What is the concordance between parent- and education professional-reported adaptive functioning in autistic children using the VABS-II?
Heather L Moore, Ann Le Couteur, Tony Charman and 3 others
PMID 35579790WHAT IT FOUND
Parents rated autistic children's adaptive skills higher than school staff did, particularly in socialisation and motor domains.
Agreement was poor overall, meaning a child's function looks different at home than at school. Both perspectives are needed for accurate assessment.
Key findings
01Parents rated their child's overall adaptive functioning significantly higher than education professionals did.
02Agreement between parents and school staff was poor for the overall score and most domains, with only Daily Living Skills showing fair reliability.
03The gap between parent and teacher ratings was larger for children with lower nonverbal ability.
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
Parents were interviewed by a researcher to complete the form, whereas education professionals completed a self-administered questionnaire. This difference in administration method could have influenced the ratings. The study did not collect data on the education professionals' characteristics, such as their experience with autism or class sizes, which might affect how they rate children. The sample was drawn from a specific trial population with lower ability levels, which may not represent all autistic children, particularly those with higher nonverbal abilities. Children were slightly older when rated by education professionals than by parents, though this difference was small (1.25 months on average).
Declared interests
The study was funded by the National Institute of Health Research (NIHR) and the Medical Research Council. One author has received consultancy fees from pharmaceutical companies and royalties from publishers. Another author receives fees from a not-for-profit training company related to the intervention being studied in the main trial.
The easy way to misread this
Do not assume that the discrepancy between parent and teacher ratings indicates that one informant is wrong or exaggerating. The differences were systematic and linked to the child's ability level and the context of the behaviour, not just rater bias. Treating these reports as conflicting evidence rather than complementary context-specific data will lead to an incomplete assessment of the child's needs.