Differences in profiles of emotional behavioral problems across instruments in verbal versus minimally verbal children with autism spectrum disorder.
Megan Fok, Vanessa H Bal
PMID 31102337WHAT IT FOUND
On the CBCL, parents reported more anxiety and depression symptoms in verbally fluent children with autism than in children with limited speech.
On the ABC, minimally verbal children showed more lethargy, and children with less speech showed more hyperactivity. The two forms gave different profiles.
Key findings
01On the CBCL, verbally fluent children had higher internalizing domain scores than minimally verbal and phrase-speech children, and externalizing domain scores did not differ across language groups.
02On the ABC, minimally verbal children had higher lethargy scores than phrase-speech and verbally fluent children, and both minimally verbal and phrase-speech children had higher hyperactivity scores than verbally fluent children.
03Fewer minimally verbal and phrase-speech children scored in the clinically significant range on the CBCL internalizing domain than verbally fluent children.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample came from a research collection, not a general clinic, and the authors say it may underrepresent minimally verbal children. 87% were male, 79% were white, and 60% had maternal education of a bachelor's degree or higher, so the groups may not match a typical clinic population. The study did not have CBCL item-level data, so it cannot tell whether the CBCL misses symptoms in children with limited speech or whether those children truly have fewer internalizing symptoms. The CBCL asked about the previous 6 months, while the ABC asked about the previous 4 weeks. The ABC Lethargy subscale used in this paper has no clinical cut-off, so its score differences are harder to translate into clinical concern.
Declared interests
The paper lists research support from the NIH extramural program. The supplied text does not include a conflict-of-interest declaration.
The easy way to misread this
Do not conclude that minimally verbal children have fewer emotional problems than verbal children. The lower CBCL internalizing scores may reflect that the form asks about thoughts and feelings that are hard to assess without spoken language.