The Broader Autism Phenotype in Mothers is Associated with Increased Discordance Between Maternal-Reported and Clinician-Observed Instruments that Measure Child Autism Spectrum Disorder
- 340 Downloads
Autism spectrum disorder (ASD) diagnosis relies on parent-reported and clinician-observed instruments. Sometimes, results between these instruments disagree. The broader autism phenotype (BAP) in parent-reporters may be associated with discordance. Study to Explore Early Development data (N = 712) were used to address whether mothers with BAP and children with ASD or non-ASD developmental disabilities were more likely than mothers without BAP to ‘over-’ or ‘under-report’ child ASD on ASD screeners or interviews compared with clinician observation or overall impression. Maternal BAP was associated with a child meeting thresholds on a maternal-reported screener or maternal interview when clinician ASD instruments or impressions did not (risk ratios: 1.30 to 2.85). Evidence suggests acknowledging and accounting for reporting discordances may be important when diagnosing ASD.
KeywordsAutism Diagnostic Interview-Revised Autism Diagnostic Observation Schedule Autism spectrum disorder Broader autism phenotype Instrument discordance
We would like to thank the families and children who participated in this research. Additionally, we would like to thank SEED principal investigators, co-investigators, project coordinators, and project staff. This work was funded by Autism Speaks Predoctoral Weatherstone Fellowship Grant 10052 and six cooperative agreements from the Centers for Disease Control and Prevention: Cooperative Agreement Number U10DD000180, Colorado Department of Public Health; Cooperative Agreement Number U10DD000181, Kaiser Foundation Research Institute (CA); Cooperative Agreement Number U10DD000182, University of Pennsylvania; Cooperative Agreement Number U10DD000183, Johns Hopkins University; Cooperative Agreement Number U10DD000184, University of North Carolina at Chapel Hill; and Cooperative Agreement Number U10DD000498, Michigan State University. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. This work was presented at the 2017 International Meeting for Autism Research in San Francisco, California and was part of Dr. Rubenstein’s doctoral dissertation.
ER conceived, designed, analyzed, wrote, and edited the manuscript. RE, LA, LW, CD, GW, and LY aided in study design, editing, and reviewing the manuscript. AO, BP, AH, and consulted on methods and edited and reviewed the manuscript. JD contributed in formulating the research question, study design, writing and editing the manuscript.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Bishop, D. V. M., Maybery, M., Maley, A., Wong, D., Hill, W., & Hallmayer, J. (2004a). Using self-report to identify the broad phenotype in parents of children with autistic spectrum disorders: A study using the Autism-Spectrum Quotient. Journal of Child Psychology and Psychiatry and Allied Disciplines, 45(8), 1431–1436. doi: 10.1111/j.1469-7610.2004.00325.x.CrossRefGoogle Scholar
- Bora, E., Aydin, A., Sarac, T., Kadak, M. T., & Kose, S. (2016). Heterogeneity of subclinical autistic traits among parents of children with autism spectrum disorder: Identifying the broader autism phenotype with a data-driven method. Autism Research, 10(2), 321–326. doi: 10.1002/aur.1661.CrossRefPubMedGoogle Scholar
- Constantino, J. N. (2002). Social Responsiveness Scale. Los Angeles, CA: Western Psychological Services.Google Scholar
- Constantino, J. N., & Gruber, C. P. (2012). Social Responsiveness Scale (2nd edn). Los Angeles: Western Psychological Services.Google Scholar
