Assessing Irritability in Children with Autism Spectrum Disorder Using the Affective Reactivity Index.
Carla B Kalvin, Theresa R Gladstone, Rebecca Jordan and 4 others
PMID 32734421WHAT IT FOUND
The ARI effectively measures irritability in children with autism.
Noncompliance was a stronger predictor of irritability than anxiety. Anxiety only increased irritability in children who did not have high levels of noncompliance.
Key findings
01The ARI showed excellent internal consistency and identified clinically significant irritability in 61% of the sample.
02Noncompliance was more strongly associated with irritability than anxiety, and was the only factor with a unique contribution when both were analyzed together.
03Anxiety contributed to heightened irritability only in children with low levels of noncompliance; for those with high noncompliance, anxiety had no effect on irritability.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The cross-sectional design cannot prove that noncompliance or anxiety cause irritability. The sample size was small (81 children), which limited statistical power. Participants were mostly boys and were recruited from a specialty university program, so results may not generalize to girls or community-based populations. The study relied solely on parent reports for symptoms of irritability, anxiety, and noncompliance.
Declared interests
Dr. Sukhodolsky receives royalties from Guilford Press for a treatment manual on CBT for anger and aggression in children. Other authors declared no conflicts of interest.
The easy way to misread this
Do not assume that treating anxiety will reduce irritability in all children with ASD. The study found that anxiety only predicted irritability in children who did not have high levels of noncompliance. For children with significant noncompliance, anxiety had no effect on irritability scores.