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Understanding behavioural and academic outcomes for autistic children in mainstream education: toward a family and ecological-systems approach
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Date
2026-03-14
Authors
Fitzgerald, Billy
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
Autistic children (AC) experience, on average, higher rates of internalising and externalising difficulties and lower levels of prosocial behaviour and academic performance than non-autistic peers. These outcomes are shaped by influences across multiple levels of the child’s ecological context, yet the relative contributions of child, family, and wider systemic factors remains insufficiently understood. Guided by an ecological systems perspective, this PhD thesis investigated behavioural and academic outcomes among AC attending mainstream educational settings through a multi-method, multi-level research programme comprising four interrelated studies. Study 1 systematically reviewed longitudinal quantitative research examining the associations between family processes, conceptualised as psychological and interpersonal factors operating across the parental, dyadic, and family-system levels, and later behavioural outcomes among AC. Sixteen of the 17 included studies reported significant associations between at least one family process and later behavioural outcomes, with parenting stress and aspects of the parent–child relationship demonstrating the most consistent associations, even when adjusting for key child characteristics including intellectual functioning. Studies 2 and 3 built on these findings by examining the relative contributions of child characteristics, family processes, family structural factors, and satisfaction with family–professional relationships to behavioural and academic outcomes among AC in mainstream education using cross-sectional data (Study 2) and prospective data at six and 12 months (Study 3). Across both studies, factors associated with outcomes varied by outcome domain and timeframe. Family processes, particularly parenting and caregiver stress, together with child sleep quality, were associated with behavioural difficulties cross-sectionally and at six months, while autistic traits showed the strongest associations with difficulties by 12 months. Prosocial behaviour was associated with autistic traits in both cross-sectional and longitudinal analyses, with caregiver depression showing the strongest association with prosocial behaviour at 12 months. Greater family-system cohesion and satisfaction with the family–healthcare relationship were associated with reductions in behavioural difficulties over time, highlighting the potential importance of these family-system and mesosystemic processes for behavioural trajectories. Academic performance was less consistently associated with the factors examined, with comorbidity status emerging as a correlate in cross-sectional analyses, while sleep quality and family structural factors demonstrated minimal associations longitudinally. Study 4 extended understanding of family–professional relationships through qualitative methods exploring families’ perceptions of positive and negative relationships with healthcare and educational professionals. Findings highlighted the interconnected influence of structural and interpersonal factors on families’ experiences of support, emphasising the importance of tailored family-focused support, collaboration, and communication characterised by consistency, openness, clarity, and warmth. Positive family–professional relationships were perceived to contribute to family empowerment, emotional well-being, and willingness to engage with professionals, while professional attunement to AC’s emotional and sensory needs, developmental pace and individual interests was important to positive experiences of support and child engagement. Families also described structural barriers to accessing and coordinating support across services. Integrating systematic review, cross-sectional and longitudinal quantitative, and qualitative evidence, this thesis advances a multilevel ecological understanding of behavioural and academic outcomes among AC. The findings highlight potentially modifiable targets, including parenting stress, child sleep quality, family cohesion, and family–professional relationships, and underscore the need for accessible, coordinated, family-centred approaches to supporting AC and their families.
Description
Controlled Access
Keywords
Autism , Family–professional relationships , Family processes , Behavioural , Academic , Mixed-methods
Citation
Fitzgerald, B. 2026. Understanding behavioural and academic outcomes for autistic children in mainstream education: toward a family and ecological-systems approach. PhD Thesis, University College Cork.