Parental Misattribution of Environmental Stress Reaction Symptoms to Autism

This research aims to characterize parental misattribution to autism of challenging child behaviors related to environmental stress.

To identify differences between parental concern about behavioral challenges and child diagnoses, researchers reviewed records of children assessed at a child development clinic (N = 50, mean age = 4.38), genetics clinic (N = 26, mean age = 4.59), and therapeutic preschool (N = 30, mean age = 3.75), comparing referral information with child diagnoses postassessment. Surveys of parental and teacher concerns regarding children at therapeutic preschool who were not referred for consultation (N = 49) were reviewed and compared with the referral population to assess for referral bias.

A high rate of parental concern about autism/neurodevelopmental disabilities was found in therapeutic preschool referrals (63%) and the child development clinic (74%), with fewer concerns in the genetics clinic (19%), in contrast with substantially lower numbers ultimately diagnosed with autism spectrum disorder (13%, 32%, and 8%, respectively). Across clinics, parents demonstrated greater concern about autism than environmental stress. In all clinics, more children had symptoms related to environmental stress than referrals suggested. Seventy-seven percent of children in the therapeutic preschool, 30% in the child development clinic, and 47% in the genetics clinic were diagnosed with trauma and stressor-related disorders. The results from children not referred for consultation suggest that referral bias plays a role in this phenomenon because parents of these children express similar levels of concern about their child's development (32%) and challenges related to environmental stressors (29%).

The results suggest a tendency for parents seeking consultation to attribute to autism behavioral symptoms related to environmental stress.