Abstract

The Autism Spectrum Screening Questionnaire (ASSQ) is equipped with good properties for screening the broader phenotype of autistic traits, but it is standardized for a limited age range—from 7 to 16 years. To contribute to the early detection of Autism Spectrum Disorder (ASD), particularly in high functioning children with ASD, likely to cause maladjustments during school age, the present study examined psychometric properties to apply the ASSQ to a younger age. We tested parents’ ASSQ ratings for preschool children in clinical (N = 154, average age 60.77 months, range 55–72 months) and community settings (N = 1390, average age 60.53 months, range 57–68 months) in Japan. The results showed, just as in school-aged children, the ASSQ had reliability and validity as a screening instrument for preschool children in community settings. A cut-off of 7 with sensitivity of 0.93 and specificity of 0.84 is recommended for community screening. Still, based on the current study with a clinical group, an optimal cut-off score with high sensitivity and high specificity for parents’ ASSQ ratings could not be established. The clinicians should be reminded that the ASSQ is a screening instrument, not a diagnosing instrument. Also, this result suggest multi-faceted evaluation is necessary in clinical settings, for example, the addition of teachers’ ratings.

Highlights

  • Autism spectrum disorder (ASD) is characterized by severe social communication deficits and stereotyped, repetitive behaviors [1]

  • We evaluated the severity of autistic symptoms using the Autism Diagnostic Interview Revised (ADI-R) [38, 39] and the Autism Diagnostic Observation Schedule-2 (ADOS-2) [40, 41], administered by research-reliable interviewers

  • This study examined the Autism Spectrum Screening Questionnaire (ASSQ)’s psychometric properties among preschool children recruited from the community and clinical settings

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Summary

Introduction

Autism spectrum disorder (ASD) is characterized by severe social communication deficits and stereotyped, repetitive behaviors [1]. Recognition that social difficulties characteristic of ASD can appear in many different variants, depending on language skills, general ability level, severity of symptoms, context, and coexisting disorders, has led to a dramatic increase in the number of children diagnosed with ASD. The median prevalence of autism worldwide is 0.62– 0.70% [2, 3], the latest large-scale surveys have estimated 1–2% [4,5,6,7,8]. Adaptation of the ASSQ to preschool children

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