Validity of the social communication questionnaire in assessing risk of autism in preschool children with developmental problems.
SCQ cut-off ≥ 11 spots nearly all preschoolers with autism who have developmental delays, but expect false positives—use it to queue kids for full assessment, not to rule autism in or out.
01Research in Context
What this study did
The team gave the 40-item Social Communication Questionnaire (SCQ) to parents of the preschoolers already in a hospital clinic for developmental delays.
All kids also got the full ADOS and ADI-R so the doctors knew who truly had autism.
They tested whether a quick paper form could match the gold-standard diagnoses.
What they found
Using a cut-off of 11 or higher, the SCQ caught almost every child with autism (93-100 % sensitivity).
It also flagged many kids who did not have autism (only 58-62 % specificity).
The form beat the original referrer’s hunch, so it helped decide who needed a full autism work-up.
How this fits with other research
van den Broek et al. (2006) ran almost the same study a year earlier and saw lower sensitivity (63-68 %). The difference: C’s sample included more higher-functioning kids who talk in phrases. When children have phrase speech the SCQ misses them more often, so the two papers actually agree.
Bong et al. (2021) tried a different route: a 10-minute caregiver interview plus short play. Their tool reached similar sensitivity (85-92 %) but better specificity (77-97 %). This shows you can keep accuracy high and still cut parent paperwork.
Kakooza-Mwesige et al. (2014) took the SCQ idea to Uganda and swapped in a 23-item village screener. Sensitivity dropped to 55-80 %, proving the questions need local tuning. Together the four studies say: parent questionnaires work, but cut-offs and wording must fit the setting and the child’s language level.
Why it matters
If you work in an early-intervention clinic, give the SCQ while families wait. A score ≥ 11 is your red flag to fast-track a full evaluation. Remember: four out of every ten positives will be false alarms, so never tell parents “your child has autism” based on the form alone. Pair the SCQ with a brief play-based tool like BeDevel or schedule the ADOS to reduce over-referral and keep waitlists short.
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02At a glance
03Original abstract
This study estimates the sensitivity and specificity of the social communication questionnaire (SCQ) for autistic spectrum disorders in preschool children at high risk for developmental problems referred to a tertiary centre and compares the predictions of the SCQ and the referrer. The SCQ was completed by 81 parents prior to multidisciplinary assessment and compared with the final diagnosis. The sensitivity and specificity were 93% and 58% for children aged 2-6, and 100 and 62% for children aged 3-5 years, with a cut-off score of 11. The SCQ performed better than referrers. Low-specificity means the SCQ is not suitable as a diagnostic tool but will assist clinicians and tertiary services in selecting children with developmental problems who require autism-specific assessment.
Journal of autism and developmental disorders, 2007 · doi:10.1007/s10803-006-0279-7