www.ijcrsee.com
793
Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
Original scientific paper
Received: July 28, 2025.
Revised: November 21, 2025.
Accepted: December 05, 2025.
UDC:
xxx
xxx
10.23947/2334-8496-2025-13-3-793-810
© 2025 by the authors. This article is an open access article distributed under the terms and conditions of the
Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
*
Corresponding author: m.zamfirov@fppse.uni-sofia.bg
Abstract: Over the years, research has demonstrated that individuals with autistic spectrum disorders are a hetero-
geneous group. In recent years, the concept of inclusive education has provided additional insight into the possibilities of
working with children with ASD in mainstream schools. The purpose of this study is to outline the specific strengths, capacities,
and opportunities for supporting children and students with ASD in mainstream schools. The Classification of Functioning,
Disability, and Health for Children and Youth (ICF-CY) indicators were used as a basis and applied to different forms of ASD
diagnosis, looking for more detailed individual profiles and common resources outlined despite the possible differences by
gender, age, diagnoses, and according to specific difficulties and areas where children and students have difficulties. Sample
comprised 201 children and students, aged 3-19 years. The results highlight the strengths and resources of a large number of
the respondents with ASD, outlining their capacity in communication, language mastery and thinking. From one-fifth to more
than half of the respondents do not encounter challenges when the environment and context are supportive. The reported
results highlight the implications of the universal tool that teachers and educators have for thorough and in-depth outlining the
personal development scope and areas. It can serve as a screening instrument in mainstream setting, alerting mainly teachers,
but also families about the measures that address needs of children and students with ASD in view to facilitate personal growth.
Keywords: children with Autism Spectrum Disorder, inclusive environment, Classification of Functioning, Disability,
and Health for Children and Youth (ICF-CY).
Milen Zamfirov
1*
, Мargarita Bakracheva
1
, Kaloyan Damyanov
1
, Lyudmila Belenska-Todorova
2
,
Polina Daskalova-Petkova
1
1
Faculty of Educational Studies and the Arts, Sofia University St. Kliment Ohridski, Sofia, Bulgaria,
e-mail: m.zamfirov@fppse.uni-sofia.bg, mbakrachev@uni-sofia.bg, kdamjanov@uni-sofia.bg, daskalova.poli@gmail.com
2
Faculty of Medicine, Sofia University St. Kliment Ohridski, Sofia, Bulgaria, e-mail: lbelenska@uni-sofia.bg
Screening Tool Facilitating Mainstream School Practitioners to Assess
Educational Needs of Children With Autism Spectrum Disorders: The
Bulgarian Case
Introduction
The diagnostic profiles of children with autism spectrum disorder (ASD) reveal a spectrum of chal-
lenges that underscore the complexity of their educational requirements. Most notably, communication
deficits manifest through limited social engagement and difficulties in comprehending verbal cues, neces-
sitating individualised interventions tailored to each child’s unique profile (Bagetti et al., 2023). These pro-
files often highlight a reliance on specific support frameworks, such as those aligned with the International
Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY), to ensure effective
inclusion in educational settings. The heterogeneity observed in social interactions indicates not only a
need for targeted language development programs but also emphasises fostering emotional regulation
and cognitive skills, which are critical for academic achievement. Overall, understanding these diagnostic
profiles is crucial for developing long-term support strategies to enhance the educational outcomes and
social adaptation of children with ASD.
The diagnostic criteria for ASD have evolved significantly, particularly with the publication of the
DSM-5, which redefines ASD as a single continuum rather than a collection of distinct categories. This
modification aimed to streamline the diagnostic process and reflect the heterogeneous nature of the
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Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
spectra. Current criteria necessitate the presence of symptoms in two critical domains: social commu-
nication and restricted, repetitive behaviours, which must manifest in early developmental periods and
cause functional impairments in daily life (Durkin, 2019). Recent analyses emphasise the necessity for
a multidimensional approach to assessment, considering cognitive, emotional, and social factors indica-
tive of each child’s unique profile. Furthermore, the utilisation of frameworks such as the International
Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY) has underscored the
significance of context in understanding the educational and interpersonal needs of children with ASD,
thus advocating for inclusive strategies that consider individual variability.
The heterogeneity in symptomatology and behavioural manifestations among children with Autism
Spectrum Disorder (ASD) presents significant challenges for both diagnostic processes and interven-
tion strategies. Individuals on the autism spectrum exhibit a diverse range of communication difficulties,
social interaction impairments, and behavioural issues, necessitating a nuanced understanding of their
individual needs to effectively tailoring educational strategies. Research indicates that this heterogene-
ity frequently involves limited social engagement, whereby numerous children avoid peer contact and
experience difficulties with group participation, underscoring the need for targeted interventions to foster
social skills and inclusion. Furthermore, deficits in cognitive and emotional regulation can impede chil-
dren’s ability to manage daily activities, as they frequently encounter challenges in maintaining attention
and coping with frustration. As noted in the literature, employing assessment tools such as the Adaptive
Behaviour Assessment System (ABAS-3) can provide a comprehensive framework to evaluate function-
ing and guide individualised support, ensuring that each child’s educational experience is appropriately
customised (Shah et al., 2019).
The role of early diagnosis in educational planning for children with ASD is pivotal, as it enables
tailored interventions that align with the unique needs of each child. Early identification facilitates the
implementation of specific educational strategies that consider not only the diagnostic criteria but also the
broader biopsychosocial context, as emphasised in the International Classification of Functioning, Disabil-
ity, and Health for Children and Youth (ICF-CY) (Mahdi et al., 2018; Vallefuoco et al., 2022). Research has
demonstrated that children experience significant challenges in communication and social interactions, of-
ten necessitating individualised educational frameworks that promote engagement. Furthermore, effective
educational planning incorporates insights into environmental factors, as these contexts significantly influ-
ence children’s participation and functionality in educational settings. The emphasis on early diagnosis un-
derscores the importance of a proactive approach that enables educators and caregivers to foster holistic
development and support inclusion, thereby addressing both immediate and long-term educational needs.
Multidisciplinary assessments are crucial in developing comprehensive diagnostic profiles for chil-
dren with Autism Spectrum Disorders (ASD), as they provide a holistic view of an individual’s strengths
and challenges. By incorporating insights from various professionals, such as clinicians, educational spe-
cialists, and therapists, these assessments lead to tailored interventions that address the diverse needs
of autistic children (
Mahdi et al., 2018
; Balsa, 2023). For instance, the analysis of functional profiles utilis-
ing the ICF-CY highlights significant variations in social and communicative capabilities among children,
revealing that many experience difficulties in initiating social contact and participating in group activities.
