The Education Program Changed Knowledge and Stigma Associated with Autism Spectrum Disorder in Japanese High School Students

Background: Autism spectrum disorders (ASD) is often misunderstood in Japan (Koyama et al., 2008), and stigma associated with ASD in Japanese college students was higher than their American counterparts (Someki et al., 2015). Furthermore, even though factors such as gender (i.e., females report less stigma than males) are known to affect stigma associated with ASD in the U.S. (e.g., Tipton & Blacher, 2013), the same tendency was not observed in Japan (e.g., Someki et al., 2015). In contrast, accurate knowledge about positive outcomes of people with ASD contributed to less social distance (i.e., less stigma) in Japanese high school students (Torii et al., 2015). These findings suggest that, in different cultures, different factors impact on stigma towards people with ASD.  

Objectives:   The purpose of this study was to 1) examine the effectiveness of the education program to increase knowledge and decrease stigma (i.e., less social distance) associated with ASD in Japanese high school students, and 2) examine the relations between stigma and knowledge about ASD, previous direct experiences with ASD, previous learning experiences about ASD, and previous exposure to ASD information in mass media.

Methods: A total of 1,111 high school students (453 males, 649 females) in an urban city in Japan participated in the study. Each participant filled out the pre- and post-test with 32 items: 3 demographic information items (e.g., age, gender), 6 items on previous direct experiences with people with ASD, 9 items on knowledge about ASD, 7 items on life style, and 7 items on social distance towards people with ASD (i.e., stigma measure: Bogardus, 1933). For the intervention, the first author, an expert in ASD, gave a lecture to the participants about these disabilities.  

Results: The ASD knowledge mean scores significantly decreased (i.e., gain in ASD knowledge) from the pre-test (M= 2.55, SD= 0.55) to the post-test (M= 2.06, SD= 0.68), t (1,050) = 25.60, p< .01. Further, the social distance mean scores also decreased (i.e., less stigma) from the pre-test (M= 2.36, SD= 0.64) to the post-test (M= 2.12, SD= .64), t (1,076) = 16.35, p< .01. In terms of the relation between stigma and other factors, more accurate knowledge about ASD was strongly correlated with less social distance (i.e., less stigma: Z = .449, p< .01). Additionally, previous experiences interacting with students with ASD, Z =.109, p< .01, learning experiences about ASD in the classroom, Z = .101, p< .01, and previous exposure to ASD information through mass media, Z = .125, p< .01, were all positively related to lesser social distance (i.e., more experiences were related to less stigma). 

Conclusions:   The ASD education program was proven to be effective for increasing accurate knowledge on ASD as well as lowering stigma associated with ASD in Japanese high school students. Further, more accurate knowledge on ASD as well as previous direct interactions with students with ASD, opportunities to learn about these disabilities, and exposure to information about these disabilities were all correlated with lesser stigma associated with ASD.