Do Kindergarten-Level Behaviour Profiles of Children with Autism Spectrum Disorder (ASD) Differ from Profiles of Children with Other Developmental Disabilities?

Background: The possible increases in the prevalence of Autism Spectrum Disorder (ASD), the burden it causes, and the inconsistencies in timing and accuracy of ASD diagnoses together suggest a need for system-level changes in the way the needs of children with ASD are addressed. Tools facilitating allocation of intervention strategies for children at early ages, who may not even have a confirmed ASD diagnosis yet have potential to alleviate the burden of this disorder. In Ontario, Canada, developmental data are collected for all kindergarten children at regular intervals with the Early Development Instrument (EDI). For a proportion of three cohorts, it was possible to ascertain whether these children were diagnosed with ASD or any other developmental disability by age 9. This sample is investigated here for potential kindergarten behaviour patterns that may distinguish children with ASD from those with other disorders.

Objectives: To establish whether kindergarten age behaviour profiles of children with ASD differ from those of children with other developmental disabilities, and from those of typically developing children.

Methods: The EDI is a teacher-completed questionnaire measuring developmental health across five domains: Physical Health and Well-Being, Social Competence, Emotional Maturity, Language and Cognitive Development, and Communication Skills and General Knowledge. The EDI included information on whether or not a child had identified special needs (SN) in kindergarten.

The analyses were based on EDI data collected from 2005-2007 matched at child level with Grade 3 provincial test data collected from 2008-2010. Approximately 57% of the available data were matched, creating a sample of 63,870 children (50.6% boys, mean age 5.7 years). The provincial databases provided information on whether a child had ASD or another developmental delay in Grade 3. MANOVAs compared EDI scores on domains and subdomains between children with and without a grade 3 ASD diagnosis. Children with an ASD or other delay in Grade 3 who also had SN in kindergarten were considered as “early identified”, while those without SN as “late identified”.

Results: Children with Grade 3-ASD and with Grade 3-other delay scored lower than typically developing children on all domains. Children who were “early identified” had consistently lower scores than those “late identified”. In both groups, however, children with ASD had lower scores in the Social Competence and Emotional Maturity domains than children with other delays, but better in the Language and Cognitive Development domain. Among the “early identified”, children with ASD also had better scores in Physical Health and Well-being than children with other delays.

Conclusions: Our analyses indicate that children with ASD can be distinguished on broad characteristics of their behavioural profile from children with other disabilities; they function better in cognitive areas but worse in social-emotional areas. Further research is needed to examine more specific areas within the broad domains to increase the description’s precision. Our results indicate that the population-based collection of EDI data can assist in monitoring the prevalence of children with ASD-like characteristics and thus could help in making decisions about allocating necessary resources within the educational system and beyond.