School participation in autistic girls and boys: The role of social-communication abilities and extrinsic barriers

This study aimed to offer a depiction and comprehensive understanding of school participation in autistic youth, which has received limited exploration. Parents of 871 autistic youth aged 7 or 15 were invited to participate in a study, among whom 600 agreed, allowing data collection on diagnosis, comorbidities, school, professional support, and parental characteristics. They were asked to fill in questionnaires assessing executive functions, social-communication difficulties, and school participation, completed by 241. Structural equation modeling and descriptive methods were employed to examine factors influencing school participation and the desire for change. Social-communication abilities stand out as the sole intrinsic determinant associated with school participation. Being a female and having an intellectual disability might negatively impact mainstream school attendance, without exerting a similar influence on activity attendance and involvement. Caregivers identified school demands and the sensory environment as extrinsic barriers to school participation, while teachers' attitudes and peer relationships were seen as both potential barriers and facilitators. Finally, 36%-58% indicated a desire for increased participation in at least one school activity. Our findings highlight the need to reduce stigma around autism, improve school support, and give special consideration to the schooling experiences of autistic girls.Lay AbstractSchool participation factors in autism have received limited attention. We examined this question using structural equation modeling and descriptive methods. Our findings indicate that heightened social-communication difficulties, rather than executive dysfunctions and comorbidities, are associated with decreased school participation of autistic youths. Furthermore, exploratory analyses showed that being female and having an intellectual disability negatively affect attending mainstream school for autistic children and teenagers, but not their attendance and involvement in school activities. Caregivers point out school demands, sensory environment, and teachers' and peers' attitudes as major factors affecting participation, often expressing a desire for increased participation for their child. These results hold significant implications for improving educational environments for autistic girls and boys.