Prediction of Maladjustment Trajectories during Elementary and Junior High School with Symptoms of ASD Assessed in Preschool

Background: It is important to understand ASD symptoms in early childhood, especially in naturalistic contexts. If a preschool teacher can easily grasp the ASD characteristics of the child, that will enable to start developmental supports in early stages of the childhood. We developed Transitional Assessment Sheet for Preschoolers (TASP) which is a screening tool that preschool teachers can easily grasp the state of preschool children, TASP can grasp not only ASD symptoms but also ADHD symptoms and DCD symptoms. While studying the long-term course over 10 years in our cohort study, we examined the relationship among ASD symptoms which had grasped by preschool teachers and the adaptation in their adolescent.

Objectives: We examined how the ASD characteristics of children in early childhood grasped by TASP influences the adaptation to school and mental health in their elementary and junior high schools in our cohort study.

Methods: The sample comprised 3,717 participants (1,908 boys and 1,809 girls) of our cohort study investigated annually for 10 years between the 3rd grade of preschool (age 5 or 6) and 3rd grade of junior high school (age 14 or 15). We examined 3 kinds of developmental disorder symptoms (ADHD, ASD, and DCD) assessed at preschools as predictors of developmental trajectories of 4 maladjustment variables (academic failure, peer problems, internalizing problems and externalizing problems) during 9 years in elementary and junior high schools using the conditioned latent growth model. Developmental disorder symptoms were rated by preschool teachers using our original scale, TASP. TASP consists of 35 items from 7 subscales (Hyperactivity/Impulsivity, Inattention, Social Interaction, Communication, Inflexibility, Fine Motor, and Gross Motor) and its reliability and validity were examined from various aspects (internal and test-retest reliability and factorial, concurrent and predictive validity). Socio-emotional maladjustment was rated by teachers of elementary and junior high school using Strengths and Difficulties Questionnaire (SDQ), an internationally used scale for assessment of emotional and behavioral problems. Academic achievement was measured with Kyokenshiki Norm-Referenced Test, a standard achievement test widely used in schools around Japan.

Results: The conditioned latent growth model showed the following results: (a) Level of peer problem was predicted by high hyperactivity/impulsivity, poor social interaction, and poor gross motor skills through the impact of hyperactivity/impulsivity was diminished in high graders; (b) Level of academic achievement was predicted by low hyperactivity/impulsivity, elevated inattention, poor communication skill, and poor fine motor skill though impacts of hyperactivity/impulsivity and communication were diminished in high graders; (c) Level of internalizing problem was predicted by poor social interaction, poor communication skills, elevated inflexibility, and poor gross motor skills through impacts of communication and inflexibility were reduced in high graders; (d) Level of externalizing problem was predicted by high hyperactivity/impulsivity and elevated inattention though impacts of hyperactivity/impulsivity were reduced in high graders.

Conclusions: We found that ASD characteristics, grasped by preschool teachers in early childhood using TASP, predict social isolations and depressed states in their elementary and junior high schools.