(PS4-69) School Anxiety and Autism: Contributing Factors and Impact of School-based Facing Your Fears (FYF-SB)

Background: Autistic youth are more likely to experience school-related anxiety and engage in school avoidance than non-autistic peers (Adams et al., 2018; Munkhaugen et al., 2017). Prior research suggests that anxiety broadly contributes to autistic students’ school-specific anxiety and absences (Adams, 2022; Melin et al., 2022). Specific social-emotional risk factors for school avoidance include challenging peer interactions and withdrawal (Ochi et al., 2020; Munkhaugen et al., 2019). School-based anxiety interventions for autistic youth, such as School-Based Facing Your Fears (FYF-SB), may address school avoidance risk factors (Reaven et al., 2022).

Objectives: The aims were to determine (1) child-rated social-emotional and behavioral challenges contributing to autistic students’ school anxiety and (2) the impact of FYF-SB on school anxiety and related challenges. It was hypothesized that (1) child-rated peer problems and emotional symptoms (e.g., withdrawal) would contribute to school anxiety and (2) students completing FYF-SB would demonstrate lower levels of school anxiety and social-emotional problems at post compared to Usual Care (UC).

Method: The present study was part of a cluster randomized trial examining FYF-SB implemented via a train-the-trainer model (see Reaven et al., 2024). FYF-SB is a manualized CBT program (psychoeducation plus graded exposure) delivered in small groups at school. Students with autism or suspected autism and anxiety (N=81; aged 8-14) were enrolled and randomized to FYF-SB (n=39) or UC (N=42). Students completed SCARED and SDQ measures pre-post intervention. The SCARED School Avoidance subscale (e.g., “I worry about going to school.”) and the SDQ Peer Problems, Emotional Symptoms, Conduct Problems, and Hyperactivity subscales were used.

Results: Bivariate Pearson correlations revealed a positive association between SCARED School Avoidance and SDQ Peer Problems (r=.31, p< .01) and SDQ Emotional Symptoms (r=.61,p< .001). In a multiple linear regression (R²=.37, F(2,67)=20.0, p< .001), emotional symptoms (β=.58, p< .001), but not peer problems (p=.75), significantly contributed to school anxiety. T-tests comparing FYF-SB and UC at post indicated that the FYF-SB group had significantly fewer emotional symptoms (t(73)=-2.6, p< .01), although groups did not significantly differ in school anxiety (t(75)=-.38, p=.35). 

Discussion: Results suggested that students with autism or suspected autism who reported greater emotional symptoms reported more school anxiety, regardless of level of peer problems. Thus, a CBT intervention like FYF-SB that provides strategies for managing emotions (e.g., somatic management, positive self-statements) may help address school-specific anxiety. Indeed, the group receiving FYF-SB reported fewer emotional symptoms at post compared to UC, despite no significant differences in school-specific anxiety directly. Not all FYF-SB participants may have identified school-specific anxiety in graded exposure sessions, whereas all students learned emotion regulation skills in psychoeducation sessions. Further research is needed to explore whether FYF-SB is more effective for decreasing school anxiety for specific students or over time.