Brief Report: An Evaluation of the Social Communication Questionnaire as a Screening Tool for Autism Spectrum Disorder in Young People Referred to Child & Adolescent Mental Health Services.
The SCQ is too inaccurate to screen for ASD by itself in community mental health referrals.
01Research in Context
What this study did
The team gave the Social Communication Questionnaire (SCQ) to school-age kids who were already sent to community mental health clinics. They then checked if the SCQ score matched the final ASD diagnosis made by the clinic.
The goal was to see if the SCQ could act as a quick first-step screener in real-world CAMHS referrals.
What they found
The SCQ missed too many kids who truly had ASD and flagged too many who did not. Sensitivity and specificity were both poor, so the tool could not reliably sort the caseload.
In short, the SCQ failed as a stand-alone screen in this setting.
How this fits with other research
Posserud et al. (2009) and Kahng et al. (1999) showed the older ASSQ worked well in 7- to 14-year-olds when both parents and teachers filled it out. Their positive results remind us that tool choice matters: ASSQ, not SCQ, had strong accuracy in similar age bands.
Jutley-Neilson et al. (2013) also found the SCQ under-performed, but they blamed visual loss in kids with septo-optic dysplasia. The new CAMHS study points to referral noise instead. Both papers agree the SCQ misses cases; population differences explain why, so the findings do not truly clash.
Hartwell et al. (2025) scanned 37 ASD screeners and concluded no single tool wins on every metric. Their map places the SCQ in the "use with caution" zone, matching the negative verdict here.
Why it matters
If you work in community clinics, do not rely on the SCQ alone to green-light or rule out ASD. Pair it with developmental history, observation, or a different questionnaire. Quick screens can still help, but this study warns that an SCQ cut-off will misclassify many of the kids you see every day.
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02At a glance
03Original abstract
The SCQ is a widely used screening measure for the assessment of autism spectrum disorder (ASD). However, its sensitivity and specificity when used with older children in the context of community Child & Adolescent Mental Health services is unclear. Seventy-seven (Mean age = 12.8 years) young people with suspected ASD were screened using parent- and teacher-reported SCQ's before completing a comprehensive diagnostic assessment. Of the 77 young people included, 44 (57%) met criteria for an ASD diagnosis. Our results indicated that regardless of informant, SCQ scores did not significantly predict the outcome of the diagnostic assessment. Based on the published cut-off score for the SCQ, Receiver Operating Characteristic curve analyses revealed a lower than expected sensitivity and specificity. This suggests that the SCQ is not an effective screening tool when used in the context of community Child & Adolescent Mental Health services.
Journal of autism and developmental disorders, 2019 · doi:10.1007/s10803-019-03982-6