The Role of Presence of ASD Symptoms in the Variability Between Parent and Teacher Ratings of Social Skills in School-Age Children Evaluated for ASD

Background: When assessing children for autism spectrum disorder (ASD), clinicians often utilize measures from multiple informants to get a comprehensive picture of the child’s functioning. Clinicians may gather information from both parents and teachers; however, variability may exist between informants due to factors such as informant bias and differences between settings (Ducekot et al., 2015). Whereas factors such as the child’s age, gender, and IQ have been shown to predict variability between informant reports (Stratis & Lecavalier, 2015), little research has examined how high/low symptoms of ASD relates to this variability.

Objectives: The current study explores: 1) If parent- and teacher-reports of symptoms in school-age children evaluated for ASD are correlated; 2) If not, does presence of ASD symptoms (i.e., high; minimal-to-no) serve as a moderator of the relation between parent- and teacher-reports, after controlling for previously established covariates (i.e., child age, gender, IQ).

Methods: Parents, teachers and clinicians completed study measures for 43 children (ages = 3-16; 22 received an ASD diagnosis; 21 received other diagnoses) as part of an ASD evaluation at a university-based clinic. Parents and teachers completed the Social Responsiveness Scale (First or Second Edition; SRS), assessing social behavior deficits associated with ASD. Clinicians completed the Childhood Autism Rating Scale, Second Edition (CARS-2), assessing behaviors associated with ASD. Multiple regression was conducted using PROCESS for SPSS (Hayes, 2013) predicting teacher-reported SRS scores from parent-reported scores, while controlling for the child’s age, gender, and IQ, and including CARS-2 scores as a moderating variable.

Results: Preliminary analyses revealed no significant correlation between parent- and teacher-reported social behavior deficits (SRS; r = .084, p = .592). When predicting teacher-reported SRS scores via multiple regression analysis, the addition of CARS-2 and parent-reported SRS scores in Step 2 did not account for significant variance over and above covariates, ∆R² = .13, ∆F(2, 37) = 2.99, p = .06. However, the interaction term (parent-reported SRS scores X CARS-2 scores) entered in Step 3 accounted for significant variance in teacher-reported SRS scores, ∆R² = .10, ∆F(1, 36) = 5.68, p = .02. Specifically, a significant positive relation emerged between parent- and teacher-reported SRS scores when high symptoms of ASD were present (high CARS-2), yet a non-significant relation emerged between parent- and teacher-reported SRS scores when minimal-to-no symptoms of ASD were present (low CARS-2; Figure 1).

Conclusions: Clinician-reported levels of ASD symptoms moderated the relation between parent- and teacher-reported deficits in social behavior. Although parent- and teacher-reports on the SRS are similar when symptoms are high, they are not related in children with minimal-to-no symptoms as observed by clinicians. This suggests that when ASD symptoms are more severe, agreement among raters is consistent; however, children with minimal-to-no symptoms are likely to have varying reports between parents and teachers. Identifying this non-significant relation present in reports of children with minimal-to-no symptoms helps to identify another potential predictor of report variability. Future studies will be needed to determine the potential reasons for this discrepancy in children with minimal-to-no symptoms.