Additionally, the findings emphasise the necessity of individualised support, as children often require long-
term assistance in language development and emotional regulation. This multidisciplinary approach not
only enhances documentation and evaluation processes but also aligns interventions more closely with
the real-world complexities faced by children with ASD, facilitating their long-term inclusion and support.
Accurate diagnosis of ASD is fraught with challenges, significantly compromising the efficacy of long-term
support and inclusion strategies, as outlined by the ICF-CY framework. The diagnostic variability can
result from overlapping symptoms with other developmental disorders and a lack of standardised assess-
ment tools, which complicates the determination of individuals’ functional abilities. Further complicating
matters are the acknowledged heterogeneity among children with ASD, where individual differences in
communication, social skills, and cognitive functioning necessitate personalised diagnostic approaches
(Hayden-Evans et al., 2022). Additionally, environmental factors, ranging from familial support to school
contexts, play a crucial role in shaping the developmental trajectories of these children, underscoring the
necessity for a framework that considers these variables. Moreover, the need for long-term interventions
that address specific challenges in communication and emotional regulation emphasises the critical na-
ture of accurate initial diagnoses to effectively tailor educational support.
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Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
Autism Spectrum Disorders (ASD) encompass a range of neurodevelopmental conditions charac-
terised by impairments in communication, social interaction, and repetitive behaviours. The heterogeneity
of ASD manifests variably across individuals, influencing their daily functioning and quality of life. This
complexity is reflected in the increasing prevalence of ASD diagnoses and the subsequent increase in
the educational support requirements of the affected children. Research indicates that children with ASD
typically experience challenges in communication, attention, and social skills, necessitating tailored inter-
ventions. Moreover, factors such as social engagement, emotional regulation, and cognitive flexibility play
critical roles in their development, underscoring the necessity for an inclusive educational framework that
accommodates these diverse needs. Utilising the International Classification of Functioning, Disability
and Health (ICF-CY) framework allows for a comprehensive understanding of how environmental and
personal factors interact with the core characteristics of ASD, ultimately guiding effective support strate-
gies (Viljoen, 2019; Krieger, 2022).
Understanding the intricacies of diagnostic profiles is essential for effectively meeting the educational
requirements of children with ASD, as these profiles encompass each child’s distinct challenges and abili-
ties. Thorough evaluations reveal considerable variation in social and communicative skills, directly shaping
individualised educational approaches. This underscores the need for bespoke interventions to bolster vari-
ous aspects of communication, emotional management, and social integration. Employing frameworks such
as ICF-CY provides a more profound understanding of how children’s impairments interact with their daily
activities, stressing the importance of continuous support across various contexts. This comprehension
forms the foundation for effective long-term strategies to improve academic and social outcomes, ensuring
that children with ASD flourish in inclusive settings (Okoye et al., 2023; Narciso et al., 2024). Furthermore,
as noted in, acknowledging in symptom presentation can inform the creation of targeted interventions, fur-
ther emphasising the importance of personalised support tailored to specific diagnostic profiles.
The educational needs of children with ASD are highly complex, influenced by a multitude of fac-
tors, including individual capabilities, environmental influences, and social contexts. Evidence suggests
that interventions tailored to the unique profiles of these children can significantly enhance their learn-
ing experiences and overall functionality. Critical areas of focus include language development, social
skills, and emotional regulation, as children frequently experience difficulties in communication and social
interactions. Furthermore, the International Classification of Functioning, Disability, and Health for Chil-
dren and Youth (ICF-CY) emphasises that contextual elements play a crucial role in shaping educational
outcomes (Viljoen, 2019). Differences in functional abilities are frequently observed across gender lines,
necessitating gender-sensitive approaches to educational strategies (Buxbaum , 2021). Bystrova et al.
(2017) confirmed that children with ASD have specific features of visual perception irrespective the level
of intelligence and perceive graphic images differently, is important for the school educational environment
Addressing these diverse needs through individualised education plans can facilitate both inclusion
and long-term support for children with ASD within educational settings (Erasmus, 2018; Hasson et al., 2022).
The traditional deficit-based model of autism has increasingly been challenged by the neurodiver-
sity paradigm, which conceptualizes autism as a natural variation in human cognition and emphasizes
the need to support autistic strengths within inclusive environments (Pellicano and den Houting, 2022).
The authors advocate for greater emphasis on contextual factors—such as sensory-friendly settings and
inclusive educational practices—rather than narrowly targeting individual deficits. They also highlight the
importance of participatory research approaches, exemplified by Australia’s Autism CRC, which aligned
research agendas with community-defined priorities and invested in lifespan-oriented supports co-devel-
oped with autistic individuals.
Autism’s heterogeneity has also received growing attention. For example, the shift to a single ASD
diagnosis in DSM-5 has been critiqued for obscuring meaningful subgroups. A dimensional approach—
considering variables such as language ability, intellectual level, gender, and comorbidities—can better
capture individual differences and guide tailored and individualized interventions (Lai et al., 2013).
Recent neuroimaging studies further support autism’s complexity. Using resting-state functional
MRI and regularized canonical correlation analysis (rCCA), researchers identified three key brain–behav-
ior dimensions—verbal IQ, social affect, and restricted and repetitive behaviors (RRB)—and four repro-
ducible autism subtypes with distinct neural and gene expression profiles: (1) high verbal IQ with elevated
RRB; (2) low verbal IQ with elevated RRB; (3) high social-affect symptoms with low RRB; and (4) low
social-affect symptoms with high RRB. Transcriptomic analyses showed that each subtype was associ-
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Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
ated with unique gene expression patterns, pointing to molecularly and neurofunctionally distinct forms
of autism (Buch et al., 2023). These findings underscore the neurobiological heterogeneity of ASD and
challenge its conceptualization as a uniform condition, highlighting the value of dimensional and subtype-
specific approaches in research and intervention.
Recent research has placed greater emphasis on learning environments and inclusive education,
highlighting the critical role of educational context and individualized support in promoting positive out-
comes for autistic students. Lohmann et al. (2023) studied the use of Universal Design for Learning (UDL)
in inclusive preschool science classrooms, showing that UDL strategies support diverse learners, includ-
ing children with ASD, by enhancing engagement and understanding. Their findings provide empirical
support for UDL’s role in early inclusive education (Lohmann et al., 2023).
Similarly, differentiated instruction - adapting teaching methods, materials, and assessments to stu-
dents’ individual needs - has been shown to significantly improve task completion, academic engagement,
and performance for children with ASD (Ameen, 2024). Furthermore, multi-sensory teaching grounded in
a neurodiversity perspective supports greater engagement and learning for neurodiverse students with
ASD (Sewell, 2022).
In a multicenter study across 10 countries (N = 122), clinicians used the ICF–CY checklist to assess
functioning in individuals with ASD, identifying 139 relevant categories across body functions, activities, and
environmental factors. The results underscore the heterogeneity of ASD and support the use of the ICF–CY as
a comprehensive framework for individualized support and inclusive education planning (Mahdi et al., 2018).
The findings of our study align with the results of an international clinical investigation by Mahdi et al.
(2018), which applied the ICF-CY framework to assess functioning in individuals with ASD across diverse
cultural contexts. Their study identified a broad range of relevant categories, highlighting significant variability
in abilities, support needs, and environmental influences. This reinforces our focus on identifying individual
strengths and contextual facilitators in children and students with ASD. Like their findings, our results em-
phasize that many autistic individuals demonstrate competencies in areas such as communication, cognitive
processing, and learning—particularly when supported by inclusive, well-adapted environments.
The focus of the contemporary approach to managing ASD has been directed on a bio-psycho-
social framework that considers an individual‘s abilities and disabilities as a result of the interaction
between health, environment and personal factors (WHO, 2001; WHO, 2007) and the creation of the
International Classification of Functioning, Disability and Health (ICF). An example of work in this direction
is a series of international studies (
Mahdi et al., 2018
) and studies in other countries involving experts
worldwide (Bölte et al., 2014) with the aim of adapting the International Classification of Functioning,
Disability and Health (ICF) guidelines for autism spectrum disorders (ASD) and, specifically, functioning
in autism (as operationalised by the ICF), drawn from the perspective of diagnosed individuals, family
members and professionals.
The provision of long-term support and inclusion for children with ASD is essential for fostering opti-
mal developmental outcomes and enhancing the quality of life for both the child and their family. Compre-
hensive interventions that extend beyond the initial diagnosis are critical; they assist in addressing not only
academic challenges but also the social and emotional deficits that characterise the disorder. Research
indicates that children with ASD often require individualised support, including tailored educational strate-
gies and consistent adult supervision, to promote engagement and participation in diverse settings. Moreo-
ver, the ICF-CY framework underscores the importance of contextual factors in evaluating the functionality
and capabilities of these children, which encompasses their sustainability in educational environments and
community life (Damyanov, 2024). Ongoing support not only mitigates behavioural challenges but also
facilitates meaningful peer interactions, contributing to the child’s overall well-being and social integration.
The ICF-CY provides a comprehensive framework for assessing the diverse needs of children, par-
ticularly those diagnosed with ASD. This classification model emphasises the significance of understand-
ing not only disabilities but also the functional capacities and social participation of children, enabling a
more holistic approach to intervention and support. The heterogeneity of ASD, highlighted in the ICF-CY
framework, reveals substantial variations in social interactions and communication abilities among the
affected children, necessitating tailored educational strategies. Furthermore, ICF-CY underscores the
critical role of contextual factors in shaping developmental outcomes and emphasises the necessity for
individualised support mechanisms (Nugent, 2016; Dale, 2021). Utilisation of this classification system
can facilitate enhanced identification of specific educational requirements, thereby assisting educators
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Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
and clinicians in fostering inclusive environments that promote meaningful participation for children with
ASD. Table 1 describes the main areas of challenges (Damyanov et al., 2023).
Table 1. ICF-CY Dimensions and Functioning Levels
Dimension Functioning Level Example Prevalence Rate
Body Function
Functions related to mental
and behavioural performance
Cognitive functioning,
emotional regulation
Approximately 70% of children with
ASD exhibit challenges in this area
Activities
Capabilities to execute tasks
or actions
Learning, communication,
self-care
Over 40% of children with ASD have
significant difficulties
Participation Involvement in life situations
Engagement in social
activities, schooling
Estimated 30% of children with ASD
experience barriers
Environmental
Factors
External factors influencing
functioning
Support from family,
educational settings
Positive support can reduce challenges
for up to 50% of children
The ICF serves as the basis for assessing and measuring disability. In recent years, research has
been conducted to nationally adapt assessment tools according to the World Health Organization’s Inter-
national Classification of Functioning, Disability, and Health (ICF), including its version for children and
youth, e.g. in Taiwan (Hwang et al., 2015). In some studies, a differentiation was made, with those trained
to implement the Identification Card comprising only teachers; the Functional Diagnosis group only of
multidisciplinary health professionals from Disability Services; and the group for the Achievable Functional
Goal Profile and Individual Education Action Plan being heterogeneous in composition and comprising
both teachers and operators from Disability Services (Mohapatra and Dwivedi, 2024). Some research
has pointed towards creating a single disability variable for children with varying degrees of disability,
ICD-10 diagnoses, and age using the WHO ICF-CY coding system for bodily functions (Illum and Gradel,
2015). Other ICF-CY-based studies have focused on specific conditions. An example is the functioning of
individuals with autism spectrum disorder (ASD) are the research, conducted with representatives from
10 countries (
Mahdi et al., 2018
) and assessment of adults activity and participation in Taiwan (Liao et al.,
2022), the degree of functioning of children and their families in Argentina (Napoli et al., 2021). Studies are
also focused on other groups with disabilities, eg. such as cerebral palsy (Schiariti et al., 2014). Studies are
also being conducted not only to adapt and validate, but also to monitor the applicability of the International
Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY). An example
is social and scholastic inclusion for students with disability in Treviso province, Italy (De Polo et al., 2009).
In this article are reported the results concerning the implementation of ICF-FY by teachers and
educators as a part of the teams, ensuring personal development in mainstream inclusive setting.
