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Living with impairment: Behavioral, emotional and social adjustment of siblings of children with autism
Emily G. Lefkowitz, Susan G. Crawford and Deborah Dewey
Abstract
Children's self-reports and parents' reports were used to investigate the behavioral, emotional and social adjustment of siblings of children with autism. Participants were 98 siblings of children with autism and one of their parents and 48 siblings of typically developing children and one of their parents. Siblings completed the Feelings, Attitudes and Behaviors Scale for Children (FAB-C) and parents completed the Connors' Rating Scales-Revised (CRS-R). Results suggested that siblings of children with autism are at increased risk for behavioral and emotional problems and difficulties in social competence compared to siblings of typically developing children. These findings are important, as previous research has shown that children with behavioral and emotional difficulties, poor peer relations and social isolation are at increased risk for adjustment difficulties later in life. Significant correlations were found between parents' and children's scores for measures of behavior, social competence, and emotion only for the children with autism. This finding suggests that relative to parents of typical children, parents of children with autism may be particularly cognizant of the functioning and adjustment of their typical children.
Introduction
Autism, a complex neurological disorder, is characterized by a triad of impairments in the areas of communication, socialization, and ritualistic behavior (Volkmar & Pauls, 2003). Because autism impacts the ability to communicate and is associated with behavioral problems, siblings of children with autism face particular obstacles in their interactions with their disabled sibling. It has been commonly assumed that siblings of children with a disability are more susceptible to experiencing adjustment problems compared to siblings of children with no known disability (Rodrigue, Geffken & Morgan, 1993). A recent meta-analysis of 25 studies found, however, that children with mental retardation had a small negative effect on their siblings relative to siblings of normally developing children (Rossiter & Sharpe, 2001). Research that has specifically examined the psychosocial adjustment of siblings of children with autism has yielded discrepant results. Some studies found siblings of children with autism to be maladjusted in their behavioral and social functioning, with high levels of loneliness, problems with peers, and behavioral problems (Bagenholm & Gillberg, 1991; Hastings, 2003; Rodrigue et al., 1993; Verte, Roeyer & Buysse, 2003). In contrast, other studies have reported that siblings of children with autism were well-adjusted with no specific psychosocial problems (Gold, 1993; Kaminsky & Dewey, 2002; Mates, 1990). Why such conflicting findings exist in the literature is not entirely clear, but could be related to the relatively small sample sizes employed in previous research, the lack of a typically developing comparison group, the use of direct (sibling) versus indirect (parents) measures of sibling adjustment, and not controlling for the influence of sociodemographic factors such family size, gender of the sibling and birth order of the sibling.
One factor that could contribute to the inconsistency in the findings reported in the literature is the use of child versus parent measures of the siblings' adjustment. Studies have found that parents' reports of children's adjustment were more negative than children's self-reports, both for siblings of normally developing children (McHale, Sloan & Simeonsson, 1986) and for siblings of children with a disability (Rossiter & Sharpe, 2001). Verte and colleagues (2003) noted, however, that parents' and siblings' assessments in the area of social competence broadly matched each other. Thus, when examining the adjustment of siblings of children with autism, it is important to investigate both the siblings' perceptions of their adjustment, as well as parents' perceptions of their children's adjustment.
Recent literature has found associations between sociodemographic variables and siblings' behavioral, emotional and social adjustment. Large family size has been noted to be associated with fewer feelings of embarrassment and a feeling of shared responsibility regarding the sibling with autism and appears to promote better sibling adjustment (Kaminsky & Dewey, 2002; McHale et al., 1986). Sibling gender has also been found to have an impact on adjustment. Hastings (2003) found that brothers engage in fewer prosocial behaviors and experience more adjustment problems, while Verte et al. (Verte et al., 2003) noted that sisters had more positive self-concepts. Siblings younger than the child with autism have been found to be more affected than older siblings, with younger siblings exhibiting less prosocial behavior (Hastings, 2003). Other studies, however, failed to find family size, gender, and age effects on sibling adjustment (Gold, 1993; Mates, 1990; Roeyers & Mycke, 1995).
