Too anxious to achieve? A quantitative investigation of anxiety and academic achievement in autistic children

Abstract

Mental health conditions, and anxiety disorders in particular, are highly prevalent in the autistic community. Around 70% of autistic children experience at least one mental health condition, and approximately 40% have impairing symptoms of anxiety. In recent years, research has identified two distinct presentations of anxiety symptomatology in autistic children – typical anxiety symptoms, referring to symptoms of anxiety consistent with those observed in the non-autistic population, and atypical anxiety symptoms, referring to symptoms of anxiety which are unique to the autistic population and linked to the core characteristics of autism. Despite recent progress in this field, our understanding of the presentation and consequences of anxiety symptomatology in autistic children remains limited. In non-autistic children, a link has been established between anxiety symptomatology and academic achievement, with anxious students tending to produce poorer academic outcomes. Notably, although autistic children collectively demonstrate wide variability in academic achievement, autistic children in general tend to underperform academically. The aim of this research project was to advance the existing knowledge regarding both anxiety symptoms and academic achievement in autistic students. This was achieved by exploring the prevalence and presentation of anxiety symptoms within a group of Australian autistic children, as well as investigating the impact of anxiety symptoms on these children and their families. In addition, the children’s academic achievement was explored, with a particular focus on any relationship between anxiety symptomatology and academic achievement. The research presented here involved a series of four quantitative studies. The first study explored parent-reported anxiety symptomatology in a sample of 100 school-aged autistic children using an autism-specific assessment of anxiety symptomatology, the Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD). The second study investigated both typical and atypical presentations of anxiety, gathering both parent-report and child-report data on anxiety symptomatology from a sample of 30 autistic children, using the ASC-ASD and the Spence Children’s Anxiety Scale (SCAS). In both studies, high rates of anxiety symptomatology were identified, and items measuring atypical symptoms of anxiety were endorsed frequently. The third study utilised parent- and child-report data from the SCAS and the Child Anxiety Life Interference Scale to examine the extent and types of life interference experienced by 30 autistic children and their families, as a result of the child’s anxious symptomatology. Findings from this study indicated high levels of anxiety-related life interference, with school performance reported by both parents and children as being the domain most impacted by anxious symptomatology. The final study explored academic achievement, measured using the Kaufman Test of Educational Achievement – Third Edition, Brief Form (KTEA-3 Brief), and its relation to ASC-ASD and SCAS anxiety symptomatology in 29 autistic children. Academically, children in this study collectively performed below standardised norms. However, with a small number of exceptions, academic achievement was not associated with anxiety symptomatology on either anxiety measure at total scale or subscale levels. Taken together, these studies provide further evidence for the high prevalence of anxiety symptoms within the autistic population, and contribute to a deeper understanding of the unique presentation of anxiety symptomatology in autistic children. These studies also provide preliminary evidence of the potential consequences of anxiety symptomatology, in terms of life interference for autistic children and their families. Although anxiety symptomatology was not significantly associated with standardised academic achievement scores, children and parents both perceived school performance as being impacted by anxiety symptomatology, suggesting that this is an important area for future research. Overall, this thesis makes a significant and unique contribution to our understanding of anxiety symptomatology and academic achievement in autistic children.