- Crocetti, E., Moscatelli, S., Van der Graaff, J., Keijsers, L., van Lier, P., Koot, H. M., et al. (2016). The dynamic interplay among maternal empathy, quality of mother-adolescent relationship, and adolescent antisocial behaviors: new insights from a six-wave longitudinal multi-informant study. PloS ONE, 11(3), e0150009. doi: 10.1371/journal.pone.0150009.CrossRefPubMedPubMedCentralGoogle Scholar
- de Bildt, A., Sytema, S., Ketelaars, C., Kraijer, D., Mulder, E., Volkmar, F., et al. (2004). Interrelationship between autism diagnostic observation schedule-generic (ADOS-G), autism diagnostic interview-revised (ADI-R), and the diagnostic and statistical manual of mental disorders (DSM-IV-TR) classification in children and adolescents with mental retardation. Journal of Autism and Developmental Disorders, 34(2), 129–137. doi: 10.1023/B:JADD.0000022604.22374.5f.CrossRefPubMedGoogle Scholar
- de Jonge, M., Parr, J., Rutter, M., Wallace, S., Kemner, C., Bailey, A., et al. (2015). New interview and observation measures of the broader autism phenotype: group differentiation. Journal of Autism and Developmental Disorders, 45(4), 893–901. doi: 10.1007/s10803-014-2230-7.CrossRefPubMedGoogle Scholar
- De la Marche, W., Noens, I., Kuppens, S., Spilt, J. L., Boets, B., & Steyaert, J. (2015). Measuring quantitative autism traits in families: Informant effect or intergenerational transmission? European Child and Adolescent Psychiatry, 24(4), 385–395. doi: 10.1007/s00787-014-0586-z.CrossRefPubMedGoogle Scholar
- De Los Reyes, A., & Kazdin, A. E. (2008). When the evidence says, “Yes, no, and maybe so”: attending to and interpreting inconsistent findings among evidence-based interventions. Current Directions in Psychological Science, 17(1), 47–51. doi: 10.1111/j.1467-8721.2008.00546.x.CrossRefPubMedPubMedCentralGoogle Scholar
- De Los Reyes, A., Youngstrom, E. A., Pabon, S. C., Youngstrom, J. K., Feeny, N. C., & Findling, R. L. (2011). Internal consistency and associated characteristics of informant discrepancies in clinic referred youths age 11 to 17 years. Journal of Clinical Child and Adolescent Psychology, 40(1), 36–53. doi: 10.1080/15374416.2011.533402.CrossRefPubMedPubMedCentralGoogle Scholar
- Derguy, C., M’Bailara, K., Michel, G., Roux, S., & Bouvard, M. (2016). The need for an ecological approach to parental stress in autism spectrum disorders: the combined role of individual and environmental factors. Journal of Autism and Developmental Disorders, 46(6), 1895–1905. doi: 10.1007/s10803-016-2719-3.CrossRefPubMedGoogle Scholar
- Gartstein, M. A., Bridgett, D. J., Dishion, T. J., & Kaufman, N. K. (2009). Depressed mood and maternal report of child behavior problems: Another look at the depression-distortion hypothesis. Journal of Applied Developmental Psychology, 30(2), 149–160. doi: 10.1016/j.appdev.2008.12.001.CrossRefPubMedPubMedCentralGoogle Scholar
- Heun, R., Muller, H., & Papassotiropoulos, A. (1998). Differential validity of informant-based diagnoses of dementia and depression in index subjects and in their first-degree relatives. Social Psychiatry and Psychiatric Epidemiology, 33(10), 510–513. doi: 10.1007/S001270050087.CrossRefPubMedGoogle Scholar
- Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of Autism and Developmental Disorders, 43(2), 371–381. doi: 10.1007/s10803-012-1576-y.CrossRefPubMedPubMedCentralGoogle Scholar
- Ingersoll, B., & Hambrick, D. Z. (2011). The relationship between the broader autism phenotype, child severity, and stress and depression in parents of children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 337–344. doi: 10.1016/j.rasd.2010.04.017.CrossRefGoogle Scholar
- Ingersoll, B., Hopwood, C. J., Wainer, A., & Brent Donnellan, M. (2011a). A comparison of three self-report measures of the broader autism phenotype in a non-clinical sample. Journal of Autism and Developmental Disorders, 41(12), 1646–1657. doi: 10.1007/s10803-011-1192-2.CrossRefPubMedGoogle Scholar
