Parent And Teacher Report Of Social Skills In Children .

2y ago
262.99 KB
7 Pages
Last View : 7d ago
Last Download : 8m ago
Upload by : Josiah Pursley

LSHSSParent and Teacher Report of SocialSkills in Children With AutismSpectrum DisordersDonna S. MurrayCincinnati Children’s Hospital Medical Center, University of Cincinnati, OHLisa A. RubleUniversity of Kentucky, LexingtonHeather WillisVanderbilt University, Nashville, TNCynthia A. MolloyCincinnati Children’s Hospital Medical Center, University of CincinnatiSocial skills deficits are a core and defining feature ofpervasive developmental disorders (American Psychiatric Association [APA], 2000). Pervasive developmental disorders is an umbrella term that is more commonlyreferred to as autism spectrum disorders (ASD). The five specificdisorders included in ASD are autistic disorder, Rett’s disorder,childhood disintegrative disorder, Asperger syndrome, and pervasive developmental disorder not otherwise specified (PDD-NOS).In addition to social skills deficits, these disorders are characterizedby severe and pervasive impairment in communication. Also present are stereotyped patterns of behavior, interests, and activities.The qualitative impairments that define these disorders are discrepant relative to the individual’s developmental level or mental age(APA, 2000).The importance of social development on outcomes in adulthood has been recognized for decades. Schalock and Harper (1978),Greenspan and Shoultz (1981), and Huang and Cuvo (1997) conducted studies on the outcomes of individuals with mild or moderate mental retardation. The overwhelming consensus was that themajor cause of unsuccessful employment was a lack of social skillsand inappropriate social behaviors rather than issues related toemotional disturbance or antisocial behavior. Similar argumentshave been made for adults with autism (Schopler & Mesibov, 1983).Longitudinal research by Sigman et al. (1999) revealed a directrelation between cognitive and language outcomes and the socialbehaviors of adolescents with autism. Ingersoll, Schreibman, andStahmer (2001) found that children with autism who were ratedas having high social avoidance had poorer language outcomesABSTRACT: Purpose: The purpose of this study was to examinethe agreement between parent and teacher perceptions of specificsocial behaviors in children with autism spectrum disorders (ASD).Method: Informant ratings were generated concerning 45 childrenwith ASD between the ages of 5 and 14 years who were enrolledin social skills groups at 2 Midwestern outpatient autism treatmentcenters.Results: Moderate agreement was observed between parents andteachers for the overall social skills rating scores (r 0.34; p 0.05),but there was little agreement on specific social items. Distinctpatterns of skill profiles emerged. Parents consistently providedrelatively higher ratings on items that pertained to initiatinginteractions. Teachers, on the other hand, consistently providedhigher ratings on items related to responding to and maintaininginteractions. Parents and teachers agreed most often on itemsof affective understanding and perspective taking.Conclusion: These findings suggest that specific social behaviors maybe context dependent, indicating the need for a multi-informantapproach to provide a more complete profile of a child’s social abilities,which is necessary for generating a more effective treatment plan.LANGUAGE, SPEECH,ANDHEARING SERVICESINKEY WORDS: autism, social skills, parent, teacher reportSCHOOLS Vol. 40 109–115 April 2009 * American Speech-Language-Hearing Association0161-1461/09/4002-0109109

