AdaptiveBehaviorandPsychiatricSymptomsusingthe BehaviorAssessmentSystemforChildren– Version3:ResultsfromtheABC-CTFeasibilityStudy

• Evaluationsofschool-agedchildrenwithautismspectrumdisorder(ASD)includebothcoresymptoms(e.g.socialcommunication)andco-occurringbehaviors(e.g.adaptivebehavior(1)andpsychiatricsymptoms(3)).

• Assessingmultipledomainsofbehavioroftenrequiresindividualizedstandardizedassessmentswhichcanbeburdensomeonfamilies(4).

• TheBehaviorAssessmentSystemforChildren- Version3 (BASC-3)isacomprehensiveratingscalethatassaysmultipledomainsofbehavior(2).

• WeaskedwhethertheBASC-3candifferentiateASDfromtypically-developing(TD)school-agedchildrenandwhetheritdemonstratesconvergencewithmorecommonly-usedmeasuresofadaptivefunctioningandpsychiatricsymptoms.

1) InvestigategroupdifferencesinadaptivebehaviorandpsychiatricsymptomsinchildrenwithASDandTDusingtheBASC-3 compositescores.Hypothesis:ChildrenwithASDwillshowdecreasedadaptivebehaviorandIncreasedpsychiatricsymptomscomparedtoTD.

2) ExamineconvergentvalidityoftheBASC-3 inchildrenwithASDbycomparingthismeasuretotheVinelandAdaptiveBehaviorScales,SecondEdition(VABS-II)parentinterviewandtheChildandAdolescentSymptomInventory-5(CASI-5)/EarlyChildhoodInventory-5(ECI-5).Hypothesis:TheBASC-3 domainswillcorrelatetocorrespondingVABS-II,CASI-5/ECI-5 domains.

Participants:• EnrolledintheAutismBiomarkersConsortiumforClinicalTrialsStudy(ABC-CT),amulti-site

feasibilitystudyincludingbehavioralandexperimentalmeasures• Eligibility:

- ASDmetcriteriaontheAutismDiagnosticObservationSchedule-IIModule1,2,or3(ADOS-II),AutismDiagnosticInterview-Revised(ADI-R)- TDscreenednegativeforpsychiatricdisorders- ParticipantsincludedinthissamplecompletedtheBASC-3,CASI-5/ECI-5 andVABS-IImeasures

QuestionnairesandInterviews:• BASC-3:parentratingscaletoevaluateadaptiveandchallengingsocialandemotionalbehaviors

acrosscommunityandhomesettings(2)- Comprehensivescoringincludes:compositescales(i.e.internalizingproblems),clinicalscales(i.e.depression)adaptivescales(i.e.socialskills),contentscales(i.e.executivefunctioning)andclinicalindices(i.e.Autismprobability)- 10-20minutes- 175questions

• CASI-5/ECI-5: parentratingscalebasedin DSM-5-toassesssymptomsrelatedtovariouspsychiatricdisorders

- 10-20minutes- 173questions

• VABS-II(SurveyInterviewForm):parentinterviewtoassessadaptivebehaviorsacrossthelifespan- 30-60minutes

StatisticalPlan:• Aim1:Independentsamplet-teststoexaminegroupdifferences• Aim2:Correlationstoexamineconvergentvalidity

SummaryofResults:• ThefollowingBASC-3 domainswithintheASCpositivelycorrelatedwithcorrespondingVABS-II

domains:• FunctionalCommunication(BASC-3)&Communication(VABS-II)• DailyLivingSkills(BASC-3)&ActivitiesofDailyLiving(VABS-II)

• TheSocialSkillsdomainoftheBASC-3 didnotcorrelatewiththeSocializationdomainoftheVABS-II.However,theBASC-3AdaptabilitydomainwaspositivelyrelatedtotheVABS-II CopingSkillssub-domain.

