Peer victimization is typically defined as being the target, directly or indirectly, of an aggressive action. In this context, aggression is defined as an action/behavior that is intended to harm the target of that action/behavior. Here, it is important to distinguish between the terms peer victimization and bullying, which are often incorrectly used to mean the same thing. Bullying refers to being a target of aggression, but differs from peer victimization in that bullying requires that the aggressor has power, in terms of status, physical size or strength, or psychological control, over the target of the aggression. Thus, all bullying falls under the definition of peer victimization but not all peer victimization falls under the definition of bullying. Peer victimization targeting those with ASD, most likely, should be classified as bullying since the symptoms of ASD and associated social difficulties make it unlikely that they have more power than someone targeting them. Similarly, it is unlikely that aggressive actions by those with ASD could be classified as bullying since those with ASD often do not have power over the targets of their actions, and much of the aggression that they exhibit is reactive rather than instrumental to be used as a tool for maintaining power over the individual being targeted.
One problem with using terms like bullying, teasing, or being mean in the measurement of peer victimization is that these terms, from the perspective of participants, can be subjective, interpreted quite broadly, and are often seen as being synonymous with one another. In measuring peer victimization, it is critical to use items that describe the specific aggressive behaviors (e.g., hit, kick, call mean names) targeted at the victim. This specificity impacts measurement validity and in turn, internal validity of studies of peer victimization. It is also important to distinguish between the various forms of peer victimization, such as physical, verbal, electronic, relational, and physical. This is key to building effective intervention strategies since different forms of peer victimization are associated with different outcomes and predictors (see next section).
This section will outline the current knowledge about the prevalence of peer victimization in children and adolescents with ASD, as well as the factors found to be associated with peer victimization in this population.
Prevalence of peer victimization. Numerous studies indicate that individuals with ASD tend to be viewed less positively by their typically developing peers (Bauminger and Kasari 2000; Chamberlain et al. 2007; Humphrey and Symes 2010, 2011; Jones and Frederickson 2010; Locke et al. 2010; Lyons et al. 2011; Petrina et al. 2014). Thus, it is not surprising that children and adolescents with ASD are commonly targeted for peer victimization. Multiple studies have shown than those with ASD experience higher rates of peer victimization than TD peers (Bear et al. 2015; Humphrey and Symes 2011; Rose et al. 2015; Rowley et al. 2012; Twyman et al. 2010; Wainscot et al. 2008; Zeedyk et al. 2014) and peers with other disabilities (Humphrey and Symes 2011; Rowley et al. 2012; Twyman et al. 2010; Zeedyk et al. 2014). Parents of children and adolescents with ASD report peer victimization rates ranging from around 40% to 90% across studies (Cappadocia et al. 2012; Little 2002; Maiano et al. 2016; Sterzing et al. 2012), with variability explained to some extent by how peer victimization is measured (Maiano et al. 2016; e.g., lifetime vs. weekly occurrence). Nevertheless, even if the true rates of peer victimization for this group fall at the lower end of this range that would indicate a substantial number of individuals with ASD are encountering negative peer experiences.
A few studies have tested differences in rates for types of victimization, such as verbal, relational, and physical (Adams et al. 2014; Bear et al. 2015; Kloosterman et al. 2013; Maiano et al. 2016; Nowell et al. 2014; Wainscot et al. 2008; Zeedyk et al. 2014). Overall, these studies find that verbal victimization occurs the most often, which is similar to what is seen in studies of TD children and adolescents with mixed findings when examining frequencies between relational and physical victimization (Adams et al. 2014; Bear et al. 2015; Kloosterman et al. 2013; Zeedyk et al. 2014).
Factors associated with peer victimization. To obtain a fuller picture of peer victimization in children and adolescents with ASD, some studies have begun to test the associations between peer victimization and various factors. One of the more consistent findings across such studies show that those in general education setting are more likely to be targets of peer victimization than those in special educational settings (Bitsika and Sharpley 2014; Blake et al. 2012; Maiano et al. 2016; Zablotsky et al. 2013; Zeedyk et al. 2014). Thus, studies may want to put a special focus on individuals who are “mainstreamed” in general education. A few studies have tried to understand how variability in social-communication skills in this group might be associated with peer victimization, with mixed findings (Cappadocia et al. 2012; Rowley et al. 2012; Sterzing et al. 2012; Storch et al. 2012). Some of these studies find social-communication skills to be positively associated, others negatively associated, and some studies find null effects. A few explanations have been provided for these discrepant findings: higher abilities may make it more likely that self-reporting adolescents with ASD are aware of these negative interactions, or it may be that certain settings (e.g., mainstreamed classrooms or unsupervised settings) can result in difficulties in social-communication skills becoming more or less of a liability for being a target of peer victimization. In other words, if individuals with better skills are more likely to have access to more inclusive environments, this may also raise their risk of being targeted by similar-aged peers.
