Construction and Validation of the Esbcq: The Early Social Communicative Behavior Questionnaire

Poster Presentation
Friday, May 11, 2018: 11:30 AM-1:30 PM
Hall Grote Zaal (de Doelen ICC Rotterdam)
M. Buruma and E. M. Blijd-Hoogewys, INTER-PSY, Groningen, Netherlands

There has been an increasing interest in the diagnosis of Autism Spectrum Disorders (ASD) in infants (children younger than 3 years). These children have limited social communication skills, such as poor joint attention and symbolic play.

In ASD diagnostics, parent questionnaires are often used. In 2009, we developed the Early Social Communicative Behavior Questionnaire (ESCBQ; Blijd-Hoogewys & Buruma, 2009). The ESBCQ items are formulated, based on 1) literature research concerning both typical and atypical development of early social communicative behavior in infants, 2) existing instruments concerning this topic, and 3) clinical expertise with young children with ASD. The following subjects are questioned: eye contact, social interest, reaction to name, emotions, attachment, sharing pleasure, taking turns, looking, following gaze, following a point, pointing, showing, giving, playing, interaction games, imitation, gestures, and language.


The objective of this study was to develop a questionnaire that can be easily used to measure early social communicative behavior in infants in a reliable and valid way.


The ESBCQ is a parent questionnaire, consisting of 108 items, questioning early social communication skills that typically developing children should master at the age of 24 months. The ESBCQ-2 is a shortened version of 58 items.

*Research group 1 - Standardization group ESBCQ-1

In order to explore the psychometric properties of the ESCBQ, 1230 parents of typically developing children aged 0-6 years filled in the questionnaire. Also, 108 parents of children with ASD filled in the ESBCQ.

*Research group 2 - Standardization group ESBCQ-2

Data collection is ongoing. Currently, 402 parents have filled in the questionnaire (222 boys, 180 girls). Also, 204 parents of children with ASD (INTER-PSY & Virenze) and 86 parents of children (Driestroom) with an intellectual disability filled in the ESBCQ-2.


*Research 1:

It takes 20-25 minutes to fill in the ESBCQ. The total score shows a steady increase with age, with a plateau at 30 months, for both boys and girls. The questionnaire has good psychometric properties: the internal consistency, based on inter-item reliability, is good (Cronbