Transition to Mainstream Secondary School and Special Challenges for Children with an Autism Spectrum Disorder (ASD): Considerations Beyond the Triad of Impairments

Background: Transitions throughout education mark important developmental milestones, but negotiating transitions can be challenging for children with ASD, especially those with resistance to change. Difficulties in social interaction, communication and cognitive inflexibility all potentially influence success. Co-morbid disorders, such as ADHD, can exacerbate adjustment difficulties. The needs of children with ASD are not yet acknowledged by educational policies and practice.

Objectives: We aimed to assess, in a prospective study, the range and extent of difficulties faced by children with ASD transitioning between mainstream primary and secondary school. We wished to evaluate what additional support needs should be provided, and how the nature and severity of autistic traits influenced prospects of a successful transition.

Methods: Standardized assessments of 30 children (from 30 schools in UK) with ASD (mean age 11.28 yrs; SD0.4, mean IQ 88.79, SD17.48) were obtained from school and home visits prior to transition. Cognitive, executive and adaptive functioning were measured by WISC-IV, BRIEF and VABS-II respectively, plus the Beck Youth Inventory and the Parenting Stress Index.

Results:   At initial evaluation, 89.3% had significantly discrepant cognitive profiles on the WISC-IV. We discovered a substantial difference existed between the children’s relatively good cognitive abilities and their adaptive behavior, which impacted on their ability to handle the everyday demands of their school environment. Adaptive functioning was up to 6 years below their peers on the VABS-II: 30% were Borderline and 26.7% in the Mild Learning Disability range. Many had poorly developed executive functions (encompassing planning and organizational skills, emotional regulation, and attention). 87% had Global Executive Composite scores (BRIEF) within the range of clinical concern. Comorbidity, including anxiety (41.4%), disruptive behavior (31%), anger (41.4%), and depression (41.4%) were significantly more common than expected from comparison data in this age group. Most (65.5%) had exceptionally poor self-esteem compared to their peers. 58.7% of families had clinically significant parenting-stress levels as measured by the Parenting Stress Index, usually exacerbated by concerns about managing their child’s pending transition to secondary education.

Conclusions: ASD is  cognitively a complex condition; measures of symptom severity and the degree of generalized learning difficulties do not fully reflect a child’s individual needs and the potential risks associated with major life transitions. Many children in mainstream education do not successfully make the transition to secondary education and subsequently drop out, failing to achieve their potential as fully functioning members of society. Families need exceptional support at this time of transition, but few receive it; their stress levels are high. The importance for educational management of taking into account a complex cognitive profile (exceptionally poor working memory or processing speed for example), is emphasized by our study findings. Teachers are rarely aware of these issues and need education themselves about the impact of ASD on children’s ability to learn.