Issues in Comprehensive Pediatric Nursing

ISSN: 0146-0862 (Print) 1521-043X (Online) Journal homepage: http://www.tandfonline.com/loi/icpn20

Bullying of Students with Asperger Syndrome

Susan Carter Ed. D.
To cite this article: Susan Carter Ed. D. (2009) Bullying of Students with Asperger Syndrome,
Issues in Comprehensive Pediatric Nursing, 32:3, 145-154, DOI: 10.1080/01460860903062782
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Issues in Comprehensive Pediatric Nursing, 32:145154, 2009

Copyright Informa Healthcare USA, Inc.
ISSN: 0146-0862 print / 1521-043X online
DOI: 10.1080/01460860903062782

1521-043X
0146-0862
UCPN
Issues
in Comprehensive Pediatric Nursing
Nursing, Vol. 32, No. 3, June 2009: pp. 113

BULLYING OF STUDENTS WITH ASPERGER SYNDROME

Bullying
S.
Carter of Students with Asperger Syndrome

Susan Carter, Ed. D.

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Department of Special Education, Dowling College, Oakdale, New York, USA

INTRODUCTION
Aspergers Syndrome is an autism spectrum disorder in which individuals
are unable to interpret social cues, often have special interests, and are
pedantic in their expression. Children with Aspergers have social interactions that may involve extensive conversation about an all-consuming,
intense special interest; and they may be characterized as, verbose, eccentric, or overly formal in communication (Ghaziuddin & Gerstein, 1996).
Aspergers is named after Hans Asperger, an Austrian psychiatrist who
noted these characteristics in 1944 in the boys he was treating in his practice. Many students having Asperger syndrome attend public schools and
are in general or integrated classrooms where they receive interventions
related to social skills, organization, and written expression and also
receive counseling support. With medical advances and increased public
awareness, Asperger syndrome is being recognized earlier, and subsequent early intervention services are being given.
One of the problems associated with Asperger syndrome is that children and adolescents often are bullied, victimized, and shunned by peers
and siblings. Both the original work by Asperger (1944) and first-person
accounts report of the rejection and pain experienced because of incessant
tormenting and teasing by others. Children and adolescents with Asperger
syndrome have a myriad of challenges confronting them in the schools
they attend. Many will never have the opportunity to express their talents
because they are misunderstood, and often they are denied services
because they are articulate, do well academically, and appear too bright.
Received 21 February 2009; accepted 25 May 2009.
Address correspondence to Susan Carter, Ed. D., Assistant Professor, Dowling College, Department of Special Education, 150 Idle Hour Boulevard, Oakdale, New York 11769. E-mail: carters@
dowling.edu

145

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S. Carter

In actuality, many children with Asperger syndrome have significant

social deficits, severe sensory sensitivities, and are teased, isolated, and
socially excluded by their peers. As a result, due to their untreated severe
social disabilities, their gifts and natural talents are sometimes wasted
(Klin, Volkmar, & Sparrow, 2000).
Preliminary research suggests that frequencies of victimization and shunning are high. Little (2002) performed a study of 411 children and adolescents with Aspergers Spectrum Disorders and found that 94% of parents
reported that their children had been victimized by siblings and/or peers.
Klin and Volkmar (2000) found that children are often placed in ageappropriate educational settings, allowing for the worst mismatch possible,
namely the introduction of individuals with a very naive understanding of
social situations into a mix with those who can and do manipulate social situations to their advantage without the benefit of self-restraint.
Children with Asperger syndrome are also socially excluded. Many
parents express tearfully that their number-one concern is that their child
has never been invited to a birthday party. Myles and Simpson (1998)
found that parents express an overwhelming sadness when they learn that
their children have immature social skills and are ignored and rejected by
their peers. The social disability of Asperger Syndrome is invisible to medical professionals and educators, and, because they do not understand, they
do not help, especially when it comes to keeping the child safe from peers
who are aggressive. Furthermore, bullying has long-lasting effects on individuals. Studies suggest that victims with Asperger Syndrome are at risk for
internalizing problems such as depression, and they tend to lack friends and
be rejected by their peers (Olweus, 1993). In a study of 35 patients with
Asperger syndrome, Ghazuiddin, Weidmer-Mikhail, and Ghazuiddin
(1998) found that 65% had co-morbid psychiatric disorders. These included
attention problems in younger children and depression in adolescents.
PURPOSE OF THE STUDY
The purpose of the study was to measure the frequency of victimization
and shunning in children and adolescents with Asperger Syndrome and to
compare rates from this study with results of an earlier study.
METHOD
Participants
The proposal for this study was submitted and approved by the Teachers
College, Columbia University Institutional Review Board. The sample
included 34 parents having children between the ages of five to 21 years

