Brief report: The assessment of anxiety in high-functioning adolescents with autism spectrum disorder.
HFASD teens seeking anxiety treatment under-report their anxiety, so always collect parent/clinician ratings alongside self-report.
01Research in Context
What this study did
Noordenbos et al. (2012) asked high-functioning teens with autism to fill out three anxiety forms.
Parents and clinicians filled out the same forms about each teen.
The team then checked if the teen scores matched the adult scores.
What they found
The forms worked well on paper; scores were stable and clear.
Yet every teen rated their own anxiety lower than parents and clinicians did.
In short, the tools are fine, but self-report alone misses the real level of worry.
How this fits with other research
Heald et al. (2020) repeated the same check and got the same gap eight years later.
Ozsivadjian et al. (2014) looked at younger HFASD kids and saw good agreement instead.
The seeming clash is about age: teens under-report, pre-teens do not.
Kaiser et al. (2022) pooled 36 studies and confirmed the teen gap is the norm.
Why it matters
If you treat anxious HFASD teens, always collect parent or teacher ratings before you start.
Use both scores to set goals and to track if worry is really dropping.
Skipping the adult view can make you think treatment failed when the teen simply still under-reports.
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02At a glance
03Original abstract
Anxiety may exacerbate interpersonal difficulties and contribute to secondary behavioral problems in adolescents with High-Functioning Autism Spectrum Disorder (HFASD). This study was conducted to assess the psychometric properties and construct validity of measures of anxiety with a sample (n = 30) of adolescents with HFASD and comorbid anxiety disorders. Results indicate that the measures (CASI-Anxiety Scale; Sukhodolsky et al. 2008; MASC; March 1998) possess acceptable internal consistency, and there is evidence of discriminant validity. Most of the adolescents, however, under-reported problems with anxiety, compared to parent-reported and clinician-derived reports and given they were seeking treatment for anxiety problems. Findings highlight the importance of using multiple raters in clinical practice and consideration of rater discrepancies in clinical research.
Journal of autism and developmental disorders, 2012 · doi:10.1007/s10803-011-1353-3