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APHA Scientific Session and Event Listing

Recorded presentation

Kathleen Thomas, PhD¹, Mary Wagner, PhD², Gary Cuddeback, PhD, MSW¹, and Joseph Morrissey, PhD¹. (1) Program on Mental Health Services Research, Cecil G. Sheps Center for Health Services Research, University of North Carolina, 725 Martin Luther King Jr. Blvd., CB#7590, Chapel Hill, NC 27599-7590, 919 966-3387, kathleen_thomas@unc.edu, (2) Center for Education and Human Services, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025

Schools provide the backbone of services for the growing population of children with autism, but children obtain their autism diagnosis through a variety of pathways. Since schools and parents face different incentives and disincentives to identify a child with autism, there is a potential for discordance. There is altogether a dearth of nationally representative information about children with autism and how they fare in an everyday world. This presentation addresses this gap with data from the National Longitudinal Transition Study-2 on secondary students receiving special education services, to examine discordance in diagnoses (n=8,802). The analysis describes children with autism, emotional disturbance and mental retardation, characterizing overlaps and discordance in diagnoses reported by schools and parents. Multivariate logits model family and school characteristics associated with discordance in primary disability classification. There is greater agreement between school and parent report of a primary disability of autism (80%) compared with emotional disturbance (40%) or mental retardation (26%). Among children identified with autism by schools, parents in disagreement are more likely to perceive mental retardation than emotional disturbance as the primary disability. When families identify autism or mental retardation, children are younger, and families more often white with higher income compared to children identified by schools. In contrast, when families identify emotional disturbance, they are more often black. A better understanding of the nature of discordance in perceptions of autism diagnosis and ways of closing these gaps will inform policymakers, providers, and parents as they seek to collaborate in caring for children with autism.

Learning Objectives:

At the conclusion of this session, attendees will be able to
• Describe the variety of diagnoses held by children identified with a primary disability of autism by schools or parents.
• List the family and school characteristics that are associated with discordance in primary disability reported by schools and parents.
• Discuss strategies for reducing discordance and increasing collaboration between schools and parents caring for children with autism.

Keywords: Child and Adolescent Mental Health, Family/Consumer Perspective

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation