Do Caregivers and Children/ Youth with Autism Spectrum Disorders (ASD) Agree When Reporting Anxiety Difficulties? A Study Investigating Parent-Child Agreement Using the Spence Children's Anxiety Scale (SCAS)

Background:  Multiple informants are often employed to obtain more comprehensive and accurate assessment of anxiety difficulties, due to the complex and internalizing nature of anxiety in children. While the utility of the Spence Children’s Anxiety Scale (SCAS) as a screening tool for anxiety in typically developing children and youth is well established, little is known with regards to its inter-informant reliability when the scale is used to examine anxiety in children and youth with Autism Spectrum Disorder (ASD). A handful of studies reporting on other anxiety measures with this population have produced mixed findings. 

Objectives:  The present study aims to examine the utility of the SCAS in providing information on anxiety for children and young people with ASD and will specifically investigate the level of agreement between caregiver and child/ young person.

Methods:  Thirty eight caregiver-child pairs were recruited from an autism-specific school in Singapore which admits children with professionally diagnosed ASD and non-verbal cognitive scores of >70. All children were aged between 8 to 18 years and completed the SCAS self-report. Caregivers completed the caregiver version of the SCAS. Caregivers also completed the Scales of Independent Behaviour-Revised (SIB-R) in order to provide an estimate of the child’s adaptive behavior functioning. 

Results:  Data have been collected and are currently being analyzed. Parent and child SCAS correlation analyses will be carried out. To investigate differences between caregiver and child reports of anxiety, Wilcoxon Signed-ranks tests will be carried out between SCAS total and subscale scores from the different informants. Level of agreement will be derived by conducting non-parametric Chi-Square analyses to examine the extent to which clinically significant levels of anxiety as flagged by caregivers where also obtained with children’s self-reports.

Conclusions:  Preliminary analyses of our findings suggest that inter-rater agreement was low with parents often underreporting anxiety symptoms compared to their children’s self-report ratings. Our study findings highlight the high rates of parent-child discrepancy in anxiety ratings and the importance of obtaining information from multiple sources.