Understanding the diagnostic profile and educational needs of children with Autism Spectrum Dis-
orders (ASD) necessitates a comprehensive examination of their distinctive characteristics and chal-
lenges. The prevalence of ASD has drawn significant attention to the importance of tailored educational
strategies that address individual needs, particularly within the framework of the International Classifica-
tion of Functioning, Disability, and Health for Children and Youth (ICF-CY). This model emphasises the
multifaceted nature of autism and elucidates how environmental, social, and personal factors interact
to influence educational outcomes. As children with ASD frequently exhibit various impairments in com-
munication, social interactions, and emotional regulation, effective long-term support systems must be
designed to foster inclusion and participation. Consequently, this survey aims to analyse the critical role of
long-term educational interventions, emphasising the necessity for specialised approaches that promote
holistic development and social adaptation of children with ASD in inclusive settings.
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798
Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
Materials and Methods
This research is based on a field study conducted during the implementation of functional assess-
ments of children and students with special educational needs in kindergartens and schools by a team
from the Regional Center for Support of the Process of Inclusive Education (RCSPIE) in Sofia City. The
assessment process took place between September 2023 and October 2024 and included the assess-
ment of 201 children and students diagnosed with autism spectrum disorder between the ages of 3 and
19. This fieldwork provided substantial empirical data on the diverse educational and developmental
needs of children with ASD, further informing discussions about effective intervention strategies in inclu-
sive educational settings.
The functional scorecard based on the Bulgarian Model of Inclusive Education administered in this
study is designed for quantitative and qualitative indicators measuring child and adolescent development,
allowing for detailed profiling and collection of in-depth information that can be used for individual profiling.
The instrument applied in this study is the Functional Assessment Map of the Individual Needs of
Children and Students with Special Educational Needs and Chronic Diseases, officially developed and
implemented in Bulgaria in 2023 under the national project “Support for Inclusive Education,” funded by
the Ministry of Education and Science. The instrument is based on the International Classification of Func-
tioning, Disability, and Health for Children and Youth (ICF-CY) developed by the World Health Organiza-
tion (WHO, 2007), and adopts its bio-psycho-social model and coding structure.
The construction of the tool involved a multistage expert validation process, including:
• Multidisciplinary expert contributions (special educators, psychologists, speech therapists, occupa-
tional therapists, physicians, and social workers);
• External academic review by leading national scholars in the field;
• Pilot testing in partnership with UNICEF Bulgaria, involving specialists from regional support centers.
The instrument is conceptually validated by design through the ICF-CY framework and adapted to
the Bulgarian educational context.
With regard to psychometric properties, inter-rater reliability is supported by mandatory national
standardized training for all evaluators. The assessment teams operate through interdisciplinary discus-
sions, applying clearly defined scoring guidelines. For preliminary screenings, a binary system is used
(e.g., presence or absence of special needs indicators), while for full assessments, the standard ICF-CY
ordinal qualifiers (0–4) are applied for each domain.
Training for raters was delivered by master trainers certified by the Ministry of Education and Re-
gional Centers for Support of Inclusive Education. The training includes both theoretical and practical mod-
ules, emphasizing consistent application of the rating procedures and ensuring calibration among raters.
In this stage of the study, descriptive and categorical analyses were employed to present prelimi-
nary profiles of the assessed population. In future stages of the project, more advanced statistical meth-
ods such as regression analysis and multivariate models will be applied to explore deeper relationships
between the functional domains, contextual factors, and educational outcomes.
Research aim
The aim of the study is to produce initial findings, highlighting the role of teachers and educators in
inclusive environment and early screening and intervention, and:
1. provide optimal individualized profiling of strengths and weaknesses in the process of development
and interaction with children and students with ASD according to the criteria set out in the functional
scorecard;
2. facilitate professionals in the recognition and management of their observations in the process of
interaction with children with ASD;
3. outline the common features and abilities, irrespective the specificities of gender, age and type of ASD.
The research questions are:
RQ1: What specific common strengths, difficulties and resources can be highlighted and are there clear
gender, age and ASD specificities?
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799
Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
RQ2: What improvements can be made in the diagnostic process to track the personal development of
children and students with ASD?
RQ3: What conclusions can be drawn to support professionals and mainstream teachers to support the
individual potential of each child and student with ASD?
Method
ICF-FY based functional scorecard developed for Bulgaria was administered. There are 7 general
indicators, each of which contains sub-indicators), shown in table 2.
Table 2. Description of the respondents
ICF-FY based indicators Sub-indicators
1.
Language - structure of
language, rules
remembers abstract concepts, imitates sounds and phrases, lack
of speech, finds the right word, unintelligible speech, grammatically
incoherent speech, understands meaning when reading, understands
new concepts, uses speech for communicative purposes, merges
sounds, composes sentences, sound analysis and synthesis
2 Thinking
organizational skills, putting information into practice, understanding
cause and effect relationships
3 Interpersonal Interactions
emotional regulation, initiating and responding appropriately to social
interactions, responding to physical contact in a socially acceptable
manner, socially acceptable behaviour
4 Attention and perceptions
holds attention briefly, has difficulty sitting still in class, does not listen
or respond to instructions, relies on peers and copies their actions
5 Educational outcomes
has difficulty in only some areas, learns on an individual plan, works
cooperatively with other children, copes with group tasks
6 Social communication
uses inappropriate voice volume/intonation, makes off-topic
comments, maintains conversation, changes topic frequently, laughs
at inappropriate times/rude, deliberate use of eye contact
7 Auditory memory forgets instructions, needs constant guidance
Sample
A total of 201 respondents between the ages of 3 and 19 were surveyed, and assessments were
requested by their parents following a request for additional personal development support in all areas
of the country. As the focus of the study was on children and students diagnosed with ASD, 37 of the
201 respondents who did not have an accurate diagnosis or who had other behavioural and emotional/
hyperactivity disorders were excluded. Therefore, the total number of participants whose results were
analysed was 164. Due to the fact that there are missing responses for some of the indicators, in the re-
sults presented, the responses vary and for some indicators are below 164. The most common diagnosis
is F.84 ASD (118), the others are F84.8 Other pervasive developmental disorders (31) and less ASD with
complications (9), F84.1 Atypical autism (5) and Asperger - only 1 (Table 3).
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800
Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
Table 3. Description of respondents by sex, age and diagnosis
Diagnosis
Sex and age
Boys Girls
ASD with complications
(N = 9)
N =7:
2: 7 y.o., 3: 9 y.o., 1: 12 y.o. and 1: 13 y.o.
N = 2:
7 and 16 y.o
Asperger (N = 1) N = 1: 14 y.o. -
Atypical autism (N = 5)
N = 2:
7 y.o. and 8 y.o.
N = 3:
7, 10 and 11 y.o.
