SLPOtherAutism : the international journal of research and practice2017

Psychometric analysis of the Systematic Observation of Red Flags for autism spectrum disorder in toddlers.

Deanna Dow, Whitney Guthrie, Sheri T Stronach and 1 others

PMID 27132013

WHAT IT FOUND

A video observation score separated toddlers with autism from those without, especially social communication items; restricted repetitive behavior items were weaker.

Key findings

01The Composite score and red flag count discriminated children with autism from children without autism, while restricted repetitive behavior scores were weaker.

02Social communication scores separated the groups more clearly than restricted repetitive behavior scores.

03Items that did not discriminate were excluded from the severity algorithm but kept in red flag counts for clinical information.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The sample came from one university-based early detection project, so results may not apply to all community or clinic populations. Some children with uncertain diagnoses were excluded, so performance for borderline cases is unclear. The observation was coded from a standard behavior sample, so it may not work the same in other settings. The study tested how well the score separated existing diagnostic groups, not whether using it improves screening decisions or outcomes. Independent replication is needed.

Declared interests

Ms Guthrie receives royalties from use of the Autism Diagnostic Observation Schedule Toddler Module. Dr Wetherby receives royalties from use of the Communication and Symbolic Behavior Scales, but not from this study.

The easy way to misread this

Do not conclude that the score proves autism or should replace diagnosis. It only separated diagnostic groups in this sample, and independent replication is needed.

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