Parent and Teacher Reports of Internalizing Symptoms in Children and Adolescents with ASD: Implications for School Placement

Background: Children with autism spectrum disorder (ASD) often experience comorbid internalizing symptoms, such anxiety and depression. Students with ASD may require school-based services to mitigate effects of internalizing symptoms on daily school functioning and long-term educational outcomes. This information about children’s and adolescents’ emotional, behavioral, and social functioning is most useful for determining impairment and needs—including school-based supports and placements—when gathered from different informants (i.e. parents, teachers). However, differences between parent and teacher ratings of youth internalizing symptoms (INT) are common, and the effect of such differences upon school-based placement for students with ASD is unclear. Understanding how parents’ and teachers’ reports of internalizing symptoms affect school services is critical to improving school-based support for students with ASD.

Objectives: To (a) compare parent and teacher ratings of INT; (b) identify differences in INT for students in various school-based placements; and (c) explore parent and teacher ratings of INT as potential predictors of school-based placement.

Methods: Data were analyzed from the Simons Simplex Collection (SSC v15.0) and included 591 youths with ASD (age: range=6-17yrs, M=10.22, SD=3.09). Paired t-tests were used to compare parents’ Child Behavior Check List (CBCL) and teachers’ Teacher Report Form (TRF) scores on the Internalizing Composite (INT) and the three INT subscales (Somatic Complaints [SOM], Withdrawn [WTH], Anxious/Depressed [ANX/DEP]). These comparisons were then made across three school-based placement groups: 100% general education (No SpEd; n=221), mixed general and special education (Some SpEd; n=202), 100% special education (All SpEd; n=168). Forthcoming multinomial logistic regression analyses will permit identification of how these scores may predict school-based placement into one of these three groups.

Results: Overall, significant differences emerged between parent and teacher scores on SOM (CBCL M=56.55, SD=6.99; TRF M=53.96, SD=6.02), t(591)=7.4, p<.001, and WTH (CBCL M=62.54, SD=8.79; TRF M=60.51, SD=7.85), t(591)=5.07, p<.001. Among the No SpEd and Some SpEd groups, teacher and parent SOM and WTH scores differed but INT and ANX/DEP did not. However, for the All Spec group, statistically significant differences emerged between CBCL (M=55.63, SD=6.15) and TRF (M=58.02, SD=7.39) ANX/DEP t-scores, t(168)=-3.75, p<.001.

Conclusions: Overall, our findings suggest that reports of youth internalizing symptoms with ASD are nuanced in terms of the informant (i.e., parent vs. teacher) and types of internalizing symptoms (i.e., somatic complaints, withdrawn, anxious/depressed). Moreover, parent and teacher ratings of internalizing symptoms varied depending on school-based placement. These findings suggest that differences in parent and teacher ratings of internalizing symptoms—which affect multiple facets of school-based functioning for students with ASD—may impact school-based placement. This study underscores the need to utilize multi-informant data regarding internalizing symptoms so appropriate support is in place for school-age children and adolescents with ASD.