ORIGINAL PAPER

Teachers’ Perceptions Regarding the Management of Childrenwith 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

diversified teacher population. The questionnaire responses

were analyzed statistically to identify the explanatory

power of critical independent variables. The research

findings support that teachers’ specialized training and

working experience are critical inputs to improve teachers’

perceptions and efficient 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 scientific 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

123

J Autism Dev Disord (2012) 42:755–768

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 specific, ASD

students frequently display deficits 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 qualifications for a Greek tea-

cher to work in the field of special education include a

Ph.D. or a postgraduate degree in the field 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 qualifications 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 specified 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 insufficient 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; O’Neil 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 efficiently

supported particularly in case a flexible 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 deficits 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 children’s

behavior, language, social capabilities and play skills.

Children’s 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 children’s special

needs (such as on social or communication skills or lan-

guage deficits). Furthermore, specific teaching tech-

niques—rather than an integrated approach on ASD

children—are 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

diversified 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

flexible 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 specifically, this research

756 J Autism Dev Disord (2012) 42:755–768

123

examines the following core topics: evaluation of the

implications of teachers’ previous training and working

experience and the assessment of the influence 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 first 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 31–40 years age range and

80 teachers (35.24%) in the 41–50 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%) 6–10 years, 38 ones (16.67%)

11–15 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 teacher’s 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

31–40 83 36.4

41–50 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

6–10 49 21.5

11–15 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 significant studies on autism

Yes 83 36.4

No 145 63.5

Number of children with autism in the classroom

None 176 77.2

1–3 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) 42:755–768 757

123

included in the category ‘significantly trained’. The term

‘authorized’ training refers to certified training education

provided by the Ministry of Education that qualifies

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 significantly 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 final 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 teacher’s 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 defined 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 influence 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% confidence

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 significance was set at

p \ 0.05.

Results

Statistical Analysis of Questionnaires on Teachers’

Perceptions and Knowledge of ASD

The findings 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) 42:755–768

123

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 deficiency (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 field. 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 field 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 beneficial 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 difficult 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) 42:755–768 759

123

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 difficult group of stu-

dents. Furthermore, half of the study group (50.0%;

n = 114) claimed that teachers rather than medical doctors

should have the first 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 efficiency in serving and

managing ASD children. Tables 3 and 4 present the

research findings 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 specific edu-

cation in the field of autism (Table 3). The most striking,

and statistically significant 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

significant impact.

Assessment of Children with Autism The teachers’ per-

ception of how to assess ASD children differed statistically

significantly 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

field (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

significant 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 stratified 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) 42:755–768

123

ASD children did not affect significantly 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

field was significantly 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 specific education or previous

working experience and teachers without previous educa-

tion or experience on autism, respectively. More specifi-

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 beneficial 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 field 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 beneficial 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 difficult 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) 42:755–768 761

123

teachers: 51.6% compared to 26.8%; p = 0.001). The

research findings 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 findings, 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

findings 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 field 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 beneficial 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 difficult 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) 42:755–768

123

The Teacher’s Role in the Education of Children with

Autism Based on the research findings, 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 difficult

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 findings based on teachers with past working

experience on autism also supported further the earlier

findings, 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 significantly 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 difficult group of students, and, in addition, that

teachers should cooperate with specialists in order to

manage autistic children. (As these findings 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 findings 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% confidence 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 field. A core

objective of this study has been to partially mitigate this

gap, focusing in particular on the Greek educational sys-

tem. More specifically, 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 findings 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 efficient 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 significant difference

a: Without education or experience; b: with either education or experience; c: with both

J Autism Dev Disord (2012) 42:755–768 763

123

and the relevant potential outcomes. The high percentages

seen in the ‘do not know’ answers may reflect 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 specifically, 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 fields of autism. A sig-

nificant 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% confidence 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 (1.1–4.5) 0.029

Most individuals with autism do not acquire good language skills later in life 2.7 (1.4–5.2) 0.002 2.1 (1.0–4.1) 0.043

Autism exists alongside mental retardation 2.1 (1.1–4.0) 0.019 2.3 (1.2–4.5) 0.017

Autism is not a hereditary disorder – –

Autism is not a form of schizophrenia – 2.7 (1.1–6.3) 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 (1.2–4.5) 0.009

Disorders cannot be overcome to a large extent even with the appropriate education 2.9 (1.6–5.5) \0.001 2.2 (1.1–4.4) 0.025

Autistic children can have exceptional skills in a particular field 2.4 (1.2–5.0) 0.016 3.1 (1.4–7.3) 0.008

Almost every teacher can recognize autistic characteristics in a child – –

Children with autism succeed in tests that involve rote learning – 3.3 (1.6–6.4) \0.001

Education of children with autism

The most beneficial programs for autistic children are not psychoanalytic 5.6 (2.7–11.4) \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 (1.6–5.5) \0.001 2.3 (1.2–4.6) 0.014

The treatment of most autistic children should not include drugs – 2.2 (1.1–4.2) 0.024

Autistic children are better off if their education is focused on social skills rather than on

academic subjects

1.9 (1.0–3.6) 0.044 2.2 (1.1–4.5) 0.025

Auditory teaching methods are not superior to visual methods 4.3 (2.2–8.4) \0.001 5.8 (2.8–12.1) \0.001

Behaviorism is not an obsolete method 4.7 (2.3–9.4) \0.001 2.8 (1.4–5.8) 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 difficult group of students – –

Teachers rather than medical doctors should play the leading role in the educational-

therapeutic treatment of autistic students

– 2.6 (1.3–5.2) 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 (1.2–4.5) 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) 42:755–768

123

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 finding

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 flexibility and

adaptability of the educational curriculum in mainstream

and vocational schools, sufficient 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 efficiently 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 difficult

group of students to manage. These findings 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 scientific 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 significant

implications of teachers’ previous specialized education

and working experience on autism for the efficient 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 findings of

this study have also revealed ambiguities and contradic-

tions with view to the basic ASD characteristics and the

resulting tremendous difficulties in managing autistic

children. Nevertheless, the research results were seen to

improve significantly 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 (education—experience) were found to

empower teachers with knowledge and confidence,

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 fulfill ASD children’s 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 scientific staff, parents and institutions.

Appendix

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