Externalizing problems, such as poor impulse/emotional control, ADHD, and aggression, are commonly found to both predict and result from peer victimization experiences in TD children and adolescents (Card and Little 2006). Similarly, externalizing problems (which commonly co-occur with ASD) have been found to be associated with peer victimization in individuals with ASD (Cappadocia et al. 2012; Hebron and Humphrey 2014; Rieffe et al. 2012).Recent studies suggest that special attention should be given to situations when classmates provoke an aggressive reaction from their ASD classmate by purposely directing behaviors that they know will make their ASD classmate overreact emotionally (i.e., “meltdown”; Zablotsky et al. 2013).
Peer victimization has also been found to be associated with internalizing problems, such as symptoms of depression and anxiety, in studies of adolescents with ASD (Adams et al. 2014; Cappadocia et al. 2012; Rosbrook and Whittingham 2010; Storch et al. 2012; Ung et al. 2016). This association is particularly significant given that lifetime estimates of internalizing disorders for those with ASD are as high as 52% for depression and 65% for anxiety disorders, compared to rates of 5% and 20% reported in TD adolescents (Costello et al. 2005a, b; Lever and Geurts 2016; Leyfer et al. 2006; van Steensel et al. 2011).
Finally, peer victimization has been shown to be associated with school outcomes in individuals with ASD. Adams et al. (2016)) found, in two separate data sets, that both parent- and peer-reports of peer victimization were associated with feelings about school (i.e., safety, liking, belonging), behavioral problems at school, and academic performance problems. Similar to internalizing symptoms, these associations between peer victimization are particularly concerning given the overwhelming problems that adolescents with ASD have with these same school outcomes. Even among those with high cognitive abilities, individuals with ASD underperform across various measures of academic performance (Ashburner et al. 2010; Estes et al. 2011; Jones et al. 2009; Keen et al. 2015; Wei et al. 2013), are less likely to enjoy school, less likely to engage cooperatively and independently at school (Jahromi et al. 2013), and more likely to be removed from a public educational setting by way of either suspensions (Starr and Foy 2010) or being home schooled (Parsons and Lewis 2010).
The first substantial wave of studies examining peer victimization in children and adolescents with ASD has occurred over the past 5–8 years, and now the next wave of studies that build upon the finding of these early studies is beginning. The following are three suggested areas that should be considered for the next wave of studies.
Advanced methods A majority of initial studies on peer victimization in ASD were cross-sectional survey studies that utilized single-item measures to test questions of the frequency of the occurrence of peer victimization. Studies utilizing more advanced methods have just started to appear, and this trend must continue in order to inform the development of interventions that target these negative peer experiences. The focus must move from testing frequencies of these experiences, to testing associations between predictors and outcomes so that specific processes of peer victimization can be identified for this group. While it is known that those with ASD are common targets of peer victimization, little is known about what this process looks like, who is targeted, or what are the ramifications of these experiences. Unfortunately, studies that do test such associations are all cross-sectional. This means that we do not yet know if a construct under study is a predictor of and/or an outcome of peer victimization. This is a problem because many constructs that have been shown to be important for understanding peer victimization are both in studies. For instance, among typically developing children, internalizing problems are both predictors and outcomes of peer victimization (Reijntjes et al. 2010). Additionally, the dearth of longitudinal studies has resulted in little understanding of the developmental trajectories of peer victimization over the course of childhood and adolescence (e.g., when do rates peak? Decrease?). Finally, the field must ensure that the measures being utilized provide proper measurement validity. Not only should these measures have multiple items that tap into various forms of peer victimization that this group experiences, but these measures should be tested to ensure that they are valid, especially in terms self-reports.
Predictors. For many groups that are at heightened risk for being targeted for peer victimization, it is a unique physical characteristic that makes them a target, such as being obese (Adams and Bukowski 2008; Adams and Cantin 2013). Those with ASD often do not, at first glance, appear physically different than their peers. Instead, it is the behaviors that they exhibit that may cause them seem different and in turn, put them at risk for being targeted for peer victimization. However, there is tremendous phenotypic heterogeneity in these behaviors exhibited by adolescents with ASD, so knowing what puts someone with ASD at increased risk for negative peer experiences requires more than simply knowing that he/she has ASD. For example, it is possible that any number of common ASD symptoms, including decreased social and emotional insight, restricted and repetitive behaviors, or communication difficulties, might potentially place this group at increased risk for negative peer experiences. Future studies must test the various symptoms of ASD and also various comorbid issues as possible predictors.
