Discrepancies between parent and child ratings of anxiety in children with autism spectrum disorder.
Carla B Kalvin, Carolyn L Marsh, Karim Ibrahim and 5 others
PMID 31643143WHAT IT FOUND
Children with autism plus diagnosed anxiety were rated more anxious by parents than by themselves.
In autism without anxiety and typical development, children rated themselves more anxious than parents did. More severe autism symptoms linked parent ratings exceeding child ratings.
Key findings
01Parents rated children with autism and a diagnosed anxiety disorder as more anxious than those children rated themselves; children with autism without anxiety and typically developing children rated themselves more anxious than parents did.
02Parent and child anxiety ratings were moderately related in both autism groups, with correlations of 0.36 in the anxiety group and 0.53 in the autism-only group, but not related in typically developing children.
03In the combined autism group, the tendency for parent ratings to exceed child ratings was associated with more severe autism communication deficits and restricted repetitive behaviors, not with age, gender or IQ.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was cross-sectional, so it cannot show that autism symptoms caused the parent-child rating difference. The combined autism sample had 52 children, and the autism-only group had 18 children, so findings may be unstable. Participants were recruited from clinical services and treatment-seeking families, so results may not apply to children with autism who are not in care. The sample was mostly boys, so patterns in girls are unclear. Anxiety group assignment came from interviews that included both parent and child, so the same reporting pattern could have influenced both diagnosis and questionnaire scores. Typically developing children had higher IQ than the autism plus anxiety group, although the two autism groups did not differ in IQ.
Declared interests
One author receives Guilford Press royalties for a treatment manual. The other authors declare no relevant conflicts. The article is tagged as supported by NIH extramural research.
The easy way to misread this
Do not conclude that parents are more accurate than children about anxiety in autism. The study only compared ratings, and the anxiety diagnosis was made from interviews that included both parent and child, so the same reporting pattern could have influenced group assignment and questionnaire scores.