Broken Bridges: New School Transitions for Students with Autism Spectrum Disorder: A Review on Difficulties and Strategies for Success

Poster Presentation
Thursday, May 10, 2018: 5:30 PM-7:00 PM
Hall Grote Zaal (de Doelen ICC Rotterdam)
B. Bronstein1, H. J. Nuske2, E. McGhee Hassrick3, L. Hauptman4, C. A. Aponte5, L. Levato5, A. C. Stahmer6, D. S. Mandell2, P. Mundy7, C. Kasari4 and T. Smith8, (1)University of Pennsylvania, Philadelphia, PA, (2)Center for Mental Health, University of Pennsylvania, Philadelphia, PA, (3)Drexel University A.J. Drexel Autism Institute, Philadelphia, PA, (4)University of California, Los Angeles, Los Angeles, CA, (5)University of Rochester Medical Center, Rochester, NY, (6)Psychiatry and Behavioral Sciences, University of California at Davis MIND Institute, Sacramento, CA, (7)University of California at Davis, Sacramento, CA, (8)University of Rochester, Rochester, NY
Background: School transitions place enormous pressure on students to adapt quickly to new settings, which can strain their physical and mental health, and stress the family (Blair, 2002; Cairns and Harsh, 2014; Cauley and Jovanovich, 2006). Difficulties with social communication, peer relationships, resistance to change (Cuccaro et al., 2003) and intolerance of uncertainty (Boulter et al., 2014) may make new school transitions particularly difficult for students with autism spectrum disorder (ASD) and their parents. Therefore, usual transition procedures may not adequately address the needs of these students. Studies have hypothesized and measured different potential barriers to successful transition but few synthesize the transition needs of students with ASD or the benefits of specific supports.

Objectives: To review the literature on (1) transition difficulties faced by students with ASD, their families and school providers, (2) the strategies currently available to support them, and (3) inform future research about school transitions and the development of transition interventions for students with ASD, their families and school staff.

Methods: The review included 23 studies (10 primary school transition, 13 secondary school transition), with data from 394 students with ASD, 423 parents and 528 teachers, across 4 continents (North America, Europe, Africa, Australia). Authors assessed inclusion eligibility based on agreed upon criteria and reached high inter-rater reliability (Cronbach’s α= .92). Coding was conducted in two stages (Boyatzis, 1998; Bradley et al., 2007). After establishing inter-rater agreement (>80%) with the lead coder on extracting transition difficulties and strategies of two articles, each article was independently coded by two coders and consensus coded in pairs. Second, themes and subthemes of transition difficulties and strategies were constructed through consensus using constant comparative method (Glaser and Strauss, 1967). For articles reporting on transition strategies (17 of 23), two authors independently rated level of evidence on a scale outlined in Harbour and Miller (2001), from 1++ (highest quality, (systematic reviews of RCTs) to 4 (expert opinion).

Results: Results confirmed that children with ASD, their families, and school staff experienced difficulties transitioning to kindergarten and secondary school. Main student difficulties were anxiety and increased social pressure; their parents felt overwhelmed with complex placement decisions and worried about the wellbeing of their children; and teachers strove to provide appropriate supports to their students with ASD, often with inadequate resources. Preliminary findings indicated that the most useful strategies involved clarifying the transition process for parents, helping the student adjust to the new school setting, fostering communication both between the sending and receiving schools and between school and home.

Conclusions: Current research highlights the concern that children with ASD, along with their parents and teachers, struggle with transitions and additional supports could be beneficial. However, intervention development has only recently begun. Strategies that clarify the transition process for parents, adjust the student to the new setting and foster communication among the sending and receiving schools and school and home may be particularly useful. There is a pressing need for community-based rigorously-tested interventions to test the effectiveness of different school transition strategies to ensure the success of students with ASD.