Skip to main content
SpringerLink
Log in

Diagnostic Utility of Parent Ratings on the Behavior Assessment System for Children-Third Edition in Children who are Deaf and Hard of Hearing and Diagnosed with Autism Spectrum Disorder

Research on Child and Adolescent Psychopathology Aims and scope Submit manuscript

Cite this article

Abstract

Between 1 to 2 of every 1,000 children are born deaf or hard of hearing (DHH) and, of those, 30–50% have additional disabilities, including Autism Spectrum Disorder (ASD). Most measures assessing ASD characteristics rely on some degree of behavioral response to sound (e.g., responding to name, listening response), and may not be appropriate for use with children who are DHH. Further, ASD specific measures do not provide information on a child’s functional abilities across developmental domains. We conducted a cross-sectional analysis comparing mean T-scores on a standardized multidimensional measure, the Behavior Assessment System for Children, Third Edition, Parent Rating Scale (BASC-3 PRS), across three groups matched for age and sex: children who are DHH and diagnosed with ASD (DHH + ASD; n = 16); children who are DHH without ASD (DHH-ASD; n = 16); and children who are typically hearing with ASD (H + ASD; n = 16). Analyses revealed statistically significant differences across scales of Attention Problems, Atypicality, Withdrawal, Behavioral Symptoms Index, Social Skills, Leadership, Functional Communication, Activities of Daily Living, Adaptive Skills, Autism Probability Indices, and Developmental Social Disorders. Pairwise comparisons showed DHH + ASD and H + ASD mean T-scores were statistically similar and distinct from DHH-ASD mean T-scores on all these scales except for Withdrawal, Leadership, Functional Communication, and Activities of Daily Living, where pairwise comparisons varied. The findings add to the literature on ASD and DHH children and call for further exploration of the BASC-3 as a tool for both evaluation of ASD and the development of individualized treatment plans in this unique population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Data Availability

Data is available upon reasonable request to the corresponding author.

References

  • American Psychological Association. (2021). Equity, Diversity, and Inclusion INCLUSIVE LANGUAGE GUIDELINES. https://www.apa.org/about/apa/equity-

  • Antshel, K. M., & Russo, N. (2019). Autism Spectrum Disorders and ADHD: Overlapping Phenomenology, Diagnostic Issues, and Treatment Considerations. Current Psychiatry Reports, 21(5), 34. https://doi.org/10.1007/s11920-019-1020-5

    Article  PubMed  Google Scholar 

  • Benson, N. F., Floyd, R. G., Kranzler, J. H., Eckert, T. L., Fefer, S. A., & Morgan, G. B. (2019). Test use and assessment practices of school psychologists in the United States: Findings from the 2017 National Survey. Journal of School Psychology, 72, 29–48. https://doi.org/10.1016/j.jsp.2018.12.004

    Article  PubMed  Google Scholar 

  • CDC. (2020). Summary of 2020 National CDC EHDI Data. https://digitalcommons.usu.edu/jehdi/vol4/iss2/1/

  • Dale, B. A., & Neild, R. (2020). The assessment needs of families with children who are deaf and hard of hearing referred for an autism spectrum disorder evaluation. Psychology in the Schools, 57(3), 475–484. https://doi.org/10.1002/pits.22328

    Article  Google Scholar 

  • De Reyes, A. L., & Kazdin, A. E. (2005). Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study. Psychological Bulletin, 131(4), 483–509. https://doi.org/10.1037/0033-2909.131.4.483

    Article  PubMed  Google Scholar 

  • Duncan, A. W., & Bishop, S. L. (2015). Understanding the gap between cognitive abilities and daily living skills in adolescents with autism spectrum disorders with average intelligence. Autism, 19(1), 64–72. https://doi.org/10.1177/1362361313510068

    Article  PubMed  Google Scholar 

  • Gallaudet Research Institute. (2011). Regional and national summary of data from the 2009–10 annual survey of deaf and hard of hearing children and youth. GRI, Gallaudet University.

    Google Scholar 

  • Gulati, S. (2019). Language Deprivation Syndrome. In N. S. Glickman & W. C. Hall (Eds.), Language Deprivation and Deaf Mental Health (pp. 24–53). Routledge.

    Google Scholar 

  • Harris, P. A., Taylor, R., Minor, B. L., Elliott, V., Fernandez, M., O’Neal, L., McLeod, L., Delacqua, G., Delacqua, F., Kirby, J., & Duda, S. N. (2019). The REDCap consortium: Building an international community of software platform partners. In Journal of Biomedical Informatics (Vol. 95). Academic Press Inc. https://doi.org/10.1016/j.jbi.2019.103208

  • Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381. https://doi.org/10.1016/j.jbi.2008.08.010

    Article  PubMed  Google Scholar 

  • Hodkinson, R., Phillips, H., Allgar, V., Young, A., Le Couteur, A., Holwell, A., Teige, C., & Wright, B. (2023). Comparison of Diagnostic Profiles of Deaf and Hearing Children with a Diagnosis of Autism. International Journal of Environmental Research and Public Health, 20(3), 2143. https://doi.org/10.3390/ijerph20032143

    Article  PubMed  PubMed Central  Google Scholar 

  • Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Padden, C., Pollard, R., Rathmann, C., & Smith, S. (2016). Avoiding linguistic neglect of deaf children. Social Service Review, 589–619.

