ORI GI NAL PAPER

Teachers Perceptions Regarding the Management of Children

with Autism Spectrum Disorders
Christine K. Syriopoulou-Delli

Dimitrios C. Cassimos

Grigorios I. Tripsianis

Stavroula A. Polychronopoulou
Published online: 23 June 2011
Springer Science+Business Media, LLC 2011
Abstract This study examines Greek teachers percep-
tions related to the nature and management of autistic
children. To investigate these issues, a statistically reliable
number of questionnaires (n = 228) was distributed to a
diversied teacher population. The questionnaire responses
were analyzed statistically to identify the explanatory
power of critical independent variables. The research
ndings support that teachers specialized training and
working experience are critical inputs to improve teachers
perceptions and efcient serving of autistic children. A
cumulative joint effect of teachers previous specialized
education and working experience working with autistic
children was also indicated. This could be supportive of
teachers upgrading their active leading role in team
working with specialized scientic staff, parents and
institutions on autistic children.
Keywords Autism Education Teachers education
Teachers experience Teachers leading role
Autistic students
Introduction
Over the last decade, the number of children diagnosed to
suffer from autism spectrum disorders (ASD) is seen to
have increased dramatically (Arick et al. 2005; Finke et al.
2009; Harris et al. 2005; Powell and Jordan 1992). As a
consequence, more children with ASD participate in gen-
eral education (ASD Centers for Disease Control and
Prevention 2007). A prevailing tendency in the education
community lately indicates that children with disabilities,
particularly pervasive developmental disorders, join gen-
eral (mainstream) education classrooms (McDonnell
1998). Teachers specialized training is argued to be a
critical component with profound implications for the
education of ASD children (Mesibov et al. 2006).
In Greece, the idea of one school for all was intro-
duced during the last decade (Greek Government Gazette
2000). Before the application of this legislation, ASD
children had access only to special schools for the mentally
retarded. As a result, in some of these latter cases, parents
would prefer to keep their children at home, or asylums, or
youth institutions. Hence, these children were deprived of
mainstream education (Anastasiou and Polychronopoulou
2009). The Greek government has, recently, recognized the
right of ASD children to participate in the educational
process (Greek Government Gazette 2008). Since 2008,
Greek students with ASD can explore two options. They
can either attend a mainstream school class, receiving
additional support from the classroom, or special educa-
tion, teacher; or, they can attend a special integration class
C. K. Syriopoulou-Delli (&)
Department of Educational and Social Policy, University
of Macedonia, 49, Bouziki Str., Nea Philothei, 11524 Athens,
Greece
e-mail: dellis@mfa.gr
D. C. Cassimos
Pediatric Department, Democritus University of Thrace,
Alexandroupolis, Greece
G. I. Tripsianis
Department of Statistics, School of Medicine, Democritus
University of Thrace, Alexandroupolis, Greece
S. A. Polychronopoulou
Department of Primary Education, National and Kapodistrian
University of Athens, Athens, Greece
1 3
J Autism Dev Disord (2012) 42:755768
DOI 10.1007/s10803-011-1309-7
within mainstream or vocational schools. ASD students,
and especially those with limited functional capabilities,
exhibit a range of unique characteristics that pose high
challenges for teachers serving them. To be specic, ASD
students frequently display decits in cognition, commu-
nication, and socialization. Basic functional and learning
skills are often reduced or are even absent. A major con-
cern remains, however, the fact that the exact characteris-
tics of autistic disorders are not fully understood in a
consistent and integrated framework but remain largely
vague as yet.
The prerequisite formal qualications for a Greek tea-
cher to work in the eld of special education include a
Ph.D. or a postgraduate degree in the eld of special
education or educational psychology, or a degree from
either the Pedagogical Department of Primary/Special
Education or the Department of Educational and Social
Policy. Nevertheless, due to inadequate past practices and
institutional constraints, the working experience of Greek
teachers with ASD children has remained limited. How-
ever, there appear to be mounting concerns regarding
teachers appropriate qualications and education, shortage
of specialized staff, and the subsequent impact on the
quality of education provided to ASD students. In addition,
it is argued that research should also investigate everyday
problems teachers face in relation to the education of ASD
students (Scheuermann et al. 2003; Simpson 2003). The
learning objectives of teachers on ASD are not specied in
details, while there is a wide range of required knowledge
and skills (Maurice et al. 1996; National Research Council
2001; Scott et al. 2000). It is well recognized that under-
graduate training is limited and insufcient not only in the
case of Greek education but also on an international scale,
as recent relevant research indicates (McConkey and
Bhlirgri 2003; inter alia). However, a growing interest in
special education training is formed in Greece lately
(Mavropoulou and Padeliadu 2000; Syriopoulou 2003).
Probst and Leppert (2008) state that information about
the particular characteristics of children with ASD as well
as interventional methods should be strongly integrated
into the curricula of teacher-training programs. Other
studies demonstrate that teachers and other professionals
who work with ASD students need to be well trained and
supported in order to provide coordinated services that are
beyond the scope of the efforts of individual teachers
(Cotugno 2009; Dib and Sturmey 2007; Grey et al. 2005;
Lerman et al. 2008; ONeil et al. 1993; Schuster et al.
1991).
Special education and past relevant experience of
teachers serving ASD children can exert a critical impact
on teachers capability to develop a focused and interdis-
ciplinary educational curriculum. This could be efciently
supported particularly in case a exible educational
feedback mechanism would assimilate practical evidence
gained at school level. On the one hand, an adjusted edu-
cational programme tailor-made to the ASD cases could be
useful to remediate the multidimensional decits of ASD
students. On the other hand, and complementary to that, an
integrated, multidisciplinary approach could be conve-
niently designed to further support teachers and children in
the ASD front. Following the limited past research, it
appears useful, interesting and timely to investigate these
issues further (especially education and experience of
teachers serving ASD children).
A study on Greek teachers revealed that even special
education teachers are somewhat confused regarding the
basic characteristics and causes of ASD (Mavropoulou and
Padeliadu 2000). The upgrading of teachers education on
ASD contributes to the improvement of ASD childrens
behavior, language, social capabilities and play skills.
