A systematic review of screening tools in non-young children and adults for autism spectrum disorder.
For clients 4-plus years, only AQ, SCQ, and SRS have replicated evidence as ASD screeners.
01Research in Context
What this study did
Tomoya and colleagues hunted for ASD screening tools that work in people aged 4 years and up. They read every paper they could find and kept only the ones that compared a screener to the gold-standard ADOS or ADI-R.
In the end they found 17 tools, but only three had been tested in more than two independent studies.
What they found
The Autism Spectrum Quotient (AQ), Social Communication Questionnaire (SCQ), and Social Responsiveness Scale (SRS) are the only screeners with repeated evidence in older kids and adults.
All other tools lack replication, so their accuracy is still uncertain.
How this fits with other research
Allison et al. (2008) showed the Q-CHAT works well for toddlers 18-24 months old. Their positive results do not clash with Tomoya’s review; they simply cover a younger age band. Together the studies tell us we have good toddler and 4-plus screeners, but a gap still exists for preschoolers .
Balboni et al. (2014) validated the DABS for intellectual disability across the same wide age span (3-25) that Tomoya studied. Both papers stress the same lesson: choose tools that have proven sensitivity and specificity, not just a familiar name.
Smith et al. (1994) screened for psychiatric disorders in teens with mild ID. Their work mirrors Tomoya’s focus on older youth, but looked beyond ASD. Practitioners should note that comorbid conditions may require additional, validated checklists.
Why it matters
When you assess a client aged 4 or older, start with AQ, SCQ, or SRS. Document which form you used and cite the replicated evidence. Skip newer or one-study tools unless you are collecting data for further validation. This small habit raises diagnostic confidence and shields families from false positives or missed cases.
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02At a glance
03Original abstract
BACKGROUND: Existing reviews of screening tools for Autism Spectrum Disorder (ASD) focus on young children, and not all screening tools have been examined against validated diagnostic procedures. AIMS: To examine the validity of screening tools for ASD in non-young children and adults to provide clinical recommendations about the use of these tools in a variety of clinical settings. METHODS AND PROCEDURES: Electronic databases, including MEDLINE, EMBASE, PsychINFO, Cochrane Library and CINAHL, were searched through March 2017. Studies examining the validity of ASD screening tools against the Autism Diagnostic Observation Schedule and/or the Autism Diagnostic Interview - Revised in non-young children (age 4 or above) and adults were included. Three authors independently reviewed each article for data extraction and quality assessment. OUTCOMES AND RESULTS: 14 studies met the inclusion criteria, of which 11 studies were with children (4-18 years of age) and 3 studies included adults only (19 years of age and above). Included studies were conducted in a general population/low-risk sample (N = 3) and a clinically referred/high-risk sample (N = 11). In total 11 tools were included. CONCLUSIONS AND IMPLICATIONS: Only three screening tools (the Autism-Spectrum Quotient, the Social Communication Questionnaire, and the Social Responsiveness Scale) were examined in more than 2 studies. These tools may assist in differentiating ASD from other neurodevelopmental and psychiatric disorders or typically developed children. In young adult populations, the paucity of the existing research in this group limits definitive conclusion and recommendations.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.05.017