Psychiatric Symptoms in School Age Children with Autism Spectrum Disorders

Background: Youngsters with ASD have high rates of behavior and emotional problems. There is a growing body of evidence indicating that behavioral syndromes in ASD are phenotypically similar to conventional DSM-IV-defined psychiatric syndromes. However, support for such taxonomy in ASD is lacking. A valid taxonomy is a necessary step in order for psychopathology research to move forward.

Objectives: To assess the validity of parent and teacher reported DSM-IV disorders in school aged children with ASD. Data were collected with the Child Symptom Inventory-4, a DSM-IV-referenced rating scale. Items from the Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, Generalized Anxiety Disorder, and Major Depressive Disorder subscales were submitted to confirmatory factor analysis (CFA). Models were assessed for fit, and compared to those obtained for a sample of outpatient school age children without ASD with similar demographic characteristics.

Methods: Children were recruited through University-based specialized diagnostic clinics. The total ASD sample consisted of 498 children (average age=8.4 years; 83.9% male). The non-ASD outpatient comparison groups consisted of 167 parent ratings and 172 teacher ratings. CFA were conducted separately for parent and teacher ratings, using diagonally weighted least squares and polychoric correlations.

Results: Parent ratings of psychiatric symptoms for the ASD sample yielded a Root Mean Square Error of Approximation (RMSEA) of 0.0468 and a Standardized Root Mean Square (SRMR) of .0959. Teacher ratings of psychiatric symptoms for the ASD sample yielded a RMSEA of .0687 and a SRMR of .164. Fit indices compared well to those obtained for the outpatient comparison groups.

Conclusions: The data yielded good fit indices, particularly for parent ratings. This lends support to the validity of DSM-IV disorders in the ASD population. The field is in need of a concerted effort to elucidate and validate a taxonomy of behavior and emotional problems for this patient population.