A Simple New Tool for Autism Screening
- motim51
- Nov 13
- 3 min read
Diagnosis of autism is crucial in order to provide children and their families with appropriate treatment, support, and access to rights and services.
Although awareness and early identification of autism have significantly increased in recent years, there are still children who may “fall between the cracks” and fail to receive the proper care and support.
Long waiting lists and the heavy workload of pediatricians and allied health professionals may lead to missed signs or “red flags” associated with autism.
In addition, educators working in preschools and schools are sometimes uncertain about when and how to raise concerns regarding possible communication-related red flags.
It is important to emphasize that while the use of a screening tool does not confirm an autism diagnosis, it can assist community physicians, therapists, and educational staff in identifying children who should be referred for evaluation by a specialist.
Therefore, there is a growing need for short and accurate screening tools that cover a wide age range and can be easily and quickly scored.
A widely used screening tool is the SRS (Social Responsiveness Scale) - a 65-item parent-report questionnaire designed for use with children aged 4–18 years.
The SRS has been validated against established diagnostic instruments such as the ADI-R (Autism Diagnostic Interview-Revised).
However, because the assessment can take up to 20 minutes and sometimes requires complex scoring, it may not be practical for use in busy clinical or educational settings.
A recent study examined a brief 5-item version of the Social Responsiveness Scale (SRS) as a quick and simple screening tool to distinguish between children with and without autism.
The study population included 1,462 pairs (2,924 children), each consisting of a child diagnosed with autism (aged 4–18 years) and a non-autistic relative.
The five selected items were:
Plays appropriately with children his or her age (contributed more than 95% to correct classification).
Has trouble keeping up with the flow of a normal conversation.
Has more difficulty than other children with change in routine.
Is regarded by other children as “odd” or “weird”.
Avoids eye contact or has unusual eye contact.
Three of the items are taken from the Social Communication subscale, and two from the Autistic Mannerisms subscale.
A screenshot of the items from the article: The items can be seen in the table. Each item is rated from 0 to 3, with higher scores indicating a greater likelihood of autism. A total score of 4 out of 15 or higher suggests a recommendation for further evaluation.
Main Findings
Overall, the five items enabled the identification of children diagnosed with autism with very high accuracy, comparable to the original 65-item version of the scale.
The diagnostic cutoff established was a score of 4 out of 15 or higher, indicating a likelihood of autism and yielding a sensitivity of 96.9% (that is, the proportion of individuals with autism correctly identified by the screening) and a specificity of 97.3% (the proportion of individuals without autism correctly identified as such).
The tool’s performance was not affected by gender, age, ethnicity, or family income.
Important Notes and Limitations
The evaluation was conducted among children from similar family backgrounds, rather than within a random or broad clinical population.
All non-autistic children in the study were relatives of children with autism and therefore may not represent children from the general population.
The researchers note that it would be valuable to examine the 5iSRS in more diverse populations, including children with other developmental or behavioral disorders such as ADHD and anxiety, to determine whether the tool can effectively distinguish these groups from autism with similar accuracy.
The tool was tested only in children aged 4–18 years and is not intended for use with younger children. There are other screening instruments specifically designed for toddlers.
Practical Implications
This is a quick, brief, and efficient tool for the initial differentiation between children with and without autism aged 4–18 years. However, further studies are needed to validate its use across diverse clinical populations and among children with various developmental and behavioral difficulties. It is important to remember that this is a screening tool only, not a diagnostic instrument.
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