- Jones, R. M., Risi, S., Wexler, D., Anderson, D., Corsello, C., Pickles, A., et al. (2015). How interview questions are placed in time influences caregiver description of social communication symptoms on the ADI-R. Journal of Child Psychology and Psychiatry and Allied Disciplines, 56(5), 577–585. doi: 10.1111/jcpp.12325.CrossRefGoogle Scholar
- Le Couteur, A., Haden, G., Hammal, D., & McConachie, H. (2008). Diagnosing autism spectrum disorders in pre-school children using two standardised assessment instruments: the ADI-R and the ADOS. Journal of Autism and Developmental Disorders, 38(2), 362–372. doi: 10.1007/s10803-007-0403-3.CrossRefPubMedGoogle Scholar
- Lerner, M. D., Calhoun, C. D., Mikami, A. Y., & De Los Reyes, A. (2012). Understanding parent-child social informant discrepancy in youth with high functioning autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(12), 2680–2692. doi: 10.1007/s10803-012-1525-9.CrossRefPubMedGoogle Scholar
- Lord, C., Risi, S., Lambrecht, L., Cook, E. H. Jr., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223. doi: 10.1023/A:1005592401947.CrossRefPubMedGoogle Scholar
- Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (2012). Autism Diagnostic Observation Schedule (2nd edn.). Los Angeles: Western Psychological Services.Google Scholar
- Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685. doi: 10.1007/BF02172145.CrossRefPubMedGoogle Scholar
- Lyall, K., Constantino, J. N., Weisskopf, M. G., Roberts, A. L., Ascherio, A., & Santangelo, S. L. (2014). Parental social responsiveness and risk of autism spectrum disorder in offspring. JAMA Psychiatry, 71(8), 936–942. doi: 10.1001/jamapsychiatry.2014.476.CrossRefPubMedPubMedCentralGoogle Scholar
- Mikami, A. Y., Calhoun, C. D., & Abikoff, H. B. (2010). Positive illusory bias and response to behavioral treatment among children with attention-deficit/hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 39(3), 373–385. doi: 10.1080/15374411003691735.CrossRefPubMedGoogle Scholar
- Mullen, E. (1995). Mullen scales of early learning. San Antonio, TX: Pearson.Google Scholar
- Muller, J. M., Achtergarde, S., & Furniss, T. (2011). The influence of maternal psychopathology on ratings of child psychiatric symptoms: An SEM analysis on cross-informant agreement. European Child and Adolescent Psychiatry, 20(5), 241–252. doi: 10.1007/s00787-011-0168-2.CrossRefPubMedGoogle Scholar
- Nishiyama, T., Suzuki, M., Adachi, K., Sumi, S., Okada, K., Kishino, H., et al. (2014). Comprehensive comparison of self-administered questionnaires for measuring quantitative autistic traits in adults. Journal of Autism and Developmental Disorders, 44(5), 993–1007. doi: 10.1007/s10803-013-2020-7.CrossRefPubMedGoogle Scholar
- Noterdaeme, M., Mildenberger, K., Sitter, S., & Amorosa, H. (2002). Parent information and direct observation in the diagnosis of pervasive and specific developmental disorders. Autism: the international journal of research and practice, 6(2), 159–168. doi: 10.1177/1362361302006002003.CrossRefGoogle Scholar
- Pereira, A. I., Muris, P., Barros, L., Goes, R., Marques, T., & Russo, V. (2015). Agreement and discrepancy between mother and child in the evaluation of children’s anxiety symptoms and anxiety life interference. European Child and Adolescent Psychiatry, 24(3), 327–337. doi: 10.1007/s00787-014-0583-2.CrossRefPubMedGoogle Scholar
- Ringoot, A. P., Tiemeier, H., Jaddoe, V. W., So, P., Hofman, A., Verhulst, F. C., et al. (2015). Parental depression and child well-being: young children’s self-reports helped addressing biases in parent reports. Journal of Clinical Epidemiology, 68(8), 928–938. doi: 10.1016/j.jclinepi.2015.03.009.CrossRefPubMedGoogle Scholar
- Rothen, S., Vandeleur, C. L., Lustenberger, Y., Jeanpretre, N., Ayer, E., Gamma, F., et al. (2009). Parent-child agreement and prevalence estimates of diagnoses in childhood: Direct interview versus family history method. International Journal of Methods in Psychiatric Research, 18(2), 96–109. doi: 10.1002/mpr.281.CrossRefPubMedGoogle Scholar
- Ruta, L., Mazzone, D., Mazzone, L., Wheelwright, S., & Baron-Cohen, S. (2012). The Autism-Spectrum Quotient–Italian version: A cross-cultural confirmation of the broader autism phenotype. Journal of Autism and Developmental Disorders, 42(4), 625–633. doi: 10.1007/s10803-011-1290-1.CrossRefPubMedGoogle Scholar
- Rutter, M., Bailey, A., & Lord, C. (2003a). SCQ: Social Communication Questionnaire. Los Angeles, CA: Western Psychological Services.Google Scholar
- Rutter, M., Le Couteur, A., & Lord, C. (2003b). ADI-R: The Autism diagnostic interview-revised. Los Angeles: Western Psychological Services.Google Scholar
- Schendel, D. E., Diguiseppi, C., Croen, L. A., Fallin, M. D., Reed, P. L., Schieve, L. A., et al. (2012). The Study to Explore Early Development (SEED): A multisite epidemiologic study of autism by the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) network. Journal of Autism and Developmental Disorders, 42(10), 2121–2140. doi: 10.1007/s10803-012-1461-8.CrossRefPubMedPubMedCentralGoogle Scholar
- Shi, L. J., Ou, J. J., Gong, J. B., Wang, S. H., Zhou, Y. Y., Zhu, F. R., et al. (2015). Broad autism phenotype features of Chinese parents with autistic children and their associations with severity of social impairment in probands. BMC Psychiatry, 15, 168. doi: 10.1186/s12888-015-0568-9.CrossRefPubMedPubMedCentralGoogle Scholar
- Szatmari, P., MacLean, J. E., Jones, M. B., Bryson, S. E., Zwaigenbaum, L., Bartolucci, G., et al. (2000). The familial aggregation of the lesser variant in biological and nonbiological relatives of PDD probands: a family history study. Journal of Child Psychology and Psychiatry and Allied Disciplines, 41(5), 579–586.CrossRefGoogle Scholar
- The Ohio State University (OSU) Research Unit on Pediatric Psychopharmacology. (2005). OSU Autism Rating Scale (OARS; adapted for SEED) a Clinical Global Impression (CGI; adapted for SEED). Retrieved August 30, 2010, from http://psychmed.osu.edu/resources.htm.
- Vandeleur, C. L., Rothen, S., Lustenberger, Y., Glaus, J., Castelao, E., & Preisig, M. (2015). Inter-informant agreement and prevalence estimates for mood syndromes: Direct interview vs. family history method. Journal of Affective Disorders, 171, 120–127. doi: 10.1016/j.jad.2014.08.048.CrossRefPubMedGoogle Scholar
- Ventola, P. E., Kleinman, J., Pandey, J., Barton, M., Allen, S., Green, J., et al. (2006). Agreement among four diagnostic instruments for autism spectrum disorders in toddlers. Journal of Autism and Developmental Disorders, 36(7), 839–847. doi: 10.1007/s10803-006-0128-8.CrossRefPubMedGoogle Scholar
- Westman Andersson, G., Miniscalco, C., Johansson, U., & Gillberg, C. (2013). Autism in toddlers: Can observation in preschool yield the same information as autism assessment in a specialised clinic? The Scientific World Journal, 2013, 384745. doi: 10.1155/2013/384745.PubMedPubMedCentralGoogle Scholar
- Wiggins, L. D., Bakeman, R., Adamson, L. B., & Robins, D. L. (2007). The utility of the Social Communication Questionnaire in screening for autism in children referred for early intervention. Focus on Autism and Other Developmental Disabilities, 22(1), 33–38. doi: 10.1177/10883576070220010401.CrossRefGoogle Scholar
- Wiggins, L. D., Reynolds, A., Rice, C. E., Moody, E. J., Bernal, P., Blaskey, L., et al. (2015). Using standardized diagnostic instruments to classify children with autism in the study to explore early development. Journal of Autism and Developmental Disorders, 45(5), 1271–1280. doi: 10.1007/s10803-014-2287-3.CrossRefPubMedPubMedCentralGoogle Scholar