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Predicting ADOS Scores Based on Behavioral Ratings from Parents and Pre-School Teachers
Information from different informants such as parents and teachers is regarded as valuable as it can contribute to early detection of autism spectrum disorder (ASD; Dereu et al., 2012) and lead to a greater understanding of how the child is functioning in different environments. However, information can differ between informants (Rescorla et al., 2014; Stratis & Lecavalier, 2015). The ASEBA Preschool Forms Child Behavior Checklist (CBCL) and Teacher Report Form (C-TRF) 1.5 - 5 years (Achenbach & Rescorla, 2000) are often used as screening instruments for behavioral symptoms and psychiatric conditions in children. Among other scales, the forms include a total problem scale and a scale that is related to autism symptoms, i.e. Pervasive Developmental Problems (PDP). It is still rather unexplored how well these scales are correlated with clinical assessment of ASD symptoms.
Objectives:
The aim of the study was to investigate how much variance of the ADOS – 2 comparison scores (CS) can be explained by scores on the CBCL and C-TRF (total problem scale and the autism-related PDP scale). We expected that scores from both parents (CBCL) and pre-school teachers (C-TRF) would predict autism symptoms, measured by the ADOS-2 CS at 3 years of age. We also explored if any of the two informants contributed more than the other to the model.
Methods:
Fifty-seven 3-year-old children from an at-risk-for-ASD sibling study (33 (18 girls) high-risk-for-ASD with no diagnosis; 10 (5 girls) high-risk-for-ASD with ASD diagnosis and 14 (7 girls) controls) participated. Multiple linear regressions with CBCL and C-TRF entered as predictors were conducted separately for the total problems scale and the autism related PDP scale, with ADOS- 2 CS as the dependent variable throughout.
Results:
For the total problems scales, the model was significant (R2 = .189, P =.004), and neither CBCL nor C-TRF contributed uniquely to the prediction of ADOS-scores (Betas = .309 - .189, Ps = .186 - .237). For the PDP-scale, the model was significant (R2 = .298, P = < .001) and only the preschool teachers’ ratings contributed uniquely to model fit (Beta = .538, P = .010, explained variance 23 %). This pattern of results was also replicated when excluding all low-risk participants from the analyses.
Conclusions:
Combined, behavioral ratings based on the CBCL and C-TRF explained a substantial proportion of the variance in the ADOS scores. Parents´ scores on the CBCL total and PDP subscales did not give a unique contribution to the prediction of ADOS scores over and above the contribution provided by preschool teachers’ ratings. In contrast, the pre-school teachers’ ratings on the PDP scales (but not total scores) made a unique contribution to the prediction of ADOS-2 CS- scores. This suggests that pre-school teachers’ ratings may be particularly useful in the context of early diagnosis of autism.