compared to children with less social avoidance. Peer engagement,as a specific social behavior, appeared to play a pivotal role inenhancing adolescents’ cognitive and language outcomes.Although impaired social skills are a key feature of ASD, research indicates that specific social symptomatology varies fromperson to person (Beglinger & Smith, 2005; Borden & Ollendick,1994), an observation that was first made by Wing and Gould (1979)almost 30 years ago. What is surprising is the lack of informationconcerning the reliability, consistency, and specificity of the socialpresentation across environments, such as home and school. Thisinformation is important because practitioners such as diagnosticians, clinicians, and school-based interventionists often rely onreports or rating scales from people such as parents and teachers tosupplement assessment tools (Lecavalier, Aman, Hammer, Stoica, &Mathews, 2004). A high congruency between raters would provideclinicians with increased confidence using a single informant approach and enable them to assume that social competency skills aresimilarly demonstrated and stable across environments. Constantinoand colleagues (2003) examined this issue and evaluated autisticsymptoms using the Social Responsiveness Scale (SRS). Theyfound a high degree of correlation between mother, father, andteacher report, suggesting universality in the expression of autismspecific traits and accuracy in single informant reporting by anadult who has frequently observed the child in naturalistic socialsettings with peers (Constantino et al., 2003).Other studies have found differences between raters dependingon the role of the rater in the child’s life. Achenbach, McConaughy,and Howell (1987) conducted a meta-analysis of 119 studies ofemotional and behavioral problems in children and found modestagreement between informants playing a similar role with respect tothe child. However, they also reported that the agreement betweenindividuals playing a similar role (teacher–teacher) was muchhigher than the agreement between individuals playing differentroles, such as parent–teacher. In another study of 505 autistic andnon-autistic preschool children, Rapin, Steinberg, and Waterhouse(1999) found modest interrater agreement on measures of behavioracross typical raters (parents, teachers, neurologists, and psychiatrists) at different times and in different settings. Szatmari, Archer,Fisman, and Streiner (1994) studied 83 high-functioning preschoolers with ASD and found better agreement between parentsand teachers on measures of adaptive skills compared to measuresof autism symptomatology. These findings have been interpretedas evidence that observers are sensitive to different aspects of behavior and that the differences in their ratings reflect true differencesrather than an unreliable instrument (Rapin et al., 1999).If there is indeed low congruency between raters, this information would lend support for the need for multiple cross-informantsin order to develop a complete picture of a child’s abilities acrossenvironments. In a study examining the correspondence of ratingsof social competence in children and adolescents with typical development, Renk and Phares (2004) argued specifically for the useof multiple informants. They found that the highest congruencywas observed between teachers and peers and postulated that thisfinding may be due, in part, to the setting. They concluded thatbehavior is highly influenced by situational specificity. In theirstudy of parent and teacher reports of pragmatic aspects of communication on children with pervasive or specific developmentaldisorders, using the Children’s Communication Checklist (CCC),Bishop and Baird (2001) found low congruency between raters.However, they did find a relationship between the ratings and the110LANGUAGE, SPEECH,ANDHEARING SERVICESINdiagnosis and interpreted the discrepancy in ratings of social communication abilities as evidence that these skills are context dependent. The results of these studies suggest that to obtain a completepicture of a child’s social functioning, which may be particularlyimportant for treatment planning, a single informant would need toobserve the child in every possible setting. Because this is not feasible in a clinical or school setting, professionals must make useof other methods that include cross-informants.In summary, although there is confirmation to support adequacyof a single informant approach for the identification of autismspecific behaviors (Constantino et al., 2003), there is equally strongevidence for the need for multiple informants to identify specificskills and abilities (Bishop & Baird, 2001; Renk & Phares, 2004).Differentiating abilities that are context bound from those that arestable is essential for treatment progress monitoring and follow-up(Yoder, 2008). Yoder and McDuffie (2006) offered three criteriafor practitioners to use when judging whether an ability is learned:stability, generalization, and maintenance. Therefore, informationon the stability of skills across various contexts is essential for effective treatment planning and progress monitoring (Yoder, 2008),and an accurate description of social behaviors is critical for development of appropriate intervention plans and measurement oftreatment progress (i.e., stability, generalization) and follow-up (i.e.,maintenance).The purpose of this study was to examine the agreement betweenparent and teacher perceptions of specific social behaviors in children with ASD. Previous studies primarily examined agreement ofautistic symptoms rather than specific social behaviors. This studycontributes to the body of knowledge by examining the agreementof specific social behaviors for the purpose of planning for intervention. Although it was expected that disagreements in ratings betweenparents and teachers would be observed, as suggested by the workof Bishop and Baird (2001), the pervasive social impairment that isevident in children with ASD would suggest otherwise, as supportedby the work of Constantino et al. (2003). Therefore, no directionalhypothesis was proposed for this exploratory study.METHODParticipantsThis study is unique from the majority of studies of social skillsbecause the participants were referred to a clinical treatment program for intervention rather than recruited for a laboratory-basedresearch study. Using participants who were referred for a clinicaltreatment program has been suggested as important for translationalresearch (Hoagwood, Burns, Kiser, Ringeisen, & Schoenwald,2001). The treatment centers were located at two Midwest regionalautism specialty centers. Data were collected from the medicalcharts of 45 children and adolescents who were referred for socialskills intervention. All participants had a clinical diagnosis of autistic disorder, Asperger syndrome, or PDD-NOS according to theDiagnostic and Statistical Manual of Mental Disorders—FourthEdition (APA, 2000). Of these, most of the participants had a clinical diagnosis of Asperger syndrome (see Table 1). The participantsranged in age from 5 to 14 years, with a mean age of 10.0 years(SD 2.4 years), and were referred by physicians, allied healthprofessionals, or parents for participation in social skills groupSCHOOLS Vol. 40 109–115 April 2009

