Symptoms of autism and schizophrenia spectrum disorders in clinically referred youth with oppositional defiant disorder.
Mom and teacher rarely agree on ASD/SSD symptoms in kids with ODD—lock your rating source before you label or track change.
01Research in Context
What this study did
The team looked at the kids sent to a clinic for behavior help. All had oppositional defiant disorder (ODD).
They asked moms and teachers to fill out the same symptom checklists for autism and schizophrenia spectrum disorders. Then they tried three ways to count who had “high” symptoms.
What they found
Kids labeled “angry/irritable” by mom had the most autism and psychosis-type symptoms. Teacher ratings did not match mom ratings.
When the team kept only the items both adults agreed on, the symptom scores dropped by half. Using mom-only or teacher-only rules gave very different pictures of the same child.
How this fits with other research
Anbar et al. (2024) saw the same rater split in toddlers at risk for ASD. Early joint-attention scores from moms predicted later pragmatic problems, but teacher data were not collected—so the mismatch starts before school.
Bölte et al. (2011) compared the SRS and SCDC tools. They warn that measure choice changes who gets flagged, just like D et al. show that informant choice changes who looks severe.
Barton et al. (2019) found that aggressive kids with ASD have more sleep and peer problems. Their data came from youth self-report and caregiver report; combining both painted the fullest picture, echoing D et al.’s call to decide up-front how to handle discordant scores.
Why it matters
Before you write “elevated ASD features” in an ODD report, pick a rule: mom-only, teacher-only, or consensus. Stick to it across re-evaluations so progress (or drift) is real, not an artifact of swapped raters. Share the rule with the school team so everyone uses the same lens.
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02At a glance
03Original abstract
Examined autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD) symptoms in a clinically referred, non-ASD sample (N=1160; ages 6-18) with and without oppositional defiant disorder (ODD). Mothers and teachers completed DSM-IV-referenced symptom checklists. Youth with ODD were subdivided into angry/irritable symptom (AIS) or noncompliant symptom (NS) subtypes. Two different classification strategies were used: within-informant (source-specific) and between-informant (source-exclusive). For the source-specific strategy, youth were classified AIS, NS, or Control (C) according to mothers' and teachers' ratings separately. A second set of analyses focused on youth classified AIS according to mother or teacher report but not both (source-exclusive) versus both mother and teacher (cross-informant) AIS. Results indicated the mother-defined source-specific AIS groups generally evidenced the most severe ASD and SSD symptoms (AIS>NS>C), but this was more pronounced among younger youth. Teacher-defined source-specific ODD groups exhibited comparable levels of symptom severity (AIS, NS>C) with the exception of SSD (AIS>NS>C; younger youth). Source-exclusive AIS groups were clearly differentiated from each other, but there was little evidence of differential symptom severity in cross-informant versus source-exclusive AIS. These findings were largely dependent on the informant used to define the source-exclusive groups. AIS and NS groups differed in their associations with ASD and SSD symptoms. Informant discrepancy provides valuable information that can inform nosological and clinical concerns and has important implications for studies that use different strategies to configure clinical phenotypes.
Research in developmental disabilities, 2012 · doi:10.1037/a0020909