Given the conflicting findings reported in the literature, the main purpose of this study was to expand on previous research by investigating the behavioral, emotional and social adjustment of a large sample of siblings of children with autism compared with siblings of children with no known disability. The second objective was to examine the agreement between the siblings' and parents' assessments of siblings' adjustment. The final objective was to investigate the influence of a number of sociodemographic factors (i.e., family size, gender of the sibling, age of the sibling, gender of the child with autism, age of the child with autism, birth order) on sibling adjustment.
Method
Participants
Ninety-eight siblings of children who had received a diagnosis of autism according to parent report and their parents, and 48 siblings of typically developing children with no known disability and their parents participated in the study. Siblings of children who had received a diagnosis of Asperger's Syndrome or Pervasive Developmental Disorder - Not Otherwise Specified were not included in this sample. Siblings of children with autism and their parents were recruited via the Internet through the state autism society (n=81), with the remainder recruited from local special education schools (n=17). All of the parents of the children with autism that participated in this study reported that the diagnosis of autism had been made by a qualified physician and that the sibling of the child with autism had not been diagnosed with any learning or behavior problems. Siblings of typically developing children were recruited through elementary and middle schools. Parents of these children reported that the siblings of typically developing children were developing normally and had not been diagnosed with any learning or behavior problems.
Measures
Feelings, Attitudes, and Behaviors Scale for Children (FAB-C) (Beitchman, Kruidenier, Inglis & Clegg, 1996). The FAB-C is a self-report instrument designed to assess problems in children 6-13 years of age. It consists of 48 yes/no statements. Children are asked to indicate whether or not the statements describe them by circling yes or no. The questionnaire consists of 5 scales that measure conduct problems, self-image, worry, negative peer relations and antisocial attitudes. In addition, a problem index that identifies possible psychiatric problems can be derived. The FAB-C was validated on a normative group of 1,988 children (Beitchman et al., 1996). Higher scores indicate more severe psychosocial problems. A T score of > 65 is considered an extreme score and indicative of a potentially significant clinical problem. Beitchman et al. (1996) reported internal consistency reliabilities ranging from .61 to .78 across subscales. Test-retest reliabilities over a 10-day interval ranged from .55 to .78 for the subscales.
Conners' Rating Scales-Revised (CRS-R) (Conners, 1997). The CRS-R provided a parental report of the behavioral, emotional and social functioning of the sibling. This questionnaire is composed of 80 items. Four response choices were available for each question, not true at all (never, seldom), just a little true (occasionally), pretty much true (often, quite a bit), very much true (very often, very frequent), and the score on each item ranged from 0 to 3. The CRS-R is composed of 10 domains, 4 of which were evaluated in the present study: oppositional, social problems, anxious-shy and perfectionism (i.e., 30 items in total were used to evaluate these 4 domains). It was validated on a normative group of 2,485 participants (Conners, 1997). Higher scores indicate more severe psychosocial problems. A T score of > 65 is considered an extreme score and indicative of a potentially significant clinical problem. Connors (1997) reported internal consistency coefficients for the various subscales that ranged from .75 to .90 and test-retest reliability coefficients for a 6 week interval that ranged from .60 to .90.
The FAB-C and the CRS-R were selected for this study because they appeared to assess similar areas of functioning. Thus, they allowed for a more direct comparison of siblings' and parents' reports on the following constructs: Behavioral: Conduct problems (FAB-C) - Oppositional (CRS-R); Emotional: Worry (FAB-C) - Anxious/shy (CRS-R); Social competence: Negative peer relations (FAB-C) - Social problems (CRS-R).
Sociodemographic Questions. Parents were asked to provide demographic information on the number of children in the family and the age and gender of each child in the family. In addition, parents of children with autism were asked to provide information on birth order and age differences between the sibling and the child with autism.
