School Anxiety Experienced by Autistic Children: A Systematic Review of Contributing Factors

Anxiety about school is becoming increasingly recognised among Autistic learners, yet the term is often applied in essentialist ways that obscure its underlying contributors. Our systematic review aimed to identify and evaluate research examining demographic and psychosocial factors contributing to school anxiety among Autistic learners. We included studies which reported a relationship – without attributing it to a non-contributing reason – between school anxiety and a potential contributing factor among Autistic learners. We searched PsycINFO, Medline, ERIC, and Scopus through March 2025. Eight papers (N = 767 participants) met the inclusion criteria, including three qualitative and five quantitative studies. We conducted a narrative synthesis and assessed quality using STROBE and CASP. Three studies investigated individual-level factors (e.g., age, gender) with mixed significance. Five identified microsystemic, or school-based, contributors, including social expectations (n = 4), academic and cognitive expectations (n = 2), and the physical and structural design of school environments (n = 4). Using a critical realist lens, we propose a layered ecological framework in which neuro-normative epistemic injustice shapes the microsystem through school-based contributors, or affordances, that manifest as individual differences. Most eligible studies were limited in epistemic depth, overlooking interrelations and deeper macrosystemic mechanisms. Despite generally moderate to high quality, key limitations included reliance on service-based recruitment, underrepresentation of marginalised identities, and dominance of non-Autistic informants – reinforcing epistemic injustice by sidelining Autistic perspectives. Our findings highlight the need for inclusive, participatory methods capable of capturing the complex, macrosystemic realities of Autistic learners’ experiences of school anxiety.