A factor analysis of challenging behaviors assessed with the Baby and Infant Screen for Children with aUtism Traits (BISCUIT-Part 3)
Introduction
Autism Spectrum Disorders (ASD) are a set of neurodevelopmental conditions, generally appearing in early childhood (Freitag, 2007; Matson, 2007a; Müller, 2007). The disorders can be highly debilitating and have a life long course (Billstedt & Gillberg, 2005; Matson, Anderson, & Bamburg, 2000; Matson et al., 1996; Matson, Carlisle, & Bamburg, 1998). Without intervention, symptoms tend to remain (Dawson, Matson, & Cherry, 1998; Lattimore, Parsons, Reid, & Ahearn, 2006). As a result, there has been an international move to intensive behavioral interventions at very early ages (Eikeseth, 2008; Matson & Smith, 2008). The notion that early intervention is best practice has also provided impetus for the notion that large-scale screening and diagnosis of at risk children is not only advisable, but essential (Itzchak, Lahat, Burgin, & Zachor, 2008).
ASD also presents with a number of co-occurring disorders which can cloud the diagnostic picture and at the same time complicate treatment and impact prognosis (Agaliotis & Kalyva, 2008; Baird et al., 2006; Heiman and Berger, 2008; Horner, Diemer, & Brazeau, 1992; Paclawskyj, Matson, Bamburg, & Baglio, 1997). Other commonly co-occurring conditions are comorbid psychopathology (Ghaziuddin, Tsai, & Ghaziuddin, 1992; Goldstein & Schwebach, 2004; Matson & Nebel-Schwalm, 2007; Tantum, 2000) and challenging behaviors (Matson, Bamburg, Cherry, & Paclawskyj, 1999; Matson, Dixon, & Matson, 2005).
Young children with ASD are at greater risk for challenging behaviors than children with other forms of developmental disabilities (Gadow, DeVincent, Pomeroy, & Azizian, 2004; Hartley, Sikora, & McCoy, 2008). Furthermore, effective behaviorally based treatments for aggression, self-injury, and stereotypies have been reported (Eason, White, & Newsom, 1982; Matson & LoVullo, 2008). Therefore, effective early intervention with respect to specific challenging behaviors is a particularly salient issue for future research.
Currently the only measure specifically designed to assess challenging behaviors in very young children is the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT-Part 3). The purpose of this study was two fold. First, we wished to establish the factor structure of the scale. Second, we compared infants and toddlers with ASD on those factors to at risk children without an ASD diagnosis. These data should be helpful in further clarifying the nature of challenging behaviors in youngsters with ASD, and provide information for clinicians about what behaviors they are likely to encounter in a treatment setting.
Section snippets
Participants
Participants in this study were 270 infants and toddlers enrolled in an early intervention program funded by the State of Louisiana. EarlySteps is Louisiana's Early Intervention System under the Individuals with Disabilities Education Act, Part C, which provides services to infants and toddlers and their families from birth to 36 months. Children qualify for these services if they have a developmental delay or a medical condition likely to result in a developmental delay. To be included in this
Results
An exploratory factor analysis was conducted to identify the underlying latent structure of the BISCUIT-Part 3. Due to the likelihood of psychological constructs being correlated (Fabrigar, Wegener, MacCallum, & Strahan, 1999), an oblique rotation was selected. Principle axis factoring with a promax rotation was employed. The optimal factor structure was selected by examining the screen plot, and considering the Kaiser Criterion and comprehensibility of the factors (Costello & Osborne, 2005).
Discussion
Results of the exploratory factor analysis yielded a factor structure consistent with the literature on people with developmental disabilities (Rojahn, Aman, Matson, & Mayville, 2003; Rojahn, Matson, Lott, Esbensen, & Smalls, 2001; Rojahn, Matson, & Naglieri, 2004). Factor 1 consisted of items addressing physical aggression, property destruction, yelling, and disrobing. Factor 1 will be labeled “Aggressive/Disruptive Behavior.” Factor 2 consisted of items involving repetitive body movements,
Purpose
The purpose of Study 2 was to evaluate the BISCUIT-Part 3 with regards to group differences and the ability to predict group membership. Differences between those with and without ASD have been examined.
Participants
A total of 775 participants were included in Study 2. The clinical group was comprised of the participants included in Study 1. This group included 270 participants diagnosed with ASD. Demographics of this group are outlined in Study 1. The control group for Study 2 included 505 infants and
Results
Test administration for Study 2 was identical to test procedures for Study 1. To evaluate group differences along the three factors established in Study 1, a series of Mann–Whitney U tests were employed. Results indicated that scores on each of the three factors were significantly greater for the ASD group than for the control group. See Table 2 for the Mann–Whitney U tests results.
To determine the ability of the three factors to predict group membership, a binary logistic regression was
Discussion
The abovementioned results indicate that the three factors of the BISCUIT-Part 3 can accurately predict group membership. Additionally, according to the Mann Whitney analysis, infants and toddlers with ASD scored significantly higher on all of the factors of the BISCUIT-Part 3 when compared to infants and toddlers in the control group. These findings are consistent with research conducted on older children with ASD, as findings suggest that children with ASD engage in more challenging behaviors
General discussion
The heterogeneity of symptom expression of ASD outlines the necessity of comprehensive and accurate assessments tools that examine the core symptoms of ASD. Children with ASD are at an increased risk of exhibiting challenging behaviors, with approximately 60% displaying them, in some form (Gurney, McPheeters, & Davis, 2006; Icasiano, Hewson, Machet, Cooper, & Marshall, 2004). Although research examining challenging behaviors in children with ASD reveals high rates of problem behaviors, research
Acknowledgements
The authors would like to acknowledge the State of Louisiana, Office for Citizens with Developmental Disabilities, EarlySteps program for participation in this project.
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