Modifying a general social-emotional measure for early autism screening

Abstract

Objective: Broadband social-emotional screening tools are designed to evaluate a child’s social development and interactions. Such tools are expected to have reasonable sensitivity for identifying children at risk for autism spectrum disorder (ASD) but would also likely over-estimate risk for ASD since other conditions can also affect social development. In this study, a subset of ASD items from one general social-emotional screening measure, the Ages & Stages Questionnaires: Social Emotional, 2nd edition, was analyzed to determine if use of an ASD subscale might improve prediction of ASD risk for young children.

Methods: The ASD subscale was used with 60 families who had a child referred for an ASD evaluation. Social-emotional screening and ASD screening results were compared with the subsequent results from gold-standard diagnostic testing for ASD at a regional autism center, using contingency matrices.

Results: As expected, the social-emotional screening tool identified nearly all of the children in the high-risk clinical sample. Use of the ASD subscale increased specificity for ASD (from 4% to 52%) and demonstrated correct prediction of ASD diagnosis in 70% of ASD cases.

Conclusions: These preliminary results suggest that using a subset of ASD-specific items on a social-emotional screening tool can increase the tool’s specificity for ASD, by isolating ASD-specific concerns.

Keywords:

• Autism
• early identification
• social-emotional
• screening
• specificity

Acknowledgments

The authors thank the families at the children’s hospital for their participation in this project.

Disclosure statement

In accordance with Taylor & Francis policy and my ethical obligation as a researcher, I am reporting that the first and third authors receive royalty payments due to authorship (third author) and supporting authorship (first author) of the assessment tool studied in this manuscript. No other potential conflicts of interest exist for any of the authors.

Funding

This project has no federal funding.