Verbal Ability and Psychiatric Symptoms in Clinically Referred Inpatient and Outpatient Youth with ASD.

Psychiatric symptoms were measured by caregiver report, so the results may reflect what parents observed and rated rather than what the youth experienced. The study was cross-sectional, so it cannot show whether verbal ability influenced symptoms or whether symptoms influenced communication and functioning. Minimally verbal status was defined by ADOS-2 module, which is an imperfect index of verbal ability, and changing the threshold changed some findings. Effects were small for many comparisons, and the groups did not differ on impairment cutoffs for nearly all disorders. The sample was mostly Caucasian males with low-average to borderline nonverbal IQ, so it may not represent girls, higher-IQ youth, or other backgrounds. Data came from two different settings and used different IQ tests and collection timing, and inpatient/outpatient differences were large, so setting may shape the symptom picture. Some analyses used listwise deletion when caregiver ratings were incomplete.

One author declared being a shareholder in Checkmate Plus, the publisher of the Child and Adolescent Symptom Inventory, which was the main psychiatric symptom measure. All other authors declared no conflicts of interest. No funding source is stated in the supplied text.

Do not conclude that minimally verbal youth are protected from depression, anxiety, or oppositional problems. The differences were cross-sectional, mostly small, and caregiver report may under-detect internalizing symptoms in youth with limited speech.