Teachers Perceptions Regarding The Management of Children With Autism Spectrum Disorders

J Autism Dev Disord (2012) 42:755768
DOI 10.1007/s10803-011-1309-7
ORIGINAL PAPER
Teachers Perceptions Regarding the Management of Children

with Autism Spectrum Disorders
Christine K. Syriopoulou-Delli Dimitrios C. Cassimos
Grigorios I. Tripsianis Stavroula A. Polychronopoulou
Published online: 23 June 2011

Springer Science+Business Media, LLC 2011
Abstract This study examines Greek teachers perceptions related to the nature and management of autistic
children. To investigate these issues, a statistically reliable
number of questionnaires (n = 228) was distributed to a
diversified teacher population. The questionnaire responses
were analyzed statistically to identify the explanatory
power of critical independent variables. The research
findings support that teachers specialized training and
working experience are critical inputs to improve teachers
perceptions and efficient serving of autistic children. A
cumulative joint effect of teachers previous specialized
education and working experience working with autistic
children was also indicated. This could be supportive of
teachers upgrading their active leading role in team
working with specialized scientific staff, parents and
institutions on autistic children.
C. K. Syriopoulou-Delli (&)
Department of Educational and Social Policy, University
of Macedonia, 49, Bouziki Str., Nea Philothei, 11524 Athens,
Greece
e-mail: dellis@mfa.gr
D. C. Cassimos
Pediatric Department, Democritus University of Thrace,
Alexandroupolis, Greece
G. I. Tripsianis
Department of Statistics, School of Medicine, Democritus
University of Thrace, Alexandroupolis, Greece
S. A. Polychronopoulou
Department of Primary Education, National and Kapodistrian
University of Athens, Athens, Greece
Keywords Autism Education Teachers education

Teachers experience Teachers leading role
Autistic students
Introduction
Over the last decade, the number of children diagnosed to
suffer from autism spectrum disorders (ASD) is seen to
have increased dramatically (Arick et al. 2005; Finke et al.
2009; Harris et al. 2005; Powell and Jordan 1992). As a
consequence, more children with ASD participate in general education (ASD Centers for Disease Control and
Prevention 2007). A prevailing tendency in the education
community lately indicates that children with disabilities,
particularly pervasive developmental disorders, join general (mainstream) education classrooms (McDonnell
1998). Teachers specialized training is argued to be a
critical component with profound implications for the
education of ASD children (Mesibov et al. 2006).
In Greece, the idea of one school for all was introduced during the last decade (Greek Government Gazette
2000). Before the application of this legislation, ASD
children had access only to special schools for the mentally
retarded. As a result, in some of these latter cases, parents
would prefer to keep their children at home, or asylums, or
youth institutions. Hence, these children were deprived of
mainstream education (Anastasiou and Polychronopoulou
2009). The Greek government has, recently, recognized the
right of ASD children to participate in the educational
process (Greek Government Gazette 2008). Since 2008,
Greek students with ASD can explore two options. They
can either attend a mainstream school class, receiving
additional support from the classroom, or special education, teacher; or, they can attend a special integration class
123
756
within mainstream or vocational schools. ASD students,

and especially those with limited functional capabilities,
exhibit a range of unique characteristics that pose high
challenges for teachers serving them. To be specific, ASD
students frequently display deficits in cognition, communication, and socialization. Basic functional and learning
skills are often reduced or are even absent. A major concern remains, however, the fact that the exact characteristics of autistic disorders are not fully understood in a
consistent and integrated framework but remain largely
vague as yet.
The prerequisite formal qualifications for a Greek teacher to work in the field of special education include a
Ph.D. or a postgraduate degree in the field of special
education or educational psychology, or a degree from
either the Pedagogical Department of Primary/Special
Education or the Department of Educational and Social
Policy. Nevertheless, due to inadequate past practices and
institutional constraints, the working experience of Greek
teachers with ASD children has remained limited. However, there appear to be mounting concerns regarding
teachers appropriate qualifications and education, shortage
of specialized staff, and the subsequent impact on the
quality of education provided to ASD students. In addition,
it is argued that research should also investigate everyday
problems teachers face in relation to the education of ASD
students (Scheuermann et al. 2003; Simpson 2003). The
learning objectives of teachers on ASD are not specified in
details, while there is a wide range of required knowledge
and skills (Maurice et al. 1996; National Research Council
2001; Scott et al. 2000). It is well recognized that undergraduate training is limited and insufficient not only in the
case of Greek education but also on an international scale,
as recent relevant research indicates (McConkey and
Bhlirgri 2003; inter alia). However, a growing interest in
special education training is formed in Greece lately
(Mavropoulou and Padeliadu 2000; Syriopoulou 2003).
Probst and Leppert (2008) state that information about
the particular characteristics of children with ASD as well
as interventional methods should be strongly integrated
into the curricula of teacher-training programs. Other
studies demonstrate that teachers and other professionals
who work with ASD students need to be well trained and
supported in order to provide coordinated services that are
beyond the scope of the efforts of individual teachers
(Cotugno 2009; Dib and Sturmey 2007; Grey et al. 2005;
Lerman et al. 2008; ONeil et al. 1993; Schuster et al.
1991).
Special education and past relevant experience of
teachers serving ASD children can exert a critical impact
on teachers capability to develop a focused and interdisciplinary educational curriculum. This could be efficiently
supported particularly in case a flexible educational
123
feedback mechanism would assimilate practical evidence