F84.8 Other pervasive
developmental disorders
(N = 31)
N = 24
1: 3 y.o., 3: 4 y.o., 2: 5 y.o., 1: 6 y.o., 5: 7 y.o., 3: 8
y.o., 5: 9 y.o., 1: 10 y.o., 1: 11 y.o., 1: 13 y.o., and
1: 14 y.o.
N = 7:
1: 4 y.o., 2: 7 y.o., 1: 8 y.o., 1: 10 y.o.
and 2: 12 y.o.
ASD (N = 118)
N = 87
1: 3 y.o., 4: 4 y.o., 8: 5 y.o., 3: 6 y.o., 18: 7 y.o., 17:
8 y.o., 14: 9 y.o., 2: 11 y.o., 4: 12 y.o., 6: 13 y.o., 4:
14 y.o., 1: 15 y.o., 2: 16 y.o., 2: 17 y.o., 1: 18 y.o.
N = 31
3: 4 y.o., 3: 5 y.o., 3: 6 y.o., 6: 7 y.o., 4:
8 y.o., 6: 9 y.o., 1: 11 y.o., 1: 12 y.o., 1:
13 y.o., 2: 16 y.o. and 1: 19 y.o.
Results
The results are reported for the seven survey indicators. For each indicator, the significant differ-
ences reported by sex, age and diagnosis, are indicated. Data are summarized according to the number
and percentage of children and students who have challenges and who have no challenges, respectively,
on each indicator and sub-indicator. Language mastery is described by sub-indicators in Table 4.
Table 4. Scores on speech proficiency, comprehension and use of speech for communicative purposes
Language - language structure, rules N %
Remembers abstract concepts
Yes 66 43
No 88 57
Imitates sounds and phrases
Yes 140 85
No 24 15
Lack of speech
Yes 140 86
No 23 14
Finds the right word
Yes 58 44
No 75 56
Unintelligible speech
Yes 124 79
No 33 21
Grammatically incoherent speech
Yes 33 22
No 119 78
Understands meaning when reading
Yes 26 18
No 116 82
Understands new concepts
Yes 60 43
No 80 57
Uses speech for communicative purposes
Yes 100 64
No 56 26
Merges sounds
Yes 32 21
No 122 79
Constructs sentences
Yes 32 21
No 123 79
Sound analysis and synthesis
Yes 66 42
No 93 58
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Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
In respect to overall language mastery and speech development outcomes
• The main challenges are lack of speech (86%), unintelligible speech and difficulty in constructing sen-
tences (79%), understanding the meaning in reading (82%)
• More than half of children and students with ASD have difficulties in remembering abstract concepts,
new concepts and finding the right word, but 44% find the right words, 43% understand abstract con-
cepts and new concepts, 42% cope with sound analysis and synthesis.
• Much more than half of the children and students with ASD can imitate sounds and phrases (85%) and
have grammatically coherent speech (78%), 64% use speech for communicative purposes, and 79%
do not merge sounds
• No gender differences were accounted
• Significant difference was found in respect to the personal support for remembering abstract concepts
- 53% of children and students with short-term support, 40% of those with long-term support, and 19%
of those without support remember concepts compared with 82% of those without support. 47% with
short-term support, and 60% with long-term support do not remember abstract concepts (χ2 = 6.795,
p = .033; Phi and V = .210; p = .033). There was also a significant difference with respect to lack of
speech, which relates to 94% of children and students without personal support, 94% of those with
long-term support, and 73% of those with short-term support (χ2 = 14.043, p = .001; Phi and V = .294;
p = .001). Unintelligible speech occurred most frequently among children and students without per-
sonal support (94%), followed by those with long-term support (86%), and least frequently in those with
short-term support (66%) (χ2 = 11.347, p = .003; Phi and V = .269; p = .003). Reading comprehension
was also higher for children and students with short-term support (32%) compared to 7% for those
without and 10% for those with long-term support (χ2 = 11.914, p = .003; Phi and V = .290; p = .003).
The place of support emerges particularly for sentence composition, with no child in the group without
support can perform with this compared with 28% of children and students with short-term support and
19% of those with long-term support (χ2 = 6,460, р = .040; Phi and V = .204; p =.040).
• There was a significant difference also by diagnosis - in terms of imitating sounds and phrases, the
highest percentage of challenges were observed in the group Other pervasive developmental disor-
ders (94%), followed by ASD (86%), ASD with complications (67%) and atypical autism (60%) (χ2 =
12.698, p = . 013; Phi and V = .278; p = .013) and in the use of speech for communicative purposes,
where the highest rates were for ASD with complications (89%), followed by childhood autism (69%),
atypical autism (60%), and other pervasive developmental disorders (41%) (χ2 = 11,784, р = .019; Phi
and V = .275; p =.019).
• Significant differences reported by age were in imitation of sounds and phrases, where most chal-
lenges encountered 3-5 y.o., 8 and 9 y.o., 17-19 y.o. Lack of speech was prevailing (100%) for 3-6 y.o.,
97% for 7-8 y.o., 100% for 11, 17 and 18 y.o. Prevalence of unintelligible speech, 100%, was among
3-5 y.o., 15 and 17 y.o. and serious challenges for 7 y.o. Coherent speech was reported without chal-
lenges for 13 y.o. and 15 y.o. 10 y.o., 11 y.o., and 15 y.o. use speech for communicative purposes
(100%). For merging sounds best (100%) performed 4 y.o. and 5 y.o., 11 y.o., 14 y.o., 15 y.o., 17 y.o.,
and 18 y.o. Sentence composition was worst for 3-5 y.o., and best among 15 y.o., which replicates the
typical development.
The results for the mastery of cause-effect relationships, the relationship between information and
its practical application, and self-organization are described in Table 5.
Table 5. Scores for challenges and performance on the indicator Thinking
Thinking N %
Organisational skills
Yes 17 11
No 139 89
Implementation of information in practice
Yes 56 36
No 98 64
Understanding causal relationships
Yes 29 19
No 126 81
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Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
In terms of thinking, the overall results outline
• The main challenges reported concern the organisational skills (89%) and understanding causal rela-
tions (81%), whereas more than half of the respondents are unable to apply what they have learned
in practice.
• It should be noted that slightly over one third (36%) of the children and students surveyed manage to
put the information into practice
• As a significant gender difference here, it appeared that more girls (22%) compared to boys (7%) had
developed organizational skills (χ2 = 6.999, p = .012; Phi and V = .212; p = .008).
