Profiles of parent-teacher discrepancy on autistic children’s adaptive functioning

Clinical guidelines recommend collecting reports from multiple informants when identifying and diagnosing challenges in children. The current study examined parent–teacher discrepancies in rating of autistic children’s adaptive functioning and how these related to children’s executive functions. Participants (n = 194) were a subsample of autistic children (mean age = 9.2 years; 86% male) from the Pathways in ASD cohort. We used latent profile analysis to characterise profiles based on both parent and teacher reports of adaptive functioning levels. We tested links between these profiles and indices of children’s executive function and other clinical correlates. Four profiles were characterised: a lower adaptive functioning-parent higher profile, in which parents reported relatively higher scores than teachers (n = 45), an intermediate adaptive functioning profile (n = 70) and a higher adaptive functioning profile (n = 39; both characterised by similar ratings between informants) and finally, a higher adaptive functioning-teacher higher profile, in which teachers reported relatively higher scores than parents (n = 40). The higher adaptive functioning-teacher higher profile showed fewer teacher-rated executive function challenges and higher IQ compared to the other profiles. Characterising profiles facilitates interpretation of informant discrepancies and identification of clinical correlates to inform clinical decision-making.

Lay abstract:
Clinicians are advised to collect reports from multiple informants (e.g., parents and teachers), when making assessments about the wellbeing of autistic children. Parents and teachers observe children in different environments (home vs. school); therefore, collecting both reports can give a fuller account of a child’s strengths and challenges. In this investigation, we looked at parent and teacher reports of autistic children’s adaptive functioning, an important body of skills necessary for children to navigate daily life including practical, communication and conceptual skills. Currently, we know little about child characteristics associated with informant discrepancies, which means that it is a challenge to identify which children are most likely to display behaviour differently across contexts. We grouped n = 194 children based on the level of adaptive functioning reported by both their parent and teachers, and we compared the groups on key characteristics. We identified four groups: a lower adaptive functioning group with higher parent scores (n = 45), an intermediate group with similar scores from both informants (n = 70), a higher adaptive functioning group with similar scores from both informants (n = 39) and a higher adaptive functioning group with higher teacher scores (n = 40). Our findings indicate that many children display adaptive functioning skills differently across contexts, across levels of adaptive functioning skills. We found that children across groups differed on IQ, autistic traits and teacher-rated executive functioning. These findings can help clinicians identify and evaluate autistic children that might be likely to demonstrate different adaptive functioning skills in different environments, which could help with assessment and treatment planning.