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Parental Reports vs Clinical Observation

Wendy L. Stone, PhD; Edward L. Hoffman, MD; Susan E. Lewis, MA; Opal Y. Ousley

Arch Pediatr Adolesc Med. 1994;148(2):174-179.

Abstract
Objective
To determine which behavioral characteristics of autism are apparent in early childhood and to examine the relative contributions of clinical observation and parental reports to early identification of autism.

Design
Blinded comparison of behavioral data obtained through parental reports and clinical observation.

Setting
Child development referral center.

Patients
Twenty-six children (23 boys and three girls) younger than age 48 months with a clinical diagnosis of autism.

Selection Procedures
Consecutive sample.

Interventions
None.

Measurements and Results
Social interaction, communication, and activities and interests were evaluated using standard diagnostic criteria for autism. Results suggested that deficits in the areas of social interaction, imitation, play, and nonverbal communication are more prominent than insistence on sameness and routines in young children with autism. Also, parental reports and clinical observation appear to detect different aspects of abnormal behavior patterns in this sample.

Conclusions
Improved awareness of the early signs of autism should help physicians recognize this disorder in a timely manner. Further research may identify how observation of play and parental reports might be incorporated efficiently into a physician's repertoire of developmental and behavioral screening tools.

(Arch Pediatr Adolesc Med. 1994;148:174-179)

Author Affiliations
From the Vanderbilt University School of Medicine (Dr Stone) and Peabody College of Vanderbilt University (Mss Lewis and Ousley), Nashville, Tenn; the University of Missouri at Kansas City School of Medicine and The Children's Mercy Hospital, Kansas City (Dr Hoffman).

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