School dysfunction in youth with autistic spectrum disorder in Taiwan: The effect of subtype and ADHD.
Taiwanese students with autism-plus-ADHD or lower IQ face triple school trouble, so target attention and behavior supports early.
01Research in Context
What this study did
Chiang et al. (2018) looked at how kids with autism do in Taiwanese schools.
They compared grades, classroom behavior, and peer problems among youths with autism, with and without ADHD, and typical kids.
The team also checked if IQ level changed the size of any gaps.
What they found
Students with autism scored lower in all school areas than typical peers.
The struggle was biggest for youths who also had ADHD or lower IQ.
In plain words, more risk factors stacked up to mean more school trouble.
How this fits with other research
Spaniol et al. (2021) in Brazil echo the attention link: attention scores, not just IQ, predicted math and reading marks in autistic students.
The two studies look different on the surface—one flags ADHD diagnosis, the other attention test scores—but both say "pay attention to attention."
Chang et al. (2013) already showed that high-IQ Taiwanese kids with autism still lag in daily-living and social skills. Huey-Ling extends that picture by showing these gaps show up as real school dysfunction a few years later.
Barton et al. (2019) add a service twist: clinician severity ratings, IQ, and ADHD symptoms decide who actually gets help. Together the papers warn that bright, chatty students with autism-plus-ADHD may need supports yet be overlooked.
Why it matters
If you write IEPs or classroom plans, list ADHD and IQ right next to autism.
Push for executive-function and attention goals even when grades seem "okay."
Bring teacher or clinician data when you request services—parent reports alone may not be enough.
A quick attention boost, like a timed break card or seated close to the teacher, could protect grades more than you expect.
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02At a glance
03Original abstract
UNLABELLED: School dysfunction is observed in youths with autism spectrum disorder (ASD), but the factors moderating their school dysfunction have not been well explored. This study investigated school functions in youths with ASD in Taiwan, stratified by personal characteristics including demographics, ASD subtypes, intelligence profiles, and the presence of attention-deficit hyperactivity disorder (ADHD). We recruited 160 youths (aged 6-18 years, 87.5% boys) with a clinical diagnosis of ASD and 160 age and gender-matched typically developing (TD) youths. Their parents received a semi-structured psychiatric interview for their ASD and ADHD diagnoses and reported their school functions. Youths with ASD were further grouped into low-functioning autism (LFA, ASD with intellectual disability and developmental language delay, n = 44), high-functioning autism (HFA, ASD with no intellectual disability, n = 55) and Asperger's syndrome (AS, ASD with neither language delay nor intellectual disability, n = 61). Compared to TD, ASD had worse school functions in the domains of academic performance, attitude toward schoolwork, social interaction, and behavioral problems except for no academic differences from TD in HFA and ASD without ADHD. Subgroup analysis revealed that HFA and AS had better academic performance but showed worse attitude toward school than LFA. Comorbidity of ADHD negatively impacted all domains of school functions. Besides autistic and ADHD symptoms, oppositional symptoms, lower intelligence, older age, and female gender in youths also predicted school dysfunction. Although youths with ASD have school dysfunction in several domains, this study specifically addresses the role of intelligence and comorbid ADHD on their school dysfunction. Autism Res 2018, 11: 857-869. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Impaired school functions varied in ASD youths with different characteristics. Youths with autism spectrum disorder (ASD) encounter varying levels and domains of impaired performance at schools, such as lower academic performance, negative attitude toward school work, fewer reciprocal friendships, and more behavioral problems. Our results indicate that ASD youths without intellectual disability had better academic performance, but worse attitude toward school than those with intellectual disability. Co-occurrence with ADHD is associated with school dysfunction. In summary, intelligence and comorbid ADHD influences several domains of school functions.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1002/aur.1923