Journal article
Informant discrepancy defines discrete, clinically useful autism spectrum disorder subgroups
Journal of child psychology and psychiatry, v 58(7), pp 829-839
Jul 2017
PMID: 28449247
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
Discrepancy between informants (parents and teachers) in severity ratings of core symptoms commonly arise when assessing autism spectrum disorder (ASD). Whether such discrepancy yields unique information about the ASD phenotype and its clinical correlates has not been examined. We examined whether degree of discrepancy between parent and teacher ASD symptom ratings defines discrete, clinically meaningful subgroups of youth with ASD using an efficient, cost‐effective procedure.
Methods
Children with ASD (N = 283; 82% boys; Mage = 10.5 years) were drawn from a specialty ASD clinic. Parents and teachers provided ratings of the three core DSM‐IV‐TR domains of ASD symptoms (communication, social, and perseverative behavior) with the Child and Adolescent Symptom Inventory‐4R (CASI‐4R). External validators included child psychotropic medication status, frequency of ASD‐relevant school‐based services, and the Autism Diagnostic Observation Schedule (ADOS‐2).
Results
Four distinct subgroups emerged that ranged from large between‐informant discrepancy (informant‐specific) to relative lack of discrepancy (i.e. informant agreement; cross‐situational): Moderate Parent/Low Teacher or Low Parent/Moderate Teacher Severity (Discrepancy), and Moderate or High Symptom Severity (Agreement). Subgroups were highly distinct (mean probability of group assignment = 94%). Relative to Discrepancy subgroups, Agreement subgroups were more likely to receive psychotropic medication, school‐based special education services, and an ADOS‐2 diagnosis. These differential associations would not have been identified based solely on CASI‐4R scores from one informant.
Conclusions
The degree of parent–teacher discrepancy about ASD symptom severity appears to provide more clinically useful information than reliance on a specific symptom domain or informant, and thus yields an innovative, cost‐effective approach to assessing functional impairment. This conclusion stands in contrast to existing symptom clustering approaches in ASD, which treat within‐informant patterns of symptom severity as generalizable across settings. Within‐child variability in symptom expression across settings may yield uniquely useful information for characterizing the ASD phenotype.
Metrics
Details
- Title
- Informant discrepancy defines discrete, clinically useful autism spectrum disorder subgroups
- Creators
- Matthew D. Lerner - Stony Brook UniversityAndres De Los Reyes - University of Maryland, College ParkDeborah A.G. Drabick - Temple UniversityAlan H. Gerber - Stony Brook UniversityKenneth D. Gadow - Stony Brook Medicine
- Publication Details
- Journal of child psychology and psychiatry, v 58(7), pp 829-839
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- Alan Alda Fund for Communication Simons Foundation Autism Research Initiative (381283) Matt and Debra Cody Center for Autism and Developmental Disorders Arts Connection Center for Health Innovation at Adelphi University
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute
- Web of Science ID
- WOS:000403404000009
- Scopus ID
- 2-s2.0-85020487363
- Other Identifier
- 991021862260904721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Psychiatry
- Psychology
- Psychology, Developmental