Screening for Autism with the SRS and SCQ: Variations across Demographic, Developmental and Behavioral Factors in Preschool Children.
Eric J Moody, Nuri Reyes, Caroline Ledbetter and 7 others
PMID 28856480WHAT IT FOUND
Both the SCQ and SRS were adequate overall for screening autism risk in preschoolers, but false positives rose for children of lower-income, less-educated, African American or Hispanic mothers, and for children with developmental or behavior challenges.
Key findings
01Overall sensitivity and specificity were adequate for both the SCQ and SRS.
02Specificity dropped for both measures with lower family income, less maternal education, and African American race and Hispanic ethnicity of the mother.
03Specificity also dropped for both instruments when children were classified as below average on the MSEL or as having behavior problems on the CBCL.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The population comparison group overrepresented white families with higher incomes and education, and it supplied most true negatives, so specificity may be biased upward for those groups. The sample included children aged 30 to 68.9 months, so the results may not apply to older children. The SCQ has not been validated for children under 4, but 14.9% of the sample were under 4; excluding them did not change the reported relationships. The study protocol allowed up to 6 months between data collection steps, so some children may have developed between the SCQ and later measures. Not all children received ADOS and ADI-R assessments, so case status relied partly on clinician judgment.
The easy way to misread this
Do not conclude that a positive SCQ or SRS score confirms autism in a preschooler. The screeners were less specific for children with lower maternal education or household income, African American or Hispanic mothers, below-average early learning, or clinical-range behavior problems, so they may flag those challenges as risk.