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147

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of age. Eighty-eight percent of the youth were male and 12% were
female. The mean full-scale intelligence quotient (SS = 110) of the sample
was in the average range. Fifty-four percent of mothers and 46% of fathers
had degrees beyond the Bachelors degree. The participants represented
thirty-one school districts from Long Island, New York. More than
one-half of the parents had an annual income of over $90,000. Sixty-eight
percent of the youth had individualized educational plans (IEPs), legal
special education documents outlining educational goals, and school
program. Nine percent received accommodations on a 504 plan, and 24%
received no special services or accommodations.
Measures
Two instruments were used to measure victimization and shunning frequencies, the Juvenile Victimization Questionnaire (JVQ) (Hamby & Finkelhor,
1999) and an instrument consisting of three shunning questions (Little,
2002). Permission was obtained from the authors for the use in the study.
The JVQ was used to assess victimization. This instrument, designed to
measure comprehensive juvenile victimization, contains questions on
different domains of victimization, including conventional crime, child maltreatment, and peer and sibling victimization. Construct validity of the JVQ
peer-victimization items was established from the Youth Internet Safety Survey (Finkelhor, Mitchell, & Wojak, 2000). The instrument was reviewed by
focus groups, and cognitive interviews with youth were conducted in order
to assess young childrens comprehension of survey items on victimization,
which yielded low Flesch-Kindaid readability scores. Other psychometric
properties are still being established (Hamby & Finkelhor, 2001).
Parents completed five questions from Module C of the instrument.
Questions included were:
In the last year, did any kids, even a brother or sister, hit your child at

home, at school, out playing, in a store, or anywhere else?

Sometimes groups of kids or gangs attack people. In the last year, did

a group of kids or a gang hit, jump, or attack your child?

In the last year, did any kids, even a brother or sister, pick on your

child? They might pick on them by chasing them, grabbing their hair
or clothes, or making them do something they did not want to do.
In the last year, did any kids try to hurt your childs private parts on
purpose by hitting or kicking them there?
In the last year, did your child get scared or feel really bad because
other kids were picking on him/her? They might pick on them by
calling names, saying mean things to them, or saying they didnt
want them around.

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The response choices were: Never (0), once (1), twice (2), 35 times (4), 6
or more times (8). Three questions developed by Little (2002) were used to
assess social exclusion frequencies in children. Eighteen of the 34 children
in this study were included in this analysis. The questions included:

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How many times has your child (ages 514) been invited to a friends

birthday party in the last year? Response choices ranged from: This
has not happened in the last year (0), 1 time (1), 2 times (2), 3 to 5
times (3), and 6 or more times (4).
When teams are picked in school, how often is your child picked last
or almost last? Response choices were: Never (0), rarely (1), sometimes (2), often (3), and always (4).
How often does your child sit alone at lunchtime during school?
Response choices were the same as for Question 2.
The questionnaire included extra space for parent comments.
Procedures
Parents having children diagnosed with Asperger syndrome were recruited
online, in clinics, and at autism conferences. Questionnaires were mailed to
interested parents and returned by mail to the researcher. In addition to the
five JVQ and three shunning items, information about demographics,
student characteristics, family background, and educational factors were
included in the survey.
Data Analysis
Data were analyzed using SPSS version 10.0. Means and frequencies
were used to describe the demographic data (Table 1). Victimization and
shunning frequencies and percentages were obtained by transforming the
answers into dichotomous (yes/no) data. Data was coded 1 for any
affirmative response and 0 for a negative response. For example, for the
question related to being picked last for teams, never was categorized
no (0) and all others responses, such as rarely, sometimes, often,
and always were categorized yes (1). Thus, if nine of the 18 parents
registered a yes response to a question, the percentage for the question
would be 50%. Overall prevalence of victimization was derived by assigning a yes if any one of the questions was answered affirmatively, then
dividing the total number of affirmative scores by the total number of parents. In this study, 22 of 34 parents gave a yes response to at least one of
the victimization questions, yielding an overall victimization percentage of
65%. The overall prevalence of victimization, five victimization and three

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Table 1. Demographic characteristics of the sample (N = 34)

Children and adolescents with asperger
syndrome

Variable
Age of child

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Income of Parents

Mothers Highest Educational Level

Fathers Highest Educational Level

Gender
Male
Female
Full Scale Intelligence Quotient Score
Mean (N = 34)
Type of Program
Section 504 Plan
Individualized Educational Plan (IEP)
No 504 or IEP
Special Education Service
Inclusion Classroom
Resource Room
Services in Classroom and Out of Classroom
No Services

Mean
Std deviation
(N = 34)
15.03
3.34
2.9% Below $30,000
11.8% $3060,000
29.4% $6090,000
55.9% $90,000 +
14.7% High school degree
32.4% Bachelors degree
47.1 Masters degree
5.9 Doctoral degree
2.9% No High school degree
17.9% High school degree
35.3% Bachelors degree
26.5% Masters degree
17.6% Doctoral degree
88.2%
11.8%
110.06
21.10
8.8%
67.6%
23.5%
14.7%
32.4%
14.7%
38.2%

shunning questions from this study were compared with a peer victimization study using the same items and data transformation (Little,
2002). Frequencies from the previous and current study are illustrated in
Table 2.
RESULTS
This study found that nearly 65% of the parents reported that their
children had been victimized by peers in some way within the past year.

