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. 2025 May 7.
doi: 10.1007/s10803-025-06839-3. Online ahead of print.

Co-occurring Conditions and Quality of Life in Autistic Children Attending General Education or Special Education Schools

Chantal van den Helder  1 , Rachel Plak  2 , Sander Begeer  3 , Martijn Meeter  4
Affiliations

Co-occurring Conditions and Quality of Life in Autistic Children Attending General Education or Special Education Schools

Chantal van den Helder et al. J Autism Dev Disord. .

Abstract

A majority of children with autism is diagnosed with one or more co-occurring mental health conditions. We aimed to explore how co-occurring conditions and Quality of Life differ between school types (general education vs. special education schools), and whether co-occurring conditions were subject to the same trends over time for the two school types. Secondary, we aimed to analyze associations with child characteristics. Repeated cross- sectional data from 2013 to 2022 on children with autism (N = 1534,aged 5-15 years) in the Netherlands were used. Across school types, we showed a decrease in externalizing and language-learning conditions over time. Language-learning conditions became more concentrated in special education schools. Hyperactivity-inattention difficulties remained stable, emotional difficulties decreased and behavioral difficulties increased. Compared to those in general education, children in special education schools faced more behavioral and hyperactivity-inattention challenges. School type, duration of the study, externalizing, internalizing and language-learning conditions were all unrelated to QoL. Autistic girls experienced more behavioral difficulties compared to boys with autism. In conclusion, children with autism in special education schools experience similar QoL, but have more (severe) co-occurring conditions than those attending general education.

Keywords: Autism; Children; Co-occurring conditions; Education; Quality of life.

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Conflict of interest statement

Declarations. Conflict of interest: Chantal van den Helder declares that she has no conflict of interest; Rachel Plak declares that she has no conflict of interest; Martijn Meeter declares that he has no conflict of interest; Sander Begeer declares that he has no conflict of interest. The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Ethical Approval: The Scientific and Ethical Review Board of the Department of Clinical, Neuro- & Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, granted ethical clearance (reference number (VCWE 2020-041R1). Consent to Participate/Consent for Publication: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee. Personal data was processed based on informed consent using digital consent.

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