Electronic Theses and Dissertations





Document Type


Degree Name

Doctor of Philosophy




School Psychology

Committee Chair

Beth Meisinger

Committee Member

Randy Floyd

Committee Member

Robert Cohen


Improved diagnostic accuracy and intervention services for toddlers with autism spectrum disorders (ASD) necessitates early identification of children at risk for the disorder. African American and low-income children are at increased risk for delayed diagnosis; however, universal screening may identify those at risk. This study examined the utility of the Brief Infant Toddler Social Emotional Assessment (BITSEA) as an ASD screener in an exclusively African American sample. Moreover, contribution of maternal factors to predict ASD was explored. Participants were selected from the CANDLE (Conditions Affecting Neurocognitive Development and Learning in Early Childhood) study, which is an ongoing study in an urban setting evaluating factors affecting early childhood development. Data were collected from toddlers around 12 and 24 months (i.e., year 1 and year 2) and their mothers. Using items identified by the BITSEA authors, ASD, Dysregulation, and ASD + Dysregulation scales were created for each year and compared to standardized Problem and Competence scales. Internal consistency of BITSEA scales ranged from poor to good. Examination of temporal stability of the scales suggested weak yet significant correlations from both years for all scales. Correlational and ROC curve analyses indicated that the ASD scales outperformed the Problem and Competence scales as indicators of ASD. Cutpoints for the ASD scales produced good sensitivity and specificity at 24 months; however, classification accuracy statistics were lower at 12 months. Regression analyses were employed to examine the contribution of maternal variables and BITSEA ASD scales for predicting ASD risk. Results indicated that the BITSEA ASD score, maternal education, health insurance status, psychological distress, and parenting stress were significantly associated with ASD risk. Toddlers with private insurance, higher BITSEA ASD scores, and higher levels of psychological distress were at greatest risk for ASD compared to others in the study. Results were comparable at both years; however, maternal variables were more predictive at year 1. Overall, these findings suggest that the BITSEA ASD scale can be used to identify African American toddlers at risk for ASD. Additionally, awareness of maternal stress characteristics and ASD symptomology may help identify at risk toddlers who need close monitoring or further evaluation.


Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to the local University of Memphis Electronic Theses & dissertation (ETD) Repository.