Autism severity, co-occurring psychopathology, and intellectual functioning predict supportive school services for youth with autism spectrum disorder

Abstract

Supportive school services are a primary service modality for youth with autism spectrum disorder. Autism spectrum disorder, as well as co-occurring psychiatric symptoms and low intellectual abilities, interfere with academic achievement and therefore influence decisions about school services. Therefore, we examined the association of parent, teacher, and clinician ratings of autism spectrum disorder and co-occurring psychiatric symptom severity and intellectual functioning with school services. In total, 283 youth with autism spectrum disorder were assessed with clinical evaluation via the Autism Diagnostic Observation Schedule and parent and teacher versions of the CASI-4R ( Child and Adolescent Symptom Inventory). Full Scale Intelligence Quotient scores were obtained from case records. Clinical and teacher evaluations of autism spectrum disorder severity predicted services and were more strongly associated with school services than parent ratings. Teacher ratings were only associated with common school services (e.g. speech/language therapy, occupational therapy, and/or social skills training) frequency at medium and high levels of clinician-rated autism spectrum disorder severity. Higher IQ and parent-rated externalizing symptoms predicted lower likelihood of receiving school services, whereas internalizing symptoms were not predictive of school services. Autism spectrum disorder symptoms may overshadow externalizing and internalizing symptoms when considering school service supports. Results highlight the importance of evaluating autism spectrum disorder severity via multiple sources, especially in cases of unclear symptom presentation, when examining correlates of school services for youth with autism spectrum disorder.

Atypical communication characteristics among clinic-referred youth with and without autism spectrum disorder: Stability and associations with clinical correlates

“…To date, only a few studies have examined psychiatric symptoms on the delivery of school-based services for youth with ASD. For example, co-occurring ADHD in youth with ASD either does not predict school-based services despite associations with a greater need for services (Narendorf, Shattuck, & Sterzing, 2011) or higher parent-rated externalizing symptoms predict lower likelihood of receiving school-based services (Rosen, Spaulding, Gates, & Lerner, 2019). This is in contrast to the current study, in which higher teacher-rated ADHD symptoms predicted higher rates of receiving special education.…”

Comorbid Psychopathology, Challenging Behavior, Sensory Issues, Adaptive Behavior and Quality of Life in Children and Adolescents with Autism Spectrum Disorder

“…32 Similar research also focused on ASD severity, co-occurring psychopathology, and intellectual functioning predicting supportive school services for youth with ASD. 33 This research discussed how greater ASD symptom severity necessitates more intensive and frequent school supports, in addition to ASD severity, co-occurring psychiatric symptoms and low intellectual functioning may also interfere with a student's academic progress. 33…”

“…33 This research discussed how greater ASD symptom severity necessitates more intensive and frequent school supports, in addition to ASD severity, co-occurring psychiatric symptoms and low intellectual functioning may also interfere with a student's academic progress. 33…”

Who gains and who loses? Sociodemographic disparities in access to special education services among autistic students

“…One study of a nationally representative sample found that over 80% of students served under autism eligibility in the school received services that were directly related to core autism‐related impairment (i.e., language and speech, occupational therapy, and behavior management services) (Wei et al, 2014). Studies including clinic‐referred samples have also reported language and speech and occupational therapy to be common school‐based special education services received by autistic students, however, sample acquisition and sociodemographic characteristics of the samples limit the generalizability of these findings to more diverse groups of students (McDonald et al, 2019; Rosen et al, 2019; Spaulding et al, 2017). The quantity and types of services received in schools by autistic students from underserved groups have yet to be explored.…”