Tuesday, August 31, 2010

Evidence-Based Screening for Autism Spectrum Disorders

Epidemiological studies indicate a progressively rising prevalence trend for ASD over the past decade. Yet, compared with general population estimates, children with mild to moderate autistic traits remain an underidentified and underserved population in our schools. There are likely a substantial number of children with equivalent profiles to those with a clinical diagnosis of ASD who are not receiving services. Research indicates that outcomes for children on the autism spectrum can be significantly enhanced with the delivery of intensive intervention services. However, intervention services can only be implemented if students are identified. Screening is the initial step in this process. School professionals and clinicians should be prepared to recognize the presence of risk factors and/or early warning signs of ASD and be familiar with screening tools in order to ensure children with ASD are being identified and provided with the appropriate programs and services.

The following evidence-based tools have demonstrated utility in screening for ASD in educational settings and can be used to determine which children are likely to require further assessment and/or who might benefit from additional support. All measures have sound psychometric properties, are appropriate for school-age children, and time efficient (10 to 20 minutes to complete). Training needs are minimal and require little or no professional instruction to complete. However, interpretation of results requires familiarity with ASD and experience in administering, scoring, and interpreting psychological tests.
  • The Autism Spectrum Rating Scales (Short Form) (ASRS; Goldstein & Naglieri, 2009).
  • The Autism Spectrum Screening Questionnaire (ASSQ; Posserud, Lundervold, & Gillberg, 2006).
  • The Childhood Autism Spectrum Test (CAST; Williams, Allison, Scott, Stott, Baron-Cohen, & Brayne, 2006).
  • The Social Communication Disorders Checklist (SCDC; Skuse, Mandy, & Scourfield, 2005).
  • The Social Communication Questionnaire (SCQ; Rutter, Bailey, & Lord, 2003).
  • The Social Responsive Scale (SRS; Constantino & Gruber, 2005).
Of course, none of these screening measures can differentiate between the autism spectrum subtypes. A screening tool’s efficiency will also be influenced by the practice setting in which it is used. Autism-specific tools are not currently recommended for the universal screening of typical school-age children. Focusing on case finding and children with identified risk-factors and/or developmental delays increases predictive values and results in more efficient screening.

A multi-tier screening algorithm and step-by-step assessment guidelines are available from:

© Lee A. Wilkinson, PhD

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