Children and adolescents with Asperger’s syndrome: Validation of a new measure of symptomatology and a structural test of family and peer influences

Garnett, Michelle Sarah (2007). Children and adolescents with Asperger’s syndrome: Validation of a new measure of symptomatology and a structural test of family and peer influences PhD Thesis, School of Psychology, University of Queensland.

       
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Author Garnett, Michelle Sarah
Thesis Title Children and adolescents with Asperger’s syndrome: Validation of a new measure of symptomatology and a structural test of family and peer influences
School, Centre or Institute School of Psychology
Institution University of Queensland
Publication date 2007
Thesis type PhD Thesis
Supervisor Professor Candida Peterson
Abstract/Summary There is considerable debate about the core features of Asperger’s Syndrome (AS), and valid and reliable tools for evaluating core features are lacking. Anxiety and depression may impact on the severity of AS, but there is little available research addressing this issue. Family and peer experiences are known to increase anxiety in children with other forms of childhood psychopathology. Notably, family conflict and cohesion, as well as supportive peer relationships and peer victimisation, are known to be linked with anxiety, depression, and levels of adjustment and/or psychopathology in vulnerable children. However, such associations may not generalise in their scope and strength to children and adolescents with AS, because of the unique problems of this group in terms of perspective-taking, understanding others’ emotion, rigidity in thinking and behaviour, and social difficulties. The principle objectives of this programme of research were threefold. In the absence of a suitable measure of core AS dimensions, the first objective was to develop and validate a new measure of core AS characteristics. The second objective was to use this new measure to examine the association of Asperger’s/autism symptomatology (AAS) with psychological health in children and adolescents with a diagnosis of AS/autism. The third objective was to examine the links of family and peer relationships with levels of psychological ill-health and AAS in children/adolescents with a diagnosis of AS/autism. Method: Following an extensive literature review, consultation of international experts, and pilot testing, a provisional measure of 8 dimensions of AS was developed, the Australian Scale for Asperger’s Syndrome – Revised (ASAS-R). A secure website containing this and other measures was produced. A sample of eligible families was drawn from the databases of two clinics (one directed by the candidate) specialising in pervasive developmental disorders, and, of these, 856 were telephoned and invited to participate. Families who participated included 265 who had a child with AS, 96 who had a child with autism, and 53 clinically referred families whose child did not have either AS or autism. Results: The ASAS-R was found to contain five coherent and reliable dimensions – understand and express emotion, fact orientation, sensory sensitivity, perspective-taking, and rigidity. On debated dimensions of AS (motor clumsiness, executive functioning problems, stereotyped and repetitive motor mannerisms), there was no clear evidence that these were core features of AS in terms of factorial clustering. A measurement model consisting of the five dimensions showed good fit to the data. There was a significant positive association of severity of Asperger’s/autism symptomatology (AAS) and psychological ill-health, and this association was medium in magnitude. On the basis of a structural equation model building approach, negative peer and family factors (family conflict and peer victimisation) were found to predict psychological ill-health, and psychological ill-health predicted severity of AAS. Peer victimisation directly predicted AAS. Family cohesion did not directly influence child psychological health, but may increase the likelihood of family conflict, which was found to influence psychological health. Positive peer relationships were unrelated to psychological health or severity of AAS for the children in this sample. Discussion: The key contributions of this research were: (1) a consolidation of core and non-core dimensions of AS; (2) a valid and reliable measure of AS; (3) demonstration that anxiety/depression is correlated with AAS, (4) new findings regarding links between AAS and family and peer networks, (5) the suggestion that family conflict may not be directly related to AAS, but may influence AAS indirectly via psychological health, and (6) the suggestion that peer victimisation may directly impact on severity of AAS, as well as influence AAS via psychological health. The research has relevance to researchers and clinicians working in this area. The ASAS-R warrants future research as a promising tool that may ultimately prove helpful in guiding the foci of therapeutic/educational interventions. The research pointed to the potential value of assessing and treating family conflict, as well as peer victimisation, in the treatment of children/adolescents with AAS. Building family cohesion may be a fruitful way of indirectly influencing psychological health and AAS in this group. Further research is needed to evaluate the sensitivity of the tool to clinical change, and to use behavioural observation to assess the nature of family conflict as it affects children/adolescents with AAS. Limitations of the research are discussed in detail. These included reliance on parental report and a cross-sectional design.

 
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Created: Fri, 21 Nov 2008, 16:13:25 EST