Emotional and Behavioral Problems In Prescholars Children with Autism and PDD NOS: Prevalence and Risk Factor

TITLE:

Emotional and behavioral problems in prescholars children with autism and PDD NOS: prevalence and risk factor

Background:

Children with autism spectrum disorders (ASD) often exhibit behaviour and emotional problems that negatively impact everyday activities. Maladaptive behaviours can also interfere with intervention efforts and thereby impact the long-term prognosis of children with ASD.

Objectives:

The purpose of this study is to identify:

(1)  the prevalence of Clinically Significant maladaptive behaviours through parent report on the CBCL of 101 children diagnosed with AD and PDD NOS  aged 2.2 to 5.11 years and determine the similarities or dissimilarities;

(2)  subject characteristic risk factors for maladaptive behaviours (such gender, age, expressive language, severity of autistic behaviours, adaptive behaviour and regression of language or social skills);

(3)  parent-factors, such age, cultural and socioeconomic differences, family characteristic, influenced parent ratings of maladaptive behaviours.

Methods:

101 children, aged 2.2 to 5.11 years, were recruited consecutively at the Children’s Hospital Bambino Gesù in Rome between May 2009 and July 2010 and diagnosed with PDD (Pervasive Developmental Disorders) based on criteria of DSM-IV TR.

Parents completed the Child Behavior Checklist  for ages 1.5 through 5 years (CBCL, Achenbach & Rescorla 2000) and the short form Italian version of the MacArthur Communicative Development Invertories (PVB, Caselli et al. 2007); they also participated in the Vineland Adaptive Behaviour Scales, Interview Form (VABS, Sparrow et al. 2005) and the Autism Diagnostic Interview-Revised (ADI-R, Lord et al. 2000).

Children were individually administered the Autism Diagnostic Observation Schedule-Generic (ADOS-G, Lord et al. 2000) by licensed professionals.

Results:

One-third of young children with ASD (AD and PDD NOS) had a CBCL Total Problems score in the Clinically Significant range. The highest percentage of Clinically Significant scores were in the Withdrawal, Attention, and Somatic Complaints CBCL syndrome scales.

We performed univariate logistics to estimate association between each single CBCL subscale and groups (AD or PDD-NOS): only one univariate logistic was statistically significant, and show that AD group have 80% lower probability than PDD-NOS group to have affective problems

We have also identified several subject and parent characteristic risk factors for maladaptive behaviours: children’s age,  expressive language and severity of autistic behaviours, and mother’s education and occupation.

Conclusions:

An investigation of the subject characteristic correlates of maladaptive behaviours in young children with ASD is needed to identify at-risk subgroups. This research must be extented to which parent-factors, such as cultural and socioeconomic differences, influenced parent ratings of maladaptive behaviours.