Procedures
Parents provided informed consent, both for themselves and for their children; parents were assured that all responses would be confidential. Institutional review board approval was obtained. State autism societies were contacted via the internet and information regarding the research study was provided to members. In addition, parents at local schools that provided special education programs for children with autism were provided with information about the research study. In the information provided, we indicated that we were looking for families of children who had a diagnosis of autism in which there was a typically developing sibling between the ages of 6 to 13 years. Interested parents sent an e-mail expressing their willingness to participate in the study to the principal investigator. Children in the typically developing group were recruited through local elementary and middle schools. Information about the study was sent home to the parents of these children. In the information provided to these parents, we indicated that we were looking for families of typically developing children that had two typically developing children between the ages of 6 to 13 years. Again, those families interested in participating sent an e-mail expressing their willingness to participate to the principal investigator. Questionnaires were distributed via regular mail and returned in postage paid envelopes. The questionnaire to be completed by the parent was completed by the mother in more than 95% of the cases for the both autism and typically developing groups.
Results
Sample Description
In both the autism and typically developing groups there were slightly more female siblings than male siblings (autism = 57.1%, typically developing = 56.3%). All siblings were 6 to 13 years of age (autism M = 9.61 yrs, SD = 2.18; typically developing M = 9.58 yrs, SD = 2.11). The average number of children in the families of the autism group was 3.00 (SD = 1.08) and in the families of the typically developing group 2.67 (SD = 1.00). Analyses of variance (ANOVA) and chi-square tests indicated no group differences on these demographic variables.
The mean age of the children with autism was 8.34 (SD = 3.87; range 2-22 years); only 4 children with autism were older than 14 years of age. The siblings of the children with autism were older than the child with autism in 62.2% of cases. The mean age difference between the siblings and the children with autism was 3.40 years (SD = 1.98). As the typically developing siblings could have multiple other siblings, birth order and age spacing were not investigated. Eighty-six percent of parents were married in the autism group and 85% of parents were married in the typically developing group.
Sibling Adjustment on the Feelings, Attitudes, and Behaviors Scale for Children (FAB-C)
The mean scores of the siblings of children with autism and the siblings of typically developing children can be found in Table 1. A series of analysis of variance (ANOVAs) were conducted, using group and sibling gender as between-subject factors. Results revealed significant group differences on 2 subscales of the FAB-C: Conduct Problems, F(1, 142) = 5.48, p = .021 and Negative Peer Relations, F(1, 142) = 4.53, p = .035. Group differences were also found on the Derived Problem Index, F(1, 142) = 5.02, p = .027. Specifically, the siblings of children with autism scored significantly higher than the siblings of typically developing children on these measures. There were significant gender differences in the autism group and in the typically developing group on the Self-image subscale, F(1, 142) = 7.07, p = .009 and the Worry subscale, F(1, 142) = 6.89, p = .010. In both cases, boys obtained significantly higher scores than girls.
Chi square tests of association were used to examine whether there was an association between group and significant problems in functioning (i.e., did more siblings of children with autism have more extreme scores). Having a T score above 65 indicates potential clinical problems on these measures. Results of the analysis indicated that a significantly higher proportion of siblings of children with autism had extreme scores on the Conduct Problem scale than typically developing children, χ2(1, N = 146) = 5.26, p = .022, 10.0% vs. 0%. When stratified by gender, results showed that conduct problems were significantly more common for boys that were siblings of children with autism, χ2(1, N = 63) = 3.94, p = .047. No associations emerged for girls.
Sibling Adjustment on the Conners' Rating Scales-Revised (CPS-R)
The mean scores for the two groups are presented in Table 2. Results of a series of group x gender ANOVAs showed significant group differences on the Oppositional domain of the CRS-R, F(1, 137) = 4.72, p = .032. Parents of siblings of children with autism rated their children as having significantly more problems on this domain compared with parents of siblings of typically developing children There was a significant gender difference for perfectionism, F(1, 137) = 10.85, p = .001, with girls scoring lower than boys regardless of group. There was also a significant group x gender interaction on the Social Problems domain, F(1, 137) = 4.31, p = .040. Simple main effects revealed no significant group difference for boys, but for girls, sisters of children with autism had significantly higher scores on the Social Problems domain than the sisters of typically developing children, F(1, 78) = 15.81, p < .001.
