Selected Abstracts From the 2019 APSARD Annual Meeting

Objective: To assess the relationship between ADHD and performance of household chores. Method: A 72-question online questionnaire was developed to collect demographic/clinical information as well as parents’ assessment of their child’s performance of self-care (SC) and family-care (FC) chores. Results: The sample consists of 797 primary caregivers of children with ADHD. The overwhelming majority of parents believed that ADHD to some extent affected their child’s ability to independently and satisfactorily complete SC and FC chores. An inverse relationship was noted between parent ratings of a child’s ability to do chores independently and satisfactorily and the likelihood they believed ADHD affected chore performance. There was no difference in chore performance between children with or without co-morbid oppositional defiant disorder. Conclusion: Given that household routines, including chores, play an important role in children’s development and psychosocial adjustment, clinicians must be sensitive to the adverse impact that ADHD may have in this regard.

Infants' attention to eyes is an independent, heritable trait predicting later verbal competence

From birth, infants orient preferentially to faces, and when looking at the face, they attend primarily to eyes and mouth — two areas that convey different types of information. Here, in a sample of 535 5-month-old infant twins, we assessed eye (relative to mouth) preference in early infancy. Eye preference was independent from all other concurrent traits measured, and had a moderate-to-high contribution from genetic influences (A = .57; 95% CI: .45, .66). Preference for eyes over mouth at 5 months predicted higher parent ratings of verbal competence in toddlerhood, but did not predict autistic traits. These results suggest that variation in eye looking reflects a type of biological niche picking emerging before infants can select their environments by other means (crawling or walking).

A-155 The Relationship between Parent-Reported Inattention Symptoms and Intra-Individual Variability in Neuropsychological Performance in Male Children and Adolescents

Objective While previous research has demonstrated that males show greater intra-individual variability (IIV) in neuropsychological performance than females (Roalf et al., 2014), previous studies have not investigated how IIV relates to psychological factors in each gender. This study examined the relationship between psychological symptoms (i.e., depression, anxiety and inattention) and IIV in male and female pediatric samples. Method Participants included 135 male and 210 female individuals between the ages of 6 and 17 from Nathan Kline Institute’s Rockland Project. Participants endorsing a medical diagnosis associated with cognitive impairment (e.g., brain injury; n = 19) were excluded. The four psychological variables included T-scores from the Children’s Depression Inventory (CDI) total to measure depression, the Multidimensional Anxiety Scale for Children (MASC) to measure anxiety, Conners ADHD Rating Scale - Parent to measure parent-ratings of inattention, and the Conners ADHD Rating Scale – Youth to measure self-rated inattention. IIV scores for accuracy were calculated from 10 subtests from the Penn Computerized Neurocognitive Battery. Results In male participants, a regression analysis predicting IIV accuracy scores revealed that the four psychological variables together accounted for 7% of the variance in IIV accuracy scores. Conners Parent Inattention T-scores significantly predicted IIV accuracy scores in males (β = 0.19, p 0.16). In an analogous regression analysis with female participants, psychological symptoms did not significantly predict IIV accuracy scores. Conclusions Results indicated that inattention reported by parents predicted IIV accuracy for male children and adolescents in a community sample.

Diagnostic efficiency and validity of the DSM-oriented Child Behavior Checklist and Youth Self-Report scales in a clinical sample of Swedish youth

The Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) are widely used measures of psychiatric symptoms and lately also adapted to the DSM. The incremental validity of adding the scales to each other has not been studied. We validated the DSM subscales for affective, anxiety, attention deficit/hyperactivity (ADHD), oppositional defiant (ODD), conduct problems (CD), and obsessive-compulsive disorder (OCD) in consecutively referred child and adolescent psychiatric outpatients (n = 267) against LEAD DSM-IV diagnoses based on the K-SADS-PL and subsequent clinical work-up. Receiver operating characteristic analyses showed that the diagnostic efficiency for most scales were moderate with an area under the curve (AUC) between 0.70 and 0.90 except for CBCL CD, which had high accuracy (AUC>0.90) in line with previous studies showing the acceptable utility of the CBCL DSM scales and the YSR affective, anxiety, and CD scales, while YSR ODD and OCD had low accuracy (AUC<0.70). The findings mostly reveal incremental validity (using logistic regression analyses) for adding the adolescent to the parent version (or vice versa). Youth and parent ratings contributed equally to predict depression and anxiety disorders, while parent ratings were a stronger predictor for ADHD. However, the youth ADHD rating also contributed. Adding young people as informants for ODD and OCD or adding the parent for CD did not improve accuracy. The findings for depression, anxiety disorders, and ADHD support using more than one informant when conducting screening in a clinical context.