Gender. Gender differences are apparent in studies of TD adolescents across most aspects of social development (Rose and Rudolph 2006), as well as in peer victimization (e.g., rates of different types and content of victimization; Hong and Espelage 2012). Males and females often experience different forms of bullying, with boys experiencing more physical bullying (Carbone-Lopez et al. 2010), girls experiencing more relational forms (Murray-Close et al. 2007), and boys and girls experiencing similar levels of verbal bullying but with topics of verbal bullying differing by gender (Duncan 1999; Gruber and Fineran 2008). Because social experiences often vary as a function of gender, it is clear that successful interventions targeting social experience must take gender into account. Unfortunately, gender is seldom given proper attention as a variable in studies of ASD (Halladay et al. 2015) and not at all in terms of peer victimization.
References and Readings
- Adams, R. E., Fredstrom, B. K., Duncan, A. W., Holleb, L. J., & Bishop, S. L. (2014). Using self- and parent-reports to test the association between peer victimization and internalizing symptoms in verbally fluent adolescents with ASD. Journal of Autism and Developmental Disorders, 44(4), 861–872. https://doi.org/10.1007/s10803-013-1938-0.CrossRefPubMedGoogle Scholar
- Adams, R., Taylor, J., Duncan, A., & Bishop, S. (2016). Peer victimization and educational outcomes in mainstreamed adolescents with autism spectrum disorder (ASD). Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-016-2893-3.
- Ashburner, J., Ziviani, J., & Rodger, S. (2010). Surviving in the mainstream: Capacity of children with autism spectrum disorders to perform academically and regulate their emotions and behavior at school. Research in Autism Spectrum Disorders, 4(1), 18–27. https://doi.org/10.1016/j.rasd.2009.07.002.CrossRefGoogle Scholar
- Card, N. A., & Little, T. D. (2006). Proactive and reactive aggression in childhood and adolescence: A meta-analysis of differential relations with psychosocial adjustment. International Journal of Behavioral Development, 30(5), 466–480. https://doi.org/10.1177/0165025406071904.CrossRefGoogle Scholar
- Costello, E. J., Egger, H., & Angold, A. (2005a). 10-year research update review: The epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. Journal of the American Academy of Child and Adolescent Psychiatry, 44(10), 972–986. https://doi.org/10.1097/01.chi.0000172552.41596.6f.CrossRefPubMedGoogle Scholar
- Costello, E. J., Egger, H. L., & Angold, A. (2005b). The developmental epidemiology of anxiety disorders: Phenomenology, prevalence, and comorbidity. Child and Adolescent Psychiatric Clinics of North America, 14(4), 631–648., vii. https://doi.org/10.1016/j.chc.2005.06.003.CrossRefPubMedGoogle Scholar
- Duncan, N. (1999). Sexual bullying: Gender conflict and pupil culture in secondary schools. New York: Routledge.Google Scholar
- Estes, A., Rivera, V., Bryan, M., Cali, P., & Dawson, G. (2011). Discrepancies between academic achievement and intellectual ability in higher-functioning school-aged children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 41(8), 1044–1052. https://doi.org/10.1007/s10803-010-1127-3.CrossRefPubMedGoogle Scholar
- Halladay, A. K., Bishop, S., Constantino, J. N., Daniels, A. M., Koenig, K., Palmer, K., Messinger, D., Pelphrey, K., Sanders, S. J., Singer, A. T., Taylor, J. L., & Szatmari, P. (2015). Sex and gender differences in autism spectrum disorder: Summarizing evidence gaps and identifying emerging areas of priority. Molecular Autism, 6, 36. https://doi.org/10.1186/s13229-015-0019-y.CrossRefPubMedPubMedCentralGoogle Scholar
- Jones, C. R., Happe, F., Golden, H., Marsden, A. J., Tregay, J., Simonoff, E., Pickles, A., Baird, G., & Charman, T. (2009). Reading and arithmetic in adolescents with autism spectrum disorders: Peaks and dips in attainment. Neuropsychology, 23(6), 718–728. https://doi.org/10.1037/a0016360.CrossRefPubMedGoogle Scholar
- Lever, A. G., & Geurts, H. M. (2016). Psychiatric co-occurring symptoms and disorders in young, middle-aged, and older adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(6), 1916–1930. https://doi.org/10.1007/s10803-016-2722-8.CrossRefPubMedPubMedCentralGoogle Scholar
- Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., Tager-Flusberg, H., & Lainhart, J. E. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36(7), 849–861. https://doi.org/10.1007/s10803-006-0123-0.CrossRefPubMedGoogle Scholar
- Locke, J., Ishijima, E. H., Kasari, C., & London, N. (2010). Loneliness, friendship quality and the social networks of adolescents with high-functioning autism in an inclusive school setting. Journal of Research in Special Educational Needs, 10(2), 74–81. https://doi.org/10.1111/j.1471-3802.2010.01148.x.CrossRefGoogle Scholar
- Lyons, J., Cappadocia, M. C., & Weiss, J. A. (2011). BRIEF REPORT: Social characteristics of students with autism spectrum disorders across classroom settings. Journal on Developmental Disabilities, 17(1), 77–82.Google Scholar
- Murray-Close, D., Ostrov, J. M., & Crick, N. R. (2007). A short-term longitudinal study of growth of relational aggression during middle childhood: Associations with gender, friendship intimacy, and internalizing problems. Development and Psychopathology, 19(01), 187–203. https://doi.org/10.1017/S0954579407070101.CrossRefPubMedGoogle Scholar
- Nowell, K. P., Brewton, C. M., & Goin-Kochel, R. P. (2014). A multi-rater study on being teased among children/adolescents with autism spectrum disorder (ASD) and their typically developing siblings: Associations with ASD symptoms. Focus on Autism and Other Developmental Disabilities. https://doi.org/10.1177/1088357614522292.
- Rieffe, C., Camodeca, M., Pouw, L. B. C., Lange, A. M. C., & Stockmann, L. (2012). Don’t anger me! Bullying, victimization, and emotion dysregulation in young adolescents with ASD. European Journal of Developmental Psychology, 9(3), 351–370. https://doi.org/10.1080/17405629.2012.680302.CrossRefGoogle Scholar
- Rose, A. J., & Rudolph, K. D. (2006). A review of sex differences in peer relationship processes: Potential trade-offs for the emotional and behavioral development of girls and boys. Psychological Bulletin, 132(1), 98–131. https://doi.org/10.1037/0033-2909.132.1.98.CrossRefPubMedPubMedCentralGoogle Scholar
- Rowley, E., Chandler, S., Baird, G., Simonoff, E., Pickles, A., Loucas, T., & Charman, T. (2012). The experience of friendship, victimization and bullying in children with an autism spectrum disorder: Associations with child characteristics and school placement. Research in Autism Spectrum Disorders, 6(3), 1126–1134. https://doi.org/10.1016/j.rasd.2012.03.004.CrossRefGoogle Scholar
- Starr, E. M., & Foy, J. B. (2010). In parents’ voices: The education of children with autism spectrum disorders. Remedial and Special Education. https://doi.org/10.1177/0741932510383161.
- Storch, E. A., Larson, M. J., Ehrenreich-May, J., Arnold, E. B., Jones, A. M., Renno, P., Fujii, C., Lewin, A. B., Mutch, P. J., Murphy, T. K., & Wood, J. J. (2012). Peer victimization in youth with autism spectrum disorders and co-occurring anxiety: Relations with psychopathology and loneliness. Journal of Developmental and Physical Disabilities, 24, 575–590.CrossRefGoogle Scholar
- Twyman, K. A., Saylor, C. F., Saia, D., Macias, M. M., Taylor, L. A., & Spratt, E. (2010). Bullying and ostracism experiences in children with special health care needs. Journal of Developmental and Behavioral Pediatrics, 31(1), 1–8. https://doi.org/10.1097/DBP.0b013e3181c828c8.CrossRefPubMedGoogle Scholar
- Ung, D., McBride, N., Collier, A., Selles, R., Small, B., Phares, V., & Storch, E. (2016). The relationship between peer victimization and the psychological characteristics of youth with autism spectrum disorder. Research in Autism Spectrum Disorders, 32, 70–79. https://doi.org/10.1016/j.rasd.2016.09.002.CrossRefGoogle Scholar
- Wainscot, J. J., Naylor, P., Sutcliffe, P., Tantam, D., & Williams, J. V. (2008). Relationships with peers and use of the school environment of mainstream secondary school pupils with Asperger syndrome (high-functioning autism): A case-control study. International Journal of Psychology & Psychological Therapy, 8(1), 25–38.Google Scholar
- Wei, X., Lenz, K. B., & Blackorby, J. (2013). Math growth trajectories of students with disabilities: Disability category, gender, racial, and socioeconomic status differences from ages 7 to 17. Remedial and Special Education, 34(3), 154–165. https://doi.org/10.1177/0741932512448253.CrossRefGoogle Scholar
- Zeedyk, S. M., Rodriguez, G., Tipton, L. A., Baker, B. L., & Blacher, J. (2014). Bullying of youth with autism spectrum disorder, intellectual disability, or typical development: Victim and parent perspectives. Research in Autism Spectrum Disorders, 8(9), 1173–1183. https://doi.org/10.1016/j.rasd.2014.06.001.CrossRefPubMedPubMedCentralGoogle Scholar