• ThefollowingBASC-3 psychiatricsymptomdomainspositivelycorrelatedwithcorrespondingCASI-5/ECI-5 domains:

• Anxiety(BASC-3)&GeneralizedAnxiety(CASI-5/ECI-5)• Depression(BASC-3)&Dysthymic(CASI-5/ECI-5)• AttentionProblems(BASC-3)&Inattentive(CASI-5/ECI-5)• Hyperactivity(BASC-3)&Hyperactive-Impulsive(CASI-5/ECI-5)

Conclusions:• TheBASC-3 differentiatedchildrenwithASDcomparedtoTDacrossallCompositescores.• TheBASC-3 AdaptiveSkillsCompositedomainsdemonstrateconvergentvaliditywiththeVABS-II,

withtheexceptionofSocialSkills.BASC-3 SocialSkillsmayberepresentingamorenarrowsetofbehaviorsthanVABS-IISocialization,whichisanimportantconsiderationwhenusingthismeasureinASD.

• Insettingswheremultipledomainsneedtobeassessedinatime-efficientmanner,theBASC-3maybeanappropriatealternativetoindividualizedassessments.

Introduction

Objectives

Methods

Conclusions

1. Kanne,S.M.,Gerber,A.J.,Quirmbach,L.M.,Sparrow,S.S.,Cicchetti,D.V.,&Saulnier,C.A.(2010).TheRoleofAdaptiveBehaviorinAutismSpectrumDisorders:ImplicationsforFunctionalOutcome. JournalofAutismandDevelopmentalDisorders,41(8),1007-1018.doi:10.1007/s10803-010-1126-42. Reynolds,C.R.,&Kamphaus,R.W.(2015).BASC3:Behaviorassessmentsystemforchildren:Manual.Bloomington,MN:PsychCorp.3. Rosen,T.E.,Mazefsky,C.A.,Vasa,R.A.,&Lerner,M.D.(2018).Co-occurringpsychiatricconditionsinautismspectrumdisorder. InternationalReviewofPsychiatry.doi:10.1080/09540261.2018.14502294. Sikora,D.M.,Hall,T.A.,Hartley,S.L.,Gerrard-Morris,A.E.,&Cagle,S.(2007).DoesParentReportofBehaviorDifferAcrossADOS-GClassifications:AnalysisofScoresfromtheCBCLandGARS.JournalofAutismandDevelopmentalDisorders,38(3),440-448.doi:10.1007/s10803-007-0407-z

WethanktheNationalInstituteofHealthforfundingthisstudy.GrantNIMH#1U19MH108206-01,PI:McPartland.Wegreatlyappreciateallofthefamilieswhoparticipatedinthisresearchacrossstudysites(YaleUniversity,UniversityofWashington,BostonChildren’sHospital,DukeUniversity).

References

Acknowledgements

ResultsAim1cont.

EmilyPompan1,ElizabethBaker1,PatriciaRenno,Ph.D. 1,SaraWebb,Ph.D.5,FrederickShic,Ph.D.5,AdamNaples,Ph.D.2,CatherineSugar,Ph.D.1,MichaelMurias,Ph.D. 4,RaphaelBernier,Ph.D. 5,GeraldineDawson,Ph.D. 4,CharlesNelson,Ph.D. 3,JamesMcPartland,Ph.D. 2,andShafaliJeste,M.D. 1

UniversityofCalifornia,LosAngeles1,YaleUniversity2,BostonChildren’sHospital3,DukeUniversity4,andtheUniversityofWashington5

ASCDomain GroupDifferences(t-test)

SocialSkills t(47)=6.166,p=<.001

ActivitiesofDailyLiving t(47)=9.425,p=<.001

FunctionalCommunication t(40.99)=11.453,p=<.001

Adaptability t(47)=5.684,p<.001

ResultsAim2bQuestionSample

A.GeneralizedAnxiety/Anxiety

B.Dysthymic/Depression C.Inattentive/AttentionProblems

D.Hyperactive-Impulsive/Hyperactivity

CASI-5/ECI-5

-Cannotgetdistressingthoughtsoutofhis/hermind.

