We know that young people with ADHD and autism are at much greater risk of developing depression and anxiety. Emotional burden in school for students with ADHD and autism can be significant and complex. Traditionally, researchers explained this through difficulties with emotion regulation. This concept suggests that some adolescents struggle more than others to manage frustration, sadness, or anger. That explanation makes sense, but maybe it doesn’t tell the whole story.

A new study by Steve Lukito and colleagues (2025) suggests we’ve been overlooking something important: the emotional burden of school itself. Together with neurodivergent young people, they developed a new tool—the My Emotions in School Inventory (MESI). The questionnaire asks students how often certain upsetting events happen at school. These events range from unfair treatment by teachers to sensory overload or social exclusion. It also assesses how strongly these affect them emotionally.

The results are striking. Adolescents with ADHD and/or autism reported facing upsetting school events more often and reacting to them more intensely than their neurotypical peers. In other words, the same classroom can feel like a very different emotional landscape depending on who you are. These higher levels of emotional burden were linked to higher rates of depression and anxiety. This occurs independently of whether students also had difficulties regulating emotions.

What I find powerful here is the shift in perspective. Instead of looking only “inside the child” (can they regulate their emotions?), the study asks us to look at the environment: what happens in school, and how do everyday interactions accumulate as emotional weight? It shows how the way teachers, peers and the school context respond can either reduce or amplify this burden.

Of course, there are limits. The research is cross-sectional—it shows associations, not causality. It’s based on adolescents in the UK, all of whom attend mainstream schools. We don’t yet know how this plays out over time, or in other settings. However, the MESI appears to be a promising tool for schools. It is concise, reliable, and co-created with the very students it aims to represent.

The takeaway for education? Mental health problems in neurodivergent adolescents are not just about deficits in individuals. They’re probably also about the weight of school itself. To reduce risks, we must examine the emotional climate we create. This includes our small daily interactions, the way we handle discipline, or the sensory environments of our classrooms. The emotional burden is not abstract; it’s woven into the daily fabric of school life.

Abstract of the study:

Background
Mental health problems are elevated in adolescents with ADHD and/or autism. Emotion regulation deficits (ERD) have been hypothesised as a key driver of such difficulties. The Regulating Emotions – Strengthening Adolescent Resilience (RE-STAR) programme is examining an alternative pathway from neurodivergence to mental health problems, mediated by elevated emotional burden (EB) resulting from the interplay of increased exposure and an unusually intense emotional reaction to commonly upsetting events (CUEs). We present the development and application of the My Emotions in School Inventory (MESI), a self-report questionnaire co-produced with neurodivergent young people, focusing on EB in schools – a setting thought to be of particular significance in this regard.

Methods
The MESI, containing 25 school-related CUEs rated on their frequency and the intensity of negative emotions they induce, was completed by secondary school students meeting symptom cut-offs on clinically validated scales of ADHD (n = 100), autism (n = 104), ADHD + autism (n = 79) and neurotypical students (n = 452). Psychometric properties were examined. The ability of the MESI to discriminate adolescents with ADHD and/or autism from neurotypical adolescents, and to predict depression and anxiety, independently of ERD, was explored.

Results
Adolescents in the ADHD and/or autism groups experienced higher CUE frequency and intensity of reaction than their neurotypical peers. Overall levels of EB, most robustly indexed by 24 MESI CUEs, were higher in the three neurodivergent groups, though they did not differ from each other. EB in the autism and ADHD groups was generated by distinctly different CUEs. EB and ERD each contributed independently to the prediction of higher depression or anxiety.

Conclusions
Our findings illustrate the potential value of the MESI as an instrument to measure the contribution of EB alongside ERD in relation to adolescent mental health risks in ADHD and/or autism. Future studies need to investigate its role longitudinally.