Autism severity, co-occurring psychopathology, and intellectual functioning predict supportive school services for youth with autism spectrum disorder.
Clinician severity data, not parent forms, open the door to school help, and high-IQ kids with behavior issues risk being overlooked.
01Research in Context
What this study did
The team asked who gets extra help at school. They looked at kids with autism.
Clinicians, teachers, and parents each rated autism severity. The study tracked which ratings matched the services kids actually got.
What they found
Only clinician and teacher scores predicted services. Parent scores did not.
Kids with higher IQ or more acting-out behavior were less likely to get help.
How this fits with other research
Bürki et al. (2021) found the same pattern in Germany. There, low IQ and young age drove services, not severity.
Hodge et al. (2021) seems to disagree. They showed IQ, not severity, predicted daily-living skills in preschoolers. The clash is about outcome: skills versus service access.
Mazurek et al. (2019) helps explain why clinician ratings matter. Their study showed DSM-5 severity lines up with ADOS and IQ, so clinicians already fold thinking skills into their scores.
Why it matters
Bring ADOS or CARS reports to IEP meetings. Parent checklists alone may not count.
Watch bright students who act out. Their intelligence can hide needs and cut services. Push for support tied to social-communication deficits, not just IQ.
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02At a glance
03Original abstract
Supportive school services are a primary service modality for youth with autism spectrum disorder. Autism spectrum disorder, as well as co-occurring psychiatric symptoms and low intellectual abilities, interfere with academic achievement and therefore influence decisions about school services. Therefore, we examined the association of parent, teacher, and clinician ratings of autism spectrum disorder and co-occurring psychiatric symptom severity and intellectual functioning with school services. In total, 283 youth with autism spectrum disorder were assessed with clinical evaluation via the Autism Diagnostic Observation Schedule and parent and teacher versions of the CASI-4R (Child and Adolescent Symptom Inventory). Full Scale Intelligence Quotient scores were obtained from case records. Clinical and teacher evaluations of autism spectrum disorder severity predicted services and were more strongly associated with school services than parent ratings. Teacher ratings were only associated with common school services (e.g. speech/language therapy, occupational therapy, and/or social skills training) frequency at medium and high levels of clinician-rated autism spectrum disorder severity. Higher IQ and parent-rated externalizing symptoms predicted lower likelihood of receiving school services, whereas internalizing symptoms were not predictive of school services. Autism spectrum disorder symptoms may overshadow externalizing and internalizing symptoms when considering school service supports. Results highlight the importance of evaluating autism spectrum disorder severity via multiple sources, especially in cases of unclear symptom presentation, when examining correlates of school services for youth with autism spectrum disorder.
Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361318809690