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Table 2. Frequency comparison of victimization and shunning studies

Little (2002) & current study
Little (2002) aspergers disorder &
nonverbal learning disabilities

Current study
asperger syndrome

Ages 717

Ages 721

Victimization variable

(N = 411)

(N = 34)

Overall Prevalence
Hit by peers
Attacked by peers
Picked on
Hurt in private parts
Scared by peers
Shunning Variable

94%
73%
10%
55%
15%
75%
Ages 714

64.7%
47.1%
8.8%
44.1%
8.8%
50.0%
Ages 714
(N =1 8)
11.8%
5.9%
2.9%

Never invited to a birthday party

Picked last for teams
Sat alone at lunch

33%
31%
11%

Forty-seven percent reported that their children had been hit by peers or
siblings, 50% reported them to be scared by their peers, 9% were attacked
by a gang and hurt in the private parts, and nearly 12% indicated their
child had never been invited to a birthday party. Six percent were almost
always picked last for teams, and 3% ate alone at lunch every day.
Several of the parents described the nature of victimization in their
children. The extreme pain experienced by several students in this study
caused them to be suicidal, and one child, enduring prolonged bullying by
peers, wanted to be put in the street and run over. Another child was
beaten up in middle school and then tried to commit suicide. A parent
reported her son being bullied, left out, and picked on while on the bus.
One day, he ran after one of the girls, and then was kicked out of school.
Nothing was done to the girl. He has become more socially savvy as he
has gotten older and stays away from those who are unkind. Another
reports her son being egged on and told to run like a bull. After he complied, peers would laugh and call him a freak. One childs picture on the
bulletin board had his eyes scratched out. A mother felt wounded when
she went on a rafting field trip with her son and his class. She saw that he
was a peripheral person with low social status when no one wanted to
join them in their raft. A middle school girl with Asperger syndrome had
her locker vandalized after a friend had decorated it for her birthday. She
was repeatedly verbally harassed, told that everyone hated her and that
no one wanted to be her friend. While riding the school bus, peers would
throw coins at her, and talk about her engaging in sexually explicit acts

Bullying of Students with Asperger Syndrome

151

with others. A parent shared that her daughter had been scratched while
riding the bus, pushed against school lockers, mocked, laughed at by
peers, and ridiculed by teachers. A mother fought with the school to
provide an aide to protect her child. Some parents explained that the
victimization and harassment occurred over a long period of time, with
many of the children having severe migraines, school phobia, and suicidal
ideation.

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DISCUSSION
The purpose of this study was to examine the frequency of victimization
and shunning of children and adolescents with Asperger syndrome. The
intent was to compare these findings with results from a previous study.
The current study found that nearly two-thirds of the children and
adolescents with Asperger syndrome were victimized and shunned by
siblings and peers, as compared to Littles (2002) findings of an overall
frequency of 94%. Nearly one-half were afraid of their peers and had
been hit by them. Little (2002) reported that 72.9 % of the children were
hit by peers or siblings, 10% were attacked by a gang or a group of
children, 55.2% were picked on, chased, or grabbed by the hair, 15%
were hit in their private parts, and 75.5% were scared by peers, because
they were called names or picked on. Thirty-three percent of parents
reported that their child had never been invited to a birthday party, as
compared to nearly 12% in this study.
The lower frequency rates of victimization and shunning in this study
may be explained by interventions such as school tolerance programs
coupled with better understanding of Asperger syndrome. Despite the
decrease in victimization, 65% rate of victimization in children with
Asperger syndrome remains high. Perhaps the visibility of their negative behaviors put them at risk for peer victimization and shunning,
especially during middle school when peer acceptance is critical. Lack
of social skills, awkwardness, eccentricity, and all-consuming interests
in children with this diagnosis provides bullies with perfect victims
(Heinrichs, 2003). The child with Asperger syndrome who is physically
awkward, socially naive and eccentric in nature is subject to ridicule,
peer harassment, and lack of tolerance from teachers and school staff.
As stated by Hoover (2006):
Sadly, many children develop a tendency of distrust towards others,
because of social failures and negative social experiences over time, which
can lead to self-isolation and social phobia. This behavioral reaction can be
viewed as rude by others, and often people on the spectrum struggle to
understand why they are not liked or frequently feel rejected. (p. 1)