-Talksaboutdeathorsuicide-Haslittleconfidence,feelsinferiortoothers,orisveryself-conscious.

-Iseasilydistractedbyotherthingsgoingon.-Doesnotpayattentiontoclosedetailsormakescarelessmistakes.

-Interruptsorintrudesonotherpeople’sactivities.-Is“onthego”oractsasif“drivenbyamotor.”

BASC-3 -Worriesaboutmakingmistakes.

-Says“Iwanttodie”or“IwishIweredead.”-Seemslonely.

-Iseasilydistracted.-Hastroubleconcentrating.

-Interruptsotherswhentheyarespeaking.-Isinconstantmotion.

BASC-3 AdaptiveSkillsComposite(ASC)DomainScoresinASDComparedtoTD

C. D.

r=.878,p=<.001

r=.431,p=.045 r=.798,p=<.001

EnrolledinABC-CT

IncludedinSample Gender Age(years)

M(SD)

BestIQ- FullScaleorRatioDifferentialAbilitiesScales-II

M(SD)

ADOS-II SeverityScoreM(SD)

ASD n=25 n=22 17male(77%),5female(23%) 8.03(2.28) 93.09(19.41) 14.82(4.54)

TD n=26 n=26 17male(65%),9female(35%) 6.58(1.98) 114.08(9.34) N/A

A. B.

ResultsAim1

BASC-3 Composite GroupDifferences(t-test)

Externalizing t(30.834)=-5.788,p=<.001

Internalizing t(47)=-3.775,p=<.001

BehavioralSymptomsIndex

(BSI)t(47)=-11.965,p=<.001

AdaptiveSkillsComposite(ASC) t(47)=10.558,p=<.001

BASC-3 CompositeScoresinASDandTDGroups

QuestionSample(VABS-II/BASC-3)

A. Communication/FunctionalCommunication

B.DailyLivingSkills/ActivitiesofDailyLiving

C.Socialization/SocialSkills

VABS-II

-Tellsabouteverydayexperiences(i.e.,routine)indetail-Identifiesallalphabetletters

-Understandswhattodoindangeroussituations-Doesatleasttwosimplehouseholdchores

-Avoidsbeingmanipulated,dominatedortakenadvantageofbyothers-Controlsangerorhurtfeelingswhengivenconstructivecriticism.

BASC-3

-Isclearwhentellingaboutpersonalexperiences-Saysalllettersofthealphabetwhenasked

-Actsinasafemanner-Organizeschoresandtaskswell

-Showsinterestinothers’ideas.-Beginsconversationsappropriately

QuestionSample(VABS-II/BASC-3)

D.CopingSkills Sub-Domain/Adaptability

VABS-II

-Handleschangesinroutinewithoutbecomingoverlydistressed-Recoversquicklyfromaminorsetbackordisappointment

BASC-3-Adjustswelltochangesinroutine.-Recoversquicklyfromasetback

TheBASC-3 includesanAdaptabilitydomainwithintheASCthatqualitativelyoverlapswiththeCopingSkillssub-domainwithinVABS-IISocializationdomain.Hypothesis:TheBASC-3 AdaptabilitydomainwillcorrelatewithVABS-II CopingSkillssub-domain.

r=.677,p=<.001r=.580,p=.004A. B.

C.

ResultsAim2a

20 30 40 50 60 70

6

8

10

12

14

16

BASC Adaptability t-score

VAB

S C

opin

g S

kills

v-s

cale

D.

r=.612,p=<.001

40 50 60 70 80 90

40

60

80

100

BASC Depression t-scores

CA

SI/E

CI D

ysth

ymic

t-sc

ores

r=.767,p=<.001

20 30 40 5040

60

80

100

BASC Social Skills t-scores

VAB

S S

ocia

lizat

ion

Sta

ndar

d S

core

s

r=.308,p=.152