By Lisa Rapaport

(Reuters Health) – Children with autism are more likely than kids without the disorder to be bullied by siblings and peers in early adolescence, and they may have more psychological and social problems as a result, a new study suggests.

While sibling bullying during childhood has long been linked to increased risk for a variety of mental health difficulties in adolescence, research to date hasn’t offered as clear a picture of how this plays out specifically for youth with autism, researchers note in the Journal of Autism and Developmental Disorders.

For the current study, researchers followed 231 youth with autism and 8,180 without the disorder from middle childhood through early adolescence. Sibling bullying was much more common at age 11, involving about 64% of kids with autism and 48% of children without the disorder. By age 14, bullying involvement declined, affecting 36% of kids with autism and 33% of children without it.

“There is a decrease in sibling bullying involvement from the age of 11 to 14 years for both children with and without autism,” said Umar Toseeb, lead author of the study and a researcher at the University of York in the UK.

“But children with autism are still more likely to be involved in two-way sibling bullying,” Toseeb said by email. “And being involved in sibling bullying at age 11 years is associated with more emotional and behavioral difficulties at age 14.”

Early symptoms of autism can vary but may include repetitive behaviors like hand flapping or body rocking, extreme resistance to changes in routine, and sometimes aggression or self-injury. Behavioral, educational, speech and language therapy may help reduce the severity of autism symptoms in some children – but some symptoms still can lead to difficulties with social and emotional behavior well into adolescence and adulthood.

To understand how bullying impacts the lives of children with and without autism, researchers questioned children about how often they were picked on or purposely hurt by their siblings and peers and how often they were the perpetrators of such acts.

Researchers also asked parents about children’s emotional and behavioral difficulties, such as whether the child was unhappy, downhearted or restless.

Whether or not they had autism, children involved in sibling bullying were more likely to experience emotional and behavioral difficulties, the study found.

But because sibling bullying disproportionately affects kids with autism, they may be harder hit by this exposure over the long term, the authors conclude. This is particularly true for kids with autism who are involved in sibling bullying at home as well as peer bullying at school.

Because sibling bullying disproportionately affects children with autism, the researchers are calling for more resources to help children with autism and their parents identify and deal with bullying behaviors in the home, particularly earlier in childhood.

The study wasn’t designed to prove whether or how bullying might directly impact emotional or behavioral health, or how this might play out differently for kids with autism.

Even so, the results suggest that parents need to recognize the difference between normal squabbling among siblings and bullying, which may involve persistent emotional mistreatment and not necessarily physical aggression, the study team notes.

“Persistent conflicts between siblings may be indicative of sibling bullying and this should not be viewed as a normal part of growing up,” Toseeb said.

SOURCE: Journal of Autism and Developmental Disorders, online July 22, 2019.