Comparison of Parent Report and Direct Assessment of Child Ability in Toddlers

Background:  Parents observe child skills across settings and functional domains. Therefore, parent report may play a key role in the identification of developmental delays. However, recent research has raised concerns about the accuracy of parent report.

Objectives:  The current study assessed agreement on receptive language (RL), expressive language (EL), and fine motor (FM) skills, as measured by parent report and direct assessment, in toddlers.

Methods:  Participants were 109 children (66 males; mean age 24.0 ± 4.6 months) recruited through a larger study on the early detection of autism spectrum disorder (ASD). Children were divided into three groups (ASD, n = 28; Other Developmental Delay (DD), n = 57; Typical Development (TD), n = 24) according to DSM-IV-TR clinical best estimate diagnosis, using observation, history, and testing data, including Autism Diagnostic Observation Schedule (ADOS) scores. Parent report was obtained using the Vineland Adaptive Behavior Scales, Second Edition (VABS-II). Child ability was directly measured using the Mullen Scales of Early Learning (MSEL). The current study used correlation and mixed-design ANOVAs, with method as a within-subjects factor and diagnostic group as a between-subjects factor, to assess agreement.

Results:  RL scores on the VABS-II and MSEL were strongly correlated in the DD group (r(57) = .702, p < .001) and moderately correlated in the ASD (r(28) = .525, p = .004) and TD (r(24) = .404, p = .05) groups. On ANOVA, a main effect of method was not significant (F(1, 106) = .765, p = .384, η_p² = .007). EL scores were strongly correlated in the DD (r(57) = .675, p < .001) and TD (r(24) = .732, p < .001) groups, but were not significantly correlated for children in the ASD group (r(28) = .232, p = .418). On ANOVA, a main effect of method was not significant (F(1, 106) = .067, p = .796, η_p² = .001). FM scores were strongly correlated in the TD group (r(24) = .693, p < .001) and moderately correlated in the ASD (r(28) = .491, p = .008) and DD (r(57) = .555, p < .001) groups. On ANOVA, a main effect of method trended toward significance, with parents reporting slightly higher FM abilities than seen on direct assessment (F(1, 106) = 3.880, p = .051, η_p² = .035).

Conclusions:  Overall, parent report of child ability level did not differ significantly from direct assessment, across functional domains and diagnostic groups. Although ASD group EL scores were not significantly correlated, no effect of method was found on ANOVA; this may be due to limited EL abilities in the ASD group. A trend-level effect of method was found for FM scores, possibly due to child unwillingness to perform tasks on direct assessment or inaccurate parent reporting. Taken together, results suggest that parents are reliable reporters of child ability in toddlerhood, but, given moderate correlations between reported and measured behaviors, the fullest picture may be obtained by using both methods. Future research should examine specific skills that are under- or over-reported.