Table 1. Study participant characteristics.Characteristic(in press) described the use of the TSSA for social skills 9686.713.3Comorbid diagnosisaNoneDepressive disorderAnxiety disorderAttention deficit hyperactivity disorder (ADHD)ADHD and depressive or anxiety disorderDepressive and anxiety DiagnosisAutistic disorderAsperger syndromePervasive developmental disordernot otherwise specifiedaData were missing on 10 participants.intervention. Full-scale IQ scores were available from the medicalrecords of 35 participants. Because the study was a retrospectivechart review of individuals who had been referred for a clinicbased social skills group, 10 children did not have IQ scores included in the available record. The available IQ scores ranged from66 to 132, with a mean of 93.3 (SD 17.9). The groups with andwithout IQ data did not differ with respect to the distribution ofage, gender, or DSM-IV-TR diagnosis or the presence of a comorbiddiagnosis. Review of the medical charts also revealed that almost25% of the sample had a comorbid mental health diagnosis described in the medical chart (see Table 1). The study was approvedby the institutional review boards of Cincinnati Children’s HospitalMedical Center and the University of Louisville.QuestionnairesAs part of the routine intake process before intervention, parentswere asked to complete a social skills questionnaire for their childwith ASD for the purpose of treatment planning. They were alsoasked to give a questionnaire to the child’s primary teacher in orderto obtain information on skills that were observed at school. Noadditional guidelines were given for questionnaire completion.Questionnaires came from the TRIAD Social Skills Assessment(TSSA; Stone, Ruble, Coonrod, Hepburn, & Pennington, 2003).The TSSA is a criterion-based, multi-informant tool that is usedto describe the social behaviors of individuals with ASD. Thequestionnaire is divided into four areas of social development:(a) ability to understand emotions and perspectives of others (affect),(b) ability to initiate interactions, (c) ability to maintain interactions,and (d) ability to respond to others. These four subscales wererated using a Likert scale from 1 (not very well ) to 4 (very well ).The 35 items of the TSSA questionnaires are available on requestand are briefly described in Figure 1. The TSSA questionnairewas used by these centers as a supplemental descriptive tool todevelop an individual profile of social behaviors in order to aidin planning therapeutic intervention. Ruble, Willis, and CrabtreeAnalysisThe internal consistency of the TSSA was calculated separatelyfor parent and teacher ratings using Cronbach’s alpha. The sum ofthe scores for each of the four subscales (understanding emotionsand perspectives of others; initiating interactions; maintaining interactions; and responding to others) was determined and the meanscore was calculated. Pearson product–moment correlation coefficients were calculated to determine the strength of the relationshipbetween parent and teacher subscale summary scores. Each itemwas then evaluated using a weighted kappa statistic (kw) as a measure of agreement between the parent and teacher ratings on the4-point scale. The mean difference between parent and teacherrating was plotted for each item. To determine if age affected theobserved parent–teacher differences, the mean difference for eachitem was calculated separately for children ages 5 through 9 years(n 18) and children ages 10 through 14 years (n 27) and wascompared with a Wilcoxon test.RESULTSReliability as measured by internal consistency was 0.92 forparent responses and 0.94 for teacher responses. Figure 2 shows themean ratings of parent and teacher perceptions. Skills related tounderstanding affect and to initiating and maintaining interactionswith others received the lowest mean ratings by both parents andteachers. Responding to others was an area of relative strength.Correlation coefficients for subscale total scores and total scoresfrom the assessment are reported in Table 2. Correlations weremoderate to weak, with r 0.38. However, correlations betweenparent and teacher report for total score (r 0.34), ability to understand emotions and body language (r 0.38), and ability to respond(r 0.32) reached statistical significance at p 0.05.As shown in Figure 1, the kw was examined to determine theextent to which parents and teachers agreed or disagreed on each ofthe 35 items. In addition, the mean of the difference between parentand teacher rater pairs was plotted to identify items that parentsscored consistently higher compared to items that teachers scoredhigher. The positive scores (scores 0) reflect higher parent ratings;the negative scores (scores 0) reflect higher teacher ratings.The kw was uniformly low for all items, indicating poor agreement between parents and teachers on the ratings of the individualskills. The best agreement was for understanding body language(kw 0.41), understanding facial expression (kw 0.38), and understanding others’ thoughts (kw 0.33), which are all items in theaffective understanding subscale. Parents consistently rated thechildren higher on measures involving the initiation of interactions,whereas teachers rated items pertaining to maintaining and responding to interactions higher. There was no consistent pattern of parentsor teachers rating children higher on the affective understandingsubscale, which showed the highest correlation (Table 2) and hadthe three items with the best agreement.For most items, there were no significant differences in parent–teacher ratings by age group. However, there were three notableexceptions. For the item designed to measure a child’s ability toMurray et al.: Parent–Teacher Report111

