Psychiatric symptoms in preschool children with PDD and clinic and comparison samples.
Always gather parent and teacher ECI-4 ratings—each sees different anxiety and depression symptoms in preschoolers with PDD.
01Research in Context
What this study did
Thomas et al. (2004) asked parents and teachers to fill out the Early Childhood Inventory-4. They wanted to see how many psychiatric symptoms preschoolers with PDD showed compared with kids in regular and special-ed classes.
The team looked at DSM-IV items for anxiety, depression, ADHD, and oppositional behavior. They compared scores across the three groups and then checked how much parents and teachers agreed.
What they found
Preschoolers with PDD earned higher severity scores than both control groups. The biggest gaps were in anxiety and depression items.
Parents and teachers did not match. Each adult saw unique problems the other missed. Relying on only one rater would under-count symptoms.
How this fits with other research
Lecavalier (2006) later used the same two-rater method and found the same split view. Their cluster analysis showed these different views create clear behavioral profiles, backing the need for both adults.
Adams et al. (2025) pooled 44 newer studies and confirmed anxiety is common in preschool ASD. Their review treats the 2004 anxiety signal as an early data point that still holds today.
Jónsdóttir et al. (2007) followed similar children longitudinally and saw autism scores drop slightly over time. This tempers the 2004 snapshot: symptoms can shift, so re-screen each year.
Why it matters
If you assess a preschooler for ABA services, collect both ECI-4 forms before you write the treatment plan. The parent form may flag separation anxiety while the teacher form catches attention problems. Merging the two gives you a fuller picture and prevents you from missing internalizing symptoms that can block learning later.
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02At a glance
03Original abstract
OBJECTIVE: This study describes and compares the severity of DSM-IV symptoms in preschool children with diagnosed pervasive developmental disorder (PDD), clinic controls, and two community-based samples. METHOD: Parents (/and teachers) completed the early child inventory-4 (ECI-4), a DSM-IV-referenced rating scale for four samples: PDD (n = 172/160) and nonPDD psychiatric clinic referrals (n=135/101) and youngsters in regular (n=507/407) and special (n =64/140) early childhood programs. Children ranged in age from 3 to 5 years old. RESULTS: With the exception of conduct problems, the PDD group generally received higher symptom severity ratings than the regular early childhood group, but the pattern of differences compared with the other two groups often varied by type of symptom and informant. Teachers rated the PDD and nonPDD clinic groups as having equally severe ADHD and oppositional defiant disorder symptoms. Teachers rated the PDD group as having more severe anxiety and depression symptoms than parents. The Asperger group was rated by both informants as more oppositional than the autism and PDDNOS subgroups. Teachers rated males in the regular early childhood sample as having more severe ADHD and aggressive symptoms than females, but this was not the case for the PDD sample. CONCLUSION: Preschoolers with PDD exhibit more severe DSM-IV psychiatric symptoms than children in regular and special early childhood programs, and to some extent nonPDD psychiatric referrals. The concept of comorbidity warrants further exploration, as does informant-specific syndromes as validators of diagnostic constructs.
Journal of autism and developmental disorders, 2004 · doi:10.1023/b:jadd.0000037415.21458.93