• For thinking, no relation was reported with the support provided
• There was a significant relation between diagnosis and organizational skills, which were highest for
ASD with complications (44%), followed by atypical autism (25%), and lowest for ASD (9%) and other
pervasive developmental disorders (8%) (χ2 = 12,267, р = .015; Phi and V = .280; p =.015).
• Age: 15 y.o. and 16 y.o. (100%) performed best in applying the information in practice and well per-
formed (50%) 3 y.o., 10 y.o., 11 y.o., and 12 y.o. Causal relations were understoom best by 18 y.o. and
19 y.o. and worst (0%) among 17 y.o., 14 y.o., 15 y.o., 11 y.o., 5 y.o., 6 y.o., and 3 y.o.
The components of interpersonal interactions are outlined in Table 6.
Table 6. Challenges and resources outlined for interpersonal interactions
Interpersonal interactions N %
Emotional regulation
Yes 25 16
No 135 84
Initiation and appropriate response to social interactions
Yes 35 22
No 125 78
Socially acceptable response to physical contact
Yes 52 33
No 106 67
Socially acceptable behaviour
Yes 38 24
No 119 76
In respect of interpersonal interactions the summarized results indicate that
• Major challenges are observed in emotional regulation (84%), initiating and adequate involvement in
social contact (78%), and socially acceptable behaviour (76%)
• Although more than half of children and students with ASD studied do not respond in a socially ac-
ceptable manner to physical contact, it shall be noted that one-third (33%) respond appropriately and
one-fifth (24%) demonstrate socially acceptable behaviour
• No gender differences were reported
• Socially acceptable behaviour was found to have a significant relationship with support provided, with
best performance of children and students with short-term support (36%), followed by those with long-
term support (17%) and no support (14%) (χ2 = 7.165, p = .028; Phi and V = .214; p = .028).
• There was a significant relation between diagnosis and initiating and responding appropriately to so-
cial interactions; this was reported for 37% of children and students with other pervasive developmen-
tal disorders, 22% of those with ASD with complications, 18% of those with ASD, and 0% of those with
atypical autism (χ2 = 9.692, p = .046; Phi and V = .246; p = .046).
• In respect to age emotional regulation was worst among 3-5 y.o., 11 y.o., 15 y.o., 17-19 y.o. Respond-
ing appropriately to physical contact was greatest challenge (0%) for respondents aged 3-5 y., 17-19
y. and was best (100%) for 15-16 years old.
Attention and perception scores are described in Table 7.
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803
Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
Table 7. Attention and perception challenges and resources
Attention and perceptions N %
Holds attention for a short time
Yes 140 85
No 24 15
Has difficulty sitting still in class
Yes 140 86
No 23 14
Does not listen or respond to instructions
Yes 123 79
No 33 21
Relies on peers and copies their actions
Yes 32 21
No 122 79
For attention and perceptions, the results reveal that
• The main challenge for the children and students with ASD is to hold attention (85%) and, respectively,
to remain sitting still during class (86%), listening and responding to instructions (79%), and lack of
mastery of peer behaviour patterns (79%)
• One-fifth of the respondents are able to learn by role models of peers, listen and respond to instruc-
tions, and over one-tenth cope to hold their attention for long periods of time
• No gender differences were observed
• There was a significant difference in the support provided - again, the highest percentage of chil-
dren and students who perceive and respond to instructions was in the group with short-term support
(34%), followed by children and students with long-term support (14%) and only 6% in the group with-
out support (χ2 = 11.145, p = .004; Phi and V = .067; p = .004). Children and students with short-term
support were more likely (27%) than those with long-term support and no support to be able to sit still
in class (χ2 = 14,043, р = .001; Phi and V = .294; p =.001).
• Significant differences by diagnosis was accounted in attention retention, with children and students
with atypical autism performing best (40%), followed by those with ASD with complications (33%), ASD
(14%), and least (7%) for other pervasive developmental disorders (χ2 = 12.698, p = .013; Phi and V
= .278; p = .013).
• Age: Attention retention was most difficult in 3-5, 8-9, 17-19 y.o. 100% unresponsive to instructions are
3-5 y.o., 15 and 17 y.o. Imitation of peers was best (100%) for 10 and 19 y.o. and worst (0%) among r
4, 5, 11, 14-15 17-18 y.o. Difficulties to sit still in class have mainly 3-8, 11, 17 and 18 y.o
The results for educational outcomes are presented in Table 8.
Table 8. Results for challenges and coping in terms of educational outcomes
Educational performance N %
Encounters challenges only in some areas
Yes 28 19
No 120 81
Learning is according to an individual plan
Yes 43 41
No 61 59
Works cooperatively with other children
Yes 18 12
No 136 88
Copes with the group tasks
Yes 20 13
No 137 87
In respect to the educational outcomes it should be noted that only 41% of the respondents have
an individual learning plan, and more than half (59%) have no individual schedule, which is likely linked
to performance on the indicators
• The majority of the respondents have challenges in more than one area (81%) do not cope with the
group tasks (87%), and do not work collaboratively with peers (88%)
• At the same time one tenth of children and students with ASD manage to work cooperatively with
peers and cope with the set tasks, and one fifth have challenges only in some areas
• No significant differences were reported by gender and individual learning plan
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Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
• 19% of children and students with short-term support, 8% of those with long-term support and none
of those without support (14%) worked collaboratively with their peers (χ2 = 6,291, р = .043; Phi and
V = .202; p =.043).
• In terms of working collaboratively with others a significant relationship with diagnosis was accounted,
with children with atypical autism (25%) and other pervasive developmental disorders (24%) interacted
more than those with ASD with complications (13%) and ASD (7%) (χ2 = 14.844, p = .005; Phi and V =
.310; p = .005). In terms of coping with general tasks the highest percentage of performers were in the
group with ASD with complications (25%), followed by other pervasive developmental disorders (17%),
ASD (11%), and 0% in atypical autism (χ2 = 9,693, р = .046; Phi and V = .248; p = .046).
• In respect to age best performed (100%) 15, 18, and 19 y.o. Worst results for cooperative work with
peers (0%) had 3-6 y.o., 15 and 17-19 y.o. and best performed 10 y.o. Worst performance with group
tasks (0%) have 3, 5, 6, 10, 15, and 17-19 y.o.
The results for social interactions and communication are summarized in Table 9.
