Yonsei Med J.  2020 Nov;61(11):909-922. 10.3349/ymj.2020.61.11.909.

Prevalence of and Factors Associated with School Bullying in Students with Autism Spectrum Disorder: A Cross-Cultural Meta-Analysis

Affiliations
  • 1Department of Psychology, Ewha Womans University, Seoul, Korea
  • 2Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
  • 3Center for ASD and Neurodevelopmental Disorders, University of California, San Francisco, CA, USA
  • 4Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
  • 5Research Center for Child Mental Development, Hirosaki University, Hirosaki, Aomori, Japan
  • 6Department of Clinical Psychological Science, Hirosaki University, Hirosaki, Aomori, Japan.

Abstract

Through this meta-analysis, we sought to examine the prevalence of, risks for, and factors associated with bullying involvement (victimization, perpetration, perpetration-victimization) among students with autism spectrum disorder (ASD). Additionally, we attempted to examine sources of variance in the prevalence and effect sizes of bullying in students with ASD across studies. Systematic database and literature review identified 34 relevant studies (31 for Western countries, three for Eastern countries). Pooled prevalence estimates for victimization, perpetration, and perpetration-victimization in general were 67%, 29%, and 14%, respectively. The risk of victimization in students with ASD was significantly higher than that in typically developing students and students with other disabilities. Further, deficits in social interaction and communication, externalizing symptoms, internalizing symptoms, and integrated inclusive school settings were related to higher victimization, and externalizing symptoms were related to higher perpetration. Finally, moderation analyses revealed significant variations in the pooled prevalences thereof depending on culture, age, school settings, and methodological quality and in the pooled effect sizes according to publication year and methodological quality. Our results highlight needs for bullying intervention for students with ASD, especially those who are younger, are in an inclusive school setting, and have higher social difficulties and externalizing/internalizing symptoms; for intensive research of bullying experiences among students with ASD in Eastern countries; and for efforts to improve the methodological quality of such research.

Keyword

Students with ASD; bullying; prevalence; associated factors; cultural difference; methodological quality
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