Figure 1. Parent and teacher agreement on specific TRIAD Social Skills Assessment (Stone, Ruble, Coonrod, Hepburn, &Pennington, 2003) questionnaire items and mean difference scores.Figure 2. Mean subscale scores reported by teacher and parents.offer comfort, teachers of young children rated the skill higherthan parents did (kw –0.33), whereas for older children, parentsrated the skill higher than teachers did (kw 0.38) ( p 0.03). Forthe younger group, teachers rated children’s ability to respond toinvitations higher than parents did (kw –0.22); in the older group,parents rated the skill higher (kw 0.34) ( p 0.05). The sameTable 2. Pearson product–moment correlations of parent and teacherratings by subscale total score (2-tailed).Teacher reportTotal scoreAffectInitiateRespondMaintainParent report0.34*0.34*0.260.310.310.24*p .05.112LANGUAGE, SPEECH,ANDHEARING SERVICESINSCHOOLS Vol. 40 109–115 April 50.15

pattern was observed for response to questions, with teachers ratinghigher in the younger group (kw –0.56) compared to the oldergroup (kw 0.07) ( p 0.03).DISCUSSIONThis study of 45 children with ASD demonstrated patterns ofparent–teacher differences in the rating of social skills. Parents’perceptions of skills led to consistently higher ratings than thoseof teachers on items pertaining to initiating interactions, whereasteachers’ perceptions resulted in consistently higher ratings thanparents on items related to maintaining and responding to interactions (Figure 1). These findings of differences in parent andteacher perceptions in the rating of social skills are similar toreports for other measures of behavior that were rated by different types of informants (Achenbach et al., 1987; Rapin et al.,1999). Agreement based on a range of diverse behaviors tendedto be higher than agreement on specific behaviors (Rapin et al.,1999).Although modest correlations were observed between parentand teacher global perceptions of the total TSSA items and thesubscale ratings for affective understanding and response to interactions, the low kwvalues for all items indicates poor agreementon the specific items contributing to the subscale and total scores.Furthermore, within these correlated values, there are clearly systematic differences in the way that teachers and parents perceivesocial skills, as evidenced by the patterns shown in Figure 1. Futurestudies on the influence of perceptions of abilities are important(such as the amount of time a teacher has known or taught child),as is direct observation of actual skills.Interestingly, parents consistently rated their child as more ableto initiate interactions, and teachers consistently rated the child asmore able to respond to and maintain interaction. It may be thatbecause this was a sample of children who had been specificallyreferred for social skills intervention, parents of this sample perceived aspects of the child’s social skills as more impaired. Thesefindings may also reflect the behavioral expectation in the environment. For home settings, children may be more comfortable andinitiate more frequently with family members. The initiations ratedhighest by parent