Chi square tests were used to examine the association between group and extreme scores (i.e., T scores greater than 65) on the Oppositional, Perfectionism, Anxious/Shy and Social Problems domains. Results revealed that on the Social Problems domain a significantly higher proportion of siblings of children with autism displayed extreme scores, χ2(1, N = 141) = 7.46, p = .006, 18.3% vs 2.1%. There was also an association between extreme scores on the Anxious/shy domain and being a sibling of a child with autism, χ2(1, N = 141) = 3.89, p = .049, 21.5% vs. 8.3%. When these analyses were stratified by gender, results showed that extreme scores on the Social Problems, χ2(1, N = 80) = 7.19, p = .007, and Anxious/shy domains, χ2(1, N = 80) = 8.65, p = .003 were significantly more common in girls that were siblings of children with autism. No associations were noted for boys.
Relationships between sibling and parent measures
The relationships between siblings' and parents' scores were investigated using Pearson correlation coefficients. For the siblings of children with autism, significant correlations were found between parents' and children's scores for measures of behavioral, emotional, social adjustment (see Table 3). Repeated measures ANOVAs were used to compare the siblings' and parents' scores on the corresponding measures used to assess each construct. For these analyses, the between-group factors were group and gender of the sibling, while the respondent (i.e., sibling vs. parents) was the within-group factor. For the behavioral construct, a significant three way interaction was found among sibling gender, respondent and group, F(1, 137) = 4.82, p =.03. For boys, parents had significantly higher scores than their children, F(1, 59)= 17.42, p < .001), but the overall effect for group was not significant. For girls, parents also had significantly higher scores than their children, F(1, 78) = 37.13, p <.001; however, girls that were siblings of children with autism had significantly higher scores than girls that were siblings of the typically developing children, F(1, 78) = 6.65, p = .012). On the Emotional construct, significantly higher scores were found for the siblings in the autism group compared to the siblings in the typically developing group, F(1, 137) = 4.00, p = .047. There was also a significant sibling gender x respondent interaction, F(1, 137) = 5.48, p = .021. For boys, no significant difference emerged between parents and children, but for girls, parents' scores were significantly higher than their children's, F(1, 78) = 44.43, p < .001. On the Social Competence construct, parents had significantly higher scores than their children, F(1, 137) = 51.42, p < .001, and the siblings in the autism group had significantly higher scores than the siblings in the typically developing group, F(1, 137) = 8.01, p = .005.
Relationship of Sociodemographic Characteristics to Psychosocial Adjustment
A series of ANOVAs were used to examine the effects of birth order and sibling gender on the FAB-C and CRS-R in siblings of children with autism. Birth order was dichotomized based on whether or not the sibling was older or younger than the child with autism. Results indicated that female siblings had significantly better adjustment (i.e., lower scores) than males on the FAB-C Self-image, M = 46.8 vs. 50.1, respectively, F(1, 94) = 4.46, p = .037, and Worry subscales, M = 45.4 vs. 51.3, respectively, F(1, 94) = 5.03, p = .027. A significant interaction was found between sibling gender and birth order on the CRS-R Perfectionism domain, F(1, 89) = 4.60, p = .035, males who were older than the child with autism had significantly higher perfectionism scores than females who were older than the child with autism, F(1, 57) = 6.95, p = .011.
No relationship was found between sibling age and psychosocial adjustment. Similarly, no significant correlations were found between the age of the child with autism and the scores of the siblings on the FAB-C and the CRS-R. When families with three or fewer children (including the autistic child) were compared to those with four or more children, siblings from larger families had significantly lower scores on the CRS-R Anxious/shy domain, M = 49.5 vs. 54.9, respectively, F(1, 139) = 4.18 p = .043.
Discussion
The results of this study suggest that siblings of children with autism are at increased risk for behavioral and emotional problems and difficulties in social competence compared to siblings of typically developing children. In contrast to previous research (Kaminsky & Dewey, 2002; Verte et al., 2003), a significant proportion of the siblings of children with autism displayed extreme scores, indicative of potential clinical problems. These findings are important, as previous research has shown that children with behavioral and emotional difficulties, poor peer relations and social isolation are at increased risk for adjustment difficulties later in life including depression and school dropout (Parker & Asher, 1987; Pedersen, Vitaro, Barker & Borge, 2007; Renshaw & Brown, 1993).
