Study links school experiences to increased emotional burden in autistic and ADHD adolescents

King’s College London, UCL, and Anna Freud researchers find that negative school events carry twice the emotional weight for neurodivergent students compared to peers.

Adolescents with autism or ADHD experience significantly greater emotional burden from common school events than their neurotypical classmates, according to a new study published in the Journal of Child Psychology and Psychiatry.

Researchers found this heightened emotional impact is closely associated with increased risk of depression and anxiety in later life.

The study was led by King’s College London’s Institute of Psychiatry, Psychology & Neuroscience, in collaboration with UCL and Anna Freud. It forms part of the Regulating Emotions – Strengthening Adolescent Resilience (RE-STAR) program, funded by the NIHR Maudsley Biomedical Research Center and the Medical Research Council. The team co-produced a new assessment tool, the My Emotions in School Inventory (MESI), with neurodivergent youth over a 20-month period.

Findings reveal intensity and frequency of emotional response

The research involved 735 students aged 11 to 16. Of these, 213 had a formal diagnosis of autism, ADHD, or both, while the remainder were neurotypical. Participants completed the MESI tool, which asked them to rate how often they encountered 24 common upsetting school events, such as being misunderstood by teachers or excluded by peers, and to rate how upsetting each was.

Results showed that neurodivergent adolescents not only experienced these events more often, but also reacted to them more intensely. The combined effect, described as emotional burden, was calculated by multiplying frequency by intensity across all events.

Dr. Georgia Pavlopoulou, co-investigator at UCL and Anna Freud, says, “Accounts of emotional dysregulation in autism and ADHD are too often shaped by adult observations rooted in neurotypical ideas of how emotions should look and be expressed.

“This approach overlooks the real experiences of neurodivergent young people and misses the context behind their emotional responses, context only they can truly provide. That’s why we worked for over 20 months with young people to co-produce MESI, a new tool designed to better understand and support their emotional world on their terms.”

Differences in triggers between autistic and ADHD students

While overall emotional burden was found to be similar across ADHD and autistic participants, the types of triggers varied. Autistic students were more affected by peer-related issues, such as being excluded or not understanding social dynamics. Students with ADHD more often cited interactions with teachers, including being reprimanded or misunderstood in class.

Dr. Susie Chandler, joint first author at King’s IoPPN, says, “Adolescence is a key time for emotional development, and secondary school plays a role in this. Our study highlights the impact everyday school events and interactions have on young people’s emotions; and how young people with neurodevelopmental conditions in particular can find school a source of emotional challenge. Identifying common upsetting events, the findings provide some pointers for how schools can create supportive environments that promote the well-being of autistic young people and those with ADHD.”

Dr. Steve Lukito, also joint first author at King’s IoPPN, adds, “Whole-school approaches to mental health should be neurodiversity-informed and include interventions designed to reduce upsetting experiences and help students manage those negative experiences when they do occur.”