gained at school level. On the one hand, an adjusted educational programme tailor-made to the ASD cases could be
useful to remediate the multidimensional deficits of ASD
students. On the other hand, and complementary to that, an
integrated, multidisciplinary approach could be conveniently designed to further support teachers and children in
the ASD front. Following the limited past research, it
appears useful, interesting and timely to investigate these
issues further (especially education and experience of
teachers serving ASD children).
A study on Greek teachers revealed that even special
education teachers are somewhat confused regarding the
basic characteristics and causes of ASD (Mavropoulou and
Padeliadu 2000). The upgrading of teachers education on
ASD contributes to the improvement of ASD childrens
behavior, language, social capabilities and play skills.
Childrens behavioral problems may potentially induce
educational concerns and stress to teachers. This, in turn,
can ultimately hinder teachers ability to cope with
everyday problems of ASD children (Probst and Leppert
2008).
Based on past literature review, the prevailing policies
on educational preparedness of educators from across the
globe in serving children with ASD appear to be constrained with a number of limitations. The educational
curriculum on ASD, for instance, is seen to focus predominantly on particular areas of ASD childrens special
needs (such as on social or communication skills or language deficits). Furthermore, specific teaching techniquesrather than an integrated approach on ASD
childrenare promoted. This results to teachers not being
in a position to formulate spherical and clear-cut views on
their own role and service of potential ASD children cases.
A major constraint to handle these issues relates to the
diversified nature and characteristics of ASD children as
well as to the fact that these characteristics alter as the child
grows. Hence, in several countries, the prevailing policies
on educational preparedness of educators in serving ASD
children appear to be a subject of ongoing concern, evaluation, reappraisal, and reformation to dynamically adjust
to the changing perception of the autististic disorders (Lian
et al. 2008, Singapore; Mavropoulou and Padeliadu 2000,
Greece; Probst and Leppert 2008, Germany, UK, US;
Scheuermann et al. 2003, US; Simpson 2003, US; inter
alia). Broad policy measures to promote and further support special education could potentially include a variety of
flexible and focused undergraduate, postgraduate and inservice training programmes and courses, enriched with
teaching approaches tailor-made to ASD cases.
The purpose of this study is to investigate teachers
perceptions focusing on the nature and management of
children with ASD. More specifically, this research
examines the following core topics: evaluation of the

implications of teachers previous training and working
experience and the assessment of the influence and impact
on teachers perceptions and attitudes in key issues for
serving and managing ASD children.
757
Table 1 Teachers demographic and working characteristics
n
Gender
Female
166
72.8
62
27.2
B30
53
23.2
3140
83
36.4
4150
81
35.5
Male
Age (years)
Method
Participants
Greek Teachers Sample Identity
[50
3.5
No response
1.3
174
32
76.3
14.0
Rural areas
3.1
No response
15
6.6
B5
73
32.0
610
49
21.5
1115
38
16.7
[15
58
25.4
No response
10
4.4
Place of work
This applied study has been based on the construction,

evaluation and statistical analysis of a conveniently constructed questionnaire to investigate the core objectives of
teachers attitudes on issues relevant to managing autistic
children. The questionnaire was organized on the basis of
33 major questions and was subdivided in two major parts.
The first part of the questionnaire focused on the educational and professional experience of the teachers sample
population (8 questions). The second part addressed critical
questions relevant to the following core pillars: (a) nature
and characteristics of autism (7 questions); (b) assessment
of children with autism (5 questions); (c) management of
children with autism (8 questions); and (d) the teachers
role in the education of autistic children (5 questions)
(a questionnaire sample is included in Appendix).
The study cohort consists of 228 teachers [166 females
(72.8%) and 62 males (27.2%)] who met the criterion of
being a teacher currently working in the formal educational
system of Greece. As to the teacher demographic and
service characteristics, including age, work experience
(years of service) (Table 1), the sample majority, namely
84 teachers (36.56%) are in the 3140 years age range and
80 teachers (35.24%) in the 4150 years age range
(Table 1). As regards teachers years of service, the sample
majority, namely 74 teachers (32.46%) have up to 5 years
of service, 49 ones (21.49%) 610 years, 38 ones (16.67%)
1115 years, and 57 ones (25.00%) more than 15 years
(Table 1).
Furthermore, the majority of teachers sample population, namely 175 teachers (76.75%), serves in urban areas,
and 31 ones (13.60%) in semi-urban areas (Table 1). The
sample majority, namely 118 teachers (51.75%), serves
primary education, and 67 ones (29.39%) serve secondary
education (Table 1). The sample majority, namely 144
teachers (63.16%), serves in mainstream schools, 35 ones
(15.35%) in special schools, and the rest evenly divided
between special schools, integration classes, Technical
Secondary Education in Special Vocational Training Secondary Education (EEEEJ), and multicultural schools
(Table 1).
Urban areas
Semi-urban areas
Years of service
Type of educational unit in which teachers serve