Childrens behavioral problems may potentially induce
educational concerns and stress to teachers. This, in turn,
can ultimately hinder teachers ability to cope with
everyday problems of ASD children (Probst and Leppert
2008).
Based on past literature review, the prevailing policies
on educational preparedness of educators from across the
globe in serving children with ASD appear to be con-
strained with a number of limitations. The educational
curriculum on ASD, for instance, is seen to focus pre-
dominantly on particular areas of ASD childrens special
needs (such as on social or communication skills or lan-
guage decits). Furthermore, specic teaching tech-
niquesrather than an integrated approach on ASD
childrenare promoted. This results to teachers not being
in a position to formulate spherical and clear-cut views on
their own role and service of potential ASD children cases.
A major constraint to handle these issues relates to the
diversied nature and characteristics of ASD children as
well as to the fact that these characteristics alter as the child
grows. Hence, in several countries, the prevailing policies
on educational preparedness of educators in serving ASD
children appear to be a subject of ongoing concern, eval-
uation, reappraisal, and reformation to dynamically adjust
to the changing perception of the autististic disorders (Lian
et al. 2008, Singapore; Mavropoulou and Padeliadu 2000,
Greece; Probst and Leppert 2008, Germany, UK, US;
Scheuermann et al. 2003, US; Simpson 2003, US; inter
alia). Broad policy measures to promote and further sup-
port special education could potentially include a variety of
exible and focused undergraduate, postgraduate and in-
service training programmes and courses, enriched with
teaching approaches tailor-made to ASD cases.
The purpose of this study is to investigate teachers
perceptions focusing on the nature and management of
children with ASD. More specically, this research
756 J Autism Dev Disord (2012) 42:755768
1 3
examines the following core topics: evaluation of the
implications of teachers previous training and working
experience and the assessment of the inuence and impact
on teachers perceptions and attitudes in key issues for
serving and managing ASD children.
Method
Participants
Greek Teachers Sample Identity
This applied study has been based on the construction,
evaluation and statistical analysis of a conveniently con-
structed questionnaire to investigate the core objectives of
teachers attitudes on issues relevant to managing autistic
children. The questionnaire was organized on the basis of
33 major questions and was subdivided in two major parts.
The rst part of the questionnaire focused on the educa-
tional and professional experience of the teachers sample
population (8 questions). The second part addressed critical
questions relevant to the following core pillars: (a) nature
and characteristics of autism (7 questions); (b) assessment
of children with autism (5 questions); (c) management of
children with autism (8 questions); and (d) the teachers
role in the education of autistic children (5 questions)
(a questionnaire sample is included in Appendix).
The study cohort consists of 228 teachers [166 females
(72.8%) and 62 males (27.2%)] who met the criterion of
being a teacher currently working in the formal educational
system of Greece. As to the teacher demographic and
service characteristics, including age, work experience
(years of service) (Table 1), the sample majority, namely
84 teachers (36.56%) are in the 3140 years age range and
80 teachers (35.24%) in the 4150 years age range
(Table 1). As regards teachers years of service, the sample
majority, namely 74 teachers (32.46%) have up to 5 years
of service, 49 ones (21.49%) 610 years, 38 ones (16.67%)
1115 years, and 57 ones (25.00%) more than 15 years
(Table 1).
Furthermore, the majority of teachers sample popula-
tion, namely 175 teachers (76.75%), serves in urban areas,
and 31 ones (13.60%) in semi-urban areas (Table 1). The
sample majority, namely 118 teachers (51.75%), serves
primary education, and 67 ones (29.39%) serve secondary
education (Table 1). The sample majority, namely 144
teachers (63.16%), serves in mainstream schools, 35 ones
(15.35%) in special schools, and the rest evenly divided
between special schools, integration classes, Technical
Secondary Education in Special Vocational Training Sec-
ondary Education (EEEEJ), and multicultural schools
(Table 1).
Of the teachers sample population, 83 teachers (36.4%)
had previously been trained or had attended authorized
postgraduate seminars, specialized on autism, at least in
one accredited undergraduate or postgraduate course on
autism, under the auspice of the Ministry of Education.
Those teachers who had participated in unauthorized
seminars or attended only conferences (n = 7) were not
Table 1 Teachers demographic and working characteristics
n %
Gender
Female 166 72.8
Male 62 27.2
Age (years)
B30 53 23.2
3140 83 36.4
4150 81 35.5
[50 8 3.5
No response 3 1.3
Place of work
Urban areas 174 76.3
Semi-urban areas 32 14.0
Rural areas 7 3.1
No response 15 6.6
Years of service
B5 73 32.0
610 49 21.5
1115 38 16.7
[15 58 25.4
No response 10 4.4
Type of educational unit in which teachers serve
Special school 36 15.8
Mainstream school 144 63.2
Inclusive class 8 3.5
Technical school 8 3.5
Special education vocational center 5 2.2
Multicultural school 3 1.3
No response 24 10.5
Previous signicant studies on autism
Yes 83 36.4
No 145 63.5
Number of children with autism in the classroom
None 176 77.2
13 27 11.8
4 or 5 13 5.7
More than 5 4 1.8
No response 8 3.5
Previous experience with autistic children
Yes 64 28.1
No 164 71.9
J Autism Dev Disord (2012) 42:755768 757
1 3
included in the category signicantly trained. The term
authorized training refers to certied training education
provided by the Ministry of Education that qualies
teachers to work in special education units. The unau-
thorized training refers to voluntarily and privately gained
training, including special seminars, conferences, venues,
workshops, and other relevant activities on special educa-
tion. Experience in teaching and managing children with
autism in inclusive classes, mainstream schools, or special
schools was held by 64 teachers (28.1%). Teachers with
less than 2 years of experience with autistic children or
experience as a parent-relative or friend were not included
in the signicantly experienced.
