The Impact of Problem Behavior On Language Outcomes for Preschool-Aged Children with ASD

Background:   Problem behavior is a common concern for young children with ASD and other developmental disabilities (Horner, Carr, Strain, Todd, & Reed, 2002) and can interfere with social and academic success (Horner, Diemer, & Brazeau, 1992). While there are numerous studies of behavioral interventions for individuals with ASD and other developmental disabilities, the majority of interventions utilize functional behavioral assessment and environmental modifications to reduce the likelihood of problematic behaviors. There is a need for additional research on the impact problem behavior may have on child outcomes in school settings and on interventions that focus on classroom-based approaches to problem behavior. These issues have great potential to impact educational and developmental outcomes for children with ASD.

Objectives:  To investigate the relationship between teacher reports of child problem behavior and language outcomes for preschool children with ASD. 

Methods:   The sample was comprised of 181 children diagnosed with ASD and 27 teachers who were part of a completed multi-site study comparing different pre-school programs for children with ASD. Participants ranged from 3 to 5 years of age and were followed throughout the school year. Children were administered language assessments (PLS4 and Mullen) at the beginning and end of the school year. Teachers completed the Caregiver Teacher Report Form (CTRF) at the beginning of the school year. 

The CTRF is composed of 99 items pertaining to behavioral and emotional problems exhibited either now or in the past 2 months. Teachers were asked to rate the child’s behavior on a 3 point Likert scale (‘very true or often true’, ‘somewhat or sometimes true’, and ‘not true’). The CTRF produces three problem behavior scale scores and seven syndrome subscale scores.

Results:  Using hierarchical linear regression, results indicated that teacher ratings on the CTRF Externalizing behavior scale at the beginning of the year significantly predicted scores on the Mullen receptive subscales at the end of the year (β = -.10, t(176) = -2.12, p < .05) when controlling for age, pretest scores and classroom model. The Mullen receptive scores accounted for 68.2% of the variance (R² = 0.68, F(4,176) =  94.43).

Conclusions:   Those children whose teachers reported a high number of externalizing behaviors on the CTRF at the beginning of the year showed less language gains as measured by the Mullen receptive scales at the end of the year. Other scores yielded by the CTRF (‘total problem behavior’ and “internalizing behaviors’) do not influence a child’s language acquisition on either the PLS4 or the Mullen. These results suggest that it may be important to develop school-based interventions to address problem behavior for young children with ASD in an effort to eliminate possible barriers to positive outcomes.