Table 9. Results for challenges and resources in social communication
Social communication N %
Uses inappropriate voice volume/intonation
Yes 81 53
No 72 57
Makes off-topic comments
Yes 42 29
No 103 71
Keeps the conversation going
Yes 33 21
No 124 79
Often changes the subject
Yes 38 26
No 106 74
Laughs at inappropriate times / rude behaviour
Yes 84 54
No 72 46
Conscious use of eye contact
Yes 74 47
No 83 53
For social communication it can be summarized that
• The main challenge is in maintaining a conversation (79%)
• As positive result, equal number of children and students with ASD use appropriate voice volume and
intonation, and 47% consciously engage in eye contact
• As a major strength, it can be highlighted also that most children and students with ASD do not tend to
change the subject (74%) and do not make off-topic comments (71%)
• No differences were reported for gender and personal support
• Age: most challenges to keep conversation (0%) had 3-6 y.o.
Memorization of instructions and the need instructions to be repeated is presented in Table 10.
Table 10. Scores for auditory memory challenges and coping
Auditory memory N %
Forgets instructions
Yes 91 62
No 56 38
Needs constant guidance
Yes 139 88,5
No 18 11,5
For auditory memory, the results show that
• The main focus should be on the need for constant guidance (accounted for 88.5% of the respondents)
as more than half of children and students tend to forget instructions
• However, it shall be noted that 38% of the respondents do not forget and respectively follow the in-
structions
There were no differences noted for either gender, nor according to the personal support.
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805
Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
Discussions
ASD is a neurodevelopmental impairment characterized by deficits in social communication and
the presence of restricted interests and repetitive behaviours (APA, 2013). The heterogeneity of ASD is
the object of numerous studies describing specific disturbances. These have been outlined for mental
functioning in particular in children (Simonoff et al., 2008) and physical health (Cashin et al., 2018). Ash-
burner et al. (2010) outline deficits within the mainstream school in terms of emotion regulation and learn-
ing. Lifelong development impairments have also been outlined, in professional and social life of adults
(Levy and Perry, 2011; Howlin et al., 2013; Schmidt et al., 2015).
Table 11 summarizes the challenges, resources and specificity for the 7 studies areas.
Table 11. Summarized results
Functional areas Challenges Resources Specificity
overall language
mastery and speech
development
lack of speech / unintelligible
speech; difficulty in
constructing sentences,
understanding the meaning
in reading
difficulties in remembering
abstract concepts, new
concepts and finding the
right word
more than half of the children
and students with ASD can
imitate sounds and phrases and
have grammatically coherent
speech, use speech for
communicative purposes, and
do not merge sounds
of the children and students half
find the right words, understand
abstract concepts and new
concepts, cope with sound
analysis and synthesis
Ensured support is rather
important for positive
outcomes
Age and diagnosis have also
specific effect
thinking main challenges reported
concern the organisational
skills and understanding
causal relations;
more than half of the
respondents are unable
to apply what they have
learned in practice
slightly over one third of the
children and students surveyed
manage to put the information
into practice
Gender, diagnosis and age
have to be taken into account
interpersonal
interactions
major challenges are
observed in emotional
regulation, initiating and
adequate involvement in
social contact, and socially
acceptable behaviour
one-third respond appropriately;
one-fifth demonstrate socially
acceptable behaviour
Ensured support is rather
important for positive
outcomes
Diagnosis and age have
specific effect
attention and
perceptions
the main challenge for the
children and students with
ASD is to hold attention
and, respectively, to remain
sitting still during class,
listening and responding
to instructions, and lack of
mastery of peer behaviour
patterns
one-fifth of the respondents are
able to learn by role models of
peers, listen and respond to
instructions;
over one-tenth cope to hold
their attention for long periods
of time
Ensured support is rather
important for positive
outcomes
Diagnosis and age have to be
taken into account
educational
outcomes
the majority of the
respondents have
challenges in more than one
area, do not cope with the
group tasks, and do not work
collaboratively with peers
one tenth of children and
students with ASD manage to
work cooperatively with peers
and cope with the set tasks;
one fifth have challenges only in
some areas
Ensured support is rather
important for positive
outcomes
Diagnosis and age have to be
taken into account
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Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
Functional areas Challenges Resources Specificity
social
communication
the main challenge is in
maintaining a conversation
most children and students with
ASD do not tend to change the
subject and do not make off-
topic comments;
equal number of children
and students with ASD use
appropriate voice volume and
intonation;
half of them consciously
engage in eye contact
Some age specificity can be
accounted
auditory memory accounted need for constant
guidance, as more than half
of children and students tend
to forget instructions
38% of the respondents do not
forget and respectively follow
the instructions
In reply to RQ1 more common features than differences had been accounted. Important role has
the provided additional support. Some specific effects of diagnosis, age, and gender outlined, can be
informative what teachers and educators can take into account. This is supported by the ratio of children
and students having and not having additional support, which is almost equal.
In reply to RQ2 the results reveal a further implication of the scorecard, which enables teachers
and educators in easy and smooth follow-up activities. The instrument and expertise furthermore are sup-
posed to have important role in inclusive setting, empowering users in respect to their expertise and giving
indication when and what kind of expertise they can claim.
In reply to RQ3 in can be replicated once again the importance of individual work. The common
features, both concerning challenges and resources, lead to the robust conclusion was again. Only taking
in account the personal profile, but not relying on and following general indicators, can be beneficial for
support of children and students with ASD and their families.
Key areas of challenge, areas of support, and strengths in the general population of children and
students with ASD are outlined in our investigation. Irrespective of the difficulties, the fact that at least
one tenth of children and students with ASD manage to master language, the auditory memory and self-
regulation stand out in all the indicators. Social interaction and task performance are not impaired with
appropriate supports.
The main challenges for the children and students with ASD in our analyses are the prevalence of
lack of speech, unintelligible speech and difficulties in constructing sentences, understanding the mean-
ing in reading, remembering abstract concepts, new concepts and finding the right word, mastering or-
ganisational skills and understanding causal relationships, integrating knowledge into practice, emotional
regulation, initiating and adequately engaging in social contact, attention deficits, listening and responding
to instructions. The majority of respondents have difficulties in more than one area, are unable to cope
with group tasks, and are unable to work collaboratively with their peers.