Measures
The teachers opinions were evaluated using a structured
questionnaire. An initial pilot study was conducted with 20
teachers from the area of Athens, in order to test teachers
comprehension and objectivity in answering this ques-
tionnaire. The responses, feedback and nal structure of the
questionnaire were evaluated by the research team and
were also based upon and compared with relevant input
from most recent international literature on the subject
(Conroy et al. 2007; Grey et al. 2005; Probst and Leppert
2008; Roth et al. 2010). The questionnaire comprised of
four sets of questions regarding the nature and character-
istics of autism, assessment of children with autism, man-
agement of ASD children, and the teachers role in the
education of autistic children. Each question included in
the questionnaire was considered a dependent variable that
described teachers perceptions and attitudes. The respon-
ses in line with prevailing educational norms and not in
line with prevailing educational norms were discriminated
by the researchers (C.S., S.P.) based on the literature
(Conroy et al. 2007; Grey et al. 2005; Probst and Leppert
2008; Roth et al. 2010). Responses such as I do not know
and I do not answer were dened as responses not in line
with prevailing educational norms for the purpose of sta-
tistical analysis. Teachers training and education on aut-
ism, and experience in managing autistic children were the
selected independent variables. The dependent variables
were investigated and assessed under the inuence of these
independent variables.
Materials and Procedures
The questionnaires of the study were distributed to teachers
in different towns around the country during lectures
delivered by one of the researchers (S.P.). Twelve lectures
took place in seven towns/cities in mainland Greece
between November 2008 and May 2009. The core objec-
tives of these lectures were to inform voluntarily
participating teachers about critical issues of ASD. The
lecture participants were interested in seeking out spe-
cialized information on ASD, were working in different
types of schools and level of education (mainstream/spe-
cial; primary/secondary; vocational/multicultural etc.) and
had different educational background and experience with
ASD children. Random sampling was applied to one in
three attendees to whom the questionnaire was distributed.
The questionnaire responses were anonymous. A written
consent was obtained by each responder. In total, 300
questionnaires were distributed to 900 attendees of the
aforementioned lectures, and 228 were returned. The
characteristics of this teachers cohort are presented in
Table 1.
Statistical Analysis and Multivariate Logistic Regression
Statistical analysis of the data was performed using the
Statistical Package for the Social Sciences (SPSS, version
16.0, Chicago, IL, USA). All variables were categorized
and were expressed as frequencies and percentages. The
chi-square test was used to evaluate any potential associ-
ation between teachers perceptions and selected indepen-
dent variables, such as teachers education and experience
regarding the management of autistic children. To assess
the independent impact of teachers education and expe-
rience on their perceptions and knowledge of autism, a
multivariate stepwise logistic regression analysis was also
performed; teachers gender, age, place of work and years
of service were considered as possible confounders.
Adjusted odds ratios (aOR) with their 95% condence
intervals (CI) were estimated as the measure of association
of teachers education and experience in autism with their
perception and knowledge of autism. All tests were two
tailed, and the level of statistical signicance was set at
p \0.05.
Results
Statistical Analysis of Questionnaires on Teachers
Perceptions and Knowledge of ASD
The ndings regarding teachers perceptions of ASD
children are summarized in Table 2.
Overview of Key Findings
The majority of the Greek teachers cohort (55.3%) was
seen to believe that autism is the most serious mental-
health disorder among children. Less than half of the
subjects were aware of children with autism having serious
speech disorders. Nearly half of teachers sample (45.2%;
758 J Autism Dev Disord (2012) 42:755768
1 3
n = 103) did not perceive that these children would be able
to acquire good language skills at a later stage. The
teachers cohort was found to split evenly as to whether
autism exists alongside mental deciency (39.0% agreed
and 38.2% disagreed). Most teachers disagreed whether
autism is a hereditary disorder (47.4%; n = 108). Most of
the sample teachers (69.7%; n = 159) disagreed about
autism being a form of schizophrenia. The largest pro-
portion of the study group (40.8%) did not know whether
autistic children have intelligent parents. The number of
responses regarding the plausibility of diagnosing autism in
infancy was evenly split: 73 teachers (32.0%) believed that
this is plausible indeed, 79 teachers (34.6%) disagreed, and
72 teachers (31.6%) did not know. Only 34 teachers
(14.9%) did they believe that appropriate education can
contribute to overcome the disorder, while 146 teachers
(64.0%) believed that autistic children can acquire excep-
tional skills in a particular eld. Half of the teachers
cohort (50.9%; n = 116) declared capable of pinpointing
autistic characteristics.
As regards teachers perceptions with respect to the
management of ASD children, 115 teachers (50.4%) did
not know whether the best programs for autistic children
are those of the psychoanalytic type. Approximately three-
quarters (73.2%) of the study cohort were seen to believe
that ASD children should attend a special school; and, 95
Table 2 Teachers perceptions and knowledge of ASD
Agree Disagree Do not
know
No
response
n % n % n % n %
Nature and characteristics of autism
Autism is the most serious mental-health disorder 126 55.3 57 25.0 38 16.7 7 3.1
Most individuals with autism acquire good language skills at a later stage 57 25.0 103 45.2 65 28.5 3 1.3
Autism exists alongside mental retardation 89 39.0 87 38.2 42 18.4 10 4.4
Autism is a hereditary disorder 24 10.5 108 47.4 85 37.3 11 4.8
Autism is a form of schizophrenia 26 11.4 159 69.7 38 16.7 5 2.2
Autistic children have intelligent parents 46 20.2 85 37.3 93 40.8 4 1.8
Autistic children are always hyperactive 100 43.9 74 32.5 49 21.5 5 2.2
Assessment of children with autism
Autism can be diagnosed in infancy 73 32.0 79 34.6 72 31.6 4 1.8
Disorders can be overcome to a large extent with the appropriate education 34 14.9 104 45.6 86 37.7 4 1.8
Autistic children can acquire exceptional skills in a particular eld 146 64.0 5 2.2 31 13.6 46 20.2
Almost every teacher can recognize autistic characteristics in a child 116 50.9 73 32.0 30 13.2 9 3.9
Children with autism succeed in tests that involve rote learning 82 36.0 42 18.4 99 43.4 5 2.2
Management of children with autism
Psychoanalytic programs are the most benecial for autistic children 51 22.4 59 25.9 115 50.4 3 1.3
Autistic children should be educated in a special school 167 73.2 47 20.6 11 4.8 3 1.3
Autistic children are suppressed and their condition worsens in a strictly structured
environment
66 28.9 95 41.7 50 21.9 17 7.5
The treatment of most autistic children should include drugs 44 19.7 77 33.8 98 43.0 8 3.5
Autistic children are better off if their education is focused on social skills rather than on
academic subjects
126 55.3 55 24.1 40 17.5 7 3.0
Auditory teaching methods are superior to visual methods 28 12.3 91 39.9 100 43.9 9 3.9
Behaviorism is an obsolete method 34 14.9 70 30.7 115 50.4 9 3.9
It is preferable for autistic children to attend special vocational schools rather than
mainstream secondary schools
117 51.3 45 19.7 53 23.2 13 5.7
The role of the teacher in the education of children with autism
Teachers should cooperate with specialists 216 94.7 4 1.8 5 2.2 3 1.3
Autistic children constitute the most difcult group of students 130 57.0 57 25.0 38 16.7 3 1.3
Teachers rather than medical doctors should play the leading role in the educational-
therapeutic treatment of autistic students
114 50.0 56 24.6 53 23.2 5 2.2
With appropriate training, teachers can deal effectively with an autistic child 180 78.9 25 11.0 19 8.3 4 1.8
Even with the appropriate training, teachers cannot raise the question about autism 121 53.1 65 28.5 35 15.4 7 3.1
J Autism Dev Disord (2012) 42:755768 759
1 3
teachers (41.7%) considered that autistic children are not
suppressed in a strictly structured environment. Over half
of the cohort (55.3%; n = 126) agreed that children with
autism are better off receiving education on social skills
rather than academic education, and 43.9% (n = 100) did
not know whether auditory teaching methods are superior
to visual ones. Half of the study group (50.4%; n = 115)
did not consider behaviorism to be an obsolete interven-
tional method; and, half of the study group (51.3%;
n = 117) considered autistic children to be better off
receiving education at vocational schools of special edu-
cation rather than at mainstream schools.
