High Concordance of Parent and Teacher Attention-Deficit/Hyperactivity Disorder Ratings in Medicated and Unmedicated Children with Autism Spectrum Disorders
High Concordance of Parent and Teacher Attention-Deficit/Hyperactivity Disorder Ratings in Medicated and Unmedicated Children with Autism Spectrum Disorders
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DOI：
10.1089/cap.2011.0067
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发表时间：
2012-08-01
影响因子：
1.9
通讯作者：
Cleveland, Lynne A.
中科院分区：
文献类型：
--
作者：
Pearson, Deborah A.;Aman, Michael G.;Cleveland, Lynne A.
目的：比较自闭症谱系障碍（ASD）儿童的核心注意缺陷/多动障碍（ADHD）症状以及与ADHD共病的行为和情绪问题的家长和教师评分。方法：86名儿童（66名男孩，平均年龄9.3岁，智商[IQ] = 84）符合美国精神病学协会精神障碍诊断与统计手册第4版（DSM-IV）自闭症诊断访谈-修订版（ADI-R）和自闭症诊断观察表（ADOS）的ASD标准。采用康纳斯家长与教师评定量表（CPRS-R; crs - r）比较家长与教师的行为评定。年龄、ASD亚型、自闭症症状的严重程度和用药状况在多大程度上介导了这种关系。结果：家长和老师评分之间的显著正相关表明，家长和老师对孩子的核心ADHD症状以及密切相关的外化症状的感知是相似的。除对立行为外，年龄、性别、ASD亚型或自闭症严重程度对家长和教师评价之间的关系没有显著影响。一般来说，家长认为孩子的症状比老师更严重。无论是接受药物治疗的孩子还是没有接受药物治疗的孩子，家长和老师的评分模式都是高度相关的。结论：家长和老师对ADHD核心症状和与其密切相关的外化问题的认知方式相似，但对内化问题（如焦虑）的评分却不太一致。这些发现的临床意义在于父母和老师都提供了关于自闭症儿童的重要行为信息。然而，当临床医生无法获得教师评分时（例如，在学校假期期间），家长评分可以提供对儿童在学校这些领域功能的合理估计。因此，家长评分可以可靠地用于asd患儿ADHD症状的初步诊断和治疗决策（如药物治疗）。
Objective: Parent and teacher ratings of core attention-deficit/hyperactivity disorder (ADHD) symptoms, as well as behavioral and emotional problems commonly comorbid with ADHD, were compared in children with autism spectrum disorders (ASD).Method: Participants were 86 children (66 boys; mean: age = 9.3 years, intelligence quotient [IQ] = 84) who met American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for an ASD on the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). Parent and teacher behavioral ratings were compared on the Conners' Parent and Teacher Rating Scales (CPRS-R; CTRS-R). The degree to which age, ASD subtype, severity of autistic symptomatology, and medication status mediated this relationship was also examined.Results: Significant positive correlations between parent and teacher ratings suggest that a child's core ADHD symptoms-as well as closely related externalizing symptoms-are perceived similarly by parents and teachers. With the exception of oppositional behavior, there was no significant effect of age, gender, ASD subtype, or autism severity on the relationship between parent and teacher ratings. In general, parents rated children as having more severe symptomatology than did teachers. Patterns of parent and teacher ratings were highly correlated, both for children who were receiving medication, and for children who were not.Conclusions: Parents and teachers perceived core symptoms of ADHD and closely-related externalizing problems in a similar manner, but there is less agreement on ratings of internalizing problems (e.g., anxiety). The clinical implication of these findings is that both parents and teachers provide important behavioral information about children with ASD. However, when a clinician is unable to access teacher ratings (e.g., during school vacations), parent ratings can provide a reasonable estimate of the child's functioning in these domains in school. As such, parent ratings can be reliably used to make initial diagnostic and treatment decisions (e.g., medication treatment) regarding ADHD symptoms in children with ASDs.