Differences in profiles of emotional behavioral problems across instruments in verbally fluent versus language impaired children with Autism Spectrum Disorder

There has been increasing attention to the assessment of minimally verbal (MV) children with Autism spectrum disorder (ASD). Previous research has begun to examine the relationship between verbal abilities and emotional and behavioral problems (EBP). The current study compared parent-reported EBP in children of differing language levels on two instruments commonly used in ASD research and clinical practice, the Child Behavior Checklist (CBCL) and Aberrant Behavior Checklist (ABC). The study consisted of 1,937 6-18 years old children with ASD from the Simons Simplex Collection. Children were divided into three language groups, by ADOS module (Module 1 = MV, 2 = phrase speech (PS), 3 and 4 = verbally fluent (VF)) and then compared on CBCL and ABC subscales. The ABC and CBCL showed different patterns of elevations across the language groups. MV children were reported to have more impairment than VF children on the ABC Irritability, Lethargy and Hyperactivity scales. Children with less language (MV and PS) exhibited less impairment on the CBCL Internalizing domain than VF children, but did not differ on the Externalizing domain. Post hoc comparisons showed that Internalizing differences were driven by fewer children with less language exhibiting clinically elevated Anxious/Depressed scores compared to VF children. The present study underscores the significance of considering language when assessing EBP. Results have implications for the psychiatric screening of children with ASD, particularly those with language impairments. Researchers should exercise caution when applying EBP instruments designed for use with different populations and purposes to broad samples of children.Peer reviewe