The Social Responsiveness Scale (SRS; Constantino & Gruber, 2005) is a
brief quantitative measure of autistic behaviors in 4 to 18 year old children
and youth. This 65-item rating scale was designed to be completed by an adult
(teacher and/or parent) who is familiar with the child’s current behavior and
developmental history. The SRS can be completed in approximately 15 minutes and
focuses on the child’s reciprocal social interactions, a core impairment in all
pervasive developmental disorders. Standardization is based on a sample of
1,636 children drawn from the general population.
The SRS items measure the ASD symptoms in the domains of
social awareness, social information processing, reciprocal social
communication, social anxiety/avoidance, and stereotypic behavior/restricted
interests. Each item is scored from 1 (not true) to 4 (almost always
true). Scores are obtained for five treatment subscales: Social Awareness
(e.g., “Is aware of what others are thinking or feeling”), Social Cognition
(e.g., Doesn’t recognize when others are trying to take advantage of him or
her”), Social Communication (e.g., Avoids eye contact or has unusual eye
contact”), Social Motivation (e.g., “Would rather be alone than with others”),
and Autistic Mannerisms (e.g., Has an unusually narrow range of
interests”).
Interpretation is based on a single score reflecting the sum
of responses to all 65 SRS questions. Raw scores are converted to T-scores
(with mean of 50 and standard deviation of 10) for gender and rater type. A
total T-score of 76 or higher is considered severe and strongly associated with
a clinical diagnosis of autistic disorder. A T-score of 60 through 75 is
interpreted as falling in the mild to moderate range and considered typical for
children with mild or “high functioning” ASD, while a T-score of 59 or less
suggests an absence of ASD symptoms. A total raw score of > 75 was
associated with a sensitivity value of .85 and specificity value of .75 for ASD
(Autistic Disorder, Asperger’s Disorder, or PDD-NOS). The AUC was .85 for
recommended screening and clinical cutoff scores and indicates good overall
discrimination. In school settings, raw scores at or above 85 from two separate
informants provides very strong evidence of ASD. More impressive values have been noted when
using lower parent or teacher scores. For example, T-scores of > 60 from both parent and teacher have
been shown to result in a 96.8% likelihood
of a clinically identified ASD diagnosis (Constantino et al., 2003, 2007).
The SRS is an efficient tool for capturing the more subtle
aspects of social impairment associated with ASD (e.g., PDD-NOS) and reflects
the level of severity across the autism spectrum. The scale demonstrates strong
reliability across informants, acceptable internal consistency, and correlates
highly with the Autism Diagnostic Interview-Revised (ADI-R). Brief,
quantitative, and based on naturalistic observations of parents and teachers,
the SRS can be used as an effective screener in clinical or educational
settings, an aid to clinical diagnosis, or a measure of response to
intervention (Wilkinson, 2010, 2011). The SRS compares favorably to more
time-intensive measures and can help school and clinical psychologists identify
the type of social impairment characteristic of autism spectrum disorders (ASD)
in children as young as 4 years of age and guide development of
intervention/treatment programs. Of course, the results of questionnaire
measures should not replace clinical assessment and must be integrated with
information from different sources. The SRS should be used within the context
of a comprehensive evaluation, including developmental history and assessment
of intellectual, language, and adaptive behavior functioning (Wilkinson, 2010).
Further research is needed to assess how the SRS performs when differentiating children
with ASD from other childhood disorders (e.g., ADHD) and those with
intellectual disability.
References:
Chandler, S., Charman, T., Baird, G., Simonoff, E., Loucas,
T., Meldrum, D., & Pickles, A. (2007). Validation of the Social
Communication Questionnaire in a population cohort of children with autism
spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1324–1332.
Constantino et al. (2003).
Validation of a brief measure of autistic traits: Comparison of the
social responsiveness scale with the autism diagnostic interview-revised.
Journal of Autism and Developmental Disorders, 33, 427-433.
Constantino, J. N., & Gruber, C. P. (2005). Social
Responsiveness Scale. Los Angeles: Western Psychological Services.
Constantino et al. (2007). Rapid quantitative assessment of
autistic social impairment by classroom teachers. Journal of the American
Academy of Child and Adolescent Psychiatry, 46, 1668-1676.
Mash, E. J., & Hunsley, J. (2005). Evidence-based
assessment of child and adolescent disorders: Issues and challenges. Journal of
Clinical Child and Adolescent Psychology, 34, 362-379.
Norris, M., & Lecavalier, L. (2010). Screening accuracy
of level 2 autism spectrum disorder rating scales: A review of selected
instruments. Autism, 14, 263–284.
Wilkinson, L. A. (2010). A best practice guide to assessment
and intervention for autism and Asperger syndrome in schools. London: Jessica
Kingsley Publishers.
Wilkinson, L. A. (2011). Identifying students with autism
spectrum disorders: A review of selected screening tools. Communiqué, 40, pp.
1, 31-33.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers. He is also editor of a recent volume in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools and author of the book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT. His most recent book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools, (2nd Edition)
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers. He is also editor of a recent volume in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools and author of the book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT. His most recent book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools, (2nd Edition)
© Lee A. Wilkinson, PhD
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