Teacher- and parent-reported trajectories of maladaptive behaviors among individuals with autism and non-spectrum delays.
Nicole E Rosen, Hillary K Schiltz, Catherine Lord
PMID 36367328WHAT IT FOUND
Across ages 9 to 18, hyperactivity and irritability improved for most participants, but social withdrawal stayed stable.
Participants with lower verbal intelligence or more autism features started with higher symptom levels and improved less over time, regardless of teacher or parent report.
Key findings
01Teacher- and parent-reported hyperactivity and irritability showed significant improvement from late childhood into early adulthood, while social withdrawal levels remained stable over the same period.
02Participants with lower verbal intelligence quotients (VIQ) presented with more hyperactivity and irritability at age 9 and experienced significantly less improvement in these behaviors over time compared to those with higher VIQ.
03School placement effects, such as attending specialized schools or having special education teachers, were associated with different trajectories of maladaptive behaviors, but these effects largely disappeared after controlling for individual differences in autism features and VIQ.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was primarily recruited from children referred for diagnosis before age 3, so findings may not generalize to those diagnosed later. Attrition was higher among participants with lower autism feature severity and those from families with higher caregiver education, potentially biasing the sample. The study relied on informant reports (teachers and parents) rather than direct clinical observation or standardized diagnostic interviews for the behavior outcomes. The Aberrant Behavior Checklist subscales used may overlap with core autism features, making it difficult to distinguish maladaptive behaviors from autism symptoms.
Declared interests
The authors declare no conflicts of interest. The study was supported by the National Institute of Mental Health (NIMH) and the National Institute on Deafness and Other Communication Disorders (NIDCD).
The easy way to misread this
Do not assume that changing school placement (e.g., from specialized to mainstream) will independently reduce maladaptive behaviors. The study found that apparent school effects on hyperactivity and irritability disappeared after accounting for the students' individual autism severity and verbal intelligence levels.