  • Hyman, S. L., Levy, S. E., Myers, S. M., Kuo, D. Z., Apkon, C. S., Davidson, L. F., Ellerbeck, K. A., Foster, J. E. A., Noritz, G. H., O’Connor Leppert, M., Saunders, B. S., Stille, C., Yin, L., Brei, T., Davis, B. E., Lipkin, P. H., Norwood, K., Coleman, C., Mann, M., … Paul, L. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145(1). https://doi.org/10.1542/PEDS.2019-3447

  • Kaufman, N. K. (2022). Rethinking “gold standards” and “best practices” in the assessment of autism. Applied Neuropsychology: Child, 11(3), 529–540. https://doi.org/10.1080/21622965.2020.1809414

    Article  PubMed  Google Scholar 

  • Kind, A. J. H., & Buckingham, W. R. (2018). Making Neighborhood-Disadvantage Metrics Accessible — The Neighborhood Atlas. New England Journal of Medicine, 378(26), 2456–2458. https://doi.org/10.1056/NEJMp1802313

    Article  PubMed  Google Scholar 

  • Lieu, J. E. C., Kenna, M., Anne, S., & Davidson, L. (2020). Hearing Loss in Children: A Review. In JAMA - Journal of the American Medical Association (Vol. 324, Issue 21, pp. 2195–2205). American Medical Association. https://doi.org/10.1001/jama.2020.17647

  • Lord, C., Charman, T., Havdahl, A., Carbone, P., Anagnostou, E., Boyd, B., Carr, T., de Vries, P. J., Dissanayake, C., Divan, G., Freitag, C. M., Gotelli, M. M., Kasari, C., Knapp, M., Mundy, P., Plank, A., Scahill, L., Servili, C., Shattuck, P., … McCauley, J. B. (2022). The Lancet Commission on the future of care and clinical research in autism. In The Lancet (Vol. 399, Issue 10321, pp. 271–334). Elsevier B.V. https://doi.org/10.1016/S0140-6736(21)01541-5

  • Lord, C., Rutter, M., Risi, S., Gotham, K., & Bishop, S. L. (2012). Autism Diagnostic Observation Schedule - 2nd Edition (ADOS-2). Western Psychological Corporation.

  • Ludwig, N. N., Jashar, D. T., Sheperd, K., Pineda, J. L., Previ, D., Reesman, J., Holingue, C., & Gerner, G. J. (2022). Considerations for the identification of autism spectrum disorder in children with vision or hearing impairment: A critical review of the literature and recommendations for practice. Clinical Neuropsychologist, 36(5), 1049–1068. https://doi.org/10.1080/13854046.2021.2002933

    Article  PubMed  Google Scholar 

  • McFayden, T. C., Culbertson, S., DeRamus, M., Kramer, C., Roush, J., & Mankowski, J. (2023). Assessing Autism in Deaf/Hard-of-Hearing Youths: Interdisciplinary Teams, COVID Considerations, and Future Directions. Perspectives on Psychological Science. https://doi.org/10.1177/17456916231178711

    Article  PubMed  PubMed Central  Google Scholar 

  • Meinzen-Derr, J., Wiley, S., Bishop, S., Manning-Courtney, P., Choo, D. I., & Murray, D. (2014). Autism spectrum disorders in 24 children who are deaf or hard of hearing. International Journal of Pediatric Otorhinolaryngology, 78, 112–118. https://doi.org/10.1016/j.ijporl.2013.10.065

    Article  PubMed  Google Scholar 

  • Miller, L. E., Perkins, K. A., Dai, Y. G., & Fein, D. A. (2017). Comparison of parent report and direct assessment of child skills in toddlers. Research in Autism Spectrum Disorders, 41–42, 57–65. https://doi.org/10.1016/j.rasd.2017.08.002

    Article  PubMed  PubMed Central  Google Scholar 

  • National Association of the Deaf. (2023). Community and Culture - Frequently Asked Questions. https://www.nad.org/resources/american-sign-language/community-and-culture-frequently-asked-questions/

  • Nordahl-Hansen, A., Kaale, A., & Ulvund, S. E. (2014). Language assessment in children with autism spectrum disorder: Concurrent validity between report-based assessments and direct tests. Research in Autism Spectrum Disorders, 8(9), 1100–1106. https://doi.org/10.1016/j.rasd.2014.05.017

    Article  Google Scholar 

  • Paul, R., Paatsch, L., Caselli, N., Garberoglio, C. Lou, Goldin-Meadow, S., & Lederberg, A. (2020). Current research in pragmatic language use among deaf and hard of hearing children. Pediatrics, 146. https://doi.org/10.1542/peds.2020-0242C

  • Phillips, H., Wright, B., Allgar, V., McConachie, H., Sweetman, J., Hargate, R., Hodkinson, R., Bland, M., George, H., Hughes, A., Hayward, E., De Las Heras, V. F. G., & Le Couteur, A. (2022). Adapting and validating the Autism Diagnostic Observation Schedule Version 2 for use with deaf children and young people. Journal of Autism and Developmental Disorders, 52(2), 553–568. https://doi.org/10.1007/s10803-021-04931-y

    Article  PubMed  Google Scholar 

  • Reynolds, C. R., Kamphaus, R. W., & Vannest, K. (2015). Behavior Assessment System for Children, 3rd Edition (BASC-3). Pearson.

