Pearson Deborah A, Aman Michael G, Arnold L Eugene, Lane David M, Loveland Katherine A, Santos Cynthia W, Casat Charles D, Mansour Rosleen, Jerger Susan W, Ezzell Sarah, Factor Perry, Vanwoerden Salome, Ye Enstin, Narain Punya, Cleveland Lynne A
Department of Psychiatry and Behavioral Science, University of Texas Medical School at Houston, Houston, Texas 77054, USA.
J Child Adolesc Psychopharmacol. 2012 Aug;22(4):284-91. doi: 10.1089/cap.2011.0067. Epub 2012 Jul 31.
Parent and teacher ratings of core attention-deficit/hyperactivity disorder (ADHD) symptoms, as well as behavioral and emotional problems commonly comorbid with ADHD, were compared in children with autism spectrum disorders (ASD).
Participants were 86 children (66 boys; mean: age=9.3 years, intelligence quotient [IQ]=84) who met American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for an ASD on the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). Parent and teacher behavioral ratings were compared on the Conners' Parent and Teacher Rating Scales (CPRS-R; CTRS-R). The degree to which age, ASD subtype, severity of autistic symptomatology, and medication status mediated this relationship was also examined.
Significant positive correlations between parent and teacher ratings suggest that a child's core ADHD symptoms-as well as closely related externalizing symptoms-are perceived similarly by parents and teachers. With the exception of oppositional behavior, there was no significant effect of age, gender, ASD subtype, or autism severity on the relationship between parent and teacher ratings. In general, parents rated children as having more severe symptomatology than did teachers. Patterns of parent and teacher ratings were highly correlated, both for children who were receiving medication, and for children who were not.
Parents and teachers perceived core symptoms of ADHD and closely-related externalizing problems in a similar manner, but there is less agreement on ratings of internalizing problems (e.g., anxiety). The clinical implication of these findings is that both parents and teachers provide important behavioral information about children with ASD. However, when a clinician is unable to access teacher ratings (e.g., during school vacations), parent ratings can provide a reasonable estimate of the child's functioning in these domains in school. As such, parent ratings can be reliably used to make initial diagnostic and treatment decisions (e.g., medication treatment) regarding ADHD symptoms in children with ASDs.
比较自闭症谱系障碍（ASD）儿童的家长和教师对核心注意力缺陷/多动障碍（ADHD）症状以及通常与ADHD共病的行为和情绪问题的评分。
研究对象为86名儿童（66名男孩；平均年龄=9.3岁，智商[IQ]=84），他们在自闭症诊断访谈修订版（ADI-R）和自闭症诊断观察量表（ADOS）上符合美国精神病学协会《精神疾病诊断与统计手册》第4版（DSM-IV）的ASD标准。对家长和教师在康纳斯家长和教师评定量表（CPRS-R；CTRS-R）上的行为评分进行比较。还研究了年龄、ASD亚型、自闭症症状严重程度和用药状况对这种关系的调节程度。
家长和教师评分之间存在显著正相关，这表明家长和教师对儿童的核心ADHD症状以及密切相关的外化症状的认知相似。除对立行为外，年龄、性别、ASD亚型或自闭症严重程度对家长和教师评分之间的关系没有显著影响。总体而言，家长对儿童症状的评分比教师更高。接受药物治疗的儿童和未接受药物治疗的儿童，家长和教师评分模式高度相关。
家长和教师对ADHD的核心症状以及密切相关的外化问题的认知方式相似，但对内化问题（如焦虑）的评分一致性较低。这些发现的临床意义在于，家长和教师都提供了有关ASD儿童行为的重要信息。然而，当临床医生无法获取教师评分时（例如在学校假期期间），家长评分可以合理估计孩子在学校这些方面的功能状况。因此，家长评分可可靠地用于对ASD儿童的ADHD症状做出初步诊断和治疗决策（例如药物治疗）。
