Accuracy of Parental Report As Compared to Standardized Assessment: A Comparison of the Ages and Stages to the Mullen and ADOS
Objectives: The goal of this study is to assess the relationship between the ASQ and standardized assessments for children with ASD.
Methods: 51 children (47 males) who received an initial ASD diagnosis following evaluations conducted as part of a research study. All children were between the ages of 16-43 months (mean = 29.71) and referred based on parent concerns and/or recommendation from pediatrician or early interventionist. Parents completed the ASQ and children were evaluated with the Mullen Scales of Early Learning and the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2).
Results: ASQ scales were significantly correlated with T-scores from the Mullen, with significant associations between the ASQ problem solving scale and Mullen visual reception, fine motor, expressive, and receptive language domains (r’s=.53, .49, .46, and .64 respectively, all p’s<.01). The ASQ fine motor scale was associated with Mullen visual reception, fine motor, and expressive language domains (r’s=.29, .28, and .35 respectively, all p’s<.05). The ASQ communication scale was associated with Mullen visual reception, fine motor, receptive, and expressive language domains (r=.54, .32, .68 and.70 respectively, all p’s<.05). ASQ social-emotional scale was associated with Mullen visual reception, fine motor, receptive and expressive language domains (r=.42, .33, .36, .45 respectively, all p’s<.01). The ASQ communication scale was negatively correlated with the ADOS social affect score (r=-0.39, p<.05) and ADOS total score (r=-.83, p<.05).
Conclusions: Findings reveal that the ASQ is a good predictor of delays in development for children with ASD. Results provide support for the use of parent-report measures in identifying children requiring referrals for evaluations and parent perceptions regarding their children’s skill level in the specific domains of nonverbal problem solving, fine motor, and communication skills. The social-emotional scale was also associated with Mullen performance; however, this scale did not predict specific autism symptomatology on the ADOS. Instead, the communication scale of the ASQ is indicative of social and communication ASD red flags. Practitioners are encouraged to pay close attention to the communication scale when considering whether a referral for an ASD specific evaluation is necessary. Overall, the ASQ appears useful to identify developmental delays but an autism specific screener is also indicated given the more limited associations with the ADOS.