Factors influencing scores on the social responsiveness scale

Abstract

Background The Social Responsiveness Scale (SRS) is a parent-completed screening questionnaire often used to measure ASD severity. Although child characteristics are known to influence scores from other ASD-symptom measures, as well as parent-questionnaires more broadly, there has been limited consideration of how non-ASD-specific factors may affect interpretation of SRS scores. Previous studies have explored effects of behavior problems on SRS specificity, but have not addressed influences on the use of the SRS as a quantitative measure of ASD-symptoms. Method Raw scores (SRS-Raw) from parent-completed SRS were analyzed for 2,368 probands with ASD and 1,913 unaffected siblings. Regression analyses were used to assess associations between SRS scores and demographic, language, cognitive, and behavior measures. Results For probands, higher SRS-Raw were associated with greater non-ASD behavior problems, higher age, and more impaired language and cognitive skills, as well as scores from other parent report measures of social development and ASD-symptoms. For unaffected siblings, having more behavior problems predicted higher SRS-Raw; male gender, younger age and poorer adaptive social and expressive communication skills also showed small, but significant effects. Conclusions When using the SRS as a quantitative phenotype measure, the influence of behavior problems, age, and expressive language or cognitive level on scores must be considered. If effects of non-ASD-specific factors are not addressed, SRS scores are more appropriately interpreted as indicating general levels of impairment, than as severity of ASD-specific symptoms or social impairment. Further research is needed to consider how these factors influence the SRS’ sensitivity and specificity in large, clinical samples including individuals with disorders other than ASD.

Developmental pathways of language and social communication problems in 9–11 year olds: Unpicking the heterogeneity

“…The profiles and trajectories we have observed point to the possibility that some children had ASD, and that this was previously present but undetected. First, the mean total scores of the SCI-LI group fell in the severe range of the SRS indicative of ASD, and were of a similar order to the mean reported from a large sample of 2,368 ASD probands (Hus et al, 2013); 61% of the children in the SCI-LI group scored in this range, as did 20% in the SCI group. Second, the SRS subscale Autistic Mannerisms, which includes restricted and repetitive interests and behaviours (RRIBs), was significantly impaired in both groups with SCI, though particularly marked in the SCI-LI group (all had scores ≥60T indicative of a clinically significant deficit (Constantino & Gruber, 2005), as did 80% of the SCI group.…”

ADHD Symptoms, Autistic Traits, and Substance Use and Misuse in Adult Australian Twins

“…Once again, this result might indicate that lower levels of AT, as indexed by the SRS, correlate robustly with childhood externalizing problems (Hus et al, 2013) such as the onset of use. The elevated levels of cannabis use and misuse associated with high AT scores also could be a result of repetitive preoccupations associated with AT traits, which might be an underlying factor facilitating the transition from repeated cannabis use to cannabis abuse/dependence.…”

“…Second, in addition to being an index of ASD-related problems, our measure of AT likely identifi es individuals with other non-ASD behavioral problems. In fact, in a recent study of 2,368 ASD probands and their 1,913 siblings, raw SRS scores were highly associated with ASD symptoms and reduced social development but also with internalizing and externalizing problem scales of the Child Behavior Check List (Hus et al, 2013). The association between SRS scores and externalizing problems was pronounced even in those with low scores on the social development scale, indicating a potentially independent, but also bi-directional (i.e.…”

Propriedades psicométricas da Escala de Responsividade Social-2 para Transtornos do Espectro Autista

“…De fato, suspeita-se de que esses especificadores e problemas de comportamento influenciem a pontuação da ERS, pois alguns itens da escala podem avaliar sintomas que não são específicos do TEA 17 . Nesse sentido, a escala poderia avaliar não somente a gravidade dos traços autísticos de uma criança, mas também a gravidade de problemas associados 18 . Por fim, o formulário da ERS-2 utilizado avalia uma faixa etária ampla (4-18 anos) em que, mesmo em pessoas com desenvolvimento típico, há grande variação nas habilidades sociocomunicativas, de linguagem e cognitivas de forma geral.…”

“…No TEA, essa variabilidade é ainda maior. Desse modo, não se tem clareza sobre como informantes respondem (ou deveriam responder) a itens que não se aplicam a suas crianças (por exemplo: itens avaliando conversação em uma criança não verbal) 18 . Por outro lado, apesar dessas limitações, a amostragem consecutiva, características da amostra similares à do TEA na população geral (por exemplo: maior proporção do gênero masculino) e a avaliação de pacientes por clínicos experientes são os pontos fortes do estudo.…”