Temperament Variability Among Socio-Demographic and Clinical Subgroups of Children with Autism Spectrum Disorder in the Study to Explore Early Development

Background: The proposed factor structure of the Behavioral Style Questionnaire (BSQ) is not supported in children with autism spectrum disorder (ASD), for whom a 10-factor solution may be best. It is unknown whether socio-demographic and clinical variables are associated with expression of these 10 factors among children with ASD.

Objectives: To compare socio-demographic and clinical subgroups of children with ASD on alternative BSQ temperament factors.

Methods: Data were collected in the Study to Explore Early Development-Phase I (SEED1). SEED1 is a case-control study funded by the Centers for Disease Control and Prevention and conducted at multiple sites throughout the U.S. (catchment areas in CA, CO, GA, MD, NC and PA). Children with ASD were recruited through developmental disability service organizations and were aged 2-5 years at time of enrollment. Clinicians confirmed ASD status with the Autism Diagnostic Observation Schedule and Autism Diagnostic Interview Revised. BSQ data were obtained via caregiver self-administered questionnaire.

Revised BSQ (BSQ–R) Bartlett factor scores were developed via exploratory factor analysis (M=0; SD=1): (1) Maladaptivity (e.g., “bothered by changes”), (2) Environmental Sensitivity (e.g., “sensitive to noises”), (3) Quiet Persistence (“practices [to mastery]”), (4) Social Inattention (e.g., “does not acknowledge [when called]”), (5) Social Approach (e.g., “approaches [unknown children]”), (6) Activity (e.g., “[frequently] runs”), (7) Crying, (8) Rhythmicity (e.g., “hungry at dinner”), (9) Food Openness (e.g., “tries new foods”), and (10) Negative Social (e.g., “complains about friends”).

Maladaptivity, Quiet Persistence, Social Approach, Crying, Rhythmicity, Food Openness, and Negative Social were non-parametrically distributed. ANOVA and T-tests compared groups for parametric factors; Friedman ANOVAs and Wilcoxon Rank Sums compared groups for non-parametric factors.

Socio-demographic subgroups were sex (male/female), maternal race (White/Black/Other), maternal ethnicity (Hispanic/non-Hispanic), and maternal education (high school or less /some college or college degree/advanced degree). Clinical subgroups were intellectual disability (ID; no/yes) defined as a Mullen Scales of Early Learning Early Language Composite Score < 70, and nonverbal status (no/yes) measured by the Social Communication Questionnaire.

Results: White mothers reported more problems with Maladaptivity, Social Inattention, and Food Openness in their child with ASD than did Black or Other race mothers; Black mothers reported more problems with Crying than did White or Other race mothers. Hispanic mothers reported more problems with Food Openness than did non-Hispanic mothers. Mothers with HS education reported more problems with Quiet Persistence but fewer problems with Crying than did those with more education. Children with ASD and ID had more problems with Environmental Sensitivity, Quiet Persistence, Rhythmicity, Food Openness, and Activity and fewer problems with Negative Social than those without ID. Non-verbal children with ASD had more problems with Negative Social and fewer problems with Environmental Sensitivity, Quiet Persistence, Social Approach, and Rhythmicity than did verbal children with ASD. All reported differences are significant at p < .05.

Conclusions: Socio-demographic and clinical variables are associated with BSQ-R scores for children with ASD. Future research is needed to better understand these associations and the resultant impact on family functioning.