Caregiver–Teacher Agreement in Preschool ASD-Related Behaviors: Findings from the Jintan China Child Cohort

Screening for autism spectrum disorder (ASD) relies on caregiver reports during primary care visits, yet teachers offer an underutilized perspective for school nurses conducting community-based assessments. This study describes caregiver-teacher concordance on ASD-related behaviors in preschool children and identifies predictors of differences in ASD-related behavior ratings in the Jintan China Child Cohort (N = 1,209) using the Child Behavior Checklist and Teacher Report Form.Only 4.1% of children were identified with concernts by both informants and 24.7% showed disagreement; mothers reported concerns more often than teachers. Threshold-based concern ratings were positively associated (OR = 2.07, p < .001) and concordance was small (κ = 0.11, p < .001). Prenatal secondhand smoke exposure was associated with greater teacher concern (β = -0.48, p = .019); co-sleeping arrangements (β = 0.66, p = .020) and birth complications (β = 0.43, p = .036) were associated with greater maternal concern. We provide three fictional vignettes for school nursing practice.