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Follow-up of Maladaptive Behaviors in Youth with Autism Spectrum Disorders: Changes and Predictors Over Two to Eight Years

Chowdhury, Monali
http://rave.ohiolink.edu/etdc/view?acc_num=osu1343032014

Abstract Details

2012, Doctor of Philosophy, Ohio State University, Psychology.
Ample evidence suggests that young people with autism spectrum disorders (ASDs) present with a wide range of maladaptive behaviors beyond the core symptoms that define the disorder. Such maladaptive behaviors represent additional handicaps for these individuals and are associated with negative outcomes including poor social competency, academic and vocational under-achievement, among others. In spite of the prevalence and significance of maladaptive behaviors, the natural course and predictors of such behaviors are not delineated in the ASD literature. This study was conducted to add to the scant body of knowledge on this topic. Participants were recruited using patient records at Nisonger Center clinics, where potential participants were given an ASD diagnosis two-to-eight years previously. All individuals seen at the clinics had a measure of maladaptive behavior on file, assessed using the Nisonger Child Behavior Rating Form (NCBRF; Aman, Tassé, Rojahn, & Hammer, 1996). I conducted follow-ups on 342 potential participants and collected follow-up data from 143 (41.8%) of these individuals. Follow-up data included current parent-rated NCBRF and supplementary demographic information (about the individual with an ASD) from families via a structured phone interview. This information included (a) comorbid psychiatric diagnoses, (b) current educational placement, (c) current psychotropic medications, and (d) interventions received. Results indicated substantial presence of maladaptive behaviors both at initial visit (T1) and follow-up (T2). Scores differed significantly between T1 and T2 assessments on all six NCBRF subscales indicating that maladaptive behaviors changed considerably with age. Scores on three of the six NCBRF subscales (Conduct, Hyperactivity, and Self-injury/Stereotypic) showed significant decline (improvement) over time, while scores on the remaining three subscales (Insecure/Anxious, Self-isolated/Ritualistic, and Overly Sensitive) increased (deteriorated) at follow-up. Levels of maladaptive behaviors were found to vary considerably based on gender, ASD subtype, and language abilities of participants. As far as predictors of maladaptive behavior change, the tested models accounted for 39% to 50% of the variance in T2 NCBRF subscale scores. The T1 scores on the respective NCBRF subscales were the most consistent predictors of all six NCBRF subscale scores at follow-up. This indicates that a child’s individual levels of maladaptive behavior at T1 were the best predictor of maladaptive behavior over time. Other variables that significantly predicted T2 scores on one or more NCBRF subscales included T1 age, ASD subtype, and T1 language ability. Parents reported high rates (68.5%) of comorbid psychiatric conditions in this community sample unselected for psychiatric disorders and also a high rate of psychotropic medication use (52.4%). The most common comorbid disorders were anxiety disorders (37.8%) and ADHD (31.5%). At follow-up, the highest proportion of participants were placed in developmentally handicapped classes (22.7%), followed by regular classes with minimum accommodations (17.9%). The vast majority (79.7%) received at least one of the following interventions: speech and language therapy, occupational/physical therapy, or applied behavioral analytic therapy. Findings from this study add to the limited data on the natural course of maladaptive behavior in ASDs and have implications for clinicians, parents, and service providers in anticipating change over time and planning interventions.
Michael G. Aman, PhD (Advisor)
Luc Lecavalier, PhD (Committee Member)
Michael Edwards, PhD (Committee Member)
Laura Wagner, PhD (Committee Member)
212 p.
Psychology
follow-up; autism spectrum disorders; maladaptive behaviors

Recommended Citations

Citations

  • Chowdhury, M. (2012). Follow-up of Maladaptive Behaviors in Youth with Autism Spectrum Disorders: Changes and Predictors Over Two to Eight Years [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1343032014

    APA Style (7th edition)

  • Chowdhury, Monali. Follow-up of Maladaptive Behaviors in Youth with Autism Spectrum Disorders: Changes and Predictors Over Two to Eight Years. 2012. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1343032014.

    MLA Style (8th edition)

  • Chowdhury, Monali. "Follow-up of Maladaptive Behaviors in Youth with Autism Spectrum Disorders: Changes and Predictors Over Two to Eight Years." Doctoral dissertation, Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1343032014

    Chicago Manual of Style (17th edition)

osu1343032014
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© 2012, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.
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