Special school
36
15.8
144
63.2
Inclusive class
3.5
Technical school
3.5
Mainstream school
Special education vocational center
2.2
3
24
1.3
10.5
Yes
83
36.4
No
145
63.5
Multicultural school
No response
Previous significant studies on autism
Number of children with autism in the classroom

None
176
77.2
13
27
11.8
4 or 5
13
5.7
More than 5
1.8
No response
3.5
Yes
64
28.1
No
164
71.9
Previous experience with autistic children
Of the teachers sample population, 83 teachers (36.4%)

had previously been trained or had attended authorized
postgraduate seminars, specialized on autism, at least in
one accredited undergraduate or postgraduate course on
autism, under the auspice of the Ministry of Education.
Those teachers who had participated in unauthorized
seminars or attended only conferences (n = 7) were not
123
758
included in the category significantly trained. The term

authorized training refers to certified training education
provided by the Ministry of Education that qualifies
teachers to work in special education units. The unauthorized training refers to voluntarily and privately gained
training, including special seminars, conferences, venues,
workshops, and other relevant activities on special education. Experience in teaching and managing children with
autism in inclusive classes, mainstream schools, or special
schools was held by 64 teachers (28.1%). Teachers with
less than 2 years of experience with autistic children or
experience as a parent-relative or friend were not included
in the significantly experienced.
participating teachers about critical issues of ASD. The

lecture participants were interested in seeking out specialized information on ASD, were working in different
types of schools and level of education (mainstream/special; primary/secondary; vocational/multicultural etc.) and
had different educational background and experience with
ASD children. Random sampling was applied to one in
three attendees to whom the questionnaire was distributed.
The questionnaire responses were anonymous. A written
consent was obtained by each responder. In total, 300
questionnaires were distributed to 900 attendees of the
aforementioned lectures, and 228 were returned. The
characteristics of this teachers cohort are presented in
Table 1.
Measures
Statistical Analysis and Multivariate Logistic Regression
The teachers opinions were evaluated using a structured
questionnaire. An initial pilot study was conducted with 20
teachers from the area of Athens, in order to test teachers
comprehension and objectivity in answering this questionnaire. The responses, feedback and final structure of the
questionnaire were evaluated by the research team and
were also based upon and compared with relevant input
from most recent international literature on the subject
(Conroy et al. 2007; Grey et al. 2005; Probst and Leppert
2008; Roth et al. 2010). The questionnaire comprised of
four sets of questions regarding the nature and characteristics of autism, assessment of children with autism, management of ASD children, and the teachers role in the
education of autistic children. Each question included in
the questionnaire was considered a dependent variable that
described teachers perceptions and attitudes. The responses in line with prevailing educational norms and not in
line with prevailing educational norms were discriminated
by the researchers (C.S., S.P.) based on the literature
(Conroy et al. 2007; Grey et al. 2005; Probst and Leppert
2008; Roth et al. 2010). Responses such as I do not know
and I do not answer were defined as responses not in line
with prevailing educational norms for the purpose of statistical analysis. Teachers training and education on autism, and experience in managing autistic children were the
selected independent variables. The dependent variables
were investigated and assessed under the influence of these
independent variables.
Statistical analysis of the data was performed using the

Statistical Package for the Social Sciences (SPSS, version
16.0, Chicago, IL, USA). All variables were categorized
and were expressed as frequencies and percentages. The
chi-square test was used to evaluate any potential association between teachers perceptions and selected independent variables, such as teachers education and experience
regarding the management of autistic children. To assess
the independent impact of teachers education and experience on their perceptions and knowledge of autism, a
multivariate stepwise logistic regression analysis was also
performed; teachers gender, age, place of work and years
of service were considered as possible confounders.
Adjusted odds ratios (aOR) with their 95% confidence
intervals (CI) were estimated as the measure of association
of teachers education and experience in autism with their
perception and knowledge of autism. All tests were two
tailed, and the level of statistical significance was set at
p \ 0.05.
Results
Statistical Analysis of Questionnaires on Teachers
Perceptions and Knowledge of ASD
The findings regarding teachers perceptions of ASD
children are summarized in Table 2.
Materials and Procedures

Overview of Key Findings
The questionnaires of the study were distributed to teachers
in different towns around the country during lectures
delivered by one of the researchers (S.P.). Twelve lectures
took place in seven towns/cities in mainland Greece
between November 2008 and May 2009. The core objectives of these lectures were to inform voluntarily
123
The majority of the Greek teachers cohort (55.3%) was

seen to believe that autism is the most serious mentalhealth disorder among children. Less than half of the
subjects were aware of children with autism having serious
speech disorders. Nearly half of teachers sample (45.2%;
759
Table 2 Teachers perceptions and knowledge of ASD