  • Sanislow, C. A., Pine, D. S., Quinn, K. J., Kozak, M. J., Garvey, M. A., Heinssen, R. K., Wang, P.S.-E., & Cuthbert, B. N. (2010). Developing constructs for psychopathology research: Research domain criteria. Journal of Abnormal Psychology, 119(4), 631–639. https://doi.org/10.1037/a0020909

    Article  PubMed  Google Scholar 

  • Szarkowski, A., Mood, D., Shield, A., Wiley, S., & Yoshinaga-Itano, C. (2014). A Summary of current understanding regarding children with autism spectrum disorder who are deaf or hard of hearing. Seminars in Speech and Language, 35(4), 241–259. https://doi.org/10.1055/s-0034-1389097

    Article  PubMed  Google Scholar 

  • Szymanski, C. A., Brice, P. J., Lam, K. H., & Hotto, S. A. (2012). Deaf children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(10), 2027–2037. https://doi.org/10.1007/s10803-012-1452-9

    Article  PubMed  Google Scholar 

  • University of Wisconsin School of Medicine and Public Health. (2018). Area Deprivation Index v2.0. https://www.neighborhoodatlas.medicine.wisc.edu/

  • Walensky, R. P., Bunnell, R., Kent, C. K., Gottardy, A. J., Leahy, M. A., Martinroe, J. C., Spriggs, S. R., Yang, T., Doan, Q. M., King, P. H., Starr, T. M., Yang, M., Jones, T. F., Boulton, M. L., Carolyn Brooks, M., Virginia Caine, M. A., Fielding, J. E., David Fleming, M. W., Halperin, W. E., … Johnson, L. (2023). Morbidity and Mortality Weekly Report Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years-Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. MMWR Surveillance Summaries, 72(2), 1–14. https://doi.org/10.15585/mmwr.ss7202a1

  • Zhou, X., Reynolds, C., & Kamphaus, R. W. (2022). Diagnostic utility of Behavior Assessment System for Children-3 for children and adolescents with autism. Applied Neuropsychology: Child, 11(4), 647–651. https://doi.org/10.1080/21622965.2021.1929232

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to acknowledge Christine MacDonald, AuD, CCC-A, PASC, CH-AP for her contributions reviewing the audiological variables in this manuscript.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA, USA

    Arielle Spellun & Kate Linnea

  2. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Arielle Spellun

  3. Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, Boston Medical Center, Boston, MA, USA

    Arielle Spellun

  4. Department of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA

    Arielle Spellun

  5. Department of Otolaryngology and Communication Enhancement, Boston Children’s Hospital, Boston, MA, USA

    Megan Herlihy, Samantha Hasenbalg, Terrell Clark, Peter Isquith & Rachel Landsman

  6. School of Medicine, University of California San Francisco, San Franciso, California, USA

    Emily Taketa

  7. Department of Psychiatry, Boston Children’s Hospital, Boston, MA, USA

    Amber Graham

  8. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Amber Graham, Terrell Clark, Kate Linnea, Peter Isquith & Rachel Landsman

  9. Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Matthew Fasano-McCarron

  10. Boston Medical Center, Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, 801 Albany Street, 1st Floor, Boston, MA, 02119, USA

    Arielle Spellun

Authors
  1. Arielle Spellun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Megan Herlihy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Emily Taketa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amber Graham
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthew Fasano-McCarron
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Samantha Hasenbalg
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Terrell Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kate Linnea
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Peter Isquith
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Rachel Landsman
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Arielle Spellun, Megan Herlihy, Matthew Fasano-McCarron, Samantha Hasenbalg, Amber Graham, Kate Linnea, Emily Taketa, Peter Isquith, and Rachel Landsman. Data analysis was completed by Arielle Spellun, Matthew Fasano-McCarron and Emily Taketa. The first draft of the manuscript was written by Arielle Spellun and all authors read, contributed to, and approved the final manuscript.

Corresponding author

Correspondence to Arielle Spellun.

Ethics declarations

Conflict of Interests

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Spellun, A., Herlihy, M., Taketa, E. et al. Diagnostic Utility of Parent Ratings on the Behavior Assessment System for Children-Third Edition in Children who are Deaf and Hard of Hearing and Diagnosed with Autism Spectrum Disorder. Res Child Adolesc Psychopathol (2023). https://doi.org/10.1007/s10802-023-01115-3

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10802-023-01115-3

Keywords

search

Navigation