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Validation of the Social Communication Questionnaire in a Population Cohort of Children With Autism Spectrum Disorders

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ABSTRACT

Objective

To examine the properties of the Social Communication Questionnaire (SCQ) in a population cohort of children with autism spectrum disorders (ASDs) and in the general population.

Method

SCQ data were collected from three samples: the Special Needs and Autism Project (SNAP) cohort of 9- to 10-year-old children with special educational needs with and without ASD and two similar but separate age groups of children from the general population (n = 411 and n= 247). Diagnostic assessments were completed on a stratified subsample (n = 255) of the special educational needs group. A sample-weighting procedure enabled us to estimate characteristics of the SCQ in the total ASD population. Diagnostic status of cases in the general population samples were extracted from child health records.

Results

The SCQ showed strong discrimination between ASD and non-ASD cases (sensitivity 0.88, specificity 0.72) and between autism and nonautism cases (sensitivity 0.90, specificity 0.86). Findings were not affected by child IQ or parental education. In the general population samples between 4% and 5% of children scored above the ASD cutoff including 1.5% who scored above the autism cutoff. Although many of these high-scoring children had an ASD diagnosis, almost all(∼90%) of them had a diagnosed neurodevelopmental disorder.

Conclusions

This study confirms the utility of the SCQ as a first-level screen for ASD in at-risk samples of school-age children. J. Am. Acad. Child Adolesc. Psychiatry

Section snippets

METHOD

The study was approved by the South East Multicentre Research Ethics Committee (REC) (00/01/50), East Sussex Local REC (04/Q/1905/6), and West Kent Local REC (153/8/02).

SNAP Sample

The mean SCQ score in the at-risk sample was 15.2 (SD 8.6) and the sample scored across nearly the full range of the possible scores (0-39). Figure 2 shows the distribution of SCQ scores for the 255 cases seen for a research diagnostic assessment, stacked by consensus diagnosis. The bimodal distribution is due to the stratified sample design of the prevalence study (see Baird et al., 2006 for details). Figure 2 shows exact frequencies; however, all of the subsequent analyses on the at-risk

Properties of the SCQ in the At-Risk SNAP Sample

In the population-weighted SNAP sample, the SCQ discriminated well between children with and without ASD at the established cutpoint of ≥15. The Se (0.88) and Sp (0.72) were similar to that in the initial validation study (Se = 0.85; Sp = 0.75; Berument et al., 1999) and also compare well with those of two other recently published screening instruments for ASD (Social and Communication Disorders Checklist: Se = 0.90, Sp = 0.69 Skuse et al., 2005; Social Responsiveness Scale: Se = 0.85, Sp =

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    The study was funded by the Wellcome Trust and the Department of Health, United Kingdom. The authors are grateful to the children and families who participated in the study and to the clinical teams, whose collaboration made the study possible. They thank the expert group, Patrick Bolton, Antony Cox, Anne Gilchrist, Rebecca Landa, Ann Le Couteur, Catherine Lord, Lennart Pedersen, and Michael Rutter. Thanks also to Iris Carcani-Rathwell, Greg Pasco, Samantha Ross, Emma Rowley, Vicky Slonims, and Martha Turner for their help with assessments.

    Disclosure: Prof. Baird has served as an occasional expert witness for the diagnosis of autism. Prof. Pickles receives royalties from SCQ and ADOS-G instruments. The other authors have no financial relationships to disclose.

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