A Preliminary Investigation of Child, Caregiver and Sociocultural Factors Influencing Caregiver-Reported Autistic Trait Scores on the Quantitative – Checklist for Autism in Toddlers (Q-CHAT) in an Unselected Sample of Asian Toddlers

Background: There is increasing research evidence that individuals with a diagnosis of ASD lie at the extreme end of a continuum of quantifiable autistic traits and that there is moderate to high heritability of these traits in child, adolescent and adult community samples. Given this shift towards a dimensional conceptualization of ASD, a range of measures have been developed to dimensionally measure and quantify autistic traits, but to our knowledge only the Q-CHAT is available to measure autistic traits and related symptoms in toddlers. Autistic traits research has largely, if not exclusively, relied on informant report of sub-threshold symptoms, without considering whether other individual, informant or sociocultural factors may affect the reporting of autistic traits.

Objectives: This study aimed to explore the relationship between caregiver-reported autistic traits and a range of individual child (gender, IQ, birth order, verbal skills), maternal and socio-cultural variables (maternal age, education, depressive symptoms and ethnicity). Specifically, the relationship of these variables with Q-CHAT Total as well as Factor scores (social/ communication; repetitive behavior; and language/ speech subscales derived following exploratory factor analysis) was examined.

Methods: Participants were 396 2-year old toddlers (205 males) from a sample of caregivers and their children recruited into an ongoing large longitudinal birth cohort study in Singapore (GUSTO – Growing Up in Singapore Towards Healthy Outcomes) who had completed the Q-CHAT at the 2-year old follow-up of this study. Demographic information was collected in earlier stages of the study and mothers also completed a measure of depressive symptoms at various time-points throughout the study.

Results: In preliminary regression analyses, children’s higher verbal/ language scores predicted lower (i.e. less severe) Q-CHAT total, social-communicative factor and language factor scores. Increased maternal depressive symptoms also predicted higher Q-CHAT total and factor scores. When all child and maternal characteristics were considered together, maternal education, maternal depressive symptoms, children’s birth order and verbal/ language scores were significant predictors of Q-CHAT total and behavioural trait scores. Child gender and IQ and ethnicity were not predictive of any autistic trait scores.

Conclusions: The findings from this study are discussed in relation to existing literature examining the potential influence of child and caregiver characteristics in reporting autistic traits and symptoms. The potential limitations of relying exclusively on informant-based measures of autistic traits for research examining autistic traits and the broader autism phenotype in unselected samples or families of individuals with ASD respectively is also discussed.