While many studies have noted behavioral problems in siblings of children with autism (Bagenholm & Gillberg, 1991; Rodrigue et al., 1993), emotional difficulties and problems in social competence have not been consistently reported. Pilowsky et al. (2004) found no differences in emotional and social adjustment among siblings of children with autism, siblings of children with mental retardation and siblings of children with developmental language disorders. This study, however, did not include a comparison group of typically developing children. Verte and colleagues (2003) reported more behavioral problems among the siblings of children with autism compared to typically developing children, but no differences between these two groups on social competence and self-concept. In contrast, Hastings (2003) who utilized parent reports and normative data for comparison purposes found more conduct, emotional and peer problems, and less prosocial behavior in siblings of children with autism.
What could account for these varied findings? Sharpe and Rossiter (2001) in a meta-analysis of studies of siblings of children with mental retardation identified two methodological factors that appear to have a significant effect on outcome: 1) studies that used parents' reports of children's problems resulted in more negative outcomes than child self-reports and 2) studies employing normative data report worse outcomes compared with studies utilizing control groups. In addition to these methodological factors, small sample size, the use of only parent report measures of sibling adjustment, and not controlling for the influence of sociodemographic factors could also have contributed to the lack of consistency in the reported findings. To address some of these issues, the present study recruited a large sample of siblings of children with autism, employed both direct (child self-reports) and indirect (parent reports) measures of adjustment and utilized a control group of siblings of typically developing children for comparison purposes.
Consistent with previous research (Sharpe & Rossiter, 2001), parents' reports were more negative than children's self-reports, for both the siblings of children with autism and the siblings of typically developing children. Examination of the relationship between parents' reports and children's self-reports by group indicated that for the families of children with autism there was a significant association; however, this was not the case for families of typically developing children. This suggests that relative to parents of typically developing children, parents of children with autism are particularly cognizant of the functioning and adjustment of their unaffected children.
Sisters of children with autism evidenced a more positive self-image and displayed less worry than brothers. This is consistent with the findings of Hastings (2003) and Howlin (1988). Since autism is four times more prevalent in males than in females, and most prior studies were comprised of samples of 20-30 children, there was very little information on the impact of the gender of the child with autism on sibling adjustment. Our findings suggest, however, that the gender of the child with autism is not associated with sibling adjustment. Similar to the findings of Kaminsky and Dewey (2002), we found that siblings of children with autism from larger families exhibited less worry and fewer social problems than siblings from a small family. In contrast, Pilowsky and colleagues (2004) reported that sibling gender was not associated with siblings' adjustment, and that the socialization skills of siblings from larger families were delayed compared to those of siblings from smaller families. The reasons for the discrepancies in the finding of these studies is not clear, but could be due to the different measures used and differences in the participant samples.
Support groups for parents of children with autism have become common. In previous research Kaminsky and Dewey (2002) found that siblings of children with autism whose parents attended support groups displayed fewer internalizing and externalizing problems than siblings whose parents did not attend support groups. They suggested that siblings of children whose parents were active support group attendees may be more privileged to information about autism and may be more likely to interact with other families of children with autism. The social support gained from membership in such groups could also facilitate healthy psychological adjustment in siblings of children with autism. Support groups for siblings of children with autism are also becoming more common. Such groups could be an effective means of identifying and intervening with siblings of children with autism who are at risk for adjustment difficulties.
One limitation of this study is the applicability of the study's findings to siblings of children with autism in the general population. Most of the families that participated were recruited through state autism societies via the internet. Families who are willing to participate in studies online might not be representative of most families of children with autism. Further, because no face to face contact was made with the families and no children were assessed directly, we had to rely on parents' reports that their children were diagnosed with autism and that siblings were typically developing and did not have any learning or behavioral problems. It is possible that some of the children that parents' reported as having a diagnosis of autism would not meet criteria for the diagnosis. Also, some of the siblings in both the autism and the typically developing groups may have had undiagnosed learning or behavior problems.
