Patterns of Cognition, Communication, and Adaptive Behavior in Children With Developmental Disabilities.

The team watched 129 toddlers who had big delays and spoke fewer than 10 words.

Each child got two full check-ups: one by their main caregiver and one by a trained clinician.

The check-ups looked at thinking skills, talking skills, and daily living skills.

Most of the time, moms and clinicians agreed on how the child scored.

But for the kids with the least language, the scores started to drift apart.

In that tiny subgroup, caregiver ratings were higher than clinician ratings.

Tyler et al. (2021) saw the same pattern in older kids. They used parent and teacher forms instead of moms and clinicians, but the message is the same: two raters catch more than one.

Balboni et al. (2020) looked at adults and kids with severe ID. They found more adaptive skills can sit next to more problem behavior. This sounds opposite, but both studies warn us: never trust a single score.

Liyew et al. (2025) used only caregiver ATEC ratings to map sensory-cognitive patterns. Phebe’s work shows that for the most delayed toddlers, adding a clinician check could change the map.

Before you pick goals for a minimally verbal toddler, run both a caregiver interview and a direct test. If the scores clash, probe deeper. A wrong profile leads to wrong targets and wasted hours.