Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL.
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Am J Speech Lang Pathol. 2024 Jan 3;33(1):369-377. doi: 10.1044/2023_AJSLP-23-00216. Epub 2023 Nov 27.
Accurate measurement of autistic children's social communication is critical for assessing skills, setting intervention goals, evaluating change over time, determining service eligibility, and determining classroom placement. There are various types of assessments, some of which use specific tasks to elicit social communication. Structured tasks may frustrate children, inadvertently elicit irritability, and have a cascading effect on their ability to communicate. To date, no studies have evaluated how differing types of social communication assessments may exacerbate children's irritability and impact assessment scores. We examined the extent to which (a) social communication assessment type (structured vs. naturalistic) impacts autistic children's irritability and (b) child irritability is associated with social communication scores.
Autistic toddlers ( = 114, = 33.09 months, = 6.15) completed the Communication and Symbolic Behavior Scales (CSBS; structured) and a 10-min play-based mother-child interaction (MCX; naturalistic). Child irritability was scored on both assessments using a global rating scale of 0-15.
Child irritability during the CSBS was significantly higher than during the MCX ( = 4892, < .001, = .68). Higher irritability was associated with lower CSBS social communication scores ( = -0.05, = .03), but not MCX scores ( = 0.04, = .13; Theil's = 6.92, = .009).
Our findings suggest that the CSBS may pose unique challenges for autistic children, as it led to higher rates of irritability and negatively affected children's social communication scores. Evaluating the association between assessment type and irritability supports the complete characterization of autistic children's experience during assessments and clinicians in obtaining a more representative measure of social communication.
准确测量自闭症儿童的社交沟通能力对于评估技能、设定干预目标、评估随时间的变化、确定服务资格和确定课堂安置至关重要。有各种类型的评估，其中一些使用特定任务来引出社交沟通。结构化任务可能会让孩子感到沮丧，无意中引发他们的烦躁情绪，并对他们的沟通能力产生级联效应。迄今为止，尚无研究评估不同类型的社交沟通评估如何加剧儿童的烦躁情绪并影响评估分数。我们研究了以下两个方面：（a）社交沟通评估类型（结构化与自然主义）对自闭症儿童烦躁情绪的影响程度；（b）儿童烦躁情绪与社交沟通分数的关系。
自闭症幼儿（n = 114，年龄中位数= 33.09 个月，SD = 6.15）完成了沟通与象征性行为量表（CSBS；结构化）和 10 分钟基于游戏的母子互动（MCX；自然主义）。在这两个评估中，使用 0-15 分的整体评分量表对儿童的烦躁情绪进行评分。
CSBS 期间儿童的烦躁情绪明显高于 MCX 期间（ = 4892，<.001， =.68）。较高的烦躁情绪与 CSBS 社交沟通分数较低相关（ = -0.05， =.03），但与 MCX 分数无关（ = 0.04， =.13；Theil 的 = 6.92， =.009）。
我们的研究结果表明，CSBS 可能对自闭症儿童提出独特的挑战，因为它会导致更高的烦躁情绪，并对儿童的社交沟通分数产生负面影响。评估评估类型与烦躁情绪之间的关联支持对自闭症儿童评估期间体验的全面描述，也支持临床医生获得更具代表性的社交沟通衡量标准。