In conclusion, the present study found that based on both siblings' self-reports and parents' reports, siblings of children with autism experienced more problems in behavioral functioning, more emotional difficulties and lower levels of social competence than siblings of typically developing children. Clinicians working with families of children with autism should be aware that these siblings are at increased risk for difficulties in psychosocial adjustment. Further research that examines the nature of the sibling relationships in more detail and the influence of dynamic family factors such as parental stress is essential for us to better understand the experiences of siblings of children with autism.
References
Bagenholm, A., & Gillberg, C. (1991). Psychosocial effects on siblings of children with autism and mental retardation: a population-based study. Journal of Mental Deficiency Research, 35, 291-307.
Beitchman, J. H., Kruidenier, B., Inglis, A., & Clegg, M. (1996). The children's self-report questionnaire: factor score, age trends, and gender differences. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 714-722.
Conners, C. K. (1997). Conners' Rating Scales-Revised: Users Manual. Toronto: Multi-Health Systems Inc.
Gold, N. (1993). Depression and social adjustment in siblings of boys with autism. Journal of Autism and Developmental Disorders, 23, 147-163.
Hastings, R. P. (2003). Behavioral adjustment of siblings of children with autism. Journal of Autism and Developmental Disorders, 33, 99-104.
Howlin, P. (1988). Living with impairment: the effects on children of having an autistic sibling. Child: Care, Health, and Development, 14, 395-408.
Kaminsky, L. A., & Dewey, D. (2002). Psychosocial adjustment in siblings of children with autism. Journal of Child Psychology and Psychiatry, 43, 225-232.
Mates, T. E. (1990). Siblings of autistic children: their adjustment and performance at home and in school. Journal of Autism and Developmental Disorders, 20, 545-553.
McHale, S. M., Sloan, J. L., & Simeonsson, R. J. (1986). Sibling relationships with autistic, mentally retarded, and nonhandicapped brothers and sisters. Journal of Autism and Developmental Disorders, 16, 399-413.
Parker, J. G., & Asher, S. R. (1987). Peer relations and later personal adjustment: Are low-accepted children at risk? Psychological Bulletin, 102, 357-389.
Pedersen, S., Vitaro, F., Barker, E. D., & Borge, A. I. (2007). The timing of middle-childhood peer rejection and friendship: linking early behavior to early-adolescent adjustment. Child Development, 78, 1037-1051.
Renshaw, P. D., & Brown, P. J. (1993). Loneliness in middle childhood: Concurrent and
longitudinal predictors. Child Development, 64, 1271-1284.
Rodrigue, J. R., Geffken, G. R., & Morgan, S. B. (1993). Perceived competence and behavioral adjustment of siblings of children with autism. Journal of Autism and Developmental Disorders, 23, 665-674.
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quantitative integration of the literature. Journal of Child and Family Studies, 10, 65-84.
Verte, S., Roeyers, H., & Buysse, A. (2003). Behavioural problems, social competence and self-concept in siblings of children with autism. Child: Care, Health & Development, 29, 193-205.
