Best Practice Review: The Social Communication Questionnaire (SCQ)
The Social Communication Questionnaire (SCQ; Rutter, Bailey, &
Lord, 2003), previously known as the Autism Screening Questionnaire (ASQ), was
initially designed as a companion screening measure for the Autism Diagnostic
Interview-Revised (ADI-R; Rutter, Le Couteur & Lord). The SCQ is a
parent/caregiver dimensional measure of ASD symptomatology appropriate for
children of any chronological age older than fours years. It can be completed
by the informant in less than 10 minutes. The primary standardization data were
obtained from a sample of 200 individuals who had participated in previous
studies of ASD.
The SCQ is available in two forms, Lifetime and Current, each with 40 questions presented in a yes or no format. Scores on the questionnaire provide an index of symptom severity and indicate the likelihood that a child has an ASD. Questions include items in the reciprocal social interaction domain (e.g., “Does she/he have any particular friends or best friend?”), the communication domain (e.g., “Can you have a to and fro ‘conversation’ with him/her that involves taking turns or building on what you have said?”) and the restricted, repetitive, and stereotyped patterns of behavior domain (e.g., Has she/he ever seemed to be more interested in parts of a toy or an object [e.g., spinning the wheels of a car], rather than using the object as intended?”).
The SCQ is available in two forms, Lifetime and Current, each with 40 questions presented in a yes or no format. Scores on the questionnaire provide an index of symptom severity and indicate the likelihood that a child has an ASD. Questions include items in the reciprocal social interaction domain (e.g., “Does she/he have any particular friends or best friend?”), the communication domain (e.g., “Can you have a to and fro ‘conversation’ with him/her that involves taking turns or building on what you have said?”) and the restricted, repetitive, and stereotyped patterns of behavior domain (e.g., Has she/he ever seemed to be more interested in parts of a toy or an object [e.g., spinning the wheels of a car], rather than using the object as intended?”).
Compared to other screening measures, the SCQ has
received significant scrutiny and has consistently demonstrated its
effectiveness in predicting ASD versus non-ASD status in multiple studies. A meta-analysis examining the previous research
on the utility of the SCQ as a screening
instrument found it to be an acceptable
screening tool for ASD (area under the curve = 0.885) (Chesnut et al., 2017). The
scale has been found to have good discriminant validity and utility as an
efficient screener for at-risk groups of school-age children. The lifetime
version is recommended for screening purposes as it demonstrates the highest
sensitivity value. A threshold raw
score of >15 is recommended to minimize the risk of false negatives and
indicate the need for a comprehensive evaluation. Comparing autism to other
diagnoses, this threshold score resulted in a
sensitivity value of .96 and a specificity value of .80 in a large population
of children with autism and other developmental disorders. The positive
predictive value was .93 with this cutoff. The authors recommend using
different cut-off scores for different purposes and populations. Several studies (Allen et al., 2007;
Eaves et al, 2006) have suggested that a cut-off of 11 may be more clinically
useful (Norris & Lecavalier, 2010).
The SCQ is one of the most researched of the
ASD-specific evaluation tools and can be recommended for screening and as part
of comprehensive developmental assessment for ASD (Chestnut et al., 2017; Norris &
Lecavalier, 2010; Wilkinson, 2010, 2016). The SCQ (Lifetime form) is an efficient screening
instrument for identifying children with possible ASD for a more in-depth
assessment. For clinical purposes, practitioners might consider a multistage
assessment beginning with the SCQ, followed by a comprehensive developmental
evaluation (Wilkinson, 2011, 2016). However, cut-off scores may need to be adjusted
depending on the population in which it is used. The evidence also indicates
that although the SCQ is appropriate for a wide age range, it is less effective
when used with younger populations (e.g., children two to three years). It was
designed for individuals above the age of four years, and seems to perform best
with individuals over seven years of age.
References
References
Allen CW, Silove N, Williams K, et al. (2007). Validity of
the Social Communication Questionnaire in Assessing Risk of Autism in Preschool
Children with Developmental Problems. J Autism Dev Disord. 37, 1272–8.
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.
Chesnut, S. R., Wei,T., Barnard-Brak, L., & Richman, D. M. (2017). A meta-analysis of the social communication questionnaire: Screening for autism spectrum disorder. Autism, 21, 920-928. https://doi.org/10.1177/1362361316660065
Eaves L, Wingert H, Ho H, et al. (2006). Screening for Autism
Spectrum Disorders with the Social Communication Questionnaire. Developmental and Behavioral Pediatrics, 27,
95–103.
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.
Rutter, M., Bailey, A.,
& Lord, C. (2003). Social Communication Questionnaire. Los
Angeles: Western Psychological Services.
Wilkinson, L. A. (2010). A best practice guide
to assessment and intervention for autism and Asperger syndrome in schools.
London and Philadelphia: 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.
Wilkinson, L. A. (2017). A best practice guide to assessment and intervention for autism spectrum disorder in schools (2nd Edition). London and Philadelphia: Jessica Kingsley Publishers.
Lee A. Wilkinson, PhD, is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He 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.
Wilkinson, L. A. (2017). A best practice guide to assessment and intervention for autism spectrum disorder in schools (2nd Edition). London and Philadelphia: Jessica Kingsley Publishers.
Lee A. Wilkinson, PhD, is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He 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.
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