Notably, most of the children and students with ASD do not tend to change the subject and do not
make off-topic comments. Well over half of the children and students with ASD can imitate sounds and
phrases and have grammatically coherent speech, use speech for communicative purposes, and do not
blend sounds. Half of the respondents use appropriate vocal volume and intonation, and make conscious
eye contact. Almost half of the respondents find the right words, understand abstract and novel concepts,
and engage in sound analysis and synthesis. One-third of children and students with ASD respond appropri-
ately to social interactions, including remembering and following instructions. One-fifth demonstrate socially
acceptable behaviour, are able to learn from peer modelling, listen and respond to directions, and more than
one-tenth are able to maintain attention for long periods of time and have challenges in only some areas.
One-tenth of children and students with ASD are able to work cooperatively with peers and complete tasks.
In the face of the challenges outlined, especially in recent studies the focus shifted to highlighting
the strengths, capacity, and performance of individuals with ASD. In particular, the capacity of attention
to detail has been reported (Baron-Cohen et al., 2009). Conclusions reveal further how the difference in
information perception and processing leads to coping with tasks given visuospatial information process-
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Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
ing and auditory perception (Happe and Frith, 2009; Remington and Fairnie, 2017). Particular attention
is drawn to the better auditory discriminative abilities and responses of individuals with ASD compared
to typically developing individuals (Remington and Fairnie, 2017), and that research practice should fo-
cus on describing different interpretations rather than remaining with a difficulties focus (Grissom et al.,
2024). In addition to the direction outlined for a personalized approach, specific educational approaches
for individuals with autism have been proposed, including machine learning to increase fidelity in meet-
ing their unique needs (Hajjej et al., 2024), improving performance through building intraverbal skills in
adolescents (Karetnikova, 2024).
ASD appears more frequently in males than in females with a male-female ratio of 4-5:1 (Vicari et
al., 2019). There are no significant differences reported by gender, suggesting, contrary to many studies,
that difficulties have common specificities across both genders and that when a differentiated complex
assessment is used, the similarities rather than differences are highlighted. This is further supported by
the significant differences reported in diagnosis and personal support provided. Age also plays a role.
All this suggests that a comprehensive and differentiated assessment can only be adequate to out-
line a profile of personal development and that setting expectations and limits can have a guiding effect,
but only after individualizing the profile of each child/student.
The results replicate the acknowledgement of the difficulties outlined in research on children and
students with ASD , mainly in the area of communication and the need for an individualized approach
(Bagetti et al., 2023), highlighting the heterogeneity and significant percentage of coping children and
students. This also relates to the limited social communication characteristic of ASD (Durkin, 2019), which
research also confirms is not straightforward.
Rather, we view the results as confirmation of individualising the approach (Hayden-Evans et al.,
2022) and tailoring to individual characteristics [4; 6] and creating an appropriate and relevant learning en-
vironment (Bystrova et al., 2017; Shah et al., 2019) and biopsychosocial context (Vallefuoco et al., 2022).
The outlined findings focus on considering all strengths and resources and embedding them in
a real inclusive environment where children and students with ASD can flourish (Okoye et al., 2023;
Narciso et al., 2024). The findings of this study align with prior international research that utilized the ICF-
CY framework to delineate profiles of individuals with Autism Spectrum Disorder (ASD) across various
domains of functioning. These results corroborate the conclusions of earlier investigations (e.g., Mahdi
et al., 2018; Balsa, 2023, Damyanov, 2024), which underscored the critical importance of individualized
assessment and support strategies accounting for contextual and environmental factors. This congruence
between theoretical underpinnings and empirical evidence substantiates the utility of the ICF-CY frame-
work in formulating inclusive education plans and long-term support for children and students with ASD.
The main limitation of this study is the disproportion of girls and boys and the different diagnoses
and especially the small number of respondents in different age groups. All the differences reported sug-
gest the need for further research. However, the similarities and resources outlined support the conclusion
for the specific role of the context and the need to involve and inform a wider range of participants in the
inclusive environment. Empowering families, general teachers and children and students with guidelines
can promote and support the optimal developmental context for children and students with ASD.
Conclusions
The use of a comprehensive toolkit for optimal individualized profiling of strengths and challenges
in the developmental process and interaction with children with ASD is important to facilitate professionals
in recognizing and managing their observations in the process of interacting with children with ASD, and
can also be used to inform the broader range of those who interact with children and students with ASD
in inclusive settings. Awareness of mainstream teachers, peers, and families of the key areas for support
and how to facilitate communication can provide a broader supportive framework and understanding of
mechanisms for effective interaction, addressed to strengths but not to challenges. The fact that no sig-
nificant difference by gender emerged in this study is indicative that when considering general indicators
of coping, it is the support provided and environmental factors that lead the way. The main focus should
be on the need for constant guidance and ensuring supportive context. Children and students with ASD
obviously respond adequately to the environment and have no challenges when all we speak the same
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808
Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
With Autism Spectrum Disorders: The Bulgarian Case, International Journal of Cognitive Research in Science, Engineering
and Education (IJCRSEE), 13(3), 793-810.
language. The main contribution of this study is empowering teachers and educators to have active part
along with medical and other professionals in early screening and intervention and promotion of personal
development of children and students and the provided universal tool, adapted for their field of expertise.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial,
or not-for-profit sectors.
Conflict of interests
The authors declare no conflict of interest.
Data availability statement
The original contributions presented in the study are included in the article, further inquiries can be
directed to the corresponding author.
Institutional Review Board Statement
The study was approved by the Expert Council of the Regional Center for Support of the Process
of Inclusive Education (RCSPIE) in Sofia City for letter No. 2222-6 dated 08.06.2023 assigning implemen-
tation of the project BG05M2OP001-3.018-0001 Support for Inclusive Education under the Operational
Programme Science and Education for Smart Growth 2014-2020, assigned by the Bulgarian Ministry of
Science and Education. The Expert Council / the Institutional Review Board/ approved also publication of
the data with statement No 2 / 6 February 2025.
Informed Consent Statement
Informed consent was obtained for all subjects involved in the study.
Author Contributions
Milen Zamfirov - conceptualization, supervision, investigation, writing—original draft preparation,
project administration; Margarita Bakracheva - conceptualization, supervision, writing - original draft prep-
aration; Kaloyan Damyanov - conceptualization, supervision, writing - original draft preparation; Lyudmila
Filipova Belenska-Todorova - data curation, formal analysis, validation, visualization, writing – review and
editing; Polina Daskalova-Petkova - data curation.
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Zamfirov, M. et al. (2025). Screening Tool Facilitating Mainstream School Practitioners to Assess Educational Needs of Children
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