Differential Performance of Social Communication Questionnaire Items in African American/Black vs. White Children.
Ethan Dahl, Eric J Moody, Brian Barger and 5 others
PMID 36897518WHAT IT FOUND
The Social Communication Questionnaire performed differently for Black and White children.
For three items, Black caregivers were less likely to report symptoms regardless of total score. For thirteen items, reporting patterns shifted depending on the child's overall symptom severity. This variability may lead to inconsistent screening results.
Key findings
01Three SCQ items showed uniform differential item functioning, meaning Black respondents were significantly less likely to endorse these behaviors than White respondents across all levels of total SCQ score.
02Thirteen SCQ items showed non-uniform differential item functioning, where the likelihood of a Black respondent endorsing an item compared to a White respondent changed depending on the child's total SCQ score.
03Internal consistency of the SCQ was high for both groups (White α = 0.90, Black α = 0.88), but the difference between groups was statistically significant.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study did not determine the causes of the differential item functioning, such as whether it stems from cultural differences in interpreting items, comprehension issues, or actual differences in symptom presentation. The SCQ was administered by phone, which is not its standard intended use and may have influenced results. The sample included children under 5 years old, an age range where the SCQ has previously shown measurement issues, although a lower cutoff score (11) was used to optimize sensitivity for this age. The study only compared Black and White children, so findings may not generalize to other racial or ethnic groups. High correlations between race and socioeconomic factors (maternal education and household income) mean it is unclear if the differential item functioning is due to race itself or these associated demographic factors.
The easy way to misread this
Do not assume the SCQ total score is equally accurate for Black and White children. The finding that Black caregivers were less likely to endorse certain items suggests the tool may miss specific ASD symptoms in this population, potentially delaying diagnosis. However, the authors note that the causes of these differences are unknown and may be related to socioeconomic factors rather than race alone.