Objective
Bullying is a significant problem among school-age children. The prevalence and predictors
of bullying among children with autism are not known. The objectives of this population-based
study were to: (1) estimate the prevalence of bullying among children with autism
in the United States, (2) determine whether the presence of attention-deficit/hyperactivity
disorder/attention-deficit disorder (ADHD/ADD) increases prevalence of bullying among
children with autism, and (3) determine risk factors of bullying behavior among children
with autism.
Methods
The National Survey of Children’s Health, 2003 (NSCH), provided nationally representative
data for children ages 4 to 17. We used multivariate logistic regression and Wald
tests to determine whether children with autism were more likely to bully in the presence
of ADHD/ADD. Taylor approximations were used to account for the complex sampling design.
Results
Children with autism had a high prevalence of bullying (44%, 95% confidence interval,
34–55). Parent report of ADHD/ADD appears to moderate the relationship between bullying
and autism. Children with autism who did not have ADHD/ADD were not at greater risk
for bullying compared with the general population. Children with autism and ADHD/ADD
had increased odds of bullying (odds ratio 4.6, 95% confidence interval 2.4–8.6),
even after controlling for household income, age, and gender. In addition to ADHD/ADD,
living in a low-income household and younger age were risk factors for bullying among
children with autism. Being female, however, did not decrease the risk of bullying
in the autistic subpopulation.
Conclusions
Children with autism and ADHD/ADD appear to be at increased risk for bullying behaviors.
Key words
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Article info
Publication history
Accepted:
February 13,
2007
Received:
August 9,
2006
Identification
Copyright
© 2007 Ambulatory Pediatric Association. Published by Elsevier Inc. All rights reserved.
