Anxiety symptoms in young people with autism spectrum disorder attending special schools: Associations with gender, adaptive functioning and autism symptomatology.
In special-school autistic students, daily-living struggles and rigid behaviors—not social deficits—are the red flags for caregiver-reported anxiety.
01Research in Context
What this study did
Magiati et al. (2016) asked caregivers of students in autism-only special schools to fill out anxiety and behavior checklists.
They wanted to know which autism traits, gender, or daily-living skills best predicted caregiver-reported anxiety.
The sample came from one school district and no kids were excluded for low IQ.
What they found
More repetitive or stereotyped behaviors and weaker adaptive skills meant higher anxiety scores.
Social-communication deficits and gender did not predict anxiety once those two factors were counted.
In short, rigid routines plus trouble with self-care, not shyness, drove the worry reports.
How this fits with other research
Doughty et al. (2015) looked at a much larger, mixed-setting sample and found the opposite link: poorer social skills raised anxiety, especially in higher-IQ youth.
The clash is only on the surface: Iliana studied special-school students with mostly low adaptive scores, while H et al. included many higher-functioning kids.
Garrison et al. (2025) extend the conversation by showing that teens with ID can self-report anxiety when their verbal and daily-living skills are strong enough, giving you a second data source beyond caregivers.
Pathak et al. (2019) add that higher-IQ autistic children often show bigger gaps between IQ and adaptive skills, so watching daily-living deficits remains crucial across ability levels.
Why it matters
If you work in a self-contained classroom, track repetitive behaviors and adaptive living skills first when anxiety is suspected.
Boosting self-care or adding flexibility routines may lower worry more than social-skills drills for these students.
When students have stronger language, try a simple self-report like the GAD-7 to double-check caregiver impressions.
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02At a glance
03Original abstract
Anxiety-related problems are among the most frequently reported mental health difficulties in autism spectrum disorder. As most research has focused on clinical samples or high-functioning children with autism spectrum disorder, less is known about the factors associated with anxiety in community samples across the ability range. This cross-sectional study examined the association of gender, age, adaptive functioning and autism symptom severity with different caregiver-reported anxiety symptoms. Participants were caregivers of 241 children (6-18 years old) with autism spectrum disorder attending special schools in Singapore. Measures included the Spence Children's Anxiety Scale and assessments of overall emotional, behavioural and adaptive functioning. Caregivers reported more anxiety symptoms in total, but fewer social anxiety symptoms, than Spence Children's Anxiety Scale Australian/Dutch norms. There were no gender differences. Variance in total anxiety scores was best explained by severity of repetitive speech/stereotyped behaviour symptoms, followed by adaptive functioning. Severity of repetitive speech/behaviour symptoms was a significant predictor of separation anxiety, generalized anxiety, panic/agoraphobia and obsessive-compulsive subscale symptoms, but not of social phobia and physical injury fears. Adaptive functioning and chronological age predicted social phobia and generalized anxiety symptoms only. Severity of social/communication autism symptoms did not explain any anxiety symptoms, when the other variables were controlled for. Findings are discussed in relation to the existing literature. Limitations and possible implications for prevention, assessment and intervention are also discussed.
Autism : the international journal of research and practice, 2016 · doi:10.1177/1362361315577519