The Relationship Between Age, Severity, and Services for Children with ASD

Background:  Although the diagnosis of autism spectrum disorder (ASD) involves atypical social interactions, communication deficits, and restricted or stereotyped behaviors, children with ASD also show other, co-occurring behavior problems.  Unfortunately, little is known about how these co-occurring symptoms should inform targeted interventions for these children and how these interventions might vary by age.  Compared to children with other disabilities, children with ASD often receive a high number of services with a lack of a standardized treatment approach.  

Objectives:  This study examines how service receipt changes over age and whether services are tied to the presence or severity of specific behavioral problems

Methods:  Respondents included 361 parents of children ages 2-21 with ASD who completed an online survey.  Children had a mean age of 10.02 years (SD = 5.12) and received an average of 3.40 (SD = 2.13) services (range from 0 to 10 services).  Parents reported a mean behavior problem severity score of 2.43 (with 1 = no problem and 4= severe problem) on 12 behavior items from the Parental Concerns Questionnaire (McGrew et al., 2007). 

Results:  Factor analysis with varimax rotation was first performed on these 12 behavior items and two factors were extracted.  The first, named Psychiatric Behaviors, explained 27.19% of the variance and the second, named Autism Characteristics, explained an additional 22.78%. A 2x2 ANOVA was then performed for service provision by age group (age 2-9 and 10-21) for the Psychiatric Behaviors and Autism Characteristics factors.  Results showed that those receiving Special Education, PT/OT, Health, and Respite had higher scores on the Autism Characteristics factor, regardless of age group.  There was also a significant interaction (p<.05) between Speech and age group.  For the Psychiatric Behaviors factor, there was a significant relationship with age for Special Education, Health, Counseling/Psych, and Respite services, with a significant interaction (p<.05) between service provision and age for Speech and Behavior Support services.  

Conclusions:  Results show a relationship between some commonly co-occurring behavior problems reported for children with ASD.  These two factors, Psychiatric Behaviors and Autism Characteristics, may be useful in linking need to service and making decisions about important supports for children with ASD.  Our results also support the idea that treatments vary by age group, across disability severity (Green et al., 2006).  Future research should confirm the reliability of parental reporting with professional reports of behavior problems and services.   

 Key References:

Green, V. A., Pituch, K. A., Itchon, J., Choi, A., O’reilly, M. & Sigafoos, J. (2006). Internet survey of treatments used by parents of children with autism. Research in Developmental Disabilities, 27, 70-84.
McGrew, S., Malow, B. A., Henderson, L., Wang, L., Song, Y. & Stone, W. L. (2007). Developmental and behavioral questionnaire for autism spectrum disorders. Pediatric Neurology, 37, 108-116.