Screening for Autism Spectrum Disorders - Validation of the Portuguese Version of the Social Communication Questionnaire

Abstract

There are no assessment and screening tools for Autism Spectrum Disorders (ASD) validated for the Portuguese population. The Social Communication Questionnaire (SCQ) is an useful screening tool of ASD diagnosis. The main objectives of our study were to produce a Portuguese version of the SCQ (SCQ-PF), study its internal consistency, sensitivity and specificity in order to evaluate its validity as a screening instrument for ASD. We also wanted to study the impact of intellectual disability and verbal impairment and other mental disorders on SCQ-PF psychometric properties. The study included 211 children and adolescents, aged 4–17, divided in three groups: ASD Group (n = 96), Other Mental Disorders Group (OMD) (n = 63) and No Mental Disorders (NMD) Group (n = 52). Parents or other primary caregiver provided information on the SCQ items. The SCQ-PF score was significantly higher in the ASD group than in the other groups (p < 0.001). As to internal consistency, Cronbach’s alpha was 87%. ASD subjects were distinguished from subjects without ASD (OMD and NMD Groups) and the area under the curve (AUC) was 0.897 (95% Confidence Interval: 0.852–0.943), for a cutoff of 14, which yielded the highest AUC, with values of sensitivity and specificity 0.76 and 0.93, respectively. These findings show that SCQ- PF with a cutoff of 14 is an acceptable and useful screening tool for ASD in the Portuguese population.

Autism diagnosis experience and parental stress among Portuguese parents

“…In accordance with other international studies, parents in our study first noticed delays in social development, followed by ritualistic behaviours and behavioural problems. While these symptoms represent the triad of impairments characteristics of ASD, they are also more likely to be observed later in children’s development (Araújo et al , 2023; Pereira et al , 2018), which corroborating our results of a later age of first concern. However, given that Portuguese parents noticed difficulties in their child’s development at a later age, indicating that knowledge of early behavioural milestones and markers of ASD are essential for parents to hasten the diagnosis process.…”

“…However, the present results indicated an increase in the mean age of formal diagnosis compared to the study realized by Salomone et al (2015) that found the mean age to be 2.79 years. A possible explanation for this potential delay may be the characteristics of symptom severity in our sample and the inefficiency of the diagnostic practices in the last 15 years (Araújo et al , 2023). In addition, we found that on average parents consulted 3.62 professionals (ranging one to eight professionals) of various fields of expertise before obtaining the formal diagnosis.…”

“…Moreover, there is limited literature in the last decade exploring the age of ASD diagnosis, as well as reported directly from parents. The prevalence of ASD in Portugal has been consistently rising (Ara ujo et al, 2023). Therefore, based on the previous literature, the present study aims to fill this gap and (a) provide an overview of the journey that parents in Portugal currently experience to receive a formal diagnosis of ASD for their child/adolescent, (b) identify key factors that influence parental experiences of the diagnosis process such as parental stress and social support and (c) explore the impact that age of children at diagnosis, age of parents and social support have on parental stress during the experience of obtaining a formal diagnosis of ASD.…”

“…In the last 20 years, no epidemiological studies have been conducted on the prevalence of autism in Portugal. The ASD diagnosis involves a complex process with extensive and thorough investigation by various health professionals (Araújo et al , 2023) that can be performed as early as 18–24 month of age under optimal conditions. However, only a minority of children with ASD are identified by the age of three years, and many are identified after they enter school (Zeidan et al , 2022).…”