Problem Behaviors in Autism Spectrum Disorder: Association with Verbal Ability and Adapting/Coping Skills
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Data from the Autism Inpatient Collection was used to examine the relationship between problem behaviors and verbal ability, which have generally, though not universally, been highly associated. In a comparison of 169 minimally-verbal and 177 fluently-verbal 4 to 20-year-old psychiatric inpatients with ASD, the severity of self-injurious behavior, stereotyped behavior, and irritability (including aggression and tantrums) did not significantly differ, when controlling for age and NVIQ. Verbal ability was not strongly related to the severity of problem behaviors. However, lower adapting/coping scores were significantly associated with increasing severity of each type of problem behavior, even when accounting for verbal ability. Interventions to develop adapting/coping mechanisms may be important for mitigation of problem behaviors across the spectrum of individuals with ASD.
KeywordsCommunication Challenging behavior Coping skills Autism spectrum disorder (ASD) Psychiatric inpatients Autism inpatient collection (AIC)
The ADDIRC is made up of the co-investigators: Matthew Siegel, MD (PI) (Maine Medical Center Research Institute; Tufts University), Craig Erickson, MD (Cincinnati Children’s Hospital; University of Cincinnati), Robin L. Gabriels, PsyD (Children’s Hospital Colorado; University of Colorado), Desmond Kaplan, MD (Sheppard Pratt Health System), Carla Mazefsky, PhD (Western Psychiatric Institute and Clinics; University of Pittsburgh), Eric M. Morrow, MD, PhD (Bradley Hospital; Brown University), Giulia Righi, PhD (Bradley Hospital; Brown University), Susan L. Santangelo, ScD (Maine Medical Center Research Institute; Tufts University), and Logan Wink, MD (Cincinnati Children’s Hospital; University of Cincinnati). Collaborating investigators and staff: Jill Benevides, BS, Carol Beresford, MD, Carrie Best, MPH, Katie Bowen, LCSW, Briar Dechant, BS, Tom Flis, BCBA, LCPC, Holly Gastgeb, PhD, Angela Geer, BS, Louis Hagopian, PhD, Benjamin Handen, PhD, BCBA-D, Adam Klever, BS, Martin Lubetsky, MD, Kristen MacKenzie, BS, Zenoa Meservy, MD, John McGonigle, PhD, Kelly McGuire, MD, Faith McNeil, BS, Joshua Montrenes, BS, Tamara Palka, MD, Ernest Pedapati, MD, Kahsi A. Pedersen, PhD, Christine Peura, BA, Joseph Pierri, MD, Christie Rogers, MS, CCC-SLP, Brad Rossman, MA, Jennifer Ruberg, LISW, Elise Sannar, MD, Cathleen Small, PhD, Nicole Stuckey, MSN, RN, Barbara Tylenda, PhD, Brittany Troen, MA, R-DMT, Mary Verdi, MA, Jessica Vezzoli, BS, Deanna Williams, BA, and Diane Williams, PhD, CCC-SLP. We gratefully acknowledge the contributions of the coordinating site advisory group: Donald L. St. Germain, MD and Girard Robinson, MD, and our scientific advisory group: Connie Kasari, PhD., Bryan King, MD, James McCracken, MD, Christopher McDougle, MD, Lawrence Scahill, MSN, PhD, Robert Schultz, PhD and Helen Tager-Flusberg, PhD, the input of the funding organizations and the families and children who participated.
MS and CM conceived of the study and participated in its design and coordination; DW and CM performed the statistical analyses and drafted the manuscript; All authors participated in the interpretation of the data and read and approved the final manuscript. All ADDIRC sites participated in data collection.
The Autism Inpatient Collection (AIC) phenotypic database and biorepository is supported by a grant from the Simons Foundation Autism Research Initiative and the Nancy Lurie Marks Family Foundation, (SFARI #296318 to MS). This study was also supported a grant from the National Institute of Child Health and Human Development (R01HD079512 to CM) and Dr. Mazefsky received additional support from NICHD (K23HD060601).
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed involving human participants were in accordance with the ethical standards of the institutional research committees where the data was collected and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in this study.
