Can autism spectrum disorders and social anxiety disorders be differentiated by the social responsiveness scale in children and adolescents?

Cholemkery et al. (2014) asked if the Social Responsiveness Scale can tell autism from social anxiety or selective mutism.

They gave the SRS to kids with autism, social phobia, selective mutism, and typical peers. Then they looked at score overlap and added other check-ups to see if accuracy improved.

SRS scores landed in the same range for all three clinical groups. Boys with selective mutism were often labeled autistic by the SRS alone.

Adding extra questionnaires helped only a little. The scale works best as a red flag, not a final answer.

Hirota et al. (2018) still list SRS as one of only three screeners with solid backup data for ages four and up. That sounds like praise, but Hannah shows the tool can cry wolf when anxiety is present.

Koegel et al. (2014) saw the same problem with broadband scales: they flag autism too often and miss fine details. Together these papers warn that any single rating form, SRS included, is a starting point, not a finish line.

Ooi et al. (2011) found a short 9-item CBCL scale reached moderate accuracy. Hannah’s team tried stacking extra forms and still saw overlap, suggesting the issue is deeper than item count.

If you screen a quiet, anxious child, expect the SRS to lean toward autism. Plan on a second step—ADOS, ADI-R, or direct observation—before you write the report. Share this caution with teachers and parents so one score doesn’t lock a label.