Reproducibility between preschool and school-age Social Responsiveness Scale forms in the Environmental influences on Child Health Outcomes program.
Marisa A Patti, Lisa A Croen, Aisha S Dickerson and 23 others
PMID 38794898WHAT IT FOUND
Most children show minimal score changes between preschool and school-age autism trait assessments.
However, a significant portion of children who later score in the clinical range were not flagged during preschool. This suggests early screening may miss milder traits that emerge or become more apparent with age.
Key findings
01Scores were moderately correlated across forms, with most participants showing only modest changes from preschool to school-age.
02When classifications disagreed, children were more likely to be below the clinical cutoff in preschool and above it at school age.
03Having any neurodevelopmental diagnosis, including autism, ADHD, or developmental delay, was associated with higher odds of disagreement between the two forms.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study relied primarily on parent reports, which may change as parents gain more experience or perspective on their child's development. The sample was largely homogeneous, with most mothers being white, non-Hispanic, and highly educated, so results may not generalize to all populations. The study could not account for interventions or treatments children received between the preschool and school-age assessments. Many children in the larger ECHO program had only one SRS form, so the analysis was limited to those with both forms.
Declared interests
Dr. Ladd-Acosta reports consulting fees from the University of Iowa on autism epigenetics. Dr. Bilder reports consulting fees from BioMarin Pharmaceuticals, Encoded Therapeutics, and Synlogic Therapeutics. Dr. Schmidt consults for the Beasley Law Firm and Linus Technology, Inc. The authors state these are outside the scope of this project and have no competing interests relevant to the article content.
The easy way to misread this
Do not interpret the moderate overall correlation as proof that the two SRS forms are interchangeable for individual clinical decision-making. The agreement drops significantly for children near the clinical cutoff and those with neurodevelopmental diagnoses, meaning a change in classification between preschool and school age is a common finding that requires careful interpretation rather than dismissal.