- Brenner, E., & Salovey, P. (1997). Emotion regulation during childhood: Developmental, interpersonal, and individual considerations. In P. Salovey & D. Sluyter (Eds.), Emotional literacy and emotional development (pp. 168–192). New York: Basic Books.Google Scholar
- Carr, E. G., Reeve, C. E., & Magito-McLaughlin, D. (1996). Contextual influences on problem behavior in people with developmental disabilities. In L. K. Koegel, R. L. Koegel & G. Dunlap. (Eds.), Positive behavioral support: Including people with difficult behavior in the community (pp. 403–423). Baltimore: Paul H. Brookes.Google Scholar
- Duerden, E. G., Oatley, H. K., Mak-Fan, K. M., McGrath, P. A., Taylor, M. J., Szatmari, P., & Roberts, S. W. (2012). Risk factors associated with self-injurious behaviors in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(11), 2460–2470.CrossRefPubMedGoogle Scholar
- Frost, L., & Bondy, A. (2002). Picture exchange communication system. Newark, DE: Pyramid Educational Products.Google Scholar
- Kurtz, P. F., Chin, M. D., Huete, J. M., Tarbox, R. S., O’Connor, J. T., Paclawskyj, T. R., & Rush, K. S. (2003). Functional analysis and treatment of self-injurious behavior in young children: A summary of 30 cases. Journal of Applied Behavior Analysis, 36(2), 205–219.CrossRefPubMedPubMedCentralGoogle Scholar
- Ladd, M. V. (2007). Mitigate and cope: A context-based approach to intervention for problem behavior in home and community settings (Doctoral dissertation). Retrieved from ProQuest. (Publication No. 3334936).Google Scholar
- Lord, C., Rutter, M., DiLavore, P., Risi, S., Gotham, K., & Bishop, S. (2012). Autism diagnostic observation schedule—2nd edition (ADOS-2). Los Angeles: Western Psychological Corporation.Google Scholar
- Mayes, S. D., Calhoun, S. L., Aggarwal, R., Baker, C., Mathapati, S., Anderson, R., et al. (2012). Explosive, oppositional, and aggressive behavior in children with autism compared to other clinical disorders and typical development. Research in Autism Spectrum Disorders, 6, 1–10.CrossRefGoogle Scholar
- Mazefsky, C. A., Borue, X., Day, T. N., & Minshew, N. J. (2014). Emotion regulation patterns in adolescents with high-functioning autism spectrum disorder: Comparison to typically developing adolescents and association with psychiatric symptoms. Autism Research, 7(3), 344–354.CrossRefPubMedPubMedCentralGoogle Scholar
- O’Reilly, M., Rispoli, M., Davis, T., Machalicek, W., Lang, R., Sigafoos, J., … Didden, R. (2010). Functional analysis of challenging behavior in children with autism spectrum disorders: A summary of 10 cases. Research in Autism Spectrum Disorders, 4(1), 1–10. doi: 10.1016/j.rasd.2009.07.001.CrossRefGoogle Scholar
- Prizant, B. M., Wetherby, A. M., Rubin, E., Laurent, A. C., & Rydell, P. J. (2006). The SCERTS ® model: Volume I Assessment; Volume II Program planning and intervention. Baltimore: Brookes Publishing.Google Scholar
- Roid, G. H., Miller, L. J., Pomplun, M., & Koch, C. (2013). Leiter international performance scale, (Leiter-3). Los Angeles: Western Psychological Services.Google Scholar
- Rutter, M., Bailey, A., & Lord, C. (2003). Social communication questionnaire (SCQ). Los Angeles: Western Psychological Services.Google Scholar
- Saarni, C., Campos, J. J., Camras, L. A., & Witherington, D. (2007). Emotional Development: Action, Communication, and Understanding. Handbook of Child Psychology. III, 5.Google Scholar
- Siegel, M., Smith, K. A., Mazefsky, C., Gabriels, R. L., Erickson, C., Kaplan, D. … for the Autism and Developmental Disorders Inpatient Research Collaborative (ADDIRC) (2015). The autism inpatient collection: Methods and preliminary sample description. Molecular Autism: The International Journal of Research and Practice, 6, 61–71.CrossRefGoogle Scholar
- Sigafoos, J. (2000). Communication development and aberrant behavior in children with developmental disabilities. Education and Training in Mental Retardation and Developmental Disabilities, 35, 168–176.Google Scholar
- Sigafoos, J., Reichle, J., & Light-Shriner, C. (1994). Distinguishing between socially and nonsocially motivated challenging behavior: Implications for the selection of intervention strategies. In M. F. Hayden & B. H. Abery (Eds.), Challenges for a service system in transition: Ensuring quality community experiences for persons with developmental disabilities (pp. 147–169). Baltimore: Paul H. Brookes.Google Scholar
- Sparrow, S. S., Cicchetti, V. D., & Balla, A. D. (2005). Vineland adaptive behavior scales—2nd edition (VABS-II). Livonia, MN: Pearson Assessments.Google Scholar
- Williams, D. L., Mazefsky, C. A., Walker, J. D., Minshew, N. J., & Goldstein, G. (2014). Associations between conceptual reasoning, problem solving, and adaptive ability in high-functioning autism. Journal of Autism and Developmental Disorders, 44(11), 2908–2920.CrossRefPubMedPubMedCentralGoogle Scholar
- Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., … Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45(7), 1951–1966.CrossRefPubMedGoogle Scholar
- Zaidman-Zait, A., Mirenda, P., Duku, E., Szatmari, P., Georgiades, S., Volden, J., … Fombonne, E. (2014). Examination of bidirectional relationships between parent stress and two types of problem behavior in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(8), 1908–1917.CrossRefPubMedGoogle Scholar