Agree
n
Disagree
Do not
know
No
response
Nature and characteristics of autism

Autism is the most serious mental-health disorder
126
55.3
57
25.0
38
16.7
3.1
Most individuals with autism acquire good language skills at a later stage
Autism exists alongside mental retardation
57
89
25.0
39.0
103
87
45.2
38.2
65
42
28.5
18.4
3
10
1.3
4.4
Autism is a hereditary disorder
24
10.5
108
47.4
85
37.3
11
4.8
Autism is a form of schizophrenia
26
11.4
159
69.7
38
16.7
2.2
Autistic children have intelligent parents
46
20.2
85
37.3
93
40.8
1.8
Autistic children are always hyperactive
100
43.9
74
32.5
49
21.5
2.2
Assessment of children with autism

Autism can be diagnosed in infancy
73
32.0
79
34.6
72
31.6
1.8
Disorders can be overcome to a large extent with the appropriate education
34
14.9
104
45.6
86
37.7
1.8
Autistic children can acquire exceptional skills in a particular field
146
64.0
2.2
31
13.6
46
20.2
Almost every teacher can recognize autistic characteristics in a child
116
50.9
73
32.0
30
13.2
3.9
82
36.0
42
18.4
99
43.4
2.2
51
22.4
59
25.9
115
50.4
1.3
Children with autism succeed in tests that involve rote learning

Management of children with autism
Psychoanalytic programs are the most beneficial for autistic children
Autistic children should be educated in a special school
167
73.2
47
20.6
11
4.8
1.3
Autistic children are suppressed and their condition worsens in a strictly structured
environment
66
28.9
95
41.7
50
21.9
17
7.5
The treatment of most autistic children should include drugs
44
19.7
77
33.8
98
43.0
3.5
126
55.3
55
24.1
40
17.5
3.0
28
12.3
91
39.9
100
43.9
3.9
34
14.9
70
30.7
115
50.4
3.9
117
51.3
45
19.7
53
23.2
13
5.7
Autistic children are better off if their education is focused on social skills rather than on
academic subjects
Auditory teaching methods are superior to visual methods
Behaviorism is an obsolete method
It is preferable for autistic children to attend special vocational schools rather than
mainstream secondary schools
The role of the teacher in the education of children with autism
Teachers should cooperate with specialists
216
94.7
1.8
2.2
1.3
Autistic children constitute the most difficult group of students
130
57.0
57
25.0
38
16.7
1.3
Teachers rather than medical doctors should play the leading role in the educationaltherapeutic treatment of autistic students
114
50.0
56
24.6
53
23.2
2.2
With appropriate training, teachers can deal effectively with an autistic child
180
78.9
25
11.0
19
8.3
1.8
Even with the appropriate training, teachers cannot raise the question about autism
121
53.1
65
28.5
35
15.4
3.1
n = 103) did not perceive that these children would be able

to acquire good language skills at a later stage. The
teachers cohort was found to split evenly as to whether
autism exists alongside mental deficiency (39.0% agreed
and 38.2% disagreed). Most teachers disagreed whether
autism is a hereditary disorder (47.4%; n = 108). Most of
the sample teachers (69.7%; n = 159) disagreed about
autism being a form of schizophrenia. The largest proportion of the study group (40.8%) did not know whether
autistic children have intelligent parents. The number of
responses regarding the plausibility of diagnosing autism in
infancy was evenly split: 73 teachers (32.0%) believed that
this is plausible indeed, 79 teachers (34.6%) disagreed, and
72 teachers (31.6%) did not know. Only 34 teachers

(14.9%) did they believe that appropriate education can
contribute to overcome the disorder, while 146 teachers
(64.0%) believed that autistic children can acquire exceptional skills in a particular field. Half of the teachers
cohort (50.9%; n = 116) declared capable of pinpointing
autistic characteristics.
As regards teachers perceptions with respect to the
management of ASD children, 115 teachers (50.4%) did
not know whether the best programs for autistic children
are those of the psychoanalytic type. Approximately threequarters (73.2%) of the study cohort were seen to believe
that ASD children should attend a special school; and, 95
123
760
teachers (41.7%) considered that autistic children are not