The approach proceeded to also evaluate the teachers
views about their role in the education of children with
autism. The vast majority of teachers (94.7%; n = 216)
maintained that teachers should cooperate with specialists
as regards the treatment of autistic children. More than half
of the cohort (57.0%; n = 130) was seen to believe that
ASD children constitute the most difcult group of stu-
dents. Furthermore, half of the study group (50.0%;
n = 114) claimed that teachers rather than medical doctors
should have the rst word on the educational-therapeutic
treatment of an autistic student. A particularly large sample
proportion (78.9%; n = 180) was seen to support the idea
that a teacher with the appropriate training can effectively
deal with an autistic child. More than half of sample
teachers (53.1%; n = 121) were found to believe that a
teacher, despite the appropriate training, is unable to pin-
point autistic characteristics in a child, in order to raise the
question about autism and refer the child to specialists.
Teachers Perceptions of ASD Children Relative to Their
Education and Experience
The research approach was backed up with statistical
analysis focusing on selected critical independent vari-
ables. The relevant responses of the teachers cohort were
examined in relation to teachers previous education and
working experience and their efciency in serving and
managing ASD children. Tables 3 and 4 present the
research ndings of the statistical analysis on these inde-
pendent variables.
Nature and Characteristics of Autism The views and
perceptions of autism were found to differ substantially
between teachers with and without previous specic edu-
cation in the eld of autism (Table 3). The most striking,
and statistically signicant differences between these two
teacher groups were seen to be the following: (a) autism is
perceived as the most serious mental-health disorder (66.3
and 49.0% for those with and without previous education
on autism, respectively; p = 0.011); (b) autism exists
alongside mental retardation (55.4 and 29.7%, respectively;
p \0.001); and (c) autism has no genetic predisposition
(56.6 and 42.1%, respectively; p = 0.034). Teachers with
previous education did not perceive autism as a form of
schizophrenia (80.7%, compared to 63.4% of teachers
without previous education; p = 0.006). Furthermore, the
former did not recognize hyperactivity as a common fea-
ture of children with ASD (26.9%, compared to 42.2%,
respectively; p = 0.018). In addition, the teachers per-
ception of the nature and characteristics of autism differed
between teachers with and without previous experience in
this subject (Table 4).
Most of the teachers with previous experience in autism,
contrary to teachers with no previous experience, were seen
to believe that ASD constitutes the most serious mental-
health disorder (71.9 and 48.8%, respectively; p = 0.002).
Furthermore, most of ASD children were seen to not
acquire good language skills later in life (64.1 and 37.8%,
respectively; p \0.001). Experienced teachers on autism
had more often the perception that autism exists alongside
mental retardation (57.8 and 31.7%, respectively;
p \0.001). In addition, autism was not perceived as a form
of schizophrenia (85.9 and 63.4%, respectively; p =
0.001). Finally, autistic children were not perceived to
behave always hyperactively (45.3 and 27.4%, respec-
tively; p = 0.010). The gender (male/female teacher) was
also tested as an independent factor for teachers percep-
tions on ASD but was not found to exert a statistically
signicant impact.
Assessment of Children with Autism The teachers per-
ception of how to assess ASD children differed statistically
signicantly between the teachers group with previous
education on ASD against the teachers group with no
previous ASD education (Table 3). Teachers with previous
ASD education were more often seen to believe that autism
can be diagnosed in infancy (48.2 and 26.9%, respectively;
p = 0.001). Furthermore, these teachers perceived that
ASD children can achieve exceptional skills in a particular
eld (80.7 and 54.5%, respectively; p \0.001). In addi-
tion, ASD children can succeed in tests that involve rote
learning (48.2 and 29.0%, respectively; p = 0.004). Nev-
ertheless, educated teachers on ASD had the opinion that
autism cannot be overcome to a large extent (66.3 and
33.8%, respectively; p \0.001). There was no statistically
signicant difference between the two teachers groups as
regards the impression that almost every teacher could
recognize autistic characteristics in a child.
These critical issues put forward earlier were also
examined in two groups of teachers stratied according to
teachers previous working experience with ASD children.
A broad research conclusion indicates similar pattern of
responses as earlier obtained by these two teachers groups
(Table 4). Previous working experience of teachers with
760 J Autism Dev Disord (2012) 42:755768
1 3
ASD children did not affect signicantly teachers per-
ception of diagnosing autism in infancy or the ability of the
teacher to recognize autistic characteristics in a child. The
teachers gender did not modify, in general, their percep-
tions and attitudes in autism. However, the belief that
autistic children can gain exceptional skills in a particular
eld was signicantly more common among female than
male teachers (70.5 and 46.8%, respectively; p = 0.001).
Management of Children with Autism The opinions and
attitudes on certain topics of serving and managing ASD
children were found to differ considerably between
teachers with previous specic education or previous
working experience and teachers without previous educa-
tion or experience on autism, respectively. More speci-
cally, the majority of sample teachers with education and/
or experience attributed low credit to psychoanalytic pro-
grams, as it was accepted that the most benecial programs
for ASD children are not psychoanalytic ones (teachers
with education on autism: 48.2% compared to 13.1%;
p \0.001; previous working experience: 40.6% compared
to 20.1%; p = 0.001). The majority of educated and
experienced teachers were seen to believe that the treat-
ment of most ASD children should not be based on drugs
but emphasize on special education (educated teachers:
47.0% compared to 26.2%; p = 0.001; experienced
Table 3 Teachers perceptions and knowledge of ASD in relation to their previous relevant education
Education on autism p
No Yes
n % n %
Nature and characteristics of autism
Autism is the most serious mental-health disorder 71 49.0 55 66.3 0.011
Most individuals with autism do not acquire good language skills later in life 49 33.8 54 65.1 \0.001
Autism exists alongside mental retardation 43 29.7 46 55.4 \0.001
Autism is not a hereditary disorder 61 42.1 47 56.6 0.034
Autism is not a form of schizophrenia 92 63.4 67 80.7 0.006
Autistic children have intelligent parents 30 20.7 16 19.3 0.798
Autistic children are not always hyperactive 39 26.9 35 42.2 0.018
Assessment of children with autism
Autism can be diagnosed in infancy 39 26.9 40 48.2 0.001
Disorders cannot be overcome to a large extent even with the appropriate education 49 33.8 55 66.3 \0.001
Autistic children can acquire exceptional skills in a particular eld 79 54.5 67 80.7 \0.001
Almost every teacher can recognize autistic characteristics in a child 76 52.4 40 48.2 0.540
Children with autism succeed in tests that involve rote learning 42 29.0 40 48.2 0.004
Management of children with autism
The most benecial programs for autistic children are not psychoanalytic 19 13.1 40 48.2 \0.001
Autistic children should not be educated in a special school 28 19.3 19 22.9 0.520
Autistic children are not suppressed and their condition improves in a strictly structured environment 43 29.7 52 62.7 \0.001
The treatment of most autistic children should not include drugs 38 26.2 39 47.0 0.001
Autistic children are better off if their education is focused on social skills rather than on academic subjects 68 46.9 58 69.9 0.001
Auditory teaching methods are not superior to visual methods 34 23.4 57 68.7 \0.001
Behaviorism is not an obsolete method 24 16.6 46 55.4 \0.001
It is preferable for autistic children to attend special vocational schools rather than mainstream secondary
schools
26 19.9 19 22.9 0.365
The role of the teacher in the education of children with autism
Teachers should cooperate with specialists 137 94.5 79 95.2 0.820
Autistic children constitute the most difcult group of students 73 50.3 57 68.7 0.007
Teachers rather than medical doctors should play the leading role in the educational-therapeutic treatment of
autistic students
60 41.4 54 65.1 0.001
With the appropriate training, teachers can effectively deal with an autistic child 108 74.5 72 86.7 0.029
Even with the appropriate training, teachers cannot raise the question about autism 31 21.4 34 41.0 0.002
J Autism Dev Disord (2012) 42:755768 761
1 3
teachers: 51.6% compared to 26.8%; p = 0.001). The
research ndings also indicated that behaviorism is not an
obsolete intervention for ASD children (educated teachers:
55.4% compared to 16.6%; p \0.001; experienced
teachers: 54.7% compared to 21.3%; p \0.001). Further-
more, based on the ndings, in a strictly structured envi-
ronment, ASD children do not feel suppressed but tend to
improve (educated teachers: 62.7% compared to 29.7%;
p \0.001; experienced teachers: 64.1% compared to
32.9%; p \0.001). Autistic children were also believed to
be better off in case their education is focused on social
skills rather than on academic subjects (educated teachers:
69.9% compared to 46.9%; p = 0.001; experienced
teachers: 73.4% compared to 48.2%; p = 0.001). The
ndings also postulated that there is no particular advan-
tage of auditory over visual teaching methods (educated
teachers: 68.7% compared to 23.4%; p \0.001; experi-
enced teachers: 76.6% compared to 25.6%; p \0.001).
Teachers with previous special education and/or previous
working experience indicated a rather balanced view as to
whether it is preferable for ASD children to attend a spe-
cial vocational rather than a mainstream school, although
there appears to be a slight preference for the former type
of school (Tables 3, 4).
Table 4 Teachers perceptions and knowledge of autism in relation to their previous relevant experience
Experience with
autism
p
No Yes
n % n %
Nature and characteristics of autism
Autism is the most serious mental-health disorder 80 48.8 46 71.9 0.002
Most individuals with autism do not acquire good language skills later in life 62 37.8 41 64.1 \0.001
Autism exists alongside mental retardation 52 31.7 37 57.8 \0.001
Autism is not a hereditary disorder 74 45.1 34 53.1 0.277
Autism is not a form of schizophrenia 104 63.4 55 85.9 0.001
Autistic children have intelligent parents 35 21.3 11 17.2 0.482
Autistic children are not always hyperactive 45 27.4 29 45.3 0.010
Assessment of children with autism
Autism can be diagnosed in infancy 51 31.1 28 43.8 0.071
Disorders cannot be overcome to a large extent even with the appropriate education 62 37.8 42 65.6 \0.001
Autistic children can have exceptional skills in a particular eld 92 56.1 54 84.4 \0.001
Almost every teacher can recognize autistic characteristics in a child 83 50.6 33 51.6 0.897
Children with autism succeed in tests that involve rote learning 45 27.4 37 57.8 \0.001
Management of children with autism
The most benecial programs for autistic children are not psychoanalytic 33 20.1 26 40.6 0.001
Autistic children should not be educated in a special school 29 17.7 18 28.1 0.080
Autistic children are not suppressed and their condition improves in a strictly structured environment 54 32.9 41 64.1 \0.001
The treatment of most autistic children should not include drugs 44 26.8 33 51.6 \0.001
Autistic children are better off if their education is focused on social skills rather than on academic subjects 79 48.2 47 73.4 0.001
Auditory teaching methods are not superior to visual methods 42 25.6 49 76.6 \0.001
Behaviorism is not an obsolete method 35 21.3 35 54.7 \0.001
It is preferable for autistic children to attend special vocational schools rather than mainstream secondary
schools
30 18.3 15 23.4 0.380
The role of the teacher in the education of children with autism
Teachers should cooperate with specialists 153 93.3 63 98.4 0.118
Autistic children constitute the most difcult group of students 85 51.8 45 70.3 0.011
Teachers rather than medical doctors should play the leading role in the educational-therapeutic treatment of
autistic students
69 42.1 45 70.3 \0.001
With the appropriate training, teachers can effectively deal with an autistic child 124 75.6 56 87.5 0.048
Even with the appropriate training, teachers cannot raise the question about autism 41 25.0 24 37.5 0.060
762 J Autism Dev Disord (2012) 42:755768
1 3
The Teachers Role in the Education of Children with
Autism Based on the research ndings, the teachers role
in educating ASD children was shaped more clearly among
the group of teachers with previous special education on
autism than among teachers with lack of such background.
The former group of teachers was seen to more often
believe that autistic children comprise the most difcult
group of students to handle (68.7 and 50.3%, respectively;
p = 0.007). However, it was perceived that, subsequent to
ASD students receiving appropriate training, any teacher
can deal effectively with autistic students (86.7 and 74.5%,
respectively; p = 0.029; Table 3). In addition, educated
teachers on autism, more frequently, held the view that
teachers rather than medical doctors should play the lead-
ing role in the management of autistic students (65.1 and
41.4%, respectively; p = 0.001). In any case, the group of
teachers with previous education on autism more fre-
quently supported the view that, even with appropriate
training, teachers are not in a position to raise the question
about autism (41.0 and 21.4%, respectively; p = 0.002).
The ndings based on teachers with past working
experience on autism also supported further the earlier
ndings, as they were seen raising similar views (Table 4).
The perception related to the necessity of cooperation
between teachers and specialists, in order to treat ASD
children effectively, did not differ signicantly between
teachers with and without education or experience
(Tables 3, 4). Moreover, more female than male teachers
were found to believe that autistic children comprise the
most difcult group of students, and, in addition, that
teachers should cooperate with specialists in order to
manage autistic children. (As these ndings on gender were
not statistically robust they should be treated with caution).
The cumulative effects of past specialized education and
working experience on teachers perceptions of autism
were also examined. The frequencies of responses termed
in line with prevailing educational norms were higher in
the group of teachers who had both education and experi-
ence (19.7%; n = 45) than in the group of teachers without
education or experience (55.3%; n = 126) as well as than
in the group of teachers with either education or experience
only (25.0%; n = 57). The aspects of autism investigated
under the cumulative effects of teachers past education
and experience are summarized in Table 5.
The ndings produced by the multivariate logistic
regression analysis revealed that specialized education as
well as working experience remain critical and robust
independent predictors of teachers perception and
knowledge of autism. The adjusted odds ratios (aOR) were
found to range from 1.9 to 4.7 for teachers previous spe-
cialized education and from 2.1 to 5.8 for teachers pre-
vious working experience, at the 95% condence interval
(Table 6).
Discussion
Past studies have postulated that teachers perceptions and
knowledge play a crucial role on the service and manage-
ment of autistic children. However, despite its importance,
research remains surprisingly thin in this eld. A core
objective of this study has been to partially mitigate this
gap, focusing in particular on the Greek educational sys-
tem. More specically, revealing Greek teachers percep-
tions and knowledge of the nature and management of
ASD children has been, thus, a principal purpose of this
paper. The ndings are indicative of the prevailing con-
tradictions, ambiguity and confusion about autism among
teachers, especially as regards the nature of autistic disor-
der, the most efcient approaches to manage ASD students
Table 5 Cumulative effect of past specialized education and working experience on teachers perceptions of autism
a (%) b (%) c (%) p
1. Most individuals with autism do not acquire good language skills later in life 31.7 54.4 71.7 \0.001
2. Autism exists alongside mental retardation 28.6 40.4 66.7 \0.001
3. Autistic children are not always hyperactive 26.2 31.6 51.1 0.004
4. Autism can be diagnosed in infancy 27.0 38.6 51.1 0.003
5. The disorders associated with autism cannot be overcome to a large extent even with the provision of
appropriate education
31.7 54.4 73.3 0.004
6. Most therapeutic programs for autistic children are not psychoanalytic 14.3 28.1 55.6 \0.004
7. Autistic children do not feel suppressed in a strictly structured environment, and their condition improves 27.8 47.4 73.3 \0.001
8. The treatment of most autistic children should not be based on drug therapy, but rather on special education 24.6 35.1 57.8 \0.001
9. Autistic children are better off receiving education on social skills rather than an academic education 45.2 57.9 80.0 \0.001
10. Auditory teaching methods are not superior to visual methods 19.8 45.6 88.9 \0.001
The table records only the items with statistically signicant difference
a: Without education or experience; b: with either education or experience; c: with both
J Autism Dev Disord (2012) 42:755768 763
1 3
and the relevant potential outcomes. The high percentages
seen in the do not know answers may reect the obscurity
and vagueness of the concept of autism, combined with
teachers limited knowledge and practical experience on
autism.
As anticipated, the teachers population holding previ-
ous specialized education and/or experience on autism
holds clearer views and opinions on the issues put forward
by the survey. More specically, teachers with relevant
educational background and/or working experience have
the opinion that ASD can be diagnosed in infancy. Fur-
thermore, past specialized education can contribute to the
acquisition of skills in particular elds of autism. A sig-
nicant divergence between the two sample teacher sub-
groups (with or without past education and/or experience
on autism) was seen in the case of management of autistic
children. This view was related to the substantial
improvement of ASD students whenever they were taught
in a strictly structured environment, where they could
upgrade their social skills. Based on the research evidence,
Table 6 Association of teachers education and experience in autism with their perception and knowledge of autism, expressed as adjusted odds
ratios (aOR) with their 95% condence intervals (CI)
Education Experience
aOR (95%
CI)
p Value aOR (95%
CI)
p Value
Nature and characteristics of autism
Autism is the most serious mental health disorder 2.2 (1.14.5) 0.029
Most individuals with autism do not acquire good language skills later in life 2.7 (1.45.2) 0.002 2.1 (1.04.1) 0.043
Autism exists alongside mental retardation 2.1 (1.14.0) 0.019 2.3 (1.24.5) 0.017
Autism is not a hereditary disorder
Autism is not a form of schizophrenia 2.7 (1.16.3) 0.023
Autistic children have intelligent parents
Autistic children are not often hyperactive
Assessment of children with autism
Autism can be diagnosed in infancy 2.4 (1.24.5) 0.009
Disorders cannot be overcome to a large extent even with the appropriate education 2.9 (1.65.5) \0.001 2.2 (1.14.4) 0.025
Autistic children can have exceptional skills in a particular eld 2.4 (1.25.0) 0.016 3.1 (1.47.3) 0.008
Almost every teacher can recognize autistic characteristics in a child
Children with autism succeed in tests that involve rote learning 3.3 (1.66.4) \0.001
Education of children with autism
The most benecial programs for autistic children are not psychoanalytic 5.6 (2.711.4) \0.001
Autistic children should not be educated in a special school
Autistic children are not suppressed and their condition improves in a strictly structured
environment
2.9 (1.65.5) \0.001 2.3 (1.24.6) 0.014
The treatment of most autistic children should not include drugs 2.2 (1.14.2) 0.024
Autistic children are better off if their education is focused on social skills rather than on
academic subjects
1.9 (1.03.6) 0.044 2.2 (1.14.5) 0.025
Auditory teaching methods are not superior to visual methods 4.3 (2.28.4) \0.001 5.8 (2.812.1) \0.001
Behaviorism is not an obsolete method 4.7 (2.39.4) \0.001 2.8 (1.45.8) 0.006
It is preferable for autistic children to attend special vocational schools rather than
mainstream secondary schools

The role in the education of children with autism
Teachers should cooperate with specialists
Autistic children constitute the most difcult group of students
Teachers rather than medical doctors should play the leading role in the educational-
therapeutic treatment of autistic students
2.6 (1.35.2) 0.007
With the appropriate training, teachers can effectively deal with an autistic child
Even with the appropriate training, teachers cannot raise the question about autism 2.3 (1.24.5) 0.015
Results of multivariate logistic regression analysis, adjusting for teachers gender, age, place of work and years of service
764 J Autism Dev Disord (2012) 42:755768
1 3
teachers with relevant educational background and/or
experience on autism appear to marginally favor special
vocational rather than mainstream schools as more appro-
priate for ASD students. This is an interesting nding
which can imply that educational policies on autism may
have not been fully organized and developed as yet in both
mainstream and special vocational schools. If this is the
case, it raises concerns regarding the current exibility and
adaptability of the educational curriculum in mainstream
and vocational schools, sufcient training and specializa-
tion of teachers as well as adequacy of premises infra-
structure. Since these are critical policy issues, further
research on these issues should be useful.
Finally, previous education and/or experience on autism
were found to be fundamental in supporting teachers
dealing more efciently with ASD students. This can
potentially imply that teachers training in diverse educa-
tional environments has a critical impact to raise teachers
motivation and initiative contributing in special education.
The educated or experienced teachers group more often
than the noneducated or nonexperienced teachers group
was seen to believe that ASD is the most serious mental-
health disorder in children, often coinciding with mental
retardation; and, ASD students comprise the most difcult
group of students to manage. These ndings were further
validated and supported by the multivariate logistic
regression analysis. This latter approach also underlined
the independent impact of specialized education and
working experience on teachers perception and knowledge
of autism, with a twofold to threefold increase in the fre-
quency of the more in line with prevailing educational
norms response. A broad conclusion put forward by this
survey is the need for an interdisciplinary educational
background with solid training on ASD teaching approa-
ches. This would critically support teachers in undertaking
a leading role whenever working within a team together
with specialized scientic staff, parents and institutions. In
any case, teachers special education and past working
experience provide a solid fundamental backup in knowing
how to serve and manage ASD students.
A number of constraints in this study should be also
mentioned. For a start, previous research has been thin on
the issue of teachers perceptions on the management of
ASD children. In addition, the sample size was cut down in
order to keep the teachers cohort at a manageable level.
Moreover, further evaluation of the structured question-
naire and the distribution process should be ideally con-
ducted. However, despite these limitations, the results have
been encouraging, and emphasized on the signicant
implications of teachers previous specialized education
and working experience on autism for the efcient educa-
tional process of autistic children.
In conclusion, ASD students possess a variety of char-
acteristics that impose constraints on their smooth educa-
tional process but, on the other hand, induce material
challenge for the educational community. The ndings of
this study have also revealed ambiguities and contradic-
tions with view to the basic ASD characteristics and the
resulting tremendous difculties in managing autistic
children. Nevertheless, the research results were seen to
improve signicantly when a number of critical issues on
autism were examined in relation to teachers previous
special education and/or working experience. These latter
key factors (educationexperience) were found to
empower teachers with knowledge and condence,
enabling them to build upon existing knowledge of the
nature and problems of autism, without ignoring the con-
straints and unfavorable educational outcomes of ASD
children.
The positive impact of teachers previous specialized
education appears to be reinforced when seen jointly with
working experience on ASD children. Autistic children are
considered to be highly needy as regards their educational
achievements. In order to fulll ASD childrens demands,
it is crucial for teaching personnel to have been appropri-
ately trained. The present study and the limited past
research support the plausible view that teachers with rel-
evant specialized education have a broader view of autistic
disorders and are, therefore, in a better position to select
and structure their educational goals. The additional
experience gained working with and managing of autistic
children strengthens teachers self-esteem and upgrades
their position in the class, enabling them to have an active
leading role within working teams on autism, including
specialized scientic staff, parents and institutions.
Appendix
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J Autism Dev Disord (2012) 42:755768 767
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References
Anastasiou, D., & Polychronopoulou, S. (2009). Identication and
overidentication of specic learning disabilities (dyslexia) in
Greece. Learning Disability Quarterly, 32(2), 5569.
Arick, J. R., Krug, D. A., Fullerton, A., Loos, L., & Falco, R. (2005).
School-based programs. In F. R. Volkmar, R. Paul, A. Klin, & D.
Cohen (Eds.), Handbook of autism and pervasive developmental
disorders, Vol. 2, Assessment, interventions, and policy (3rd ed.,
pp. 10031028). Hoboken, NJ: Wiley. doi:10.1177/108835760
8329827.
ASD Centers for Disease Control and Prevention. (2007). Autism
information center (Online). http://www.cdc.gov/ncbdd/autism.
Conroy, M. A., Asmus, J. M., Boyd, B. A., Ladwig, C. N., & Sellers,
J. A. (2007). Antecedent classroom factors and disruptive
behaviors of children with autism spectrum disorders. Journal
of Early Intervention, 30(1), 1935. doi:10.1177/1053815107
03000103.
Cotugno, A. (2009). Social competence and social skills training and
intervention for children with autism spectrum disorders. Jour-
nal of Autism and Developmental Disorders, 39(9), 12681277.
doi:10.1007/s10803-009-0741-4.
Dib, N., & Sturmey, P. (2007). Reducing student stereotypy by
improving teachers implementation of discrete-trial teaching.
Journal of Applied Behavior Analysis, 40(2), 339343. doi:
10.1901/jaba.2007.52-06.
Finke, E. H., McNaughton, D. B., & Drager, D. R. (2009). All
children can and should have the opportunity to learn: General
education teachers perspectives on including children with
autism spectrum disorder who require AAC. Augmentative and
Alternative Communication, 25(2), 110122. doi:10.1080/07434
610902886206.
Grey, I. M., Honan, R., McClean, B., & Daly, M. (2005). Evaluating
the effectiveness of teacher training in applied behaviour
analysis. Journal of Intellectual Disabilities, 9(209), 209226.
doi:10.1177/1744629505056695.
Greek Government Gazette. (2000). Law 2817/14.3.2000. On educa-
tion of people with special needs (in Greek).
Greek Government Gazette Law. (2008). 3699/2.10.2008. Special
education and education of the handicapped or those with
special educational need (in Greek).
Harris, S. L., Handleman, J. S., & Jennet, H. K. (2005). Models of
educational intervention for students with autism: Home, center,
and school-based programming. In F. R. Volkmar, R. Paul, A.
Klin, & D. Cohen (Eds.), Handbook of autism and pervasive
developmental disorders, Vol. 2, Assessment, interventions, and
policy (3rd ed., pp. 10431054). Hoboken, NJ: Wiley.
Lerman, D., Tetreault, A., Hovanetz, A., Strobel, M., & Garro, J.
(2008). Further evaluation of a brief, intensive teacher-training
model. Journal of Applied Behavior Analysis, 41(2), 243248.
doi:10.1901/jaba.2008.41-243.
Lian, W. B., Ying, H. K., Tean, S. C. H., Lin, D. C. K., Lian, Y. C., &
Yun, H. L. (2008). Pre-school teachers knowledge, attitudes and
practices on childhood developmental and behavioural disorders
in Singapore. Journal of Paediatrics and Child Health, 44(4),
187194. doi:10.1111/j.1440-1754.2007.01231.x.
Maurice, C., Green, G., & Luce, S. C. (1996). Behavioral intervention
for young children with autism: A manual for parents and
professionals. Austin, TX: PRO-ED.
Mavropoulou, S., & Padeliadu, S. (2000). Greek teachers perceptions
of autism and implications for educational practice: A pre-
liminary analysis. Autism, 4(2), 173183. doi:10.1177/136236
1300004002005.
McConkey, R., & Bhlirgri, S. (2003). Children with autism attending
preschool facilities: The experiences and perceptions of staff.
Early Child Development and Care, 173(4), 445452. doi:
10.1080/0300443032000086926.
McDonnell, J. (1998). Instruction for students with severe disabilities
in general education settings. Education and training. Mental
Retardation and Developmental Disabilities, 33(3), 199215.
Mesibov, G. B., Shea, V., & Schopler, E. (2006). The TEACCH
approach to autismspectrumdisorders. NewYork, NY: Springer.
National Research Council, Division of Behavioral, Social Sciences
Education. (2001). Educating children with autism. Washington,
DC: National Academy Press.
ONeil, R., Williams, R., Sprague, J. R., Horner, R. H., & Albin, R.
W. (1993). Providing support for teachers working with students
with severe problem behaviors: A model for providing consult-
ing support within school districts. Education and Treatment of
Children, 16(1), 6689.
Powell, S. D., & Jordan, R. R. (1992). Remediating the thinking of
pupils with autism: Principles into practice. Journal of Autism
and Developmental Disorders, 22(3), 413418. doi:10.1007/
BF01048243.
Probst, P., & Leppert, T. (2008). Brief report: Outcomes of a teacher
training program for autism spectrum disorders. Journal of
Autism and Developmental Disorders, 38(9), 17911796. doi:
10.1007/s10803-008-0561-y.
Roth, I., Barson, C., Hoekstra, R., Pasco, G., & Whatson, T. (2010).
The autism spectrum in the 21st century: Exploring psychology,
biology and practice. The Open University, Philadelphia, PA:
Jessica Kingsley Publishers.
Scheuermann, B., Webber, J., Boulot, A., & Goodwin, M. (2003).
Problems with personnel preparation in autism spectrum disor-
ders. Focus on Autism and Other Developmental Disabilities,
18(3), 197206. doi:10.1177/10883576030180030801.
Schuster, J. W., Collins, B. C., Nelson, C. M., Gast, D. L., & Wolery,
M. (1991). The University of Kentucky program in develop-
mental and behavioral disorders. Education and Treatment of
Children, 14(4), 333348.
Scott, J., Clark, C., & Brady, M. (2000). Students with Autism:
Characteristics and Instruction Programming. San Diego, CA:
Singular Publishing.
Simpson, R. (2003). Policy-related research issues and perspectives.
Focus on Autism and Other Developmental Disabilities, 18(3),
192196. doi:10.1177/10883576030180030701.
Syriopoulou, C. (2003). Education in post-modern era: The case of
special educatiON. Athens: Grigoris Plc. (in Greek).
768 J Autism Dev Disord (2012) 42:755768
1 3
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