Abstract

A Delphi consensus methodology was used to adapt a screening tool, the Social Responsiveness Scale- 2 (SRS-2), for use with deaf children including those whose preferred communication method is sign language. Using this approach; 27 international experts (The Delphi International Expert Panel), on the topic of autism spectrum disorder (ASD) in deaf people, contributed to the review of item content. A criterion for agreement was set at 80% of experts on each item (with 75% acceptable in the final fourth round). The agreed modifications are discussed. The modified SRS-2 research adaptation for deaf people (referred to here as the "SRS-2 Deaf adaptation") was then translated into British Sign Language using a robust translation methodology and validated in England in a sample of 198 deaf children, 76 with Autism Spectrum Disorders (ASD) and 122 without ASD. The SRS-2 Deaf adaptation was compared blind to a NICE (National Institute for Health and Care Excellence) guideline standard clinical assessment. The area under the Receiver Operating (ROC) curve was 0.811 (95% CI: 0.753, 0.869), with an optimal cut-off value of 73, which gave a sensitivity of 82% and a specificity of 67%. The Cronbach Alpha coefficient was 0.968 suggesting high internal consistency. The Intraclass Correlation Coefficient was 0.897, supporting test-retest reliability. This performance is equivalent to similar instruments used for screening ASD in the hearing population.

Highlights

  • To date, there are no published Autism Spectrum Disorder (ASD) screening or diagnostic assessment tools that have been validated for use with deaf people [1]

  • Two were not eligible as they had no experience of working with deaf children with ASD, five decided not to participate, one did not have sufficient time to be involved, one did not feel they had sufficient clinical experience and one individual did not complete the demographic questionnaire in time

  • This performance is equivalent to similar instruments used for screening ASD in children/young people in the hearing population

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Summary

Introduction

There are no published Autism Spectrum Disorder (ASD) screening or diagnostic assessment tools that have been validated for use with deaf people [1]. Most current measures assume individuals can access spoken language [1,2] and often include questions or tasks that are inappropriate for use with deaf people, such as whether the person responds to their name being called [3]. Screening instruments and diagnostic interviews ask questions. Parent/Carer of a deaf child with ASD (another parent was 1 (2.5) 1 (4). A professional included in the row below) Professional 39 (97.5) 26 (96) Gender Female 34 (85) 24 (89) Male

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