suppressed in a strictly structured environment. Over half
of the cohort (55.3%; n = 126) agreed that children with
autism are better off receiving education on social skills
rather than academic education, and 43.9% (n = 100) did
not know whether auditory teaching methods are superior
to visual ones. Half of the study group (50.4%; n = 115)
did not consider behaviorism to be an obsolete interventional method; and, half of the study group (51.3%;
n = 117) considered autistic children to be better off
receiving education at vocational schools of special education rather than at mainstream schools.
The approach proceeded to also evaluate the teachers
views about their role in the education of children with
autism. The vast majority of teachers (94.7%; n = 216)
maintained that teachers should cooperate with specialists
as regards the treatment of autistic children. More than half
of the cohort (57.0%; n = 130) was seen to believe that
ASD children constitute the most difficult group of students. Furthermore, half of the study group (50.0%;
n = 114) claimed that teachers rather than medical doctors
should have the first word on the educational-therapeutic
treatment of an autistic student. A particularly large sample
proportion (78.9%; n = 180) was seen to support the idea
that a teacher with the appropriate training can effectively
deal with an autistic child. More than half of sample
teachers (53.1%; n = 121) were found to believe that a
teacher, despite the appropriate training, is unable to pinpoint autistic characteristics in a child, in order to raise the
question about autism and refer the child to specialists.
Teachers Perceptions of ASD Children Relative to Their
Education and Experience
The research approach was backed up with statistical
analysis focusing on selected critical independent variables. The relevant responses of the teachers cohort were
examined in relation to teachers previous education and
working experience and their efficiency in serving and
managing ASD children. Tables 3 and 4 present the
research findings of the statistical analysis on these independent variables.
Nature and Characteristics of Autism The views and
perceptions of autism were found to differ substantially
between teachers with and without previous specific education in the field of autism (Table 3). The most striking,
and statistically significant differences between these two
teacher groups were seen to be the following: (a) autism is
perceived as the most serious mental-health disorder (66.3
and 49.0% for those with and without previous education
on autism, respectively; p = 0.011); (b) autism exists
alongside mental retardation (55.4 and 29.7%, respectively;
123
p \ 0.001); and (c) autism has no genetic predisposition

(56.6 and 42.1%, respectively; p = 0.034). Teachers with
previous education did not perceive autism as a form of
schizophrenia (80.7%, compared to 63.4% of teachers
without previous education; p = 0.006). Furthermore, the
former did not recognize hyperactivity as a common feature of children with ASD (26.9%, compared to 42.2%,
respectively; p = 0.018). In addition, the teachers perception of the nature and characteristics of autism differed
between teachers with and without previous experience in
this subject (Table 4).
Most of the teachers with previous experience in autism,
contrary to teachers with no previous experience, were seen
to believe that ASD constitutes the most serious mentalhealth disorder (71.9 and 48.8%, respectively; p = 0.002).
Furthermore, most of ASD children were seen to not
acquire good language skills later in life (64.1 and 37.8%,
respectively; p \ 0.001). Experienced teachers on autism
had more often the perception that autism exists alongside
mental retardation (57.8 and 31.7%, respectively;
p \ 0.001). In addition, autism was not perceived as a form
of schizophrenia (85.9 and 63.4%, respectively; p =
0.001). Finally, autistic children were not perceived to
behave always hyperactively (45.3 and 27.4%, respectively; p = 0.010). The gender (male/female teacher) was
also tested as an independent factor for teachers perceptions on ASD but was not found to exert a statistically
significant impact.
Assessment of Children with Autism The teachers perception of how to assess ASD children differed statistically
significantly between the teachers group with previous
education on ASD against the teachers group with no
previous ASD education (Table 3). Teachers with previous
ASD education were more often seen to believe that autism
can be diagnosed in infancy (48.2 and 26.9%, respectively;
p = 0.001). Furthermore, these teachers perceived that
ASD children can achieve exceptional skills in a particular
field (80.7 and 54.5%, respectively; p \ 0.001). In addition, ASD children can succeed in tests that involve rote
learning (48.2 and 29.0%, respectively; p = 0.004). Nevertheless, educated teachers on ASD had the opinion that
autism cannot be overcome to a large extent (66.3 and
33.8%, respectively; p \ 0.001). There was no statistically
significant difference between the two teachers groups as
regards the impression that almost every teacher could
recognize autistic characteristics in a child.
These critical issues put forward earlier were also
examined in two groups of teachers stratified according to
teachers previous working experience with ASD children.
A broad research conclusion indicates similar pattern of
responses as earlier obtained by these two teachers groups
(Table 4). Previous working experience of teachers with
761
Table 3 Teachers perceptions and knowledge of ASD in relation to their previous relevant education
Education on autism
No
n
Yes
%

71
49.0
55
66.3
0.011
Most individuals with autism do not acquire good language skills later in life
49
43
33.8
29.7
54
46
65.1 \0.001
55.4 \0.001
Autism is not a hereditary disorder
61
42.1
47
56.6
0.034
Autism is not a form of schizophrenia
92
63.4
67
80.7
0.006
30
20.7
16
19.3
0.798
Autistic children are not always hyperactive
39
26.9
35
42.2
0.018
39
26.9
40
48.2
0.001
Disorders cannot be overcome to a large extent even with the appropriate education
49
33.8
55
66.3 \0.001
Autistic children can acquire exceptional skills in a particular field
79
54.5
67
80.7 \0.001
76
52.4
40
48.2
0.540
42
29.0
40
48.2
0.004

