Parent and Teacher Report of Behavioral Symptoms in Autism Spectrum Disorders: Assessing the Impact of Demographic and Socioeconomic Factors

Background:

Clinical evaluations of children with suspected neurodevelopmental disorders often requires observations of the child across settings, as well as, report of behavioral symptoms by multiple raters. This can be particularly informative as symptoms may be expressed differently across settings (Kanne, Abbacchi, & Constantino, 2009). However, reporting of behavior may be influenced by the reporter’s own perception of the behavior and may be subject to potential biases. Thus, understanding the validity and reliability of behavioral reports within clinical and research settings is critically important.

Objectives:

The goal of this study it so assess the impact of demographic and socioeconomic factors in the reporting of behavioral symptoms by parents and teachers in a diverse sample of children with ASD.

Methods:

The current study is part of a larger study evaluating developmental profiles of diverse children with ASD who visited a developmental disabilities clinic located in an urban city in the United States. Clinic records of children between 3 and 12 years of age with clinical diagnoses or educational classifications of an Autism Spectrum Disorder were reviewed. Information about demographics (e.g., race, ethnicity, nativity), socioeconomic factors (private vs. public insurance) were collected from the clinic records. As the measure of children’s behavioral symptoms, the Child Behavior Checklist (CBCL; Achenbach, 2000, 2001) and Teacher Report Form (TRF; Achenbach, 1997, 2001) administered in English or Spanish were scored as the dependent variable.

Results:

Preliminary analyses were conducted on the subset of children who were between 3 and 5 years of age (n = 21). Descriptions of the sample are included in Table 1. Paired-sample t-tests compared parent and teacher report of behavioral symptoms, specifically the t-scores for the DSM Oriented Scales of the CBCL and TRF. Paired-sample t-tests initially compared parent and teacher reports separately across race groups (White, African-American), finding significant discrepancies between parents and teachers report on anxiety, ADHD, and oppositional defiant behaviors for African-American children with ASD (all p’s < .05). However, for White children with ASD, discrepancies between parent and teacher report of behavioral symptoms were only observed for ADHD symptoms (p< .001). Additional analyses will be presented at IMFAR that will include additional subscales from the CBCL and TRF and the entire sample of children with ASD (age 3 to 12 years).

Conclusions:

Although there is extensive research on the utility of the CBCL and TRF in the identification of children with ASD, there is limited research investigating the impact of demographic and socioeconomic factors on the validity and reliability of these tools in diverse populations. These preliminary analyses found that teachers in general reported greater ADHD behaviors than parents did for young children with ASD. However, teachers also reported greater difficulties with anxiety and oppositional defiant behaviors for African-American children with ASD. It may be that these challenges emerge to a greater extent in the school setting. Additional analyses will investigate whether the discrepancies between parent and teacher report of behavioral symptoms varies as a function of other demographic and socioeconomic factors.