differences (Guralnick 1990; Villa et al. 1995).

Current research suggests that there may be both social

benefit and risk for children with ASD in inclusive settings.

Access to typical child models has been suggested as

one benefit to social outcomes for children with ASD. For

example, Sigman and Ruskin (1999) found that children

with ASD were more socially engaged at school if they had

access to typical children on the playground. Similarly,

Bauminger et al. (2003) found that high functioning chil-

dren with ASD were more likely to engage with a typical

peer on the playground than with children with special

needs. Some parents report their child’s inclusive experi-

ence as being characterized by peer acceptance, and being

able to form meaningful friendships with their non-dis-

abled classmates (Ryndak et al. 1995; Staub et al. 1994).

Mainstreamed classrooms may offer an ideal context to use

typical peers as social models, encouraging the mainte-

nance and generalization of skills often not achieved by

interventions that use an adult interventionist (Carr and

Darcy 1990; Roeyers 1996; Shearer et al. 1996).

However, other studies demonstrate that inclusion may

be insufficient to truly integrate children with ASD into the

social networks of their typical peers (Burack et al. 1997),

and may even pose social risks (MacMillan et al. 1996;

Ochs et al. 2001; Sale and Carey 1995). High-functioning

students with ASD may be at even greater risk for peer

rejection than more impaired students with ASD. Students

with severe disabilities may be more accepted in class-

rooms of mostly typical students because they readily stand

out. Different expectations can lead typical peers to play a

functional, protective role toward them instead of leading

to rejection. On the other hand, students with mild dis-

abilities receive little acceptance regardless of classroom

C. Kasari (&) � J. Locke � A. Gulsrud
Semel Institute, University of California Los Angeles,

68-268, Los Angeles, CA 90095, USA

e-mail: [email protected]

E. Rotheram-Fuller

Temple University, Philadelphia, PA, USA

123

J Autism Dev Disord (2011) 41:533–544

DOI 10.1007/s10803-010-1076-x

composition. Yet both groups are more stigmatized and less

accepted than typical students (Cook and Semmel 1999).

Inclusive classrooms may also be over-stimulating and

lack specified staff and resources that students with ASD

need, causing them to grow dependent on adults in the

classroom (Mesibov and Shea 1996). From interviews with

adolescents with ASD, it appears that support staff (often

in the form of a paraprofessional aide) may mark children

as being different, hindering rather than facilitating peer

relationships (Humphrey and Lewis 2008). Researchers

observing kindergarten and school aged children note that

adults assigned to children with ASD are often unsure of

what to do on playgrounds and interfere, blocking interac-

tions between children and their peers, resulting in more

isolation from peers while increasing the child with ASD’s

interactions with adults (Anderson et al. 2004). Inclusion and

the practices implemented to facilitate inclusion (e.g.,

assignment of paraprofessionals to the child with ASD) may

not always promote social success of children with ASD.

Children spend the majority of their day at school, but

studies have rarely examined the friendships and peer

interactions of children with ASD within this context.

Rather, most studies ask children or parents to identify

friendships without gathering corresponding reciprocity

data. As Bauminger and Kasari (2000) note, all of the chil-

dren in their sample of high functioning children with autism

identified a friend. Most children were identified from their

school setting; however, several children identified friends

that mothers later indicated was the child’s tutor, stepdad, or

other unusual choice. Without data from the nominated

friend of the child with ASD, we could not judge reciprocity

of friendships. In a later study of second and third grade

children, we found that approximately one-third of nomi-

nated friends reciprocated the friendship of children with

ASD at school compared to sixty percent for typical children

from the same class (Chamberlain et al. 2007). Thus, reci-

procity at school appears to be lower for children with ASD.

While multiple informants are important in determining

the social inclusion of children with ASD at school,

reporters do not always agree on the degree to which

children are socially included. In particular, children with

ASD experience misperception of their social involvement

at school; they may see themselves as more or less socially

involved than their peers or parents report. For example, in

one study we found that children with ASD saw themselves

as more connected than their peers saw them. Children

with ASD nominated many more children as friends at

school than peers nominated them (Chamberlain et al.

2007). In another study, children identified fewer friends

from any context or setting than their mothers identified for

them (Bauminger and Kasari 2000). In this latter study, we

did not obtain peer reports so that it was unclear if mothers

over-identified or children under-identified their friends.

Determining inclusion success appears different depending

on the reporter (e.g. peer, child with ASD, parent, teacher)

and the circumstances (e.g., observations of actual behavior

on playgrounds or survey).

One limitation to our current knowledge of children’s

experiences at school is that most studies describe the expe-

riences of only a few children and are limited in the number of

measures and reporters that they include. Thus, studies may

obtain the child’s report of relationships, and/or their tea-

cher’s or parent’s report, but rarely reports from peers and/or

observations of spontaneously occurring peer interactions. In

our previous reports of classroom peer nominations, both

peers and children with ASD agreed that children with ASD

were more often peripheral in their classroom social networks

(Chamberlain et al. 2007; Rotheram-Fuller et al. in press).

Children with ASD also reported lower quality friendships

(Bauminger and Kasari 2000; Chamberlain et al. 2007), and

their difficulties with their peer social networks were greater

at the older grades than the younger grades (Rotheram-Fuller

et al. in press). However, these studies did not include actual

observations of peer relationships, nor did they include

impressions from teachers. Teachers and independent

observers of children’s social interactions on the playgrounds

offer important additional information on the social inclusion

of children with ASD.

It is expected that the peer social network nominations of

children should be in line with observations of children on

their school playgrounds. Thus, peer reports of children with

ASD as peripheral to their classroom social networks should

predict that they would be largely unengaged on their school

playgrounds. Indeed, studies that have observed children

with ASD on playgrounds suggest that they are often unen-

gaged with peers; they make fewer attempts to interact with

other children, and are less responsive to other’s bids for

social interaction (Sigman and Ruskin 1999). One study

found that just four behaviors discriminated over 90% of

children with ASD on the playground from other children.

These behaviors included poor social engagement with

peers, lack of respect for personal space, isolation, and

inappropriate behavior (Ingram et al. 2007). The consistent

finding that children with ASD are isolated or unengaged on

the playground may be due to several possibilities, including

that children distance themselves from interactions with

others (perhaps wanting to be alone) or that they are unen-

gaged due to their own or others’ actions on the playground.

At this point, we do not know how the children themselves

(both peers and the child with ASD) and their teachers view

their relationships, and how these relationships may play out

on the school playground. To date, researchers have not

connected all of these measures together in the same study.

The goal of the current study was to connect self and

other perceptions to actual observations of children on their

playgrounds, and to teacher reports of social interactions at

534 J Autism Dev Disord (2011) 41:533–544

123

school. While we recognize that children can have friend-

ships in many different contexts, they spend the greatest

amount of time at school, and it is the context in which social

relationships can have added benefit to both social and

academic development. Moreover, for children with ASD,

school is the context in which they can feel loneliness and

isolation (Bauminger and Kasari 2000). We expected that

children with ASD would receive fewer reciprocated

friendship nominations, report poorer quality friendships,

and be viewed by their peers as more peripheral in their

classroom social networks (Bauminger and Kasari 2000;

Chamberlain et al. 2007; Rotheram-Fuller et al. in press). In

this study, however, a primary goal was to examine the

association between independent observations of children

on the school playground with teacher, peer and self reports

of peer relationships. We hypothesized that children who

were more peripheral in their social networks, would be less

engaged on the playground, have fewer friendships, and

receive poorer teacher reports of social skills.

Because children with ASD in this study ranged from

first to fifth grade, we were also interested in grade related

differences in our measures. In a previously completed

study involving 79 children with ASD in kindergarten

through fifth grade, grade related changes were found in

children’s social networks (Rotheram-Fuller et al. in press).

Sixty of these children are participants in the current study

and received the additional measures that are the focus of

this study (including measures of friendship quality, tea-

cher report of social relationships, and independent play-

ground observations). Thus, we can begin to examine

grade-related differences in the connections between self

and other reports and actual behaviors of children with

ASD in inclusive classrooms.

Method

Participants

A total of 243 children were prescreened for participation

in this study and 83 families signed consent from August

2003 to September 2007. The majority of families who did

not meet the prescreening criteria lived outside of our

catchment area (within 90 min of the University). Children

were included in this study if they had a diagnosis of ASD

from a licensed psychologist, if they met criteria for ASD

on the ADI-R and ADOS, were fully included in a regular

education classroom for at least 80% of the school day,

were between the ages of 6–11 years old and in grades 1–5,

and had an IQ of 65 or higher. Children were excluded

from this study if they had additional diagnoses. Of the 83

children with ASD who signed consent, 23 did not par-

ticipate for a variety of reasons (nine schools refused

participation; six parents withdrew before the assessments;

six children did not meet the IQ criteria; two children did

not meet criteria for ASD). All peers from each partici-

pating child with ASD’s classroom were then invited to

participate in the study. Both parental consent and child

assent were obtained from all participating peers.

A total of 60 children with ASD and 815 typically

developing children participated in this study. Research

clinicians not associated with the study independently

evaluated all children with ASD. Overall, 44 children

received an autism diagnosis, and 16 children received an

Asperger diagnosis. Participants were recruited from 56

classrooms in 30 different schools across the greater Los

Angeles area (53% of the schools were Title I schools). Of

the children with ASD, 15 children were in first grade, 18

children in second grade, eight children in third grade, 11

children in fourth grade, and eight children in fifth grade.

Children with ASD were from diverse ethnic backgrounds

(46.7% Caucasian, 5% African American, 21.7% Latino,

16.7% Asian, and 10% Other) and were predominantly

male (90%). All were fully included in regular education

classrooms for 80% or more of the school day and were an

average of 8.14 ± 1.56 years old, with an average IQ of

90.97 ± 16.33. One family refused the IQ test but previous

reports of IQ were in the normal range. Sixty percent of the

children with ASD were assigned a 1:1 aide in the class-

room and on the playground. Children assigned an aide had

significantly lower IQs than children without an aide,

t(1, 57) = 3.07, p = .003. Average IQ of children with NO

AIDE (N = 24) was 98.33 (SD = 19.23) and of children

WITH AIDE (N = 35) was 85.91 (SD = 11.86).

To allow for direct comparisons to the children with ASD,

a subsample of typical children was randomly selected from

each child’s classroom that matched the children with ASD

on gender, age, grade and classroom. Typically developing

children were an average of 7.86 ± 1.43 years old. Further

demographic data were not available for the matched peers.

Measures

Friendship Qualities Scale (FQS; Bukowski et al. 1994).

The FQS is a 23-item questionnaire that examined five

features of friendship quality: (a) companionship (amount

of voluntary time spent together), (b) help (encompassing

both aid and protection from victimization), (c) security

(including trust and the idea that the relationship will

transcend specific problems), (d) closeness (consisting of

both the child’s feelings toward the partner and his or her

perceptions of the partner’s feelings), and (e) conflict

(disagreements in the friendship relation). Children rated

how true a sentence description was of their best friendship

using a 5-point Likert scale (1 = never to 5 = always).

This measure has been used in previous studies of children

J Autism Dev Disord (2011) 41:533–544 535

123

with autism and their peers (Bauminger and Kasari 2000;

Bauminger et al. 2004; Chamberlain et al. 2007).

Playground Observation of Peer Engagement (POPE)

(Kasari et al. 2005). Designed for this study, the POPE is a

time-interval behavior coding system. Researchers recor-

ded children’s engagement with peers on the playground,

and frequency of initiations and responses (see Table 1 for

description). Independent observers watched the target

child on the playground for 40 consecutive seconds and

then coded for 20 s for at least ten minutes during the

recess or lunch play period on two separate occasions

within 1 week. The observers noted the child’s engagement

with peers on the playground (solitary, proximity,

onlooking, parallel, parallel aware, involved in games with

rules and joint engaged with peers) in each interval.

Playground engagement states were summed for a total

proportion of intervals in each engagement state.

Coders also noted two types of children’s initiations

toward other children. First, observers coded for successful

initiations to peers where the child directs communication

to a peer/peers (e.g. offers toy, greets, asks to play game,

comments, states facts, etc.) and the peer responds with a

nonverbal gesture (e.g. head nod/shake, follows the child,

laughs, etc.) or verbal language. Second, observers rated

children’s failed initiation attempts where the target child

directs communication to a peer/peers and the peer does

not respond or ignores the child. Coders also noted two

types of child responses to others including the children’s

appropriate responses to a peer’s initiation (e.g. child says

yes when a peer asks him/her to play) as well as the child’s

missed responses to a peer’s initiation (e.g. a peer asks him/

her to play and the child does not respond). Playground

observations included a comment section where the

observer qualitatively documented whether or not the child

had a 1:1 aide and the type of activity he/she engaged in

with the child on the yard.

Playground engagement states were summed into total

interval counts that yielded a total percentage of intervals

in each engagement state, and frequency of social behav-

iors (e.g., initiating to others and responding to peers’

social overtures) within each observed interval. To correct

for varying intervals per observation, the number of

intervals children spent in each engagement state was

divided by the total number of observed intervals for that

observation period.

Prior to beginning the study, all observers were trained

and considered reliable with percent agreement [.80.
Observers then overlapped on 15% of all observations

distributed over the course of the study to assess coder

reliability and drift. When conducting reliability two

observers overlapped on sessions and began their stop-

watches at the same time, but coded independently. Reli-

ability was estimated with Kappa statistic, and averaged

.91 (range .83–.96).

Teacher Perception Measure. The Teacher Perception

Measure was a 26 item questionnaire completed by teachers

and adapted from the Personal Maturity Scale (Alexander

and Entwisle 1988), the Child Behavior Checklist for Pre-

school-Aged Children, Teacher Report (Achenbach et al.

1987) and the Behavior Problems Index (Zill 1990) by the

Early Head Start FACES program. The adapted measure

used a 3-point Likert scale to rate 12 items regarding

teachers’ perceptions of students’ social skills (1 = never,

2 = sometimes, 3 = very often) and 14 items regarding the

teacher’s perceptions of children’s classroom conduct

(1 = not true, 2 = somewhat or sometimes true, 3 = very

true or often true). The social skills domain described the

child’s strengths, such as adaptability to the school class-

room and environment, quality of interactions with peers,

and popularity or likeability among peers. The classroom

conduct domain described problems, such as disruptive,

impulsive, withdrawn, and depressive behaviors; problems

in school-related skills and motivation; and difficulty fol-

lowing directions. The Early Head Start FACES program

reported good internal consistency for this measure, ranging

from .72 to .88.

Table 1 Engagement states from the playground observation of peer engagement

Solitary/

isolated

Child plays alone, with no peers within 3 feet, and no mutual eye gaze with other children

Proximity Child plays alone within 3-foot range of peer

Onlooker Child has one-way awareness of child who is farther away than 3 feet. It appears the child is watching another child or group of

children or a game with interest or the intent to participate

Parallel Child and peer are engaged in a similar activity but there is no social behavior

Parallel aware Child and peer engaged in similar activity and mutually aware of each other during activity

Joint

engagement

Child and peer direct social behavior, e.g., offering objects, conversing, toy-taking, and other activities with a turn- taking

structure

Games with

rules

Child participates in organized sports such as 4-square, basketball, or handball and/or engages in fantasy or pretend play OR a

fantasy game that the child or his/her peers have created provided all children are playing by a set of rules that the children

have specified. A game has to be with another child

536 J Autism Dev Disord (2011) 41:533–544

123

Social Networks and Friendship Survey. Children were

asked to identify who they like to hang out with in their

classroom. From this list the children generated, they were

instructed to circle their top 3 friends, and place a star next to

their best friend from among the 3 names that were circled.

They were also asked to list any children they did not like to

hang out with (rejects). Next, participating students were

asked: ‘‘Are there kids in your class who like to hang out

together? Who are they?’’ Children listed the names of other

children who hung around together in groups; they were

reminded to include themselves in groups as well as to

remember to include students of both genders. Children

circled the groups of children who they identified as hanging

out together. This method has been used in various studies

from early childhood through adolescence to assess the

social structure of individual classrooms for both typical and

atypical populations (Cairns and Cairns 1994; Farmer and

Farmer 1996; Chamberlain et al. 2007; Locke et al. 2010).

Coding Indegrees, Outdegrees, Connects, and Rejects.

These variables were coded from the Friendship Survey.

Indegrees were coded as the total number of received

friendship nominations – the number of classmates that

listed the child as ‘‘someone they like to hang out with,’’

whereas outdegrees were coded as the total number of

outward friendship nominations by the child—the number

of classmates the child listed as ‘‘someone they like to hang

out with.’’ Children’s connects score was calculated as the

total number of children that were significantly linked on

the social network map. Each line segment from the social

network map indicated a significant connection to a

classmate from that child (See Fig. 1). Lastly, rejects were

coded as the total number of times children were identified

as someone other children ‘‘did not like to hang out with’’.

Coding Friendship Reciprocity. Children were consid-

ered to have reciprocal friendships if they selected each

other as their top 3 or best friends within the classroom. A

conservative method of determining reciprocal friendships

was used, such that when one of the students nominated

was absent, or did not complete the measure, it was coded

as missing data instead of a non-reciprocal friendship.

Coding Social Network Centrality (Cairns and Cairns

1994). Following Cairns and Cairns (1994), social network

analyses were conducted in order to obtain each child’s

social network centrality score. Social network centrality

refers to the prominence of an individual in the overall

classroom social structure. Three related scores were cal-

culated in order to determine a student’s level of involve-

ment in the classroom’s social networks: (1) the student’s

‘‘individual centrality,’’ (2) the ‘‘cluster centrality’’ of each

social group within the class, and (3) the student’s combined

‘‘social network centrality’’ score. Using methods developed

by Cairns and Cairns (1994), the first two types of centrality

were used to determine the third (Cairns et al. 1990; Farmer

and Farmer 1996). Based on categorizations by Farmer and

Farmer (1996), four levels of social network centrality were

possible. These four levels of involvement (i.e. isolated,

peripheral, secondary, and nuclear) in the classroom’s social

structure were coded from 0 to 3, to provide a system for

describing how well the child with ASD was integrated into

the informal peer networks. Children that were considered

‘isolated’ received a score of 0 for their social network

centrality and were not considered part of any cluster of

children within their classroom. Children that were consid-

ered ‘peripheral’ received a score of 1 for their social net-

work centrality and were considered on the outskirts of their

classroom’s social structure. These children may have a few

connections to other children within the classroom but are

not salient members of their classroom’s social network.

Children that were considered ‘secondary’ received a score

of 2 on their social network centrality and were considered

well connected members of their classroom social structure.

Lastly, children that were considered ‘nuclear’ received a

score of 3 on their social network centrality and were con-

sidered ‘popular’ and central members of their classroom

social structure. These children were individually salient

(nominated frequently) and were also significantly con-

nected to other children who were very salient on an indi-

vidual level. Children’s total social network centrality status

could only be as high as their lowest centrality score derived

from their individual or cluster centrality score.

Procedures

Once families completed the informed consent process,

they were assessed by independent evaluators to validate

the clinical diagnosis of ASD via the ADI-R (Lord et al.

1994) and ADOS (Lord et al. 2000) evaluations. Inde-

pendent evaluators also administered the Wechsler

Fig. 1 Sample social network map where the target child is an
isolate. All other lines stemming from children’s ID numbers indicate

significant classroom connections. Numbers in parenthesis next to the
ID number represent children’s individual scores. Numbers within the
cluster are children’s group scores (*** denotes the target child with

autism)

J Autism Dev Disord (2011) 41:533–544 537

123

Intelligence Scale for Children (WISC-III; Weschler 1991)

to obtain a developmental quotient. Children with an IQ of

65 or higher and who had a diagnosis of ASD were

included in the study.

Upon entry into the study, research personnel contacted

the target child’s school and obtained a letter of school

participation for the study. Once school approval was

obtained, consent forms were distributed to all children in

the class. Children were informed that their classroom was

selected to participate in a research study examining chil-

dren’s friendships and social skills. Children, who returned

informed consent from their parents, as well as offered

assent to join the study, completed the social network

measures (including brief demographic information) and the

Friendship Qualities Scale. To ensure understanding of the

measures, research personnel provided verbal instructions

on how to complete the instruments and individually assis-

ted children who had difficulty reading and/or writing and/or

were in the youngest grades. Children in the older grades

independently completed the measures after instructions

were given. In addition, teachers were asked to complete the

Teacher Perceptions Scale for the child with ASD during

this visit. Within the same week of distributing classroom

measures, research personnel gathered behavioral observa-

tions on the playground during two separate recess periods.

Results

Analyses below are based on 120 children, 60 children with

ASD and a paired sample of 60 typically developing peers

(children matched on age and gender from the same

classroom). There were no differences on outcome mea-

sures between children diagnosed with Asperger syndrome

(n = 16) and autism (n = 44); therefore, the following

analyses included all 60 children with ASD. We first report

descriptive data for the groups on measures of peer nom-

ination and friendship ratings: social network centrality,

friendship nominations (indegrees, outdegrees, connec-

tions, rejects, reciprocity of best and top 3 friends), and

friendship quality ratings. In each case, we tested for group

and grade-related differences. Next we report the descrip-

tive data for the playground observations of children with

ASD, and finally report individual differences in measures

for the children with ASD.

Descriptive Data: Self-and Other Perceptions of Social

Connections for Children With and Without ASD

Social Network Centrality. For the group of children with

ASD, 8 children were isolated, 25 had peripheral status, 22

had secondary status, and five had nuclear social status. In

contrast, none of the typically developing children were

isolated, six had peripheral status, 35 had secondary status

and 19 had nuclear status. See Fig. 2.

Consistent with our earlier studies, an ANOVA indi-

cated that there was a significant group difference for social

network centrality, F(1, 116) = 38.57, p .0001. Children
with ASD had significantly poorer social network centrality

(1.38 ± .09) compared to typically developing matched

peers (2.20 ± .09). There was a significant main effect of

grade level, F(1, 116) = 4.87, p = .03 where children in

the older grades (3rd–5th) had lower social network cen-

trality (1.65 ± .10) than children in the younger grades

(1st–2nd; 1.93 ± .09). There was no significant interaction

between grade and diagnostic group.

Friendships, Connections, and Rejections. A MANOVA

with grade and diagnostic group as independent variables

was used to compare the number of children’s friendships,

connections, and rejections within his/her classroom

between typically developing children and children with

ASD. Of the 120 children, 114 children were used in this

analysis because three children with ASD did not complete

the rejections portion of the friendship survey, as it was

added after the study began; thus, these students (and their

matched peers) were excluded from this analysis.

The multivariate result was significant for group, Wilks

Lambda = .79, F(1, 106) = 7.13, p B .001, indicating a

difference in friendships between children with ASD and

their typically developing peers. The univariate F tests

showed a significant difference between children with ASD

and their matched peers for the number of friends they

nominated within the classroom (outdegrees; F(1, 106) =

8.57, p = .004), the number of received friendship nomi-

nations by other children (indegrees; F(1, 106) = 18.84,

p B .001), and the number of classroom connections (con-

nects; F(1, 106) = 14.61, p B .001). Children with ASD

nominated fewer peers as friends (3.76 ± .34), were nom-

inated fewer times as a friend by peers (1.48 ± .24) and had

Fig. 2 Bar graph of the frequency of social network centrality status
for children with ASD and their typically developing matched peers

538 J Autism Dev Disord (2011) 41:533–544

123

fewer overall classroom connections (i.e., smaller social

networks; 2.76 ± .33) than their typically developing mat-

ched peers (5.17 ± .34; 2.92 ± .24; 4.54 ± .33, respec-

tively). Children with ASD did not differ from typically

developing children in their percentage of connections to

peers by gender. Boys were more often connected to boys

and girls to girls for both groups. Lastly, when examining

children’s number of rejections, there was no significant

difference in the number of rejection nominations received

by children with ASD relative to their matched peers. There

was no main effect of grade or a group by grade interaction

for these outcomes (see Fig. 3).

Reciprocal Friendships. Both reciprocated top 3 friends

and best friendships were examined using an ANOVA. For

their top 3 friends, the overall model was significant,

F(3, 99) = 13.12, p .0001 with a significant main effect
for group, F(1, 99) = 39.22, p .0001.The percentage of
children’s reciprocal friendships with their nominated top

three best friends was significantly lower for children with

ASD (17.91% ± 5.32) in comparison to their typically

developing matched peers (63.91% ± 5.07). There was no

main effect of grade or a group by grade interaction.

The overall model was significant for reciprocal best

friends, F(3,61) = 3.94, p = .0123, with a significant main

effect of group, F(1, 61) = 10.82, p = .0017. Children

with ASD had fewer reciprocal best friends than did typical

children, (11.33% ± 8.4 compared to 44.97% ± 7.08),

respectively. There was no main effect of grade or a group

by grade interaction. See Fig. 4.

In addition, there was no difference between children

with ASD and typically developing children in whether they

selected a same-sex best friend (v2(1, N = 116) = 3.42,
p = .09). The majority of both groups chose same sex best

friends, 56 out of 60 typically developing children and 46

out of 56 children with ASD. Four children with ASD did

not list any peer as a friend.

Friendship Quality Scale. A MANOVA with grade and

diagnostic group as independent variables was used to

compare the five domains of child-rated friendship quality

(i.e. companionship, help, security, conflict, and closeness)

between typically developing children and children with

ASD. Of the 120 children in the matched sample, 116

children were used in this analysis. Four children with ASD

did not list a best friend and therefore did not complete the

FQS; therefore, they were excluded from the analysis.

The multivariate result was significant for group, Wilk’s

Lambda = .84, F(1, 108) = 4.13, p = .002, indicating a

difference in friendship quality between children with ASD

and their typically developing peers. The univariate F tests

showed there was a significant difference between chil-

dren with ASD and their matched peers for closeness,

F(1, 108) = 17.87, p B .001, security, F(1, 108) = 4.45,

p = .04, helpfulness F(1, 108) = 15.00, p B .001, and

companionship, F(1, 108) = 8.60, p = .004, in that chil-

dren with ASD reported poorer friendship quality in all four

domains (see Table 2). Children’s perceptions of conflict

with respect to their best friendships were not significantly

different between the two groups. There was no main effect

of grade or a group by grade interaction for any domain of

friendship quality (see Fig. 5).

Within the Autism Group Analyses: Playground

Observations of Children with ASD

On the playground, children with ASD were engaged with

their peers for just over a third of the observed intervals on

the playground (38.6% of the total intervals). Children

engaged in structured games with rules for approximately

Fig. 3 Bar graph of children’s social network variables between
children with ASD and their typically developing matched peers

(*** p .001; ** p .01)

Fig. 4 Bar graph of children’s reciprocal friendships between
children with ASD and their typically developing matched peers

(*** p .001; * p .05)

J Autism Dev Disord (2011) 41:533–544 539

123

20% of the observed intervals, and 18.6% of the observed

intervals in joint engaged activities, such as having a

conversation. For the remaining percentage of observed

intervals, children were either solitary/unengaged (33.4%),

or in lower levels of engagement: parallel play (6%); in

proximity to other children (8%); parallel aware (engaging

in similar activities with mutual social awareness; 7%); and

onlooking (watching another group of children engaged in

a game or activity; 7%). The rate of initiations to peers

was, on average, once every 3 intervals (mean of 5.13

initiations during 15.79 observed playground intervals).

Peers responded to the child with ASD in approximately

66% of the opportunities observed. Peers also initiated to

the child with ASD an average of once every four intervals

and the child with ASD responded to the peer in 75% of the

opportunities observed.

Children with ASD who had a higher percentage of

intervals observed in joint engagement and games on the

playground also initiated to other children more often on the

playground, r = .45, p B .001, and responded more to peers’

initiations, r = .57, p B .001. In addition, children with ASD

who were more engaged on the playground were significantly

less likely to have a 1:1 aide, r = -.27, p = .04.

Qualitative notes from observations: In order to deter-

mine if children with an aide were more likely to be inter-

acting with their aide rather than with other children, we

examined the qualitative comments made by the indepen-

dent coders for each observation. During the playground

observations the observer noted if the child was interacting

with their aide or with peers. Two raters further coded the

qualitative comments about what the child was doing during

recess. These raters agreed 100% on the statements about the

child’s behavior and the role of the aide. Categories included

child unengaged but peers nearby, completely unengaged

with peers or adults, wandering or unfocused, engaged with

the aide or engaged with peers. Half of the children assigned

an aide were observed as unengaged on the playground (18/

36 children or 50%), 12 were wandering or unfocused and 6

were unengaged with peers but other children were nearby

(e.g., eating nearby, or digging in the sand nearby). Another

14% (5 children) were observed interacting with their aide

only. The rest of the sample (13/36 or 36%) was observed

interacting with peers or engaged in games. Children with an

aide were most often unengaged on the playground, neither

interacting with peers or with the aide.

Connections Between Playground Observations, Peer,

Self and Teacher Reports for Children with ASD

Correlations were run to determine if playground variables

(engagement/games, unengaged/solitary, initiations, respon-

ses) were associated with peer nominations (indegrees, out-

degrees, rejects, connects), social network centrality (SNC),

and friendship quality for the children with ASD. None of the

correlations reached significance.

We then explored whether children with ASD who were

more engaged on the playground differed by teacher report

of social skills. Using chi square statistics, we found that

teachers rated children who were more engaged on the

playground as having higher social skills, although the

association was only marginally significant, v2(1, N = 56) =
3.78, p = 06.

Next we tested whether the children who had a reci-

procal friendship were more engaged on the playground,

and whether peers rated these children differentially.

Twenty percent of the children with ASD (N = 12) had at

least one reciprocal friendship. These children had signif-

icantly higher social network centrality scores (2.17 ± .20)

as compared to children with ASD who did not have a

reciprocal friendship (1.24 ± .11; v2(1, N = 49) = 11.59,
p = .001). Having a reciprocal friendship, however, was

not associated with being more engaged on the playground

(v2(1, N = 49) = .67, p = 1.00).

Discussion

Children with ASD in general education classrooms are

most often on the periphery of their classroom social

Table 2 Estimated mean differences and standard errors in friend-
ship quality between children with autism and their matched controls

Friendship quality Autism Matched control

Closeness 19.35 (.51) 22.35 (.49)

Conflict 8.38 (.48) 8.19 (.46)

Security 16.25 (.51) 17.74 (.49)

Companionship 13.35 (.49) 15.34 (.47)

Helpfulness 16.87 (.63) 20.25 (.47)

Fig. 5 Bar graph of children’s friendship quality between children
with ASD and their typically developing matched peers

(*** p .001; ** p .01; * p .05)

540 J Autism Dev Disord (2011) 41:533–544

123

networks. Their social networks are smaller than typical

classmates, the friendships they identify are less often

reciprocated, and the quality of their friendships is poorer.

These data for children in first through fifth grade are con-

sistent with a previous report on second and third graders

(Chamberlain et al. 2007), and further document the sig-

nificant social impairment that these children experience at

school. However, the current data go beyond our earlier

report in three main ways.

First, our previous study was limited to a small number

of high functioning children with ASD (N = 17) and a

more cohesive set of classrooms in which schools partici-

pating tended to have more services available, and may

have been motivated to participate because ‘things were

going well’ (Chamberlain et al. 2007). We found that none

of the children in our previous study were isolated, but they

were more often peripheral in their social networks.

Moreover, a gender effect was noted, with mostly boys

with ASD connected to social networks of girls (Cham-

berlain et al. 2007). In the current study, a larger sample of

60 children with ASD was recruited from a diverse set of

classrooms (half were from Title I schools). We found

again that children with ASD were mostly peripheral in

their classroom social networks, but there were also iso-

lated children (approximately 13% of the sample). The

gender effect we found previously was not noted in the

current study. Thus, consistent with typical peer social

interactions, boys were connected to boys and girls to girls,

and these findings were consistent for younger and older

children with ASD (Fein 1981; Pellegrini et al. 2007).

Reciprocity of friendships was particularly low for this

sample of children, 18% compared to 64% of their typical

classmates, and also lower than a previous study of 34% of

second and third graders with ASD (Chamberlain et al.

2007). Friendships of children with ASD may be better

characterized as unilateral rather than reciprocal. Because

friendships in the school context are important given the

amount of time children spend in school, and the impor-

tance of friends in promoting social and academic out-

comes (Ladd 1999), it will be important for future studies

to determine whether unilateral friendships satisfy similar

needs as reciprocal friendships for children with ASD

(Freeman and Kasari 1998). Additionally, friendships

outside of the school setting may provide a protective

function to children while in school, although studies have

not examined this possibility.

Second, there is some data suggesting that children with

ASD have poorer relationships at older ages (Orsmond et al.

2004; Rotheram-Fuller et al. in press). While we found

group effects in nearly all measures with children with ASD

doing less well compared to their typically developing

classmates, we found few grade differences and no grade by

group differences. There was only a grade effect for social

network centrality with all children (children with and

without ASD) having lower social network centrality at the

older grades. Relationships in general become more selec-

tive (and perhaps more challenging to maintain) as children

get older (Howlin et al. 2004; Orsmond et al. 2004). This

phenomenon appears the same for children with ASD as it is

for typically developing children.

Third, prior studies have not linked peer and child self

reports to systematic and independent playground observa-

tions and teacher reports. Thus, the current study extends our

previous findings by examining the links between peer, self,

and teacher reports, and observations of children in their

natural environment at school. One might expect that chil-

dren whose peers see them as more socially connected to

other children in the class would also be more engaged on

the playground. Yet, contrary to our expectations, there was

little association between playground engagement and peer

nominations of social connections. Regardless of social

status in the classroom, children with ASD were just as

likely to be unengaged on the playground if they were rated

as popular or isolated. Moreover, even with a reciprocal

friendship, children with ASD were no more engaged on the

playground than were children with ASD who did not have a

reciprocal friendship. Although a limitation of the study is

the lack of comparable playground data for the typical peers,

these data do provide insight into the potential problems

children with ASD experience on the playground, despite

having some important connections to their peers.

There are several reasons why the playground may be a

difficult environment for children with ASD. One is that in

contrast to the structure and expectations of the classroom in

which children may be able to connect with peers, the

playground is often chaotic and crowded. Even with a

reciprocal friend, children with ASD may be unable to

access the playground culture at their school. While adults

may be present on the yard, they are often more concerned

with safety than with facilitation of engagement between

peers (Anderson et al. 2004). Indeed, adults often believe

recess is a time away from adult intrusions, and that most

children understand how to play with each other (Giangreco

and Broer 2005). Yet, for children with ASD, playing and

engaging with others is likely the most difficult time of their

day. It seems likely that the playground is a good setting for

social skills interventions for children with autism. As a

result, one of the most common interventions for children

with ASD is to assign support staff, often in the form of a 1:1

aide (Anderson et al. 2004). In this study, over half of the

children were assigned an aide. Children with aides were

less likely to be engaged with peers on the playground, and

qualitative data indicated they were mostly unengaged from

their peers and also not engaged with their aides. These data

suggest that aides were unable to facilitate more peer

engagement of children on the playground. Future studies

J Autism Dev Disord (2011) 41:533–544 541

123

should carefully consider the role of the paraprofessional

assigned to children with ASD. Several studies now high-

light the critical need for aide training, so that aides learn

how to best facilitate interactions between children, and take

care not to stigmatize and otherwise isolate the child with

ASD (Anderson et al. 2004; Humphrey and Lewis 2008;

Brown et al. 2001).

Finally, the situation for children with ASD in inclusive

classrooms was not completely bleak. Children with ASD

did not differ from typical children in the number of

rejection nominations they received from their peers. This

finding, along with the relatively low levels of isolated

children nominated on the social networks measure, sug-

gests that children with ASD have more potential for fitting

into their typical school classrooms than other data-based

and anecdotal reports would suggest (Church et al. 2000;

Humphrey and Lewis 2008). Rather than active rejection,

children with ASD may fall into the class of neglected

children, often overlooked as potential playmates by other

children in the class (Asher and Wheeler 1985).

While our informant measures (peer, teacher and child with

ASD) did not link to our playground observations, observa-

tions of children on the playground yielded consistent data for

children’s level of engagement with initiations and responses

to peers. When children were engaged in games or conver-

sations, there were more initiations and responses to and from

peers. Thus, increasing engagement with children on the

playground is an important target of intervention that may

move children from the periphery of groups to more central

roles within the group. More engagement may lead to

increased opportunities to hone social skills, both in navigat-

ing positive interactions, and in negotiating conflicts. Better

engagement on the playground also appears associated with

more get-togethers of children outside of school (Frankel et al.

2010). Therefore, a goal for future studies will be to more

closely examine the effects of increased engagement on

children’s social developmental outcomes.

The current study goes beyond earlier studies by com-

bining data from multiple sources and by using multiple

methods on a large sample of children with autism. Still,

there remain a number of limitations that should be con-

sidered in interpreting the findings, and in designing future

studies. First, this study highlights some of the difficulties

in working within school settings that involve as few as 1

or 2 classrooms per school that contain a child with autism.

Obtaining enough data on each child becomes a challenge

when sample sizes are fairly large (n = 60) and classrooms

are many, as in the present report. Beyond the relatively

small corpus of observational data per participant (two

recess periods in one week contributing less than 30 min of

observational data), other limitations include the lack of

data on the typically developing matched peers. We were

unable to collect playground observational data and other

background information on the typical classmates. This

may be avoided in future studies if the typical classmates

are consented and matched from the beginning of the

study. Our approach was to utilize all of the children in the

class to obtain the social network centrality measure and

then to randomly select one child who could match the

child with autism on meaningful variables of age, gender

and same classroom. We were not able to verify ethnicity,

or other background variables on the children, and it is

possible that these variables may have influenced the

results despite the fact that children were in the same class,

same school and same neighborhood. Future studies will

need to consider these factors in making comparisons to

children with autism in general education classrooms.

In summary, this study provides a unique look into the

school social experiences of a diverse group of high-

functioning children with ASD. Information was gathered

from multiple sources, including the child with ASD, his or

her peers, and teacher, as well as independent observations

of interactions on the child’s playground. While measures

converged from multiple informants (teachers, peers and

child with ASD) on the level of connection between the

child and his or her peers and the reciprocity of their

friendships, there was little association to observations

made independently on the playground. Thus, these data

yield a complicated picture of the social lives of children

with ASD suggesting that success with peers may be

greater if the supports are in place to engage children with

their peers on the school playground.

Acknowledgments This study was supported by NIMH grant
5-U54-MH-068172 and HRSA grant UA3MC11055. We thank the

children, parents, schools and teachers who participated, and the

individuals who contributed countless hours of assessments, inter-

vention, and coding, Laudan Jahromi, Lisa Lee, Eric Ishijima, Kelly

Goods, Nancy Huynh, Mark Kretzmann, Tracy Guiou and Steve

Johnson. We especially appreciate the statistical support of Jeff Wood

and Fiona Whalen from the UCLA Semel Institute Statistical Group

and to Steven Kapp for feedback on earlier versions of the paper.

Open Access This article is distributed under the terms of the
Creative Commons Attribution Noncommercial License which per-

mits any noncommercial use, distribution, and reproduction in any

medium, provided the original author(s) and source are credited.

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544 J Autism Dev Disord (2011) 41:533–544

123

  • Social Networks and Friendships at School: Comparing Children With and Without ASD
    • Abstract
    • Introduction
    • Method
      • Participants
      • Measures
      • Procedures
    • Results
      • Descriptive Data: Self-and Other Perceptions of Social Connections for Children With and Without ASD
      • Within the Autism Group Analyses: Playground Observations of Children with ASD
      • Connections Between Playground Observations, Peer, Self and Teacher Reports for Children with ASD
    • Discussion
    • Acknowledgments
    • References

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Two Factor Model of ASD Symptoms

One of the key factors in determining whether an individual has Autism Spectrum Disorder (ASD) is in their social and communication skills. Individuals who are diagnosed with ASD have delayed joint attention, eye gazing, and other social interactions such as pointing (Swain et al., 2014).

Joint attention is an important social skill to master because it is a building block for developing theory of mind which, helps us to understand other’s perspectives. Korhonen et al. (2014) found that individuals with autism have impaired joint attention. However, some did not show impairment in joint attention, which lead to evidence that suggests there are different trajectories for joint attention. One suggestion as to why Korhonen et al. (2014) found mixed results, is that there is evidence that joint attention may not be directly linked to individuals with ASD since they were unable to find a difference in joint attention between ASD and developmentally delayed (DD) individuals. Another suggestion for the mixed results, is individual interest in the task vary. Research has found that while individualized studies are beneficial in detecting personal potential and abilities, it would be difficult to generalize the study in order to further research to ASD as a whole (Korhonen et al., 2014). In addition to joint attention, atypical gaze shifts is a distinguishing factor in individuals with ASD. Swain et al. (2014) found the main difference between typically developing (TD) and ASD individuals in the first 12 months of life is in gaze shifts. Individuals that were diagnosed with ASD earlier had lower scores on positive affect, joint attention, and gaze shifts, however those diagnosed later differed from typically developing (TD) only in gaze shifts. It is not until 24 months that later onset ASD individuals significantly differ from their TD peers, by displaying lower positive affect and gestures (Swain et al., 2014). These findings may lead to other ASD trajectories.

Another defining characteristic of ASD is the excess of restrictive patterns of interest and repetitive motor movements. These patterns and movements often impaired the individual from completing daily tasks. Like joint attention and gaze shifts, these repetitive movements and patterns of interest have different trajectories (Joseph et al., 2013). Joseph et al. (2013) found that individuals with high cognitive functioning ASD engage in more distinct and specific interests and less in repetitive motor movements than individuals with lower cognitive functioning ASD. Another finding showed that at the age of two, repetitive motor and play patterns were more common than compulsion. By the age of four all these behaviors increased however, repetitive use of specific objects was found to be less frequent in older children than younger children. This finding suggests that the ritualistic behaviors and motor movements may present themselves differently based on the age of the individual (Joseph et al., 2013).

Joseph et al. (2013), Korhornen et al. (2014), and Swain et al. (2014) all defined key characteristics of an ASD individual and explains the different trajectories of each characteristic. The difficulty with the trajectories is that it is specific to each individual, some symptoms may worsen while others remain stable. It is also difficult to generalize finding with small sample sizes (Joseph et al., 2013).

Discussion Questions:

1. Korhonen et al. (2014) did not use preference-based stimuli to look for joint attention and did not separate high- from low-functioning ASD individuals. Do you think that there could be a difference in level of motivation from each group? If so, how do you think this could change the results?

2. Swain et al. (2014) found that early and late onset of ASD did not differ in their social skills scores at the age of 12 months. If we know that their social skills do not differ then, is there another factor that would allow diagnosis of late onset ASD to be diagnosed at an earlier point in development?

3. Joseph et al. (2013) explains that it is difficult to assess the trajectories of ASD with a small sample size however, how do you think that their findings still help advance the research on ASD?

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