The most beneficial programs for autistic children are not psychoanalytic
19
13.1
40
48.2 \0.001
Autistic children should not be educated in a special school
28
19.3
19
22.9
Autistic children are not suppressed and their condition improves in a strictly structured environment
The treatment of most autistic children should not include drugs
43
38
29.7
26.2
52
39
62.7 \0.001
47.0
0.001
0.520
Autistic children are better off if their education is focused on social skills rather than on academic subjects
68
46.9
58
69.9
Auditory teaching methods are not superior to visual methods
34
23.4
57
68.7 \0.001
0.001
Behaviorism is not an obsolete method
24
16.6
46
55.4 \0.001
It is preferable for autistic children to attend special vocational schools rather than mainstream secondary
schools
26
19.9
19
22.9
0.365

137
94.5
79
95.2
0.820
73
50.3
57
68.7
0.007
Teachers rather than medical doctors should play the leading role in the educational-therapeutic treatment of
autistic students
60
41.4
54
65.1
0.001
With the appropriate training, teachers can effectively deal with an autistic child
ASD children did not affect significantly teachers perception of diagnosing autism in infancy or the ability of the
teacher to recognize autistic characteristics in a child. The
teachers gender did not modify, in general, their perceptions and attitudes in autism. However, the belief that
autistic children can gain exceptional skills in a particular
field was significantly more common among female than
male teachers (70.5 and 46.8%, respectively; p = 0.001).
Management of Children with Autism The opinions and
attitudes on certain topics of serving and managing ASD
children were found to differ considerably between
teachers with previous specific education or previous
108
74.5
72
86.7
0.029
31
21.4
34
41.0
0.002
working experience and teachers without previous education or experience on autism, respectively. More specifically, the majority of sample teachers with education and/
or experience attributed low credit to psychoanalytic programs, as it was accepted that the most beneficial programs
for ASD children are not psychoanalytic ones (teachers
with education on autism: 48.2% compared to 13.1%;
p \ 0.001; previous working experience: 40.6% compared
to 20.1%; p = 0.001). The majority of educated and
experienced teachers were seen to believe that the treatment of most ASD children should not be based on drugs
but emphasize on special education (educated teachers:
47.0% compared to 26.2%; p = 0.001; experienced
123
762
Table 4 Teachers perceptions and knowledge of autism in relation to their previous relevant experience
Experience with
autism
No
n
Yes
%

80
48.8
46
71.9
62
37.8
41
64.1 \0.001
0.002
52
31.7
37
57.8 \0.001
74
45.1
34
53.1
0.277
0.001
104
63.4
55
85.9
35
21.3
11
17.2
0.482
Autistic children are not always hyperactive
45
27.4
29
45.3
0.010
51
31.1
28
43.8
0.071
65.6 \0.001

62
37.8
42
Autistic children can have exceptional skills in a particular field
92
56.1
54
84.4 \0.001
83
50.6
33
51.6

45
27.4
37
57.8 \0.001
33
20.1
26
40.6
0.001
29
17.7
18
28.1
0.080
Autistic children are not suppressed and their condition improves in a strictly structured environment
54
32.9
41
64.1 \0.001
0.897
44
26.8
33
51.6 \0.001
Autistic children are better off if their education is focused on social skills rather than on academic subjects
79
48.2
47
73.4
42
25.6
49
76.6 \0.001
0.001
35
21.3
35
54.7 \0.001
It is preferable for autistic children to attend special vocational schools rather than mainstream secondary
schools
30
18.3
15
23.4
0.380
153
85
93.3
51.8
63
45
98.4
70.3
0.118
0.011
69
42.1
45
70.3 \0.001

Teachers rather than medical doctors should play the leading role in the educational-therapeutic treatment of
autistic students
teachers: 51.6% compared to 26.8%; p = 0.001). The

research findings also indicated that behaviorism is not an
obsolete intervention for ASD children (educated teachers:
55.4% compared to 16.6%; p \ 0.001; experienced
teachers: 54.7% compared to 21.3%; p \ 0.001). Furthermore, based on the findings, in a strictly structured environment, ASD children do not feel suppressed but tend to
improve (educated teachers: 62.7% compared to 29.7%;
p \ 0.001; experienced teachers: 64.1% compared to
32.9%; p \ 0.001). Autistic children were also believed to
be better off in case their education is focused on social
skills rather than on academic subjects (educated teachers:
123
124
75.6
56
87.5
0.048
41
25.0
24
37.5
0.060
69.9% compared to 46.9%; p = 0.001; experienced

