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The experience of friendship, victimization and

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Research in Autism Spectrum Disorders

Journal homepage: http://ees.elsevier.com/RASD/default.asp

The experience of friendship, victimization and bullying in children with

an autism spectrum disorder: Associations with child characteristics and
school placement
Emma Rowley a, Susie Chandler b, Gillian Baird c, Emily Simonoff d, Andrew Pickles d,
Tom Loucas e, Tony Charman b,*
a
Child Development & Disability Service, City & Hackney Teaching Primary Care Trust, London, United Kingdom
b
Centre for Research in Autism and Education, Department of Psychology and Human Development, Institute of Education, London, United Kingdom
c
Guys & St Thomas NHS Foundation Trust, London, United Kingdom
d
Institute of Psychiatry, Kings College London, United Kingdom
e
School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom

A R T I C L E I N F O A B S T R A C T

Article history: Children with an autism spectrum disorder (ASD) may be vulnerable to social isolation and
Received 16 January 2012 bullying. We measured the friendship, ghting/bullying and victimization experiences of
Received in revised form 8 March 2012 1012-year-old children with an ASD (N = 100) using parent, teacher and child self-report.
Accepted 8 March 2012 Parent and teacher reports were compared to an IQ-matched group of children with
special educational needs (SEN) without ASD (N = 80) and UK population data. Parents and
Keywords: teachers reported a lower prevalence of friendships compared to population norms and to
Autism spectrum disorders children with SEN without an ASD. Parents but not teachers reported higher levels of
Friendship
victimization than the SEN group. Half of the children with an ASD reported having
Bullying
friendships that involved mutuality. By teacher report children with an ASD who were less
Victimization
School placement
socially impaired in mainstream school experienced higher levels of victimization than
more socially impaired children; whereas for more socially impaired children victimiza-
tion did not vary by school placement. Strategies are required to support and improve the
social interaction skills of children with an ASD, to enable them to develop and maintain
meaningful peer friendships and avoid victimization.
2012 Elsevier Ltd. All rights reserved.

1. Introduction

Peer friendships are a signicant social experience for children and adolescents, constituting a basic and essential
affective relationship based upon reciprocal, stable interactions within the context of a close and relatively long-term tie
(Dunn, 1993). Moreover, friendship provides children with a context within which to develop and practice fundamental
prosocial behaviours, including mutual caring, companionship, and empathy. Thus, friendship both requires and helps to
develop social skills, contributing to all areas of development including cognitive and language ability, symbolic thinking
and emotional understanding; as well as providing the child with a sense of belonging and self-worth (Bagwell, Newcomb,
& Bukowski, 1998).

* Corresponding author.
E-mail address: t.charman@ioe.ac.uk (T. Charman).

1750-9467/$ see front matter 2012 Elsevier Ltd. All rights reserved.
doi:10.1016/j.rasd.2012.03.004
 Author's personal copy

E. Rowley et al. / Research in Autism Spectrum Disorders 6 (2012) 11261134 1127

1.1. Friendship in children with an autism spectrum disorder

Autism spectrum disorders (ASDs), the common clinical term for childhood autism and the related pervasive
developmental disorders (PDDs) described in the psychiatric classication systems (APA; DSM-IV-TR, 2000; WHO; ICD-10,
1993) are neurodevelopmental disorders characterized by impairments in social interaction and communication and by
rigid behaviour. The diagnostic criteria include a failure to develop appropriate peer relationships. Not surprisingly, the
research literature suggests that children with an ASD may struggle to initiate play with their peers, preferring structured
activities that provide clear and explicit rules, with low levels of social exchange (Bauminger & Shulman, 2003). As a result,
they may have limited experience with their peers, lacking the social skills and know how of friendship building (e.g.
Lawson, 2001). Social interaction can be a stressful and anxiety-provoking experience for children with an ASD (Carrington,
Templeton, & Papinczak, 2003), not least because they often lack adequate understanding of the social hierarchy that exists
in schools (Sainsbury, 2000). Despite this, research has shown that children with an ASD desire social relationships and
identify feelings of loneliness signicantly more often than typically developing children (Bauminger & Kasari, 2000).
Moreover, personal accounts of the experience of people with ASD have not only demonstrated their ability to reect on their
own social relationships, but also highlighted the importance of such relationships in their lives (Hurlbutt & Chalmers, 2002;
Jones & Meldal, 2001). Some children with an ASD want a friend but do not appreciate that for age peers this would usually
involve social reciprocity, shared interests and turn-taking. At times children with ASD may show rigidity in friendships by
dominating conversations and activities, lecturing, etc. This suggests that, whilst children with ASD may experience
additional challenges in forming social relationships, their desire for inclusion within a friendship group, and conversely the
impact of exclusion from such groups, may impact on their quality of life and psychological wellbeing.

1.2. Bullying and victimization

Bullying is dened as the systematic, repeated abuse of power involving physical and verbal abuse as well as acts of
indirect aggression, characterized by gossiping, spreading malicious rumours and deliberate attempts at exclusion from
the childs social peer group (Smith & Sharp, 1994). Bullying and peer victimization are associated with both short- and
long-term negative psychological outcomes for children (Juvonen, Nishina, & Graham, 2000; Nansel et al., 2001). It is
well-established that a number of children who are victimized by other children also show bullying behaviour towards
others (Solberg, Olweus, & Endresen, 2007). Children with cognitive and physical disabilities have been shown to be at
greater risk of bullying and social exclusion than their non-disabled peers (Thompson, Whitney, & Smith, 1994; Van
Cleave & Davis, 2006). Among children with disabilities, severity of a childs disability has been associated with lower
peer acceptance in mainstream school settings (Cook & Semmel, 1999). Furthermore, children with disabilities report
that peer relationships and exclusion from social groups are ongoing problems throughout their school life (Lightfoot,
Wright, & Sloper, 1998).

1.3. Bullying in children with an autism spectrum disorder

Given the additional social challenges experienced by children with an ASD in forming social relationships they are likely
to be at greater risk of social isolation and peer relationship difculties than their typically developing peers. A UK National
Autistic Society parental survey found that over 40% of children with an autism spectrum disorder have experienced bullying
and peer victimization at school (Batten, Corbett, Rosenblatt, Withers, & Yuille, 2006). Even higher gures were found in a
large web-based parental survey (75%; Little, 2001) and a small in-depth interview study (73%; Wainscot, Naylor, Sutcliffe,
Tantam, & Williams, 2008). In a large sample of adolescents with an ASD and average intelligence (Van Roekel, Scholte, &
Didden, 2010) rates of teacher-, peer- and self-report of bullying victimization varied between 6% (for peer-report of
victimization) and 46% (for teacher-report of bullying). A recent UK study found that pupils with ASD experienced higher
frequency of bullying than pupils with other special educational needs (SEN; pupils with dyslexia) and pupils without
identied SEN (Humphrey & Symes, 2010).
Little research has explored the specic factors that increase the vulnerability of children with an ASD to bullying.
Children with an ASD often struggle to decipher the intricacies of nonverbal behaviour such as tone of voice, gestures, facial
expressions and body language. Moreover, their literal interpretation of language can make it hard to understand social rules
and the motives of other children when it comes to sharing jokes, making them an easy target for derision and mockery. In
addition, their restricted and sometimes unusual range of interests, repetitive behaviours and narrow focus of conversation
can cause them to stand out as different, compounding their isolation and making them more prone to teasing and rejection
by their peers (Carrington & Graham, 2001).
In the UK, as elsewhere, there have been initiatives to facilitate the inclusion of children with an ASD into mainstream
educational settings. This can present parents with a considerable dilemma: whilst their child may be able to cope well with
the academic demands of a mainstream school setting, their social integration difculties may put them at a disadvantage
when it comes to forming and maintaining friendships with their peers and avoiding victimization. Some evidence suggests
that, in certain situations, mainstream school placements may lead to increased rejection of children with disabilities
(Macmillan, Gresham, & Forness, 1996; Ochs, Kremer-Sadlik, Solomon, & Gainer Sirota, 2001), with severity of a childs
disability being associated with lower peer acceptance (Cook & Semmel, 1999). One assumption that is sometimes made by
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1128 E. Rowley et al. / Research in Autism Spectrum Disorders 6 (2012) 11261134

parents and professionals is that such peer relationship difculties may be reduced or avoided within a special education
context with structured support and lower social demands.

1.4. The current study

Thus whilst over the past decade there have been an increasing number of reports of aspects of friendship and bullying/
victimization in children and young people with ASD, to date few studies have attempted to triangulate parent, teacher and
self-report of friendships and bullying/victimization in ASD and many samples in the literature have been small and not
well-characterized. We took advantage of information collected as part of a prevalence study of ASD (The Special Needs and
Autism Project (SNAP); Baird et al., 2006) to examine data on the experiences of friendship, victimization (being bullied) and
of bullying (or ghting with) other children in a large sample of children with an ASD. Our rst aim was to provide descriptive
data on friendships and victimization in a large, well-characterized sample of children with an ASD using multiple methods:
parent, teacher and child self-report. Rates were compared to population data and to levels in an IQ-matched group of
children with SEN but not an ASD. The sample included children attending mainstream and special schools. We also explored
whether friendships and experiences of bullying were systematically associated with the following child characteristics:
type of school, IQ, language ability, and severity of social, communication and repetitive impairments.

2. Method

The study was approved by the South East Multicentre Research Ethics Committee (REC) (00/01/50).

2.1. Participants

The children in this study were a subsample (N = 100) of the Special Needs and Autism Project (SNAP) sample drawn from
a total population cohort of 56,946 children (Baird et al., 2006). Each child received a comprehensive diagnostic assessment
including standardized clinical observation (Autism Diagnostic Observation Schedule-Generic (ADOS-G; Lord et al., 2000))
and parent interview assessments of autistic symptoms (Autism Diagnostic Interview-Revised (ADI-R; Lord, Rutter, & Le
Couteur, 1994)), adaptive behaviour (Vineland Adaptive Behavior Scale (VABS; Sparrow, Balla, & Cichetti, 1984), language
and IQ, psychiatric comorbidities and a medical examination. The team (GB, ES, TC) used International Classication of
Diseases (ICD-10) research criteria to derive a clinical consensus diagnosis of childhood autism (N = 45) and other ASDs
(N = 55) (see Baird et al., 2006; for details). The one hundred 1012 year old (mean (SD) age in months = 137.2 (8.3)) children
(88 boys and 12 girls) included in the present report all completed Module 3 of the ADOS-G meaning that self-report of
friendship and bullying experiences was available in addition to parent and teacher report. All 100 children were uent in
spoken English. For the purposes of the current report sections of the ADOS videotapes had to be reviewed and transcribed
and the rst 100 (from a total of 117) ADOS Module 3s available for children with an ASD diagnosis were coded in this way.
In the UK children with ASD and other special educational needs can be placed in mainstream schools, in mainstream
schools with special supportive units or resources bases or in special school. The setting any individual child is educated in
will vary according to child characteristics, parental preference and local service provision. Fifty-one of the children with an
ASD were attending mainstream schools, whilst 49 attended special schools or special units (attached to mainstream
schools), including schools/units for children with moderate and severe intellectual disability and a number of specialist
schools/units for children with an ASD.
Parent and teacher reports from the Strengths and Difculties Questionnaire (SDQ; see below) were compared to
population norms. However, from the SNAP sample we also had parent (N = 80) and teacher (N = 74) SDQ data on a same age
IQ-matched group of children with SEN but not an ASD. These children met clinical consensus ICD-10 criteria for an
intellectual disability (N = 43), language disorder (N = 10), hyperkinetic disorder (N = 13) and a number of other
neurodevelopmental conditions (N = 14).

2.2. Measures

2.2.1. Parent and teacher report of friendships, ghting/bullying and victimization (being bullied)
Parents of 95 children with an ASD and teachers of 86 children with an ASD and parents of 80 children with an SEN but not
ASD and teachers of 73 children with an SEN but not ASD had completed the Strengths and Difculties Questionnaire (SDQ-P
and SDQ-T, respectively; Goodman, 1997). Three individual items were used in the current analysis: Has at least one good
friend, Often ghts with other children or bullies them and Picked on or bullied by other children. Each item is rated on a 3-
point ordinal scale: 0 (Not true), 1 (Somewhat true) 2 (Certainly true). Parents are asked to rate their childs behaviour over
the past six months; teachers in the current school year. UK normative data are available on the parent and teacher SDQ
(Green, McGinnity, Meltzer, Ford, & Goodman, 2005; Meltzer, Gatwood, Goodman, & Ford, 2000). Endorsement of the SDQ
items in the current sample were compared to those of the combined 1999 (Meltzer et al., 2000) and 2004 (Green et al., 2005)
samples for boys aged 1115 years (N = 4076; kindly supplied by Robert Goodman, personal communication, 12 November
2008).
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E. Rowley et al. / Research in Autism Spectrum Disorders 6 (2012) 11261134 1129

2.2.2. Child self-report of friendships and victimization (being bullied)

The Autism Diagnostic Observation Schedule-Generic (ADOS-G; Lord et al., 2000) is a widely used, standardized
diagnostic assessment tool, which uses semi-structured activities, questioning and conversation to assess the childs
communication, reciprocal social interaction, play or imagination, stereotyped behaviours and restricted interests. Module 3
is intended for verbally uent children who are able to produce a range of sentence types, and can use language to provide
information about events out of the context of the immediate situation. In addition to a number of play-based tasks and
activities, the template for the Module 3 interview involves the examiner asking about and providing prompts for the child to
talk in some detail about his/her own experience and understanding of friendship (interviewer prompts include: Do you
have some friends?, What do you like to do together?, What does being a friend mean to you?). It also has a sections asking
whether they have experienced difculties getting along with other children at school, whether they have ever been teased
or bullied, and his/her understanding of why this might be (interviewer prompts include: Do you ever have trouble getting
on with other children at school?; Were you ever teased or bullied? Why, do you think?). Clearly, child characteristics
including cognitive and language ability and degree of social impairment and of insight will affect both how a child
understands these questions and how they respond. However, in an attempt to use this available self-report material the
childrens responses to these sections were transcribed verbatim.
The transcripts were coded for friendship and victimization experiences using two separate 6-point ordinal scales,
developed for the purposes of this study. On the Friendship scale zero represented least well developed friendships (i.e. child
unable to name any friends) and ve represented most well developed friendships (i.e. has best friend or condent, involving
mutuality). On the Victimization scale zero was given to children who reported never having experienced any form of
bullying, teasing, exclusion or peer victimization and a score of ve was given to those children who described having
experienced frequent regular victimization and bullying in the form of verbal teasing, physical aggression or a combination
of these, deliberately directed towards them by his/her school peers. Thirty randomly selected transcripts were scored by a
second rater nave to the purpose of the study and high inter-rater agreement was achieved on both scales (intraclass
correlation coefcient = 0.88 for Friendships scale and 0.94 for Victimization scale, respectively). In a small number of cases
(N = 11), it was not possible to assign friendship or bullying scores, since the childs verbal account was too limited or
ambiguous to allow for accurate scoring and Friendship and Victimization scores are reported for the remaining 89 children.
Ninety-nine of the children with an ASD completed the Wechsler Intelligence Scale for Children (WISC-III-UK edition;
Wechsler, 1992). For one ASD case and 2 SEN non-ASD cases imputed full-scale IQs from the regression of full scale IQ on
Ravens Standard Progressive Matrices (SPM; Raven, Court & Raven, 1990) in the full sample. Ninety-nine children completed
the British Picture Vocabulary Scale (BPVS 2nd Edn.; Dunn, Dunn, Whetton, & Burley, 1997) a measure of receptive
vocabulary. ADOS-G social and communication domain scores were used as measures of current symptom severity.

2.3. Analysis

For comparison between the ASD and SEN groups and to compare to the UK norms we examined differences between 0/1
(Not true; Somewhat true) and 2 (Certainly true) for each SDQ item using chi-square tests. Odds ratios (OR) and 95%
condence intervals (CI) were calculated using the Wald procedure. Agreement between parent and teacher scores on the
SDQ items was examined using Cohens kappa. Ordinal regression was used to examine association between variables.
Group mean differences in child background characteristics in mainstream vs. special school were examined using t-tests.
Ordinal SDQ item scores and child Friendship scale and Bullying scale scores were examined using MannWhitney non-
parametric tests. All analyses were conducted using Stata 9 (Stata, 2005).

3. Results

The ASD groups mean full-scale IQ was 80.2 (SD = 20.0), not signicantly different (t(178) = 0.77, p = 0.44) from the SEN
group with mean 78.0 (18.7). The ASD groups mean receptive language score on the BPVS was 89.4 (16.6), higher than that of
the SEN group (84.0 (16.2); t(176) = 2.18, p = 0.03).
Parent and teacher scores on the three SDQ items examined are shown in Table 1. One third of parents and one half of
teachers reported that it was certainly true that the children with an ASD had a best friend; a lower proportion than in UK
norms where the large majority of parents and teachers indicated that children certainly had a best friend (x2(1) = 443.0,
OR = 0.037 (95% CI 0.0230.058), p < 0.0001; and x2(1) = 30.0, OR = 0.313 (0.2020.485), p < 0.0001, respectively). The ASD
group were also reported by parents but not teachers to have a best friend compared to the SEN group (x2(1) = 24.5,
OR = 0.205 (0.1080.360), p < 0.0001 and x2(1) = 0.21, OR = 0.863 (0.4581.624), p = 0.65, respectively). One-in-seven
parents of children with an ASD reported that their child certainly fought with or bullied other children. This was higher
than the UK norms (x2(1) = 40.3, OR = 5.85 (CI 3.1610.83, p < 0.0001) but not different to the distribution for children with
SEN without an ASD (x2(1) = 0.51, OR = 1.41 (0.5523.59), p = 0.47). Teacher reported ghting and bullying in the ASD group
(7.6%) did not differ from either the UK norms (x2(1) = 2.12, OR = 1.86 (0.7964.36), p = 0.15) or the SEN group (x2(1) = 1.27,
OR = 0.54 (0.1831.60), p = 0.26). Being picked on or bullied by other children was rated certainly true by one third of
parents of children with an ASD, higher than the UK norms (x2(1) = 79.4, OR = 6.02 (3.859.40), p < 0.0001) and children with
SEN without an ASD (x2(1) = 7.27, OR = 2.75 (1.305.82), p = 0.007). Teacher report of victimization (11.6% certainly true) in
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1130 E. Rowley et al. / Research in Autism Spectrum Disorders 6 (2012) 11261134

Table 1
Parent and teacher SDQ items reporting on friendships, ghting/bullying other children and bullying/victimization.

Parent SDQ item ASD group SEN group UK norms boys 1115 years

(N = 95) N (%) (N = 80) N (%) N (%)

Has at least one good friend Not true 30 (31.6%) Not true 6 (7.5%) Not true 88 (2.2%)
Somewhat true 33 (34.7%) Somewhat true 17 (21.3%) Somewhat true 182 (4.5%)
Certainly true 32 (33.7%) Certainly true 57 (71.2%) Certainly true 3,748 (93.3%)

Often ghts with other Not true 59 (62.1%) Not true 58 (73.4%) Not true 3,555 (88.5%)
children or bullies them
Somewhat true 23 (24.2%) Somewhat true 13 (16.5%) Somewhat true 356 (8.9%)
Certainly true 13 (13.7%) Certainly true 8 (10.1%) Certainly true 106 (2.6%)

Picked on or bullied Not true 26 (27.7%) Not true 36 (45.6%) Not true 2,954 (73.7%)
by other children
Somewhat true 37 (39.4%) Somewhat true 31 (39.2%) Somewhat true 752 (18.8%)
Certainly true 31 (33.0%) Certainly true 12 (15.2%) Certainly true 303 (7.6%)

Teacher SDQ item ASD group SEN group UK norms boys 1115 years

(N = 85) N (%) (N = 74) N (%) N (%)

Has at least one good friend Not true 24 (28.2%) Not true 10 (13.7%) Not true 137 (4.6%)
Somewhat true 14 (16.5%) Somewhat true 20 (27.4%) Somewhat true 468 (15.6%)
Certainly true 47 (55.3%) Certainly true 43 (58.9%) Certainly true 2,390 (79.8%)

Often ghts with other Not true 63 (74.1%) Not true 54 (74.0%) Not true 2,470 (82.0%)
children or bullies them
Somewhat true 16 (18.8%) Somewhat true 10 (13.7%) Somewhat true 423 (14.0%)
Certainly true 6 (7.6%) Certainly true 9 (12.3%) Certainly true 118 (3.9%)

Picked on or bullied Not true 49 (57.0%) Not true 46 (62.2%) Not true 2,407 (80.4%)
by other children
Somewhat true 27 (31.4%) Somewhat true 21 (28.4%) Somewhat true 464 (15.5%)
Certainly true 10 (11.6%) Certainly true 7 (9.5%) Certainly true 121 (4.0%)

the ASD group was higher than UK norms (x2(1) = 11.8, OR = 3.12 (1.586.19), p = 0.0006) but no different from that for
children with SEN without an ASD (x2(1) = 0.20, OR = 1.26 (0.4543.49), p = 0.66).
The distribution of childrens self-report Friendship and Victimization scores rated from the ADOS-G transcripts are
shown in Table 2. Although 95% of children with an ASD described having some degree of individual or group friendship with
his/her peers at school, in only about half of the sample did these involve reported clear mutuality (scores of 3 or greater).
Three-quarters of the group reported some experience of teasing, being bullied, exclusion or conict with other children. For
40% of the group this led to feelings of exclusion and rejection (scores of 3 or greater).

Table 2
Children with and ASDs scores on child report Friendship and Victimization scales from ADOS-G interview.

Score Friendship scores

Frequency (N = 89) %

0 Child has no friends 4 4.5%

1 Has a friendship group of peers 17 19.1%
2 Friends within a group or club setting 26 29.2%
3 Friend with shared play and activities 24 27.0%
4 Groups of friends with reciprocal activities 13 14.6%
5 Child has denite best friend 5 5.6%

M 2.45
SD 1.24

Score Victimization scores

Frequency (N = 89) %

0 Child is not teased or bullied 22 24.7%

1 Minor disagreements 16 18.0%
2 Frequent conict 14 15.7%
3 Teasing or name calling leading to feeling excluded 18 20.2%
4 One of physical or verbal bullying, feels picked on 13 14.6%
5 Child is physically or verbally bullied 6 6.7%

M 2.02
SD 1.61
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E. Rowley et al. / Research in Autism Spectrum Disorders 6 (2012) 11261134 1131

Table 3
Mean IQ, receptive language and autism symptom scores for children attending mainstream and special school/unit.

Mainstream school (N = 51) Special school/unit (N = 49)

Mean (SE) Mean (SE)

Full-scale IQ 87.4 (2.8)*** 72.7 (2.5)

Receptive vocabulary 94.4 (2.0)*** 84.4 (2.5)
Social interaction 6.4 (0.4) 7.1 (0.5)
Communication 2.5 (0.2) 2.6 (0.3)
Repetitive behaviour 1.6 (0.2)** 2.7 (0.3)
** Indicates groups differ at p < 0.01.
*** Indicates groups differ at p < 0.001.

Parent and teacher agreement on the three SDQ items was modest but signicant for the children with an ASD
(kappa = 0.15 (p < 0.05), 0.21 (p < 0.01) and 0.19 (p < 0.01) for best friend, ghts/bullies and picked on/bullied,
respectively). These compare to 0.07, 0.22 and 0.24, respectively, for the UK norms for boys. Spearmans rho correlations for
agreement between the children with an ASDs self-report Friendship scale and teacher and parent report of a best friend on
the SDQ were also modest and non signicant (rho = 0.16 and 0.20, both p = ns). However, agreement between the child self-
report Victimization scale and teacher and parent report of being picked on/bullied on the SDQ was higher and signicant
(rho = 0.32 and 0.29, p < 0.01 and p < 0.05, respectively).
Examining associations between child characteristics and scores on the friendship, victimization and ghts/bullies
measures for the ASD group only we conducted a series of ordinal regressions with FSIQ, BPVS score and ADOS social,
communication and repetitive behaviour domain scores as the predictor variables. None of the child characteristics
predicted parent or teacher scores on the SDQ items. Severity of ADOS social domain scores were negatively associated with
child rated Friendship (t = 3.11, p < 0.01) and Victimization (t = 2.38, p < 0.05) scores. Thus, children whose social and
communication symptoms were less severe reported both higher levels of friendship and higher levels of bullying and
victimization.
Next, we compared the friendship, bullying and victimization scores of the children with ASD attending mainstream
schools and those attending special schools/units. First, we determined whether child characteristics differed by school
placement. As shown in Table 3, children with ASD attending mainstream school had higher IQ (t(99) = 3.90, p = 0.0002) and
language scores (t(97) = 3.12, p = 0.002) than those attending special schools. Those in special schools also scored higher on
the restrictive and stereotyped behaviour symptom domain (t(98) = 3.03, p = 0.003) but not on the social interaction
(t(98) = 0.97, p = 0.33) or communication domains (t(98) = 0.29, p = 0.77).
Since the child characteristics that varied between the children in mainstream vs. special schools/units (IQ, language
ability, repetitive symptoms) were largely unrelated to parent and teacher SDQ scores, we examined differences in SDQ
scores between children in mainstream vs. special schools/unit. Compared to children in special schools those in
mainstream schools scored higher on the parent rated best friend SDQ item (mean (SE) = 1.21 (0.12) vs. 0.83 (0.11);
z = 2.82, p < 0.05), lower on the parent rated ghts/bullies other children SDQ item (0.74 (0.12) vs. 0.29 (0.08); z = 3.10,
p < 0.01), and higher on the teacher rated picked on/bullied SDQ item (0.71 (0.11)) vs. 0.39 (0.10); z = 2.40, p < 0.05).
These contrasts were repeated controlling for FSIQ, BPVS and the 3 ADOS domain scores using a logistic regression and
[(Fig._1)TD$IG]
1.2

1
Teacher SDQ Picked on/Bullied

Low ADOS Social

0.8 High ADOS Social

0.6

0.4

0.2

0
Mainstream school Special school/unit

Fig. 1. Interaction between school placement and ADOS social domain score on teacher rated picked on/bullied score (mean, SE).
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1132 E. Rowley et al. / Research in Autism Spectrum Disorders 6 (2012) 11261134

Table 4
Friendship and bullying scores for children attending mainstream and special needs schools.

Mainstream school (N = 51) Special school/unit (N = 49)

Mean (SE) Mean (SE)

Parent SDQ best friend 1.21 (0.12)* 0.83 (0.11)

Parent SDQ ghts/bullies 0.29 (0.08)*** 0.74 (0.12)
Parent SDQ picked on/bullied 1.08 (0.11) 1.02 (0.12)
Teacher SDQ best friend 1.34 (0.13) 1.20 (0.14)
Teacher SDQ ghts/bullies 0.27 (0.08) 0.39 (0.10)
Teacher SDQ picked on/bulled 0.71 (0.11)* 0.39 (0.10)
Child friendship score 2.45 (0.18) 2.45 (0.20)
Child bullying score 2.30 (0.24) 1.71 (0.24)

Note: Data incomplete. Ns range from 41 to 48 for mainstream and 42 to 47 for special needs groups, respectively.
* Indicates groups differ at p < 0.05.
*** Indicates groups differ at p < 0.001.

the differences between mainstream and special school remained signicant for the parent ghts/bullies (t = 3.01,
p < 0.01) and the teacher picked on/bullied (t = 2.09, p < 0.05) variables. In order to test whether there were
interactions between autism severity, school placement and the teacher rating of victimization a logistic regression was
run with school placement and ADOS Social domain score split at the median value (6; 7) entered as dichotomous
variables. As shown in Fig. 1, there was a signicant interaction (t = 2.37, p < 0.05). By teacher report children with an
ASD who were less socially impaired in mainstream school experienced higher levels of victimization; whereas for
children with an ASD who were more socially impaired levels of victimization did not vary by school placement. Child
self-report on the Friendship and Victimization scales did not differ by school placement (z = 0.23, p = 0.76 and z = 0.76,
p = 0.45, respectively) (Table 4).

4. Discussion

The current study explored the friendship and bullying/victimization experiences of children with an ASD in mid-
childhood, using information from parents and teachers, as well as from children themselves. Roughly half of the children
themselves reported what appear to be meaningful friendships involving mutuality. This is in line with what was reported by
teachers, half of whom rated certainly true on the question that asked if the child had one good friend; although only one
third of parents said that their child had one good friend. Despite this encouraging picture that a substantial minority of
children with an ASD have friendships, as might be expected for children with a social communication disorder, the rates
were lower than that in the general population and in children with SEN without an ASD.
In terms of childrens experience of victimization, although almost all children reported some experience of
disagreements with other children this led to feelings of exclusion and rejection in 40% of the children with ASD. Parents
reported some degree of victimization for three-quarters of the children which was certainly true for one third of children,
although the ratings of teachers were somewhat lower (30% and 10%, respectively). Parent ratings of the victimization
experiences of children with an ASD were several times higher than the population rates and higher than those for children
with SEN without an ASD. Teacher ratings of victimization were also higher than the population norms but did not differ
between the ASD and SEN groups.
Parents but not teachers also reported higher levels of ghting with or bullying other children, compared to the UK
norms, but these rates did not differ between the ASD and the SEN groups. This is in line with a large US survey (Montes &
Halterman, 2007). The reliance on this single question does not allow us to separate out getting into ghts from more direct
bullying behaviour. Clearly, the sample of behaviour on which parents and teachers are making their judgements about
children are different from one another. It is possible that parents are over-estimating how common victimization occurs or
that teachers are under-reporting but in-depth qualitative studies are required to answer this question. Another
consideration to bear in mind is that both parents and teachers might not always be able to distinguish ghting from
bullying, particularly in children with an ASD some of whom may lack the insight to be a reliable informant of such
interactions with peers.
These ndings are consistent with other studies which report that friendship is a major area of difculty for children with
an ASD (Bauminger & Kasari, 2000; Bauminger & Shulman, 2003), being characterized by less frequent social interaction and
fewer close friendships than are seen within a typically developing population (Wainscot et al., 2008). With respect to
bullying/victimization a parental survey conducted by the UK National Autistic Society (Batten et al., 2006) found that two in
ve children with autism had experienced some form of bullying. Other studies have reported an even high prevalence (e.g.
Humphrey & Symes, 2010; Little, 2001; Wainscot et al., 2008), although differences in sampling, methods and denitions
make comparison of rates obtained across studies difcult. Our rates are overlapping with the largest study conducted to
date (Van Roekel et al., 2010) who reported rates between 6% and 46% depending on the respondent. It extends the literature
by using a combination of child, parent and teacher report. In common with other studies agreement across the parent,
teacher and self-report was only modest.
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E. Rowley et al. / Research in Autism Spectrum Disorders 6 (2012) 11261134 1133

Children with lower social and communication impairment scores reported more meaningful child friendships. The
centrality of social interaction in the development and maintenance of peer relationships, and the associated social
decit in children with autism, has been well documented (e.g. Knott, Dunlop, & Mackay, 2006; Orsmond, Krauss, &
Seltzer, 2004). There might also be a direct association between social understanding and communicative competence
and this nding, simply indicating that less impaired (more socially and linguistically able) children might be better at
reporting the friendship experiences that they have.
Children with lower social and communication impairment scores also reported higher levels of victimization and
bullying. Put the other way round, more socially able children reported more bullying and victimization. One possibility is
that children with less impaired social ability may be more attuned to subtle forms of bullying and peer exclusion, and
therefore tend to notice and report (in the ADOS interview) higher levels of bullying. An alternative view is that children with
greater levels of social skills are likely to be more socially involved with their peers, and engage in social interactions with
other children more frequently, thus facing an increased likelihood of negative social experiences such as teasing and
bullying. This explanation is supported by evidence that children with more impaired social ability may intentionally avoid
social contact during break and lunch times, preferring to stay within supervised or quieter areas of the school, with the
result that they not only minimize the risk of encountering socially demanding situations, but also reduce their risk of being
targeted by bullies (Wainscot et al., 2008).
Motivated by the idea that the environment of smaller and more highly staffed special schools might offer some
protection against bullying or more opportunity to form friendships with similar peers, we explored whether there was
an interaction between experiences of victimization and levels of social impairment and school placement. Children
with an ASD who were less socially impaired in mainstream school experienced higher levels of victimization; whereas
for children with an ASD who were more socially impaired levels of victimization did not vary by school placement. This
is consistent with the idea that children with the most social interest in mainstream might render themselves more
vulnerable to victimization as they are more likely to make social approaches and be rebuffed or ridiculed by their peers
in a mainstream setting (Humphrey & Symes, 2010). Sofronoff, Dark, and Stone (2011) recently reported that social
vulnerability was the strongest predictor of bullying in a large sample of children with Asperger syndrome.
Understanding such complex social processes requires research that looks at social understanding and social behaviour
(i.e. social approaches and responses to other children) in relation to data on friendships, victimization and bullying.

4.1. Limitations

The primary limitation of the present study is that the variables used to explore the experiences of friendship and bullying/
victimization in this sample of children with an ASD were either single items from the SDQ or retrospectively re-coded from
measures completed as part of a larger study whose focus was on measuring autistic behaviours (ADOS). This contrasts with
other research where children and adults were given denitions of bullying before they completed questionnaires (e.g. Van
Roekel et al., 2010). Reliance on single items also raises issues regarding both reliability and measurement error. Furthermore,
the SDQ item of bullying (ghts with other children or bullies them) might not alert parents and teachers to the important
verbal and social bullying that occurs within groups of children. The coding scheme from the child interview sections of the
ADOS has not been validated but the content appeared to have relatively high face value, certainly in terms of the childrens
experience of peer relationships. However, we were able to demonstrate good inter-rater reliability for the post hoc scoring of
the friendship and bullying/victimization coding scheme scored form the ADOS-G videotapes. In addition, SDQ data from a
large, population-representative sample of UK children was available, as were data from a group of children with SEN without
an ASD. Finally we did not measure social desirability or interest alongside the data on friendships.

4.2. Conclusions

This multi-informant study contributes to our understanding of the difculties experienced by children with an autism
spectrum disorder in forming and maintaining meaningful friendships, as well as the bullying and victimization they face
during middle childhood. The study found that friendship quality (in terms of having a best friend) was lower than in the
typical population and for children with SEN without an ASD; and that experiences of being victimized/bullied were higher.
Furthermore, some of these experiences systematically related both to child characteristics and to school placement,
although complex associations between these variables existed. Further research is needed to explore the specic way in
which these characteristics inuence a childs ability to form friendships or determine the responses that they get from his/
her peer group and whether this differs in different school settings. By identifying such mechanisms it would be possible to
design social skills training or school programmes to promote more meaningful peer friendship and reduce conict and
victimization in school age children with an ASD. Whilst interventions on an individual level may usefully contribute to the
development of social skills and understanding in children with an autism spectrum disorder; future research should also
examine the role that both teachers, parents and peers might play in facilitating friendship formation and supporting
ongoing peer relationships (Laugeson et al., 2009). In tackling the problem of bullying and social exclusion, a future
direction might be more widespread implementation of school-based anti-bullying schemes, including peer support and
mentoring programmes, as well as more specialist training for parents and professionals working with this vulnerable
population.
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1134 E. Rowley et al. / Research in Autism Spectrum Disorders 6 (2012) 11261134

Acknowledgements

The study was funded by the Wellcome Trust and the Department of Health. We are grateful to all the children and
parents for their participation.

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