Measures of Symptom Severity in Preschoolers with Autism Spectrum Disorder: The Role of Maternal Anxiety
Objectives: This research examined the relationship between maternal anxiety and parent-report and objective measures of ASD symptom severity. Specifically, it was hypothesized that parent-reported symptoms of ASD would not be significantly correlated with clinical symptom severity. Additionally, maternal anxiety and clinical assessment of ASD severity was not expected to be significantly correlated; however a positive and significant relationship between maternal anxiety and parent-reported symptom severity was expected.
Methods: The sample consisted of 198 preschool-aged children with ASD (82% male) who were followed throughout the school year as part of a completed multi-site study comparing comprehensive treatment models (Boyd, et al., 2013). Children were between the ages of 3 and 5 years during enrollment (M = 48 mo. Range = 34-62 mo.), and were evaluated at three time points (pre-test, post-test, and follow-up). Only data collected at pre-test were utilized in the current study. The Autism Diagnostic Observation Schedule (ADOS; Lord et al., 1999) was used to measure clinical assessments of symptom severity. ADOS severity scores were then compared to parent-reports of symptom severity, as measured by the Social Responsiveness Scale (SRS; Constantino, 2003). The relationship of each measure to self-reported maternal anxiety scores on the Endler Multidimensional Anxiety Scales – Trait (EMAS-T) was also assessed (Endler, et al., 1991).
Results: Pearson rs were calculated to determine the correlation between maternity anxiety scores on the EMAS-T, and symptom severity scores on the ADOS and SRS. No significant relationship was found between clinical symptom severity and parent-reported symptom severity (r(182) = .072, p = .331). Further, standardized clinical symptom severity and maternal anxiety were not significantly related (r(180) = .050, p = .509). However, a strong relationship between parent-reported symptom severity and maternal anxiety level was detected (r(182) = .269, p = .001). Results provide support for our hypotheses and indicate that parent-reported symptom severity scores are not significantly related to objective measures of symptom severity; however, a significant relationship does exist between maternal anxiety and parent-reported symptom severity.
Conclusions: Results indicate that parents and clinicians may not agree on ASD symptom severity and suggest the possibility that maternal anxiety may be an influential factor. The potential implications of a relationship between maternal anxiety and parent perception of symptom severity are discussed. Future studies may investigate the impact of maternal anxiety on diagnostic decisions and/or parent-child relationships, with the ultimate goal of improving quality of life for family members impacted by ASD diagnosis.
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