teachers: 73.4% compared to 48.2%; p = 0.001). The
findings also postulated that there is no particular advantage of auditory over visual teaching methods (educated
teachers: 68.7% compared to 23.4%; p \ 0.001; experienced teachers: 76.6% compared to 25.6%; p \ 0.001).
Teachers with previous special education and/or previous
working experience indicated a rather balanced view as to
whether it is preferable for ASD children to attend a special vocational rather than a mainstream school, although
there appears to be a slight preference for the former type
of school (Tables 3, 4).
763
Table 5 Cumulative effect of past specialized education and working experience on teachers perceptions of autism
a (%)
b (%)
c (%)
1. Most individuals with autism do not acquire good language skills later in life
31.7
54.4
71.7
\0.001
2. Autism exists alongside mental retardation
28.6
40.4
66.7
\0.001
3. Autistic children are not always hyperactive
26.2
31.6
51.1
0.004
4. Autism can be diagnosed in infancy
27.0
38.6
51.1
0.003
5. The disorders associated with autism cannot be overcome to a large extent even with the provision of
appropriate education
31.7
54.4
73.3
0.004
6. Most therapeutic programs for autistic children are not psychoanalytic
14.3
28.1
55.6
\0.004
7. Autistic children do not feel suppressed in a strictly structured environment, and their condition improves
8. The treatment of most autistic children should not be based on drug therapy, but rather on special education
27.8
24.6
47.4
35.1
73.3
57.8
\0.001
\0.001
9. Autistic children are better off receiving education on social skills rather than an academic education
45.2
57.9
80.0
\0.001
10. Auditory teaching methods are not superior to visual methods
19.8
45.6
88.9
\0.001
The table records only the items with statistically significant difference
a: Without education or experience; b: with either education or experience; c: with both
The Teachers Role in the Education of Children with

Autism Based on the research findings, the teachers role
in educating ASD children was shaped more clearly among
the group of teachers with previous special education on
autism than among teachers with lack of such background.
The former group of teachers was seen to more often
believe that autistic children comprise the most difficult
group of students to handle (68.7 and 50.3%, respectively;
p = 0.007). However, it was perceived that, subsequent to
ASD students receiving appropriate training, any teacher
can deal effectively with autistic students (86.7 and 74.5%,
respectively; p = 0.029; Table 3). In addition, educated
teachers on autism, more frequently, held the view that
teachers rather than medical doctors should play the leading role in the management of autistic students (65.1 and
41.4%, respectively; p = 0.001). In any case, the group of
teachers with previous education on autism more frequently supported the view that, even with appropriate
training, teachers are not in a position to raise the question
about autism (41.0 and 21.4%, respectively; p = 0.002).
The findings based on teachers with past working
experience on autism also supported further the earlier
findings, as they were seen raising similar views (Table 4).
The perception related to the necessity of cooperation
between teachers and specialists, in order to treat ASD
children effectively, did not differ significantly between
teachers with and without education or experience
(Tables 3, 4). Moreover, more female than male teachers
were found to believe that autistic children comprise the
most difficult group of students, and, in addition, that
teachers should cooperate with specialists in order to
manage autistic children. (As these findings on gender were
not statistically robust they should be treated with caution).
The cumulative effects of past specialized education and
working experience on teachers perceptions of autism
were also examined. The frequencies of responses termed

in line with prevailing educational norms were higher in
the group of teachers who had both education and experience (19.7%; n = 45) than in the group of teachers without
education or experience (55.3%; n = 126) as well as than
in the group of teachers with either education or experience
only (25.0%; n = 57). The aspects of autism investigated
under the cumulative effects of teachers past education
and experience are summarized in Table 5.
The findings produced by the multivariate logistic
regression analysis revealed that specialized education as
well as working experience remain critical and robust
independent predictors of teachers perception and
knowledge of autism. The adjusted odds ratios (aOR) were
found to range from 1.9 to 4.7 for teachers previous specialized education and from 2.1 to 5.8 for teachers previous working experience, at the 95% confidence interval
(Table 6).
Discussion
Past studies have postulated that teachers perceptions and
knowledge play a crucial role on the service and management of autistic children. However, despite its importance,
research remains surprisingly thin in this field. A core
objective of this study has been to partially mitigate this
gap, focusing in particular on the Greek educational system. More specifically, revealing Greek teachers perceptions and knowledge of the nature and management of
ASD children has been, thus, a principal purpose of this
paper. The findings are indicative of the prevailing contradictions, ambiguity and confusion about autism among
teachers, especially as regards the nature of autistic disorder, the most efficient approaches to manage ASD students
123
764
Table 6 Association of teachers education and experience in autism with their perception and knowledge of autism, expressed as adjusted odds
ratios (aOR) with their 95% confidence intervals (CI)
Education
aOR (95%
CI)
Experience
p Value
aOR (95%
CI)
p Value

Autism is the most serious mental health disorder
2.2 (1.14.5)
0.029
2.7 (1.45.2)
0.002
2.1 (1.04.1)
0.043
2.1 (1.14.0)
0.019
2.3 (1.24.5)
0.017
Autistic children are not often hyperactive
2.7 (1.16.3)
0.023

2.4 (1.24.5)
0.009
2.9 (1.65.5)
\0.001
2.2 (1.14.4)
0.025
Autistic children can have exceptional skills in a particular field
2.4 (1.25.0)
0.016
3.1 (1.47.3)
0.008

Education of children with autism
3.3 (1.66.4)
\0.001
5.6 (2.711.4) \0.001
Autistic children are not suppressed and their condition improves in a strictly structured
environment
2.9 (1.65.5)
\0.001
Autistic children are better off if their education is focused on social skills rather than on
academic subjects
1.9 (1.03.6)
0.044

4.3 (2.28.4)
4.7 (2.39.4)
\0.001
\0.001
It is preferable for autistic children to attend special vocational schools rather than
mainstream secondary schools
2.3 (1.24.6)
0.014
2.2 (1.14.2)
0.024
2.2 (1.14.5)
0.025
5.8 (2.812.1) \0.001

2.8 (1.45.8)
0.006
The role in the education of children with autism

Teachers rather than medical doctors should play the leading role in the educationaltherapeutic treatment of autistic students
2.3 (1.24.5)
2.6 (1.35.2)
0.007
0.015
Results of multivariate logistic regression analysis, adjusting for teachers gender, age, place of work and years of service
and the relevant potential outcomes. The high percentages

seen in the do not know answers may reflect the obscurity
and vagueness of the concept of autism, combined with
teachers limited knowledge and practical experience on
autism.
As anticipated, the teachers population holding previous specialized education and/or experience on autism
holds clearer views and opinions on the issues put forward
by the survey. More specifically, teachers with relevant
educational background and/or working experience have
123
the opinion that ASD can be diagnosed in infancy. Furthermore, past specialized education can contribute to the
acquisition of skills in particular fields of autism. A significant divergence between the two sample teacher subgroups (with or without past education and/or experience
on autism) was seen in the case of management of autistic
children. This view was related to the substantial
improvement of ASD students whenever they were taught
in a strictly structured environment, where they could
upgrade their social skills. Based on the research evidence,
teachers with relevant educational background and/or

experience on autism appear to marginally favor special
vocational rather than mainstream schools as more appropriate for ASD students. This is an interesting finding
which can imply that educational policies on autism may
have not been fully organized and developed as yet in both
mainstream and special vocational schools. If this is the
case, it raises concerns regarding the current flexibility and
adaptability of the educational curriculum in mainstream
and vocational schools, sufficient training and specialization of teachers as well as adequacy of premises infrastructure. Since these are critical policy issues, further
research on these issues should be useful.
Finally, previous education and/or experience on autism
were found to be fundamental in supporting teachers
dealing more efficiently with ASD students. This can
potentially imply that teachers training in diverse educational environments has a critical impact to raise teachers
motivation and initiative contributing in special education.
The educated or experienced teachers group more often
than the noneducated or nonexperienced teachers group
was seen to believe that ASD is the most serious mentalhealth disorder in children, often coinciding with mental
retardation; and, ASD students comprise the most difficult
group of students to manage. These findings were further
validated and supported by the multivariate logistic
regression analysis. This latter approach also underlined
the independent impact of specialized education and
working experience on teachers perception and knowledge
of autism, with a twofold to threefold increase in the frequency of the more in line with prevailing educational
norms response. A broad conclusion put forward by this
survey is the need for an interdisciplinary educational
background with solid training on ASD teaching approaches. This would critically support teachers in undertaking
a leading role whenever working within a team together
with specialized scientific staff, parents and institutions. In
any case, teachers special education and past working
experience provide a solid fundamental backup in knowing
how to serve and manage ASD students.
A number of constraints in this study should be also
mentioned. For a start, previous research has been thin on
the issue of teachers perceptions on the management of
ASD children. In addition, the sample size was cut down in
765
order to keep the teachers cohort at a manageable level.

Moreover, further evaluation of the structured questionnaire and the distribution process should be ideally conducted. However, despite these limitations, the results have
been encouraging, and emphasized on the significant
implications of teachers previous specialized education
and working experience on autism for the efficient educational process of autistic children.
In conclusion, ASD students possess a variety of characteristics that impose constraints on their smooth educational process but, on the other hand, induce material
challenge for the educational community. The findings of
this study have also revealed ambiguities and contradictions with view to the basic ASD characteristics and the
resulting tremendous difficulties in managing autistic
children. Nevertheless, the research results were seen to
improve significantly when a number of critical issues on
autism were examined in relation to teachers previous
special education and/or working experience. These latter
key factors (educationexperience) were found to
empower teachers with knowledge and confidence,
enabling them to build upon existing knowledge of the
nature and problems of autism, without ignoring the constraints and unfavorable educational outcomes of ASD
children.
The positive impact of teachers previous specialized
education appears to be reinforced when seen jointly with
working experience on ASD children. Autistic children are
considered to be highly needy as regards their educational
achievements. In order to fulfill ASD childrens demands,
it is crucial for teaching personnel to have been appropriately trained. The present study and the limited past
research support the plausible view that teachers with relevant specialized education have a broader view of autistic
disorders and are, therefore, in a better position to select
and structure their educational goals. The additional
experience gained working with and managing of autistic
children strengthens teachers self-esteem and upgrades
their position in the class, enabling them to have an active
leading role within working teams on autism, including
specialized scientific staff, parents and institutions.
Appendix
123
766
123
767
123
768
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J Autism Dev Disord (2012) 42:755768