Use of the Social Responsiveness Scale to Discriminate Between Autism Spectrum Diagnoses and Communication Disorders

Background:  

The Social Responsiveness Scale (SRS) is a parent-report instrument often used in clinical settings. It is commonly is used to obtain information on symptom magnitude in children suspected of having social problems, and in particular, children suspected of having  autistic spectrum problems and/or developmental impairment. The SRS total score has been found to distinguish between children who have an Autism Spectrum Disorder (ASD) and typically developing controls (Constantino, et al. 2007) and unaffected siblings of children diagnosed with an ASD (Frazier, et al, 2009). A limited amount of research has been conducted on the SRS using comparison populations with overlapping symptom presentation. One study compared SRS scores in ASD and non-ASD special education children with intellectual and behavioral problems (Charman et al. 2007), and found the SRS to useful in discriminating ASD and nonASD children in this population.  As yet, there is relatively little research that has been conducted to evaluate the use of the SRS in discriminating between children with ASDs and specific communication disorders (i.e., specific language impairment). 

Objectives:  

The goal of the present study was to investigate the use of the SRS total score and/or subscales in discriminating between children with an autism spectrum diagnosis and those diagnosed with specific language disorder, controlling for level of intellectual and/or adaptive behavior functioning.

Methods:  

Participants included 80 children (63 male) referred to a hospital based clinic for assessment of a possible autism spectrum disorder.  Children ranged in age from 48 months to 156 months (Mean = 80.7, S. D. = 30.1). Children and their primary caregivers participated in a neuropsychological evaluation which included diagnostic assessment (ADI-R, ADOS), assessment of intellectual, language, magnitude of triad and associated symptoms.   Sixty-six children received an autism spectrum disorder diagnosis (autistic disorder, PDD-NOS) and 14 children received a diagnosis of a communication disorder (either expressive language disorder or mixed receptive-expressive language disorder), according to DSM-IV TR criteria. Caregivers of all participants completed the SRS as well.  Initial analyses tested for between-group differences on age, gender, and intellectual functioning; those that differed between diagnostic groups were included in subsequent analyses as covariates.  Between-group differences on the SRS scales were evaluated using a one-way MANCOVA, with diagnostic group as the between-subjects factor and SRS subscales and total score as the outcome variables(s).

Results:  

The two groups did not differ on age, gender, or  intellectual functioning .   The overall test was significant (F(6, 73)=3.91; p=0.016).  Follow up tests revealed that the ASD group had increased scores (indicative of increased social problems) on the Social Motivation, (F (1, 78) = 18.0, p < .001), Autistic Mannerisms (F (1, 78) = 7.73, p= 0.008), Social Communication (F (1, 78) = 7.70, p = 0.008) and Total SRS scale, (F (1, 78) = 10.71, p =0.002).  The groups did not significantly differ on the remaining SRS subscales.

Conclusions:

Caregiver-report of social behaviors related to social communication, motivation and autistic mannerisms on the SRS does distinguish between children diagnosed  with an ASD and those with a Communication disorder.