PMID- 28449247 OWN - NLM STAT- MEDLINE DCOM- 20180330 LR - 20180330 IS - 1469-7610 (Electronic) IS - 0021-9630 (Linking) VI - 58 IP - 7 DP - 2017 Jul TI - Informant discrepancy defines discrete, clinically useful autism spectrum disorder subgroups. PG - 829-839 LID - 10.1111/jcpp.12730 [doi] AB - BACKGROUND: Discrepancy between informants (parents and teachers) in severity ratings of core symptoms commonly arise when assessing autism spectrum disorder (ASD). Whether such discrepancy yields unique information about the ASD phenotype and its clinical correlates has not been examined. We examined whether degree of discrepancy between parent and teacher ASD symptom ratings defines discrete, clinically meaningful subgroups of youth with ASD using an efficient, cost-effective procedure. METHODS: Children with ASD (N = 283; 82% boys; M(age) = 10.5 years) were drawn from a specialty ASD clinic. Parents and teachers provided ratings of the three core DSM-IV-TR domains of ASD symptoms (communication, social, and perseverative behavior) with the Child and Adolescent Symptom Inventory-4R (CASI-4R). External validators included child psychotropic medication status, frequency of ASD-relevant school-based services, and the Autism Diagnostic Observation Schedule (ADOS-2). RESULTS: Four distinct subgroups emerged that ranged from large between-informant discrepancy (informant-specific) to relative lack of discrepancy (i.e. informant agreement; cross-situational): Moderate Parent/Low Teacher or Low Parent/Moderate Teacher Severity (Discrepancy), and Moderate or High Symptom Severity (Agreement). Subgroups were highly distinct (mean probability of group assignment = 94%). Relative to Discrepancy subgroups, Agreement subgroups were more likely to receive psychotropic medication, school-based special education services, and an ADOS-2 diagnosis. These differential associations would not have been identified based solely on CASI-4R scores from one informant. CONCLUSIONS: The degree of parent-teacher discrepancy about ASD symptom severity appears to provide more clinically useful information than reliance on a specific symptom domain or informant, and thus yields an innovative, cost-effective approach to assessing functional impairment. This conclusion stands in contrast to existing symptom clustering approaches in ASD, which treat within-informant patterns of symptom severity as generalizable across settings. Within-child variability in symptom expression across settings may yield uniquely useful information for characterizing the ASD phenotype. CI - (c) 2017 Association for Child and Adolescent Mental Health. FAU - Lerner, Matthew D AU - Lerner MD AUID- ORCID: 0000-0002-7373-6663 AD - Department of Psychology, Stony Brook University, Stony Brook, NY, USA. FAU - De Los Reyes, Andres AU - De Los Reyes A AD - Department of Psychology, University of Maryland, College Park, MD, USA. FAU - Drabick, Deborah A G AU - Drabick DAG AD - Department of Psychology, Temple University, Philadelphia, PA, USA. FAU - Gerber, Alan H AU - Gerber AH AD - Department of Psychology, Stony Brook University, Stony Brook, NY, USA. FAU - Gadow, Kenneth D AU - Gadow KD AD - Department of Psychiatry, Stony Brook Medicine, Stony Brook, NY, USA. LA - eng PT - Journal Article DEP - 20170427 PL - England TA - J Child Psychol Psychiatry JT - Journal of child psychology and psychiatry, and allied disciplines JID - 0375361 SB - IM MH - Adolescent MH - Autism Spectrum Disorder/*classification/*physiopathology/therapy MH - Child MH - Female MH - Humans MH - Male MH - Parents MH - Phenotype MH - School Teachers MH - *Severity of Illness Index OTO - NOTNLM OT - Autism spectrum disorders OT - assessment OT - nosology OT - phenotype OT - questionnaires EDAT- 2017/04/28 06:00 MHDA- 2018/03/31 06:00 CRDT- 2017/04/28 06:00 PHST- 2017/01/18 00:00 [accepted] PHST- 2017/04/28 06:00 [pubmed] PHST- 2018/03/31 06:00 [medline] PHST- 2017/04/28 06:00 [entrez] AID - 10.1111/jcpp.12730 [doi] PST - ppublish SO - J Child Psychol Psychiatry. 2017 Jul;58(7):829-839. doi: 10.1111/jcpp.12730. Epub 2017 Apr 27.