Assessment Modality (Parent Questionnaire vs. Clinical Interview) Impacts Adaptive Functioning Scores in Preschoolers at Heightened Genetic Risk of ASD

Background: The DSM-5 emphasizes the significance of adaptive function in the diagnosis of neurodevelopmental disorders, but these skills can be difficult to characterize in young children using standardized assessments. To date, there has been a paucity of research comparing adaptive functioning measures to each other, specifically within the preschool age group. Strong correlations have been reported across some adaptive functioning assessments when used with typically developing populations, but research in ASD populations has found significant discrepancies between assessments (Lopata et al., 2013). Prior literature suggests that at least a sub-group of younger siblings of children with ASD who do not develop ASD themselves are at heightened risk for a variety of developmental difficulties by age 3 (Messinger et al., 2013; Ozonoff et al., 2014). Accurately measuring adaptive functioning in this group is crucial, as these scores are used to design intervention plans that support school readiness. In order to determine the scope and targets of support, it is essential to find standardized assessments that accurately assess the adaptive skills of preschoolers at all levels of functioning.

Objectives: Determine which modality of assessment (parent report or clinician interview) better characterizes adaptive functioning by comparing scores on two commonly used assessments (the Adaptive Behaviors Assessment System, Second Edition (ABAS-II) Parent Form, and the Vineland Adaptive Behavior Scales-II (VABS-II) Survey Interview Form) with each other and with a measure of general developmental functioning (the Mullen Scales of Early Learning; MSEL).

Methods: Twenty-six 3-year-olds returned for a diagnostic visit as part of their participation in the longitudinal Infant Brain Imaging Study (IBIS). Participants fell into one of two groups: (1) at high-familial risk for ASD by virtue of having an older sibling with ASD, but not currently diagnosed with ASD themselves (HR-neg, N=20) and (2) at low-familial risk for ASD with no ASD diagnosis themselves (LR; N=6). All parents were mailed the ABAS-II to complete at home, while the MSEL and VABS-II were administered during the diagnostic visit.

Results: Across all domains of developmental function, children in both groups performed in the average range (Table 1) and did not differ significantly from one another (Welch’s ps<.10). Within-group correlations were performed to assess relationships between VABS-II, ABAS-II, and MSEL scores. In the HR-neg group, VABS-II scores correlated with scores on the MSEL, while ABAS-II did not. In contrast, neither VABS-II nor ABAS-II scores correlated with MSEL scores in the LR group (which we will add to by the conference date).

Conclusions: Preliminary analyses indicate that the modality of assessment (parent questionnaire vs. clinical interview) impacts children’s adaptive functioning scores, particularly when children are at heightened genetic risk for ASD. Our findings suggest that since parents of HR-neg children might not have a typical model to compare against when independently completing a questionnaire about adaptive functioning, that a clinical interview could provide critical support to more accurately capture children’s strengths and weaknesses. Therefore, researchers should be cautious in assuming that different measures of adaptive behaviors are comparable in this age range and in HR samples.