Agreement between mother, father, and teacher ratings of cognitive disengagement syndrome (sluggish cognitive tempo) in children with autism and children with ADHD.

Abstract

No studies have analyzed differences between mother, father, and teacher ratings of cognitive disengagement syndrome (CDS; formerly sluggish cognitive tempo). The sample included 1,115 children with autism and/or attention-deficit/hyperactivity disorder (ADHD) 4-16 years of age who were rated by mothers on the Pediatric Behavior Scale. Subsets of these children were also rated by fathers and/or teachers, resulting in 896 mother/father, 964 mother/teacher, and 745 father/teacher dyads. The CDS factor comprised four items assessing the core features of CDS: cognitive disengagement (in a fog/confused and stares/preoccupied/in own world) and hypoactivity (sluggish/slow moving/low energy and drowsy/sleepy/not alert). Overall, 37% of teachers, 22% of mothers, and 16% of fathers rated the children as significantly elevated on CDS symptoms. Teacher scores were significantly higher than mother scores, whose scores exceeded those of fathers. Agreement on whether a child had CDS was fairmoderate for mothers and fathers but poor for parents and teachers. Findings of more severe CDS teacher than parent ratings are in marked contrast to the opposite pattern found in studies of anxiety, depression, ADHD, oppositional behavior, conduct problems, autism, bullying, and victimization. Children may display fewer behavior problems at school than at home, and parents may be more aware of their child's internal state than teachers. However, teachers may be more aware of the cognitive component of CDS that might interfere with functioning in the classroom more so than at home. Cognitive demands in school may reveal and intensify CDS symptoms. Findings highlight the importance of multi-informant ratings in research and clinical practice. Public Significance StatementCognitive disengagement syndrome (CDS; formerly sluggish cognitive tempo) has two dimensions: cognitive disengagement (blank staring, daydreaming, in a fog) and hypoactivity (underactive, slow moving, lethargic, and drowsy). Teachers rated children with ADHD and autism as having more severe CDS symptoms than did parents (which is the opposite pattern found for behavior problems, anxiety, and depression), highlighting the importance of obtaining multi-informant ratings in research and clinical practice.

Cognitive Disengagement Syndrome–Clinical Interview (CDS-CI): Psychometric support for caregiver and youth versions.

“…Second, although our study used two methods for assessing CDS symptoms (rating scales and clinical interviews), both methods are based on self-reported information, and no procedures were used for possible response bias or atypical/random responding. Third, the only external validity examined in the present study was broad functional impairment, and it will be important to examine CDS-CI scores in relation to specific domains of functioning, including in the school context (e.g., Mayes et al, 2023). Fourth, only cross-sectional data were available in the present study, precluding determining any temporal associations.…”