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Table 1
Sibling self-reports: Mean scores for siblings of children with autism and siblings of typically developing children on the FAB-C
|
Scale
|
Overall |
Autism |
Typically Developing |
|
|
Autism N=98 |
Control N=48 |
Males N=42 |
Females N=56 |
Males N=21 |
Females N=27 |
|
Self-image
|
48.2 ± 8.7
|
46.7 ± 6.6
|
51.0 ± 11.2
|
46.2 ± 5.5**
|
48.1 ± 7.3
|
45.6 ± 5.8**
|
|
Conduct problems
|
48.1 ± 10.8*
|
44.3 ± 7.1
|
50.1 ± 11.6
|
46.5 ± 9.9
|
44.5 ± 8.1
|
44.0 ± 6.4
|
|
Worry
|
47.7 ± 11.7
|
44.6 ± 10.2
|
50.7 ± 12.3
|
45.5 ± 10.8*
|
47.4 ± 12.5
|
42.4 ± 7.6*
|
|
Negative Peer Relations
|
46.7 ± 10.8*
|
43.0 ± 8.1
|
46.5 ± 11.7
|
47.1 ± 10.2
|
43.0 ± 8.3
|
43.0 ± 8.1
|
|
Anti-Social Behavior
|
52.0 ± 9.8
|
51.4 ± 11.5
|
52.2 ± 10.0
|
51.9 ± 9.7
|
50.4 ± 13.0
|
52.2 ± 10.3
|
|
Problem index
|
53.2 ± 8.6*
|
49.6 ± 11.2
|
52.2 ± 7.2
|
53.9 ± 9.5
|
46.8 ± 11.1
|
51.7 ± 11.0
|
* p <.05, ** p<.01, ***, p<.001
Results are mean ± standard deviation
Abbreviation: FAB-C: Feelings, Attitudes, and Behaviors Scale for Children
Table 2
Parent reports of sibling adjustment: Mean scores for parents of siblings of children with autism and parents of siblings of typically developing children on the CRS-R
|
Scale
|
Overall |
Autism |
Typically Developing |
|
|
Autism N=98 |
Control N=48 |
Males N=42 |
Females N=56 |
Males N=21 |
Females N=27 |
|
Oppositional
|
55.2 ± 10.8*
|
50.9 ± 8.2
|
54.5 ± 10.6
|
55.7 ± 11.0
|
53.8 ± 9.4
|
48.7 ± 6.4
|
|
Anxious/shy
|
55.3 ± 13.9
|
51.0 ± 9.5
|
53.0 ± 12.0
|
56.9 ± 15.1
|
52.4 ± 12.0
|
50.0 ± 6.9
|
|
Perfectionism
|
50.6 ± 9.3
|
50.3 ± 10.7
|
52.8 ± 11.1
|
48.9 ± 7.5**
|
54.5 ± 13.9
|
47.1 ± 5.7**
|
|
Social Problems
|
54.7 ± 12.3
|
48.6 ± 7.9
|
53.2 ± 12.2
|
55.9 ± 2.4***
|
51.6 ± 10.8
|
46.3 ± 3.3
|
* p <.05, ** p<.01, ***, p<.001
Results are mean ± standard deviation
Abbreviation: CRS-R: Conners' Rating Scales-Revised
Table 3
Comparison of siblings and parent assessments on corresponding FAB-C and CRS-R scales
|
| |
|
Autism |
Typically Developing |
Construct |
FAB-C |
CRS-R |
Mean difference between scales |
Pearson correlation coefficient: r value (p value) |
Mean difference between scales |
Pearson correlation coefficient: r value |
|
Behavioral adjustment
|
Conduct problems
|
Oppositional
|
7.1 + 11.6
|
.43 (<0.001)
|
6.7 + 9.6
|
.22 (0.13)
|
|
Emotional adjustment
|
Worry
|
Anxious/shy
|
7.8 + 16.0
|
.24 (0.02)
|
6.5 + 12.4
|
.21 (0.15)
|
|
Social adjustment
|
Negative peer-relations
|
Social problems
|
8.2 + 11.5
|
.52 (<0.001)
|
6.6 + 9.8
|
.26 (0.08)
|
Mean differences between corresponding FAB-C and CRPS-R scales are given as mean ± standard deviation; in all cases higher scores were recorded on the CRS-R scale
Abbreviation: FAB-C: Feelings, Attitudes, and Behaviors Scale for Children; CRS-R: Conners' Rating Scales-Revised
Submitted by
Emily G. Lefkowitz
Suffern High School, Suffern
New York, U.S.A.
Susan G. Crawford
Behavioural Research Unit, Alberta Children's Hospital
Calgary, Canada
Deborah Dewey
Department of Pediatrics, University of Calgary
Calgary, Canada
Department of Community Health Science, University of Calgary
Calgary, Canada
Corresponding Author: Deborah Dewey, Ph.D., Behavioural Research Unit, Alberta Children's Hospital
Email: Deborah.Dewey@calgaryhealthregion.ca
2888 Shaganappi Trail N.W., Calgary, Alberta Canada, T3B 6A8,
Tel: (403) 955-7394
Fax: (403) 955-2772
Acknowledgements
The authors thank Marilyn Wagner, Winifred Gleason, and Joseph Miller for reviewing the manuscript. We also thank the children and parents who participated in the study.
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