Parent-Teacher Discrepancy in Ratings of Executive Functioning in Black and White Children with ASD

Poster Presentation
Friday, May 3, 2019: 5:30 PM-7:00 PM
Room: 710 (Palais des congres de Montreal)
S. I. Habayeb1, L. Kenworthy1, S. Rau1, M. Miller1, A. C. Armour1, K. D. Csumitta2 and A. B. Ratto1, (1)Children's National Health System, Washington, DC, (2)National Institutes of Health, Bethesda, MD
Background: Racial based reporting biases have been found, wherein teachers report higher rates of externalizing symptoms in Black children than parents do (Harvey et al., 2013), and than reported for White peers (Lau et al., 2004). In children with Autism Spectrum Disorder (ASD), increased discrepancy between parent and teacher report on standardized questionnaires can affect clinical characterization and subsequent treatment involvement (Lerner et al., 2017). While some research has explored parent reported differences in executive functioning (EF) across race (Ratto et al., 2016), research has not yet explored the impact of parent-teacher discrepancy on the characterization of these skills.

Objectives: To explore parent-teacher discrepancy in ratings of EF across race.

Methods: Data were collected from 284 children with ASD as part of neuropsychological evaluations at an academic medical center (N=1290). Full-scale IQ (FSIQ) was determined using standardized intelligence measures (Table 1). Parent and teacher forms of the Behavior Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, & Kenworthy, 2000) were used to assess EF skills yielding T-scores. To assess parent-teacher discrepancy, difference scores were calculated (parent – teacher; Figure 1). Regression analyses (including age and FSIQ) explored whether race predicted parent-teacher discrepancy, parent, and teacher ratings of EF.

Results: Controlling for age and FSIQ, significant discrepancies were found between parent and teacher report for ratings of Black children compared to White children on the following subscales and indices: “Inhibit” (B = -5.247, p = 0.045), “Monitor” (B = -5.947, p = 0.024), “Initiate” (B = -6.140, p = 0.023), “Organization of Materials” (B = -11.649, p = 0.027), and “Meta-Cognitive Index” (B = -5.188, p = 0.047), with parents rating lower symptoms than teachers. Race significantly predicted parent report, with Black parents rating lower levels of symptoms than White parents on the following subscales: “Inhibit” (B = -5.395, p = 0.009), “Initiate” (B = -3.960, p = 0.024), “Plan/Organize” (B = -4.147, p = 0.028), “Organization of Materials” (B = -3.625, p = 0.040), “Monitor” (B = -5.346, p = 0.004), “Behavior Regulation Index” (B = -4.105, p = 0.033), “Meta-Cognitive Index” (B = -4.227, p = 0.014) and “Global Executive Composite” (B = -4.461, p = 0.009). Race did not significantly predict differences in teacher report. Results maintained significance following a Benjamini-Hochberg procedure correction for multiple comparisons.

Conclusions: Race significantly predicted a difference in discrepancy between parent and teacher report of EF problems on several subdomains of the BRIEF. Compared to Caucasian children, teachers and parents disagreed more on EF ratings for Black children, with teachers on average indicating more impairment than parents. Upon further exploration, the discrepancy seems to be driven by parents of Black children rating lower levels of symptoms than parents of Caucasian children. Racial reporting differences were not found on behalf of teachers. Findings may indicate potential differences in symptom presentation between home and school, wherein home cultures may be better suited to meet the needs of Black children with ASD (Ratto et al., 2016) or may indicate underreporting of symptoms by their parents.