between parent and teacher subscale summary scores. Each item was then evaluated using a weighted kappa statistic (kw) as a mea-sure of agreement between the parent and teacher ratings on the 4-point scale. The mean difference between parent and teacher rating was plotted for each item. To determine if age affected the

Related Documents:

Parent Conners ' 10-Item Test . Parent Parent-Child Rating Scale 3.0 Teacher Teacher-Child Rating Scale 2.1 Teacher Social Competence Behavior Evaluation Scale McCabe et a 35 2006 18 30 4.2 3.17 5.42 4 W Mixed Excluded NE Parent Parent-Child Rating Scale 3.0 Teacher Teacher-Child Rating Scale 2.1

2. Pittsburgh Modified Conners Teacher Rating Scale 3. Parent/Teacher DBD Rating Scale 4. Child Behavior Check List- Teacher Report Form 5. Narrative Description of Child -- Teacher 6. Academic and Behavioral Target Form 7. Classroom Management Techniques Generally, the teacher rating scales should be completed by the teacher who spends the .

Scale Structure: Parent and Teacher Total Score Parent: 17 items Teacher: 12 items Emotional Problems Parent: 9 items Teacher: 5 items Functional Problems Parent: 8 items Teacher: 7 items 4-point Likert-type rating: 0 "Not at All" ; 3 "Much or Most of the Time" Scale Structure: Self-Report (Full Length) Total Score (all 28 items) Emotional

The home and the school should be mutually informed about the progress of each child. Report cards alone are not sufficient to do this job, but report cards combined with parent conferences allow both the teacher and the parent, in a joint endeavor, to meet the individual needs of each student. A parent-teacher conference may be requested at

KINDERGARTEN Progress Report STUDENT SCHOOL YEAR SCHOOL TEACHER Homeroom: PROGRESS INDICATORS 4 - 3 - 2 - 1 - - Asterisk in front of grade indicates instruction was modified . TEACHER AND/OR PARENT COMMENTS Parent Signature Date Conference Requested by Parent Suggested Date/Time Parent Signature Date

Downtown East Village Calgary Number Per cent Number Per cent Lone-parent families 30 100% Lone-parent families 47,330 100% Female lone -parent 20 67% Female lone -parent 36,955 78% Male lone -parent 10 33% Male lone -parent 10,380 22% Marital status Downtown East Village Calgary

Wendy Lloyd, Teacher Emily Johnson, Teacher Lora McFarland, Teacher Jenna Miller, Psychologist Anne Nelson, Teacher Lacie North, Teacher Tricia Pearson, SLP Sally Rogers, Teacher Kristen Sessions, Teacher Emily Shaw, SLP Bailee VanZeben, Teacher Kristen Walters, SLP L

6 C4 C5 Tourer post 2010 1.6 Hdi 16v 110bhp (non dpfs) 66 1.6 Hdi 16V 110bhp 52 C4 PICASSO 2.0 Hdi 16V 160bhp 67 All models pre 2010 60 2.0 Hdi 16V 160bhp Auto 53 1.6i 16v Vti 120bhp 60 3.0 Hdi V6 240bhp Auto 63