Can questions about social interaction correctly identify preschool aged children with autism?
Katrina Williams1, Deborah Perkins, Danielle Wheeler
1Department of Community Child Health, Sydney Children's Hospital, Sydney, New South Wales, Australia. katrina.williams@rch.org.au
Insights
The Social Interaction Questionnaire (SIQ) aids in identifying preschool children who may need further evaluation for autism spectrum disorder (ASD). An SIQ score of 14 or higher shows high accuracy in flagging potential ASD cases.
Area of Science:
- Child Development
- Developmental Pediatrics
- Autism Spectrum Disorder Research
Background:
- Social development is a critical area often overlooked in routine medical assessments of preschool children.
- Early identification of social development deficits can aid in the early detection of autism spectrum disorder (ASD).
Purpose of the Study:
- To develop and validate a questionnaire, the Social Interaction Questionnaire (SIQ), for assessing social development in preschool children.
- To determine the SIQ's utility in identifying children who may benefit from further autism assessment.
Main Methods:
- Parents of 108 children completed the SIQ and the Childhood Autism Rating Scale (CARS).
- Receiver Operator Characteristic (ROC) curves were used to evaluate SIQ score thresholds against CARS scores (≥30).
- Logistic regression identified key questions within the SIQ with the highest predictive value for ASD.
Main Results:
- An SIQ score of 14 or higher demonstrated 85% sensitivity and 85% specificity in identifying children with a CARS score of 30 or more.
- The positive likelihood ratio was 8.3, and the negative likelihood ratio was 0.2.
- Two specific questions on the SIQ were found to be most predictive of a high CARS score.
Conclusions:
- The SIQ shows promise as a tool to assist clinicians in evaluating social development and guiding decisions for autism assessment referrals.
- Further evaluation of the SIQ at the initial point of contact within clinical services is recommended.
Aim:
We developed a questionnaire to assess social development (SIQ) in preschool children. Social development is often not included in medical assessment, though it may assist in early identification of autism spectrum disorder (ASD).
Methods:
Parents of 108 children with ASD, speech and language disorders, or 'developmental concerns', recruited from a clinical developmental assessment and community child health service, completed the SIQ, and also a Childhood Autism Rating Scale (CARS) assessment. Receiver Operator Characteristic (ROC) curves were generated to assess the performance of different questionnaire score thresholds in correctly identifying children with a CARS score of 30 or more. Logistic regression models were used to identify the questions which had the most predictive value for a CARS score of 30 or more.
Results:
An SIQ score of 14 or more correctly identified children with a CARS ≥ 30 with a sensitivity of 85%, specificity 85%, positive likelihood ratio (LR) 8.3 and negative LR 0.2. Two questions were identified as most predictive of ASD.
Conclusions:
The SIQ may assist clinicians in assessing social development and in making decisions about referral for autism assessment. Evaluation of the SIQ at the point of entry to a clinical service is needed.
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