RCTJournal of autism and developmental disorders2017

Caregiver-Teacher Concordance of Challenging Behaviors in Children with Autism Spectrum Disorder Served in Community Mental Health Settings.

Nicole Stadnick, Colby Chlebowski, Lauren Brookman-Frazee

PMID 28343342

WHAT IT FOUND

Caregivers rated challenging behaviors in children with autism spectrum disorder as more intense than teachers did.

Agreement was low, and disagreement was greatest when children had additional psychiatric diagnoses, especially ADHD or ODD.

Key findings

01Caregiver mean behavior intensity t-score was 62.62, in the clinical range, while teacher mean was 56.21, in the normal range.

02Caregiver and teacher behavior intensity ratings correlated weakly, r = .27.

03Caregivers rated behavior intensity higher than teachers when children had 1 to 2 additional psychiatric diagnoses or more than 2 additional psychiatric diagnoses; ratings did not differ when children had none.

STILL TO COME

How it was doneWhat they found

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What it does not show

The analysis used baseline ratings only, so it cannot show whether a treatment reduced challenging behaviors. Children without teacher ratings were excluded, including 47 children with no teacher data, so the findings apply to children with both caregiver and teacher reports. There was no comparison group of children without autism spectrum disorder receiving community mental health services. Caregivers and teachers observed children in different settings, so disagreement may reflect real context differences rather than a problem with either report. Teachers varied in how well they knew the child and how much classroom time they had with the child.

The easy way to misread this

Do not conclude that the AIM HI intervention reduced challenging behaviors. This paper analyzed baseline caregiver and teacher ratings only, not response to treatment.

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The study

Participants
141 children (138 caregivers, 134 teachers)
Certainty of evidence
Moderate

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    Nicole Stadnick, Colby Chlebowski, Lauren Brookman-Frazee Caregiver-Teacher Concordance of Challenging Behaviors in Children with Autism Spectrum Disorder Served in Community Mental Health Settings. Journal of autism and developmental disorders. 2017.

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