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Updated: Jun 25, 2025
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Reproducibility between preschool and school-age Social Responsiveness Scale forms in the Environmental influences on
Marisa A Patti1, Lisa A Croen2, Aisha S Dickerson3
1AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA.
Summary
Social Responsiveness Scale (SRS) scores show good consistency between preschool and school-age forms, especially for nonclinical autism traits. However, variability in early childhood may affect reliability for clinical diagnoses.
Area of Science:
- Child Psychology
- Developmental Neuroscience
- Clinical Assessment
Background:
- Autism trait development varies in early childhood, though core traits stabilize in older children.
- The Social Responsiveness Scale (SRS) assesses autism-related traits using age-specific preschool and school-age forms.
- Prior research confirmed score consistency within SRS forms, but cross-form reliability remained unevaluated.
Purpose of the Study:
- To evaluate the reproducibility and agreement of Social Responsiveness Scale (SRS) scores across its preschool and school-age forms.
- To identify predictors of score discordance above a clinical cutoff between the two SRS forms.
Main Methods:
- Utilized data from the Environmental Influences on Child Health Outcomes (ECHO) program (n=853).
- Collected maternal reports of SRS scores for preschool (average age 3.0 years) and school-age (average age 5.8 years) forms.
- Compared SRS total scores (T-scores) and agreement at a clinical cutoff (T-scores ≥ 60), analyzing discordance predictors.
Main Results:
- SRS scores across forms were broadly similar (mean difference: 3.3 points; SD: 7), with preschool scores averaging lower.
- High overall concordance (92%) was observed, with most children (88%) scoring below the clinical cutoff on both forms.
- Discordance was higher in siblings of autistic children (16%) and among children with autism diagnoses (27% vs. 4% concordant).
Conclusions:
- Social Responsiveness Scale (SRS) scores demonstrate broad reproducibility across preschool and school-age versions, particularly for nonclinical autism traits.
- Variability in preschool-age autism traits may decrease reliability when comparing with later school-age scores for individuals in the clinical range.
- Findings support SRS use across age forms but highlight potential limitations for precise clinical classification in early childhood due to developmental flux.
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