Relationship Between Wechsler Intelligence Scale for Children-IV Profiles and School Refusal in Children With Autism Spectrum Disorder

Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder that has been increasing in prevalence in recent years and is associated with many comorbid disorders. Previous studies have reported that children with ASD are more likely to be truant than children without ASD. Issues related to learning, such as social problems and cognitive dysfunction, have also been identified. Methodology In this study, we investigated the relationship between the cognitive characteristics of children with ASD and school refusal. Children between 6 and 16 years old who visited our department from 2015 to 2022 and were diagnosed with ASD were included in the study. The subjects were divided into children who were attending school and those who were not attending school, and we examined their school attendance status along with the General Ability Index (GAI) and Cognitive Proficiency Index (CPI) using the Wechsler Intelligence Scale for Children-Fourth Edition. Of the 72 participants, 56 (77.8%) were included in the study. Results We included 25 participants (11 boys and 14 girls) in the school attendance group and 31 participants (18 boys and 13 girls) in the school refusal group. We examined the Full-Scale IQ (FSIQ) and composite index scores for both groups and found no significant differences in FSIQ, Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI), Processing Speed Index (PSI), GAI, or CPI scores. However, the difference between the GAI and CPI scores was 1.16 ± 15.099 in the school attendance group and 9.48 ± 14.66 in the school refusal group. The difference between the GAI and CPI scores was greater in the school refusal group (P = 0.042). Conclusions The results of this study suggest the possibility that intra-individual differences in cognitive abilities may have an effect on school refusal of autistic children. Further research and studies are needed because there is a possibility that support methods in special-needs education will improve children's adaptation to school and learning efficiency.