The roles of attachment style and maternal depression in the development of childhood depression

This study aimed to determine how stable parent ratings of their infant's temperament/attachment style is across one year of development and establish if there is a specific pathway that leads to child depression and or internalizing and externalizing behaviors originating with maternal depression or insecure attachment styles between the infant and their mothers. The data for this study was collected as part of a multisite, randomized trial of Hawaii's Healthy Start Program (HSP) (Duggan et al., 2004). The Hawaii Healthy Start Program (HSP) is a home visiting program targeted at families at-risk of child abuse and neglect. The racial and ethnic characteristics for total participants are as follows: 12 percent identified as White, 9 percent identified as Asian, 13 percent identified as Pacific Islander, 20 percent identified as Filipino, 20 percent identified as Native Hawaiian, 27 percent identified as Black/ Multiracial (Duggan et al. 1999). The mean age for participating mothers was 23.4 (SD = 5.8) and 68 percent of the families had incomes belopoverty line (Duggan et al., 1999). The following measures were used in the present study: The Bate's Attachment Scale, The Center for Epidemiological Studies Depression Scale (CES-D), The Child Behavioral Checklist (CBCL), and The Children's Depression Inventory (CDI). Unlike the majority of literature, the present findings suggest that maternal depression and attachment issues during the first year of life served as only a very modest risk for future child internalizing symptoms. Similar to the findings regarding child depression, relations between parent and teacher rated externalizing symptoms, maternal depression, and attachment were fairly small. Only for parent rated externalizing symptoms there was a small association between externalizing score and maternal depression and a small association between parent rating of externalizing behaviors and parent ratings of child attachment. Keywords: child depression, child externalizing behaviors, maternal depression

The Impact of Bilingualism on Everyday Executive Functions of English-Arabic Autistic Children: Through a Parent-Teacher Lens

There is evidence that autistic children may have reduced executive function skills, contributing to day-to-day difficulties, but much remains unknown regarding the influence of bilingualism. We investigated its influence on sustained attention, interference control, flexible switching and working memory, in Arabic-English autistic (n = 27) and typically developing peers (n = 53) children, aged 5 to 12 years old. Parents and teachers completed rating measures assessing children’s daily EF abilities. Results showed generalized positive effects for bilingual autistic children relative to their monolingual peers across all EF domains, but using parent ratings only. The findings indicate that bilingualism does not negatively impact the executive function skills of autistic children, and that it might mitigate difficulties faced on a day-to-day basis.

Shyness and Adjustment in Early Childhood in Southeast China: The Moderating Role of Conflict Resolution Skills

The massive social change in urban China today has led to a decline in the adaptive implications of shyness for child adjustment, yet evidence of this trend in young children is limited. Moreover, the underlying mechanisms that help to explain the associations between shyness and maladjustment remains poorly understood. The primary goal of the present study was to explore the moderating role of conflict resolution skills in the links between shyness and socio-emotional and school adjustment among urban Chinese preschoolers. Data were collected from 360 children (44.4% girls, Mage = 4.72 years, SD = 0.63) in kindergartens using parent ratings, teacher ratings, and child interviews. The analyses indicated that the relations between shyness and adjustment were moderated by child conflict resolution skills, which served to buffer shy children from adjustment problems. The results were discussed in terms of the implications of conflict resolution skills for early adjustment of shy preschoolers in the Chinese context.

Parenting stress in autism spectrum disorder may account for discrepancies in parent and clinician ratings of child functioning

Elevated parenting stress among parents of children with autism spectrum disorder is well-documented; however, there is limited information about variability in parenting stress and relationships with parent ratings of child functioning. The aim of this study was to explore profiles of parenting stress among 100 parents of young children with autism spectrum disorder enrolled in two clinical trials and potential relationships between parenting stress and parent ratings of child functioning at the baseline timepoint. Secondary aims examined differential patterns of association between parenting stress profiles and parent versus clinician ratings of child functioning. A k-means cluster analysis yielded three different profiles of parenting stress (normal, elevated, and clinically significant) using scores on the Parenting Stress Index–Short Form. One-way analyses of variance revealed differential patterns of parent ratings across the three parenting stress profiles on certain domains of child functioning (e.g. problem behaviors and social impairment) and family empowerment, but similar ratings of child receptive and expressive language abilities. Clinicians blinded to study conditions also rated child functioning, but clinician ratings did not differ by parenting stress profile. Findings emphasize the importance of identifying parenting stress profiles and understanding their relationship with parent ratings, with implications for interpreting parent-report measures and measuring child response in treatment trials. Lay abstract Elevated parenting stress among parents of children with autism spectrum disorder is well-documented; however, there is limited information about differences in parenting stress and potential relationships with parent ratings of child functioning. The aim of this study was to explore profiles of parenting stress among 100 parents of young children with autism spectrum disorder enrolled in two clinical trials and to explore relationships between parenting stress level and parent ratings of child functioning before treatment. Secondary aims examined differential patterns of association between parenting stress profiles and parent versus clinician ratings of child functioning. We show that stress may influence parent ratings of certain child behaviors (e.g. problem behaviors) and not others (e.g. language), yet clinician ratings of these same children do not differ. This new understanding of parenting stress has implications for parent-rated measures, tracking treatment outcome, and the design of clinical trials.

Hair Cortisol and Self-Injurious Behavior Among Children With Autism Spectrum Disorder

Elevated salivary cortisol levels have been documented in individuals who engage in self-injurious behavior (SIB), indicating acute physiological stress. Less is known about the chronicity of stress and SIB. We analyzed the relationship between parent ratings of problem behavior and hair cortisol concentrations (an index of chronic adrenocortical activity) in 23 children with autism spectrum disorder (ASD). Parent ratings of problem behavior were not significantly correlated with hair cortisol concentrations. When children were categorized into groups based on the frequency and severity of SIB, participants with the greatest frequency and severity of SIB had higher hair cortisol concentrations compared to children without SIB. Frequent and severe SIB may be associated with altered hypothalamic-pituitary-adrenal (HPA) axis activity in children with ASD.