Abstract
Current research on children’s autistic traits in the general population relies predominantly on caregiver-report, yet the extent to which individual, caregiver or demographic characteristics are associated with informants’ ratings has not been sufficiently explored. In this study, caregivers of 396 Singaporean two-year-olds from a birth cohort study completed the Quantitative Checklist for Autism in Toddlers. Children’s gender, cognitive functioning and birth order, maternal age, and ethnic group membership were not significant predictors of caregiver-reported autistic traits. Poorer child language development and higher maternal depressive symptoms significantly predicted more social-communicative autistic traits, while lower maternal education predicted more behavioural autistic traits. Children’s language and informants’ educational level and depressive symptomatology may need to be considered in caregiver-reports of autistic traits.
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Notes
A number of researchers, clinicians and advocates prefer the use of the term Condition (autism spectrum condition; ASC) instead of disorder (ASD), as it is a less stigmatizing term. We advocate for the use of this term too, but have used the term ASD in this paper to be consistent with most existing literature and the DSM-5.
These include the Quantitative Checklist for Autism in Toddlers (Q-CHAT; Allison et al. 2008); the Autism Spectrum Quotient—Child (AQ-Child; Auyeung et al. 2008), Adolescent (AQ-Adol; Baron-Cohen et al. 2006) and Adult Versions (AQ; Baron-Cohen et al. 2001); the Social and Communication Disorders Checklist (SCDC; Skuse et al. 2005), the Social Communication Questionnaire (SCQ; Berument et al. 1999), the Social Responsiveness Scale-2 (SRS-2; Constantino 2012) and the Childhood Autism Spectrum Test (CAST; Scott et al. 2002).
Inclusion into the GUSTO Neurodevelopment cohort was prioritized for families who were willing to participate in regular assessments during centre and home visits.
Pregnancies that ended in miscarriage, mothers with Type I diabetes mellitus or those receiving chemotherapy or on psychotropic medication were not included.
The population of Singapore consists of 74.3% ethnically Chinese, 13.4% Malay and 9.1% Indians (Department of Statistics Singapore 2016), and as such Malay and Indian participants were over-sampled in the GUSTO study.
Example items include: “How easy is it for you to get eye contact with your child?”; “If you or someone else in the family is visibly upset, does your child show signs of wanting to comfort them (e.g. stroking their hair, hugging them)?”; and “Does your child do the same thing over and over again (e.g. running the tap, turning the light switch on and off, opening and closing doors)?”.
Singapore population comprises approximately 74.3% Chinese, 13.4% Malay and 9.1% Indian, according to the Department of Statistics Singapore (2016); thus, the reference group is Chinese.
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Acknowledgments
We would also like to acknowledge all members of the GUSTO study group for their contributions. The GUSTO study group includes Pratibha Agarwal, Arijit Biswas, Choon Looi Bong, Birit FP Broekman, Shirong Cai, Jerry Kok Yen Chan, Yiong Huak Chan, Cornelia Yin Ing Chee, Helen Y. H Chen, Yin Bun Cheung, Audrey Chia, Amutha Chinnadurai, Chai Kiat Chng, Mary Foong-Fong Chong, Yap-Seng Chong, Shang Chee Chong, Mei Chien Chua, Chun Ming Ding, Eric Andrew Finkelstein, Doris Fok, Marielle Fortier, Peter D. Gluckman, Keith M. Godfrey, Anne Eng Neo Goh, Yam Thiam Daniel Goh, Joshua J. Gooley, Wee Meng Han, Mark Hanson, Christiani Jeyakumar Henry, Joanna D. Holbrook, Chin-Ying Hsu, Hazel Inskip, Jeevesh Kapur, Kenneth Kwek, Ivy Yee-Man Lau, Bee Wah Lee, Yung Seng Lee, Ngee Lek, Sok Bee Lim, Yen-Ling Low, Iliana Magiati, Lourdes Mary Daniel, Michael Meaney, Cheryl Ngo, Krishnamoorthy Naiduvaje, Wei Wei Pang, Anqi Qiu, Boon Long Quah, Victor Samuel Rajadurai, Mary Rauff, Salome A. Rebello, Jenny L. Richmond, Anne Rifkin-Graboi, Seang-Mei Saw, Lynette Pei-Chi Shek, Allan Sheppard, Borys Shuter, Leher Singh, Shu-E Soh, Walter Stunkel, Lin Lin Su, Kok Hian Tan, Oon Hoe Teoh, Mya Thway Tint, Hugo P S van Bever, Rob M. van Dam, Inez Bik Yun Wong, P. C. Wong, Fabian Yap, George Seow Heong Yeo.
Funding
This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore—NMRC/TCR/004-NUS/2008 and NMRC/TCR/012-NUHS/2014. Additional funding was provided by the Ministry of Education AcRF Tier 1 funding grant R581000130112 awarded to the corresponding/senior author and Singapore Institute for Clinical Sciences—A*STAR. We are grateful to all research and admin staff of the GUSTO study for their work, support and contribution towards data collection and to all caregivers and children involved in this longitudinal study.
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DAG led the analyses and writing up of this manuscript, with contributions from DG and JK; IM conceptualized the study and oversaw all aspects of the research process from data collection and cleaning to analysis and writing up; SB and CA provided expert consultation on aspects relating to the use of the measure examined in the present study which they developed and provided specialist input in the analyses and writing up of the project. All other co-authors contributed to overseeing various aspects of the data collection of the different measures employed in this study as part of their involvement in the larger GUSTO study, and in providing input and feedback in the analyses and writing up of the present study. All authors contributed to the writing up and editing of the manuscript and all approved its final version for submission to the journal for publication.
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The fourth and fifth authors are the developers of the measure investigated in the present study (the Q-CHAT), however the measure is freely available and non-copyrighted and therefore the authors have no financial interests stemming from this research study. The other authors report no conflicts of interest.
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All procedures performed in this study which involved human participants were in accordance with the ethical standards of the institutional research board. Ethical approval for the larger study, within which this study was embedded, was provided by the Singhealth Centralized Institutional Review Board (CIRB) and the National Healthcare Group Domain Specific Review Board (DSRB), and was approved by the National University of Singapore. Informed consent were obtained from all participants at recruitment. There was no obligation to take part in the study and participants could withdraw at any point without their standard medical care being affected in any way.
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Goh, D.A., Gan, D., Kung, J. et al. Child, Maternal and Demographic Factors Influencing Caregiver-Reported Autistic Trait Symptomatology in Toddlers. J Autism Dev Disord 48, 1325–1337 (2018). https://doi.org/10.1007/s10803-018-3471-7
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DOI: https://doi.org/10.1007/s10803-018-3471-7