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Brief Report: Relationships Between Caregiver-Reported Externalizing and Internalizing Behaviors and the Modified
Jane Marryat1, Naomi O Davis2, Reginald Lerebours3
1Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC, 27705, USA.
Caregiver-reported externalizing symptoms, like ADHD, are linked to higher scores on the Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F) in toddlers. Internalizing symptoms did not show this association.
Area of Science:
- Child psychology
- Developmental pediatrics
- Autism spectrum disorder research
Background:
- Early detection of autism spectrum disorder (ASD) is crucial for timely intervention and improved child outcomes.
- Understanding factors influencing autism screening tools enhances their diagnostic accuracy.
- The Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F) is a widely used tool for early autism screening.
Purpose of the Study:
- To investigate the relationship between caregiver-reported emotional and behavioral symptoms and children's scores on the M-CHAT-R/F.
- To determine how specific symptom profiles, such as internalizing and externalizing behaviors, relate to M-CHAT-R/F results.
Main Methods:
- Recruitment of 1765 toddlers from four primary care clinics (2018-2021).
- Administration of the M-CHAT-R/F and the Child Behavior Checklist (CBCL) to caregivers.
- Utilizing correlational and group analyses to examine the associations between CBCL scales and M-CHAT-R/F scores.
Main Results:
- Modest positive correlations were observed between M-CHAT-R/F scores and CBCL scales for internalizing, externalizing, autism, ADHD, and anxiety.
- Toddlers with elevated autism and ADHD/externalizing scales had significantly higher M-CHAT-R/F scores compared to those with only elevated autism scales.
- No significant difference in M-CHAT-R/F scores was found between toddlers with elevated autism scales only versus those with elevated autism and internalizing scales.
Conclusions:
- Externalizing symptoms, particularly those related to ADHD, are associated with elevated M-CHAT-R/F scores in toddlers with autism-related behaviors.
- Internalizing symptoms did not demonstrate a significant association with M-CHAT-R/F scores in this population.
- Clinical interpretation of the M-CHAT-R/F should consider the potential impact of co-occurring psychiatric conditions, especially externalizing disorders like ADHD.
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