Evaluation of the Psychometric Properties of the Social Communication Questionnaire in Rural Kenya.
Patricia Kipkemoi, Jeanne E Savage, Joseph Gona and 7 others
PMID 38816602WHAT IT FOUND
The Kiswahili Social Communication Questionnaire accurately screens for autism in Kenyan children.
At a cut-off of 15, it identified 86.7% of autistic children with no false positives against typically developing peers. It also distinguished autism from other neurodevelopmental disabilities, though less sharply.
Key findings
01The Kiswahili Social Communication Questionnaire accurately screens for autism in Kenyan children. At a cut-off of 15, it identified 86.7% of autistic children with no false positives against typically developing peers. It also distinguished autism from other neurodevelopmental disabilities, though less sharply.
02A four-factor structure best fit the data in this setting, differing from the two-factor DSM-5 model, with items clustering around social communication, unusual communication/mannerisms, non-verbal communication, and restricted/repetitive behaviours.
03Non-verbal status significantly lowered total scores, meaning the standard cut-off may miss autistic children who do not speak.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The ADOS-2 was not administered to all participants, so diagnostic comparisons were not available for the entire sample. The study did not evaluate alternative cut-off scores, which may be necessary for non-verbal children. Cognitive functioning was not assessed, so the impact of intellectual disability on SCQ scores is unknown. There was no formal gold-standard diagnostic tool in the setting, relying instead on ADOS and clinical review. The SCQ was administered via interview rather than self-report due to low literacy, which may introduce interviewer bias. Assessors were not fully blinded to diagnostic status, as caregivers often discussed their child's difficulties during the interview.
Declared interests
The study was funded by the University of Oxford. No other conflicts of interest were declared.
The easy way to misread this
Do not assume the SCQ is equally accurate for all children. The standard cut-off of 15 resulted in significantly lower scores for non-verbal children, meaning the tool may fail to screen in autistic children who do not speak. Use clinical judgement alongside the score for non-speaking patients.