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S. Carter

Additionally, mindful of their neurological weaknesses, teachers and

clinicians are blinded by the strengths of these children (TwatchmanCullen, 1996). Nurses and teachers assume that the child with Asperger
syndrome, who has average to above-average intelligence, should know
better. Baron-Cohen (2000) found that many individuals with Asperger
syndrome in their 20s, 30s, and 40s tend to be terribly sad, describing
stories about their being bullied at school, losing jobs, and having broken
relationships. Because of difficulties in interpreting social nuance,
individuals with Asperger syndrome may not be able to discriminate
manipulation and deceit from good intentions. Individuals with Asperger
syndrome have been described as living on their own island floating in a
sea of humanity where they do have projects and plans for themselves and
compare themselves with other people, often painfully. It is difficult to
know why Asperger syndrome creates such hostility in others (Tantum,
2003).
Limitations of the Study
Participants in the study were not randomly selected due to the low
incidence of Asperger syndrome. As a result, this sample of parents may
not be representative of the true population because their involvement in
advocacy and support groups, by nature, demonstrates an interest in their
childs well-being. Parents in the study had advanced degrees, which may
have presented an opportunity factor in this study. Although the sample
size was larger than in many studies, the sample is still relatively small.
Additionally, parents may have exaggerated their childs experiences of
victimization and shunning, based on their childs frequent report of
victimization. Furthermore, the reliability and validity of the both
measures used are still being determined.
This study also represents strengths in that it replicates a prior study.
The current study validates the high numbers of students who are being
victimized and shunned, which has important ramifications for school
administrators, teachers, and medical professionals.
Implications for Nurses
The results of this study indicate that children and adolescents with
Asperger syndrome are victimized and shunned at high rates. Unfortunately, medical and school professionals need to assume that all children
are bullied to some degree, and pediatric medical professionals and
school personnel need to be better trained in identifying and treating
bullied youth. Those with Asperger syndrome are significantly more
vulnerable to the victimization and shunning that occurs during childhood

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Bullying of Students with Asperger Syndrome

153

and adolescence. Pediatricians and nurses should question parents and

children about bullying and shunning in school, especially if children are
depressed and school phobic. School nurses need to investigate physical
injuries to children with Asperger syndrome, as they often do not have the
social abilities to protect themselves from children who are aggressive.
Administrators in schools and camps also need to be alert and provide
trained staff during all unstructured activities. Children with Asperger
syndrome who go to camp may need the assistance of a trained individual
to protect them from children who bully, taunt, and tease.
School nurses, principals, and teachers need to encourage students to
confront the bully and report bullying behavior to adults who will listen.
Nurses are often the first professionals to see the student immediately
after the bullying event occurs. The student needs to be questioned about
the event in order for corrective action to be taken. School nurses also
should be alert for the isolation and shunning that occurs in this population of students, keeping a watchful eye during lunch and recess when the
child is most vulnerable. Mental health professionals need to consider
victimization and shunning when performing evaluations on children who
are exhibiting anxiety, depression, school phobia, and suicidal ideation.
Nurses should consider spearheading efforts to not only screen these
youngsters for suicide risk, but to take an active role in communicating
with the students mental health provider and teacher on a regular basis.
Nurses in schools need to take an active role in promoting ongoing
school tolerance programs. Nurses may help children and parents decide
whether the disclosure of their disability to peers and teachers may prove
beneficial in promoting acceptance. Nurses can also play an integral part
in evaluating youth who are bullied and help to provide training to other
professionals in schools, camps, daycare, and mental health settings.
CONCLUSIONS
Findings demonstrate that children with Asperger syndrome are significantly victimized and socially excluded. However, this study offers encouraging findings. Compared to an earlier study, bullying and shunning of this
population has decreased. However, the results still indicate that nearly
two-thirds of all children and adolescents with Asperger syndrome are
victimized by their peers. Pediatric nurses can take a proactive stance in
schools and mental health settings in training staff about Asperger
syndrome and conducting screenings to determine if children are being
bullied. Bullying is a lifelong injury and one that can be prevented. Nurses
in schools need to take a stronger role in bully-prevention programs and in
working with administrators to provide trained staff for the child with
Asperger syndrome during unstructured activities.

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S. Carter

Further studies are needed to determine if disclosure of the childs

disability to peers has an effect on reducing bullying. Additional
research needs to be done in order to determine if bullying and shunning
relate to depression and suicidal ideation in the child with Asperger
syndrome.

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