A Multi-Rater Study on Being Teased Among Children/Adolescents With Autism Spectrum Disorder (ASD) and Their Typically Developing Siblings

Abstract

The study examined teasing experiences among 74 individuals with autism spectrum disorder (ASD; M age = 115.7 months [9.6 years]; 83.8% male). Experiences were examined from parent, teacher, and child’s own perspectives. Factors potentially associated with being teased were investigated. Comparison data were ascertained on typically developing siblings (n = 68; M age = 116.5 months [9.7 years]; 52.9% male). Select items on the Child Behavior Checklist 6–18 and the Teacher Report Form 6–18 were utilized to calculate the prevalence of being teased; qualitative data from a subgroup of verbally fluent children with ASD (n = 50) were analyzed to provide child self-report teasing data. Children with ASD were more likely to be teased than their typically developing siblings. Characteristics that were significantly associated with being teased included higher cognitive functioning, less severe ASD symptomatology, and more time spent in inclusive educational settings. Clinical implications are discussed.

Keywords

autism spectrum disorders symptoms bullying teasing

Individuals diagnosed with an autism spectrum disorder (ASD) experience varying degrees of impairment in social interaction that lead to difficulties understanding and using the rules that govern social behaviors (Waterhouse, Wing, Spitzer, & Siegel, 1992; Wing, 1981), as well as difficulties in accurately perceiving non-verbal-social and conversational cues (Ehlers & Gillberg, 1993; Gillberg & Gillberg, 1989; Szatmari, Bremner, & Nagy, 1989). In addition, individuals with ASD may be overly literal or concrete in their interpretation of behaviors (Ehlers & Gillberg, 1993) and may use stereotyped, idiosyncratic, or overly formal language that is markedly different from language used by their peers (Waterhouse et al., 1992; Wing, 1981). Extant research suggests that characteristics such as these put children with ASD at high risk of being bullied or victimized (Card & Hodges, 2008; Hodges, Malone, & Perry, 1997; Sigman & Ruskin, 1999). A growing body of evidence indicates that individuals with ASD are more likely to be bullied than typically developing children (e.g., Carter, 2009; Little, 2002); however, to date, there is minimal research addressing the relationship between specific ASD symptoms and bullying experiences.

Frequency of Bullying/Teasing in ASD

Bullying is defined as an act that is intended to harm, that takes place repeatedly, and where there is an imbalance of power between the aggressor (bully) and target (victim; Craig & Pepler, 2003; Smith et al., 2002). Bullying can take many forms and may include behaviors that are verbal (e.g., name calling), relational (e.g., spreading rumors), or physical (e.g., hitting; Craig & Pepler, 2003). Physical aggression is the most easily recognized, but verbal bullying, although less overt, also has long-term ramifications on the social and emotional functioning of the victim (McCabe, Miller, Laugesen, Antony, & Young, 2010; Roth, Coles, & Heimberg, 2002). Teasing is one type of verbal aggression and can often be a complex, ambiguous form of bullying (Bradshaw, Sawyer, & O’Brennen, 2007) that requires an individual to make sense of multiple social cues. There is general agreement that teasing behaviors (a) include name calling, verbal harassment, or taunting and (b) are conducted with cruel intent (e.g., Bauman & Del Rio, 2006; Land, 2003). Researchers have established that bullying (including teasing) in schools is a worldwide problem (e.g., Smith, Madsen, & Moody, 1999), with estimates that between 8.4% and 23% of children are bullied (Bradshaw et al., 2007; Due et al., 2005; Nansel et al., 2001).

Children with special health care needs and/or developmental/behavioral difficulties are particularly vulnerable to peer victimization (Knox & Conti-Ramsden, 2007; Norwich & Kelly, 2004; Van Cleave & Davis, 2006; Wiener & Mak, 2009). For example, Little (2002) performed a study of 411 (ages 4–17 years; mean age = 10.5 years) children with Asperger’s disorder (AD; 75.4%), non-verbal learning disabilities (NLD; 15.3%), or both AD and NLD (9.2%; all diagnoses based on parent report). Parents completed a brief questionnaire that contained four questions related to physical forms of bullying (e.g., aggression) and one related to emotional bullying or teasing (i.e., name calling and saying mean things). Across the entire sample, 94% of parents reported that their child had been victimized; the prevalence of being bullied was four times higher among those with AD or NLD compared with a national, internet-comparison group of typically developing (TD) youth. Using the same survey items as Little (2002), Carter (2009) measured the parent-reported frequency of victimization and shunning among individuals aged 5 to 21 years (n = 34) with AD and found that 65% had been victimized, with 50% of parents reporting that their child had been emotionally bullied (i.e., teased).

More recently, Van Roekel, Scholte, and Didden (2010) used a multi-rater method to examine the prevalence of victimization among 230 children with ASD (aged 12–19 years) who were enrolled in special-education schools. “Victimization” was assessed by asking the adolescents and teachers to rate how well their class members or themselves (depending on the respondent) fit the following description: “is victimized.” All participants met criteria for ASD as determined by psychologists or psychiatrists (autism, n = 35; pervasive developmental disorder–not otherwise specified [PDD-NOS], n = 123; AD, n = 29). Results showed prevalence rates of victimization between 6% and 46%, depending on type of respondent, with teachers reporting higher frequencies of bullying than the children themselves. In similar work, Cappadocia, Weiss, and Pepler (2012) surveyed the parents of 192 individuals (mean age = 11.71 years) with ASD (AD = 54%; high-functioning autism = 14%; PDD-NOS = 13%; autistic disorder = 19%) and found that 77% of the sample had been reportedly victimized, with 67% endorsing at least one incidence of verbal victimization during the previous month. Clearly, there is a growing body of evidence suggesting that individuals with ASD are at increased risk of being bullied/teased. However, most of these works are based solely on parent report and tend to focus on higher-functioning individuals with ASD. In addition, differences across studies in prevalence of bullying appear to depend on several factors, which are discussed below.

Factors Related to Increased Risk of Being Bullied

Several characteristics have been shown to correlate with an increased likelihood of being bullied, including displays of anxiety, social withdrawal, internalizing behaviors, social-skill deficits, and provocative behaviors (e.g., impulsive behaviors, emotional dysregulation; Card & Hodges, 2008; Fox & Boulton, 2005; Hawker & Boulton, 2000). Given that children with ASD often present with many of these characteristics, it is easy to understand why rates of bullying may be higher among this population. However, certain functional characteristics (i.e., cognitive ability, degree of ASD severity) and how they may relate to being bullied have rarely been investigated. We are only aware of one study that examined the relationship between ASD symptoms and bullying. In that work, AD symptomatology, as measured by higher scores on the Krug AD Index, was negatively correlated with incidences of bullying (Shtayermman, 2007). This suggested that children with more pronounced ASD symptoms experienced less bullying, a finding the authors attributed to closer teacher-monitoring of those children who were more severely affected. However, children’s level of functioning as related to peer victimization has not been specifically investigated in other samples of children/adolescents with ASD.

Findings related to the effects of educational settings on bullying have been markedly inconsistent. Some research suggests that inclusion with TD peers may result in increased victimization (Sigman & Ruskin, 1999). Specifically, children with ASD in inclusive classroom settings were reported to have fewer friends than their TD counterparts (Orsmond, Krauss, & Seltzer, 2004) and were oftentimes less accepted by their classmates (Chamberlain, Kasari, & Rotheram-Fuller, 2007), thereby increasing their risk of victimization (Hodges et al., 1997; Sigman & Ruskin, 1999). Conversely, there is evidence that inclusion in general educational settings can be beneficial because of increased contact with TD peers who may foster friendships (Robertson, Chamberlain, & Kasari, 2003), which protects against the effects of being bullied or teased (Fox & Boulton, 2006; Hodges et al., 1997). In one study, Van Roekel and colleagues (2010) measured rates of victimization in a sample of children with ASD who were enrolled in special-education schools and concluded that although self-reports of victimization (occurring at a rate of more than once per week) were comparable to those of TD children in general-education settings, teachers reported statistically significantly higher rates of victimization relative to children’s self-reports (46% vs. 17%, respectively). In related work, researchers gathered parent perceptions about frequency of victimization among 1,167 children with ASD (ages 6 to 15 years) using online survey methods. Preliminary findings suggested that, compared with children with ASD in general education public schools, children with ASD in public or private special education schools experienced lower rates of victimization (Anderson, 2012).

These inconsistent results about the relationship between bullying and educational placement are particularly important in light of federal regulations that help to ensure that children with ASD are increasingly included in general education settings. Furthermore, children identified with high-functioning ASD may not be considered eligible for special-education services because of their ability to meet mainstream academic standards; their higher intellectual skills may disguise the pervasive nature of their social deficits, thus resulting in decreased monitoring by staff (Shtayermman, 2007).

Reporter Perceptions of Bullying

Another important consideration is perception of bullying and how this may differ across reporters (i.e., student, school staff, parent). Using a web-based survey that queried both teachers and students about bullying, Bradshaw et al. (2007) discovered that school staff, particularly at the elementary-school level, significantly underestimated the prevalence of students affected by bullying. In contrast, Van Roekel et al. (2010) reported that, in their sample of children with ASD attending special-education schools, teachers tended to report more incidences of victimization than the students themselves did. This suggested that, within this self-contained setting, the students may have received closer monitoring such that teachers were able to observe more incidences of bullying. Within general education settings, however, bullying may occur largely outside of the classroom and, thus, not be directly observed by teachers, thereby explaining the lower teacher-report rate in this particular context (Van Roekel et al., 2010).

In terms of victim perception, children with ASD typically lack the capacity to understand the mental states of others (Frith & Hill, 2003) and may not identify victimization when it actually occurs; conversely, they may misinterpret others’ actions as bullying when, in fact, it is not. However, using videotaped vignettes, Van Roekel et al. (2010) demonstrated that individuals with ASD were just as able as their TD peers to perceive and report accurately on bullying behaviors when they were in the bystander role. Yet the more the adolescents with ASD were bullied themselves (per self and teacher report), the more they misinterpreted non-bullying situations as bullying.

Purpose

In sum, the extant research on bullying in children with ASD suggests that there are high rates of victimization among children with AD when compared with TD peers, but less is known about this phenomenon as it relates to both (a) children with diagnoses across the ASD spectrum and (b) individual child/adolescent characteristics (i.e., ASD-symptom severity, level of functioning). In addition, findings are mixed regarding the effects of classroom placement on the prevalence of victimization among those with ASD; it is not clear whether inclusive educational settings are more/less associated with bullying instances. Finally, most data are based on parent report; however, comparisons across multiple reporters are key to understanding possible differences in perceptions about the victimization of children with ASD. Consequently, there is value in closing the obvious gaps in this literature. Understanding more about this phenomenon could lead to the development of ASD-specific programs that may help affected individuals accurately interpret bullying from non-bullying and how to respond appropriately, as well as highlight the need for increasing monitoring and targeted trainings for adults working with ASD populations (Hunter, Boyle, & Warden, 2007; Shtayermman, 2007). With this in mind, the purpose of the current project was threefold: (a) to quantify and compare reports of teasing/bullying within samples of children with ASD and their TD siblings from teacher, parent, and child perspectives; (b) to investigate potential associations between age, level of overall functioning, ASD-clinical severity, educational placement, and victimization (was/was not teased) among the ASD sample; and (c) to examine self-reported teasing/bullying experiences among children with ASD and compare this against both parent and teacher report. This approach collectively addresses many of the limitations of prior studies, given its focus on children with diagnoses across the ASD spectrum, comparisons with a TD sibling group, and ascertainment of data from multiple perspectives (i.e., parent, teacher, child).

Method

Participants

The sample included 74 children with ASD between the ages of 6 and 18 (M age = 115. 7 months [9.6 years], SD = 32.5 [2.7 years], range = 74–204 [6.2–17 years]; 83.8% male) who participated in the Simons Simplex Collection (SSC) at Baylor College of Medicine (BCM). The SSC is a multi-site, genetic research project that includes families with only one child with an ASD (i.e., simplex families; Fischbach & Lord, 2010). As a comparison group, data were also ascertained on the TD siblings (n = 68) of the identified children with ASD (M age = 116.5 months [9.7 years], SD = 50.4 months, range = 253 months [21 years]; 52.9% male); these siblings had been rigorously screened to rule out ASD, broader autism phenotype (e.g., subclinical expression of ASD characteristics), and significant psychiatric conditions (e.g., schizophrenia, severe obsessive compulsive disorder). Children with a confirmed diagnosis of ASD who had a completed Child Behavior Checklist 6–18 (CBCL; Achenbach & Rescorla, 2009b) on file were included in the ASD sample. Likewise, siblings who had (at minimum) a completed CBCL on file were included in the TD sample. More specific demographic information pertaining to both groups is presented in Table 1. Families were recruited into the SSC at BCM through a variety of sources, including clinic waitlists at Texas Children’s Hospital (37.8%), professional referral or other-participant referral (18.9%), in-person recruitment events (i.e., autism walks, parent-support group meetings; 13.5%), internet listservs (10.8%), flyer and poster distributions (6.8%), or some other method (12.2%).

Table 1.

Descriptive Information for the ASD and TD Sibling Groups.

		Age		FSIQ		VIQ		NVIQ		VABS
Group	% Male	M	SD	M	SD	M	SD	M	SD	M	SD
ASD	83.8	115.7	32.5	88.5	24.0	86.1	29.8	90.69	20.9	72.0	9.4
TD	52.9	116.5	50.4	—	—	—	—	—	—	104.5	11.8

Note. ASD = autism spectrum disorder; TD = typically developing; FSIQ = full-scale IQ; VIQ = verbal IQ; NVIQ = non-verbal IQ; VABS = Vineland Adaptive Behavior Scales Adaptive Behavior Composite Score.

Instruments

As part of their participation in the SSC, children with ASD were administered several phenotypic measures, including the Autism Diagnostic Observation Schedule (ADOS; Lord et al., 2000) and either the Differential Ability Scales–Second Edition (DAS-II; Elliott, 2007) or the Mullen Scales of Early Learning (Mullen, 1995), depending on the child’s developmental level. The ADOS has been shown to have sound psychometric properties (Lord et al., 2000) and is considered a “gold-standard” instrument to aid the diagnosis of ASD (Ozonoff, Goodlin-Jones, & Solomon, 2005). Both the DAS-II and the Mullen possess moderate to strong reliability, as well as moderate to excellent convergent and divergent validity (Elliott, 2007; Mullen, 1995). A calibrated severity score (CSS) was calculated from the ADOS and was used as a measure of ASD severity (Gotham, Pickles, & Lord, 2009). A recent study that computed CSS scores from ADOS raw total scores (N = 1,415) lends support to the use of this index as a measure of ASD severity, independent of individual characteristics (e.g., age, verbal IQ; Gotham et al., 2009).

In addition, parents completed (a) the Autism Diagnostic Interview–Revised (ADI-R; Rutter, LeCouteur, & Lord, 2009) and a treatment history form that included information about school placement for the children with ASD and (b) the parent-report CBCL and the survey interview version of the Vineland Adaptive Behavior Scales–Second Edition (VABS-II; Sparrow, Cicchetti, & Balla, 2005) for both children with ASD and their TD siblings. The ADI-R has been shown to have strong psychometric properties, with excellent reliability and good concurrent validity (Rutter et al., 2009). Both the ADI-R and ADOS were administered by two different research-reliable examiners, and only those children who met diagnostic cutoffs on these instruments and received a clinical diagnosis of ASD were included within the ASD sample. The CBCL demonstrates high internal consistency and test–retest reliability, as well as adequate construct and criterion-related validity (Doll, Furlong, & Wood, 1998). Psychometric properties of the VABS-II are also sound, with good to excellent internal consistency; retest reliability coefficients ranging from fair to excellent and moderate to strong interrater reliability (Sparrow et al., 2005). Teachers of the children in both groups (ASD and TD) were asked to complete the Teacher Report Form 6–18 (TRF; Achenbach & Rescorla, 2009a). The TRF has adequate test–retest reliability and exhibits high construct and convergent validity (Christenson, 1992). It was voluntary for teachers to complete questionnaires associated with the study; therefore, TRF forms were not available on every individual (TRF n ASD = 49; TRF n TD = 39).

Procedures

Families were mailed a questionnaire packet that contained CBCL forms for the children with ASD and TD siblings, along with permission slips for the study team to contact the children’s teachers for completion of the TRF. Once families consented, questionnaire packets that included the TRF were mailed to the identified teachers; as with parents, they were instructed to complete all questionnaires and mail them back to the study team in a self-addressed, stamped envelope. In cases where a questionnaire item was left blank or the response was unclear, parents/teachers were either called to clarify their true response or the questionnaire was resent to that individual for proper completion.

After the completed parent-questionnaire packets were returned, parents cooperated by phone to complete the Medical History Interview (MHI) and the Treatment History Form (THF) on the child with ASD; in some cases, however, parents completed the THF by hand (i.e., it had been included in the parent packet). Following the MHI interview, parents completed the VABS-II survey interview form about TD siblings, also by phone. Families who continued to meet eligibility criteria for the SSC after review of all questionnaire and phone-interview data were then seen for an in-person evaluation that included psychological and cognitive testing for the child with ASD, as well as parent interviews about the child with ASD (i.e., ADI-R and VABS-II). Those who continued to meet study criteria throughout this in-person evaluation were submitted for inclusion in the SSC. All questionnaires (i.e., the CBCL and TRF) and in-person clinical assessment data (i.e., ADOS) were collected within a 3-month time period to meet quarterly data submission requirements. Questionnaire, interview, and clinical-assessment data were dual-entered and validated by two separate individuals using the RexDB® data-entry and management system.

Data on being teased for both children with ASD and their TD siblings were ascertained from parent and teacher ratings on the CBCL and TRF, respectively, for the item “Gets teased a lot.” Respondents rated the frequency of being teased for a given child based on a 3-point Likert-type scale: never, sometimes, or often. Severity of ASD symptomatology in children with ASD was operationalized using domain scores on the ADOS (Language and Communication, Reciprocal Social Interaction, Stereotyped Behaviors, and Restricted Interests), as well as the ADOS-derived CSS. Because of significant variability in the cognitive profiles of children with ASD, the full-scale IQ score (FSIQ) often is not the best representation of level of cognitive functioning; therefore, verbal and non-verbal IQ scores (VIQ and NVIQ, respectively) were also examined. Cognitive scores obtained were those reported in the database as being the most representative of each child’s cognitive functioning (i.e., where a deviation score could not be calculated, a ratio score was reported). Levels of adaptive functioning were ascertained using the VABS-II. Current educational placement, per the THF, was reviewed, and only those children in public-school settings were included in analyses involving educational placement.² For the TD sample, data regarding levels of cognitive functioning were not collected (per the SSC protocol); however, level of adaptive functioning was assessed with the VABS-II. Qualitative data from a subgroup of children with ASD (n = 50), who had been administered Module 3 of the ADOS (indicating a higher level of language capability), were also included in the present study to afford an understanding of being bullied from the child’s perspective. Module 3 is the only ADOS module that asks, “Have you ever been teased or bullied?” Children’s responses to this question were extracted, coded, and tabulated.

Statistical Analyses

The frequencies of being teased/bullied in both the ASD and TD samples were calculated using item responses on the CBCL (parent report) and the TRF (teacher report). Responses were recorded as 0 = never, 1 = sometimes, or 2 = often; for analyses that focused on any degree of teasing, scores of 1 and 2 were collapsed to generate dichotomous variables (i.e., 0 = never teased, 1 = teased). To investigate demographic characteristics potentially associated with incidences of teasing in the ASD sample, correlations were calculated between select phenotypic factors and endorsement of the child being bullied by parents and teachers (separately). Specific variables of interest were age of child with ASD, ADOS domain and total scores, CSS, FSIQ, NVIQ, VIQ, and time spent in special-education and general-education settings within a public school setting.

In addition, perceptions of victimization among verbally fluent children with ASD were assessed via responses to the question, “Have you ever been teased or bullied?” on Module 3 of the ADOS. These data were coded using the following system:

0–The child responded “No” (without further elaboration).

1–The child responded “Yes” and provided an example that demonstrated unclear understanding of being teased/bullied.

2–The child responded “Yes” and provided an example that demonstrated a clear description/understanding of being teased/bullied.

Examples of responses for each categorical rating can be found in Table 2. Qualitative data were initially analyzed by the first author using the coding scheme outlined above; statement categorizations were reviewed by all co-authors to ensure agreement with coding classifications. Although the sample size for these qualitative data was small, it was not clear that children who provided a “1” response accurately understood whether they had been teased/bullied; thus, the “1” responses were discarded in final analyses. Agreement between child report of being bullied (per ADOS Module 3 responses) and both parent and teacher report was analyzed using the chi-square test of homogeneity. For all analyses, missing data were removed listwise to preserve power.

Table 2.

Examples of Responses to Question “Have You Ever Been Teased or Bullied?” on the ADOS Module 3.

Code	Example response
2	“All the time. People call me names. You don’t want to know. I know I’m not the only one bullied. I counted 23 bad words from them, 46 words in total. I said, ‘Don’t fight, this is going to lead to havoc.’”
	“Sometimes. Most people hate me ‘cause they always tease me. About how I watch those stupid kids’ shows but I don’t.”
	“Yes, C called me white boy to make himself feel better because he has a bad life.”
1	“Last year, not that much. I don’t know.”
	“Mm, I don’t know. Probably just for fun.”
	“Yes. C at lunch; C does that to me.”
0	“No.”

Note. ADOS = Autism Diagnostic Observation Schedule.

Results

Parents reported that 63.5% of children with ASD and 7.7% of the TD siblings were teased, and this difference was statistically significant, χ²(1) = 32.26, p < .0001. Teacher reports of being teased for the ASD sample were significantly lower than parent reports—40.8% versus 63.5%, χ²(1) = 6.12, p = .013; yet they also indicated that children within the ASD sample were teased at a higher rate than those in the TD sibling sample (7.7%), χ²(1) = 12.34, p < .0001. These results are presented in Figure 1.

Figure 1.

Parent and Teacher Reports of Teasing Per the CBCL and TRF Among Probands With ASD and Typically Developing Siblings.

Significant positive correlations were obtained between parent reports of teasing and child age, FSIQ, VIQ, and time spent in regular-education classes for the ASD sample (see Table 3). In these cases, higher levels of intellectual and verbal functioning, older ages, and more time spent in inclusive educational settings were associated with increased rates of being teased. Significant negative correlations were yielded between parent reports of teasing and all indices of ASD severity, as well as time spent in special education. These results similarly indicated that those children with ASD who exhibited less autism severity and who spent less time in special-education settings were more likely to have been teased. No significant associations were observed between teacher reports of teasing and any of the selected demographic characteristics.

Table 3.

Correlations Between Parent and Teacher Reports of Bullying/Teasing Among Individuals With ASD and Select Demographic Characteristics.

Variable	Parent report	Teacher report
Participant age	.21*	−.02
ADOS communication	−.37**	.12
ADOS RSI^b	−.31**	.17
ADOS RRB^c	−.25*	.02
ADOS total	−.32**	.11
CSS	−.24*	.13
FSIQ	.26**	−.07
NVIQ	.17	−.12
VIQ^g	.31**	−.03
Time in special ed.	−.26*	.04
Time in general ed.	.23*	.06

Note. ASD = autism spectrum disorder; ADOS = Autism Diagnostic Observation Schedule; RSI = reciprocal social interaction; RRB = restricted and repetitive behaviors; CSS = calibrated severity score; FSIQ = full-scale IQ; NVIQ = non-verbal IQ; VIQ = verbal IQ.

p < .05. **p < .001.

Using the aforementioned coding system for the ASD sample’s qualitative responses to being teased/bullied per the ADOS Module 3, 30 responses were coded as “0,” 11 responses were coded as “1,” and 9 responses were coded as “2.” Because of the markedly ambiguous responses under the “1” category, all “1” responses were excluded in subsequent analyses. This conservative decision was made to enhance clarity in the interpretation of results. When children did not report being bullied/teased (e.g., coded a “0”), 73.3% of the parents and 42.1% of the teachers disagreed (i.e., had said the child was bullied); when the children did report being teased/bullied (e.g., coded a “2”), 88.9% of the parents and 37.5% of the teachers were in agreement; these proportions were not statistically significant, Fisher’s exact = .662, p = .355 (child vs. parent report) and Fisher’s exact = .695, p = .414 (child vs. teacher report). Interestingly, when children did espouse being bullied/teased, 62.5% of the teachers, but only 11.1% of the parents, said that the children were not victimized (see Table 4).

Table 4.

Agreement/Disagreement Between Child, Parent, and Teacher on Bullying/Teasing Experiences.

	Teacher		Parent
Child report	No	Yes	No	Yes
Yes	62.5%	37.5%	11.1%	88.9%
No	57.9%	42.1%	26.7%	73.3%

Discussion

The purpose of the current project was threefold: (a) to quantify reports of being teased among samples of children with ASD and their TD siblings from teacher, parent, and child perspectives; (b) to investigate associations between child age, level of cognitive functioning, ASD-clinical severity, educational placement, and prevalence of victimization among the ASD sample; (c) and to codify child responses to a question about being teased/bullied on the ADOS and compare this against parent and teacher report. Findings supported previous research in that children with ASD were proportionally more likely to be teased when compared with TD children. With regard to differences across respondents, parents and teachers were in agreement in terms of the prevalence of victimization among the TD siblings (7.7% vs. 7.7%, respectively). However, there was a significant discrepancy between parent and teacher endorsement of teasing in the ASD sample (63.5% vs. 40.8%, respectively). This finding is consistent with previous research (Card & Hodges, 2008), suggesting that teachers may underreport incidences of victimization. Lower teacher endorsement of children being teased may result from several factors. First, teachers may not be in a position to directly observe all teasing behaviors, and many incidences of victimization—particularly relational bullying (e.g., gossip, ostracism)—may go unnoticed (Card & Hodges, 2008). In addition, teachers may rely on student reports of bullying rather than direct observation, and even many TD children do not report incidences of bullying to teachers (Card & Hodges, 2008). Because children with ASD often misperceive the behaviors and intentions of others, this may result in significant underreporting of bullying to teachers among the ASD population, even when compared with TD peers. In the current study, approximately 70% of the parents and 40% of teachers who responded, reported bullying/teasing when the child did not, which supports the hypothesis that children with ASD are underreporting bullying to both parents and teachers. Second, some children with ASD may inaccurately perceive what constitutes teasing or bullying. As observed in the current study, when they report such an incidence, they either (a) may not be able to describe it to the extent that it is taken seriously or (b) their description is so ambiguous that the recipient does not interpret it to be an example of bullying. Alternatively, it is possible that parental reports of bullying/teasing may be an overestimate of true incidences if they are based on their children’s reports of victimization, which may be inaccurate or reliant on misperceptions of behaviors that do not fit the criteria for bullying or teasing (Van Roekel et al., 2010). Finally, the discrepant findings across reporters may be a consequence of what the respondents believe constitutes teasing, with parents having a lower threshold than teachers.

With regard to demographic characteristics associated with reports of victimization, parents were significantly more likely to endorse that their child with ASD had been teased when the child was older (r = .21, p < .05). In addition, reports of victimization increased when the child with ASD was higher functioning (i.e., had a higher FSIQ and/or a higher VIQ) and when he/she exhibited less severe ASD symptomatology (i.e., lower scores on the ADOS subscales and CSS). This is an interesting discovery that could be explained in a couple of different ways. First, given the significant emphasis on “zero tolerance” of bullying within school settings, together with implementation of curricula to address the presence of bullying, there is likely a heightened awareness of teasing directed toward children with more obvious impairments/differences. In the same vein, children who—by appearance—seem “typical” but behave in unusual ways or lack appropriate social skills may be more of a target to bullies and not monitored as closely by teachers as are more severely affected children. Second, it seems possible that higher-functioning children with ASD are more aware of the fact that they are being teased and may respond in a way that is reinforcing for the bully (i.e., the bully gets the reaction he/she was seeking), which may encourage repeated incidents. Lower-functioning children, if teased, may not acknowledge the behavior and, thus, the effort is not reinforcing for the bully.

It is remarkable that, in contrast to parent report, significant correlations were not found between teacher reports of teasing and the demographic characteristics of interest (i.e., age, FSIQ, VIQ, CSS, ADOS domain scores). The absence of associations here may result primarily from the fact that teachers, in general, reported fewer incidences of victimization in the ASD population. However, it also suggests that when teachers do observe teasing in this population, it either (a) does not follow the same pattern as that observed by parents or (b) teachers’ perceptions of teasing may be influenced by different contextual factors. Other research has demonstrated similar parent–teacher discrepancies in perceptions of ASD samples yet congruence for TD samples. For example, Kanne, Abbacchi, and Constantino (2009) observed that parents reported substantially higher frequencies of comorbid psychiatric symptoms among their children with ASD compared with teacher reports, but that parent and teacher reports were much more consistent for the siblings of the children with ASD. This highlights the importance of considering the context in which behaviors are observed, particularly for children with ASD.

With regard to educational placement, 58% of the sample were in inclusive educational settings, whereas the remainder were placed in special-education classrooms. The percentage of the school day spent in each setting was 50.3% and 23.3% for general versus special education, respectively. Parents were more likely to endorse that their child with ASD had been teased when they spent more time in a general-education setting. This finding is consistent with some prior reports, suggesting that inclusion with TD peers (i.e., more time in general education) puts children at higher risk of bullying (Sigman & Ruskin, 1999). Provision of in-class support did not correlate with reports of teasing, which is surprising, given previous reports of increased victimization in children who are identified as receiving special education either within specialized classes or schools (Chamberlain et al., 2007; Norwich & Kelly, 2004). It may be that the influence of educational placement is specific to the population being investigated. For example, children with learning difficulties may become targets because of their academic underachievement (e.g., difficulties with reading), whereas children with ASD may be victimized because they display unusual behaviors. This is an area worthy of further research so that those working with these populations understand the specific risk factors, can appropriately structure educational settings, and can more closely monitor for victimization.

Based on children’s qualitative self-reports, approximately half denied being bullied or teased; another quarter espoused being bullied/teased but could not provide a coherent example of their experience. This suggests that the majority of these children either (a) may not recognize when they are being bullied, if and when it is taking place, and/or (b) may misinterpret what constitutes bullying. This finding is of particular relevance given that one strategy for coping with bullying, which is frequently taught and reinforced in schools, is to report bullying/teasing to an adult. If the child with ASD is misperceiving bullying behaviors, they may either over report incidences that are deemed trivial or fail to report incidences that constitute real bullying. Furthermore, children with ASD, by definition, lack the reciprocal social skills with which to navigate peer relationships and may react to the behaviors of others in ways that are inappropriate to the situation. For example, they may overreact, under react, or perceive that the bully is trying to be friendly. Either way, their behaviors may reinforce the bully’s behavior, or they may result in their own punishment if their reaction is highly inappropriate (i.e., hitting a child who laughed at him or her). Given that teasing is recognized as a complex and ambiguous behavior, it seems particularly important to help children with ASD distinguish between teasing (as well as other bullying behaviors) that they should report and prosocial behaviors (e.g., a peer trying to be helpful, a peer telling a joke).

Limitations

The quality of phenotypic data for this study was exceptional, the data were gathered from multiple perspectives, and the sample was more representative of children across the ASD spectrum than those in previously published studies; however, there are limitations that should be noted. First, the study was cross-sectional in nature; thus, inferences about causation cannot be made. Second, in-depth assessment of a range of bullying behaviors was not administered, which is a limitation inherent to the use of the SSC data set. Respondents were only able to endorse the presence or absence of teasing per the CBCL/TRF, or, in the case of the children with ASD who were able to self-report, respond to one question about being teased/bullied on the ADOS Module 3. However, it should be noted that the use of single-item responses, particularly when attempting to incorporate data from multiple perspectives, is not uncommon in bullying research (e.g., Van Cleave & Davis, 2006; Wiener & Mak, 2009). For example, in their 2006 study, Van Cleave and Davis asked their respondents (parents/caregivers) a single question to ascertain whether their child had been bullied. Other investigators have also relied on single-item measures for constructs of interest (e.g., aggression, friendships) within the SSC (e.g., Kanne & Mazurek, 2011; Mazurek & Kanne, 2010). Third, teasing was not defined for any respondents, as the SSC was interested in gathering general developmental/psychiatric data. Therefore, the understanding of what constitutes teasing may have varied across respondents. On a related note, the CBCL/TRF item does not allow for parents or teachers to provide detailed information about the form of teasing observed and does not delineate whether their report is based on direct observation or child/adolescent report. Likewise, the ADOS is not designed to be used as a self-report measure of bullying, and follow-up questions or probes to help elucidate forms of possible teasing/bullying are not a component of the instrument. However, for the purposes of this investigation, asking the children a question that was similar in format to the question posed to teachers and parents facilitated comparison across respondents.

While the sample population is representative of a wide range of levels of functioning, families self-referred to be included in the SSC, which was largely marketed as a genetic-factors study of ASD, and met very strict inclusion criteria for that project. Thus, the current sample may not be representative of the broader population of families of children with ASD. However, because the SSC study was not advertised specifically as an investigation about teasing/bullying, responses from parents and teachers could potentially be less biased than when they know that their perceptions of teasing/bullying are the primary focus of the study, which is a unique strength of this work.

Finally, as noted in the review of existing literature, increased risk of bullying is not limited to children with ASD (Knox & Conti-Ramsden, 2007; Norwich & Kelly, 2004; Van Cleave & Davis, 2006; Wiener & Mak, 2009). A clinical comparison group was not included in the current study; therefore, it cannot be concluded that the results described are necessarily specific to children with ASD.

Future Directions

It may be useful to re-contact the families in the current sample with a more in-depth measure of bullying to ascertain frequency by type of bullying. Ideally, collecting in-depth information from parents and teachers as to the types of bullying they observe may shed light on the discrepancy between parent and teacher reports. In addition, completing a structured interview with identified children with ASD regarding their perceptions and responses would be useful in determining whether there are specific patterns of misperceived behaviors.

Findings from this study support some previous results and are consistent with the realization that children with ASD are at increased risk of being teased/bullied. This may be especially true for children who demonstrate higher cognitive abilities, less ASD-symptom severity, and are included in regular-education settings for a large portion of their day. Of particular significance was the finding that parent and teacher reports are discrepant regarding incidences of teasing in the ASD population, and while it is not entirely clear why this is the case, it does focus our attention on the importance of closely monitoring children with special needs, particularly those who are higher functioning, and the need for additional teacher training in the identification of all forms of victimization. Furthermore, results from this work suggest the need for social-skills instruction for children with ASD that focuses on accurately identifying and appropriately responding to teasing/bullying incidents.

Footnotes

Acknowledgements

We are grateful to all of the families at the participating SFARI Simplex Collection (SSC) sites, as well as the principal investigators (A. Beaudet, R. Bernier, J. Constantino, E. Cook, E. Fombonne, D. Geschwind, E. Hanson, D. Grice, A. Klin, R. Kochel, D. Ledbetter, C. Lord, C. Martin, D. Martin, R. Maxim, J. Miles, O. Ousley, K. Pelphrey, B. Peterson, J. Piggot, C. Saulnier, M. State, W. Stone, J. Sutcliffe, C. Walsh, Z. Warren, E. Wijsman). We appreciate obtaining access to phenotypic data on SFARI Base.

Authors’ Note

Approved researchers can obtain the SSC population data set described in this study (https://ordering.base.sfari.org/~browse_collection/archive[sfari_collection_v8_2]/ui:view()) by applying at .

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by a grant from the Simons Foundation (SFARI SSC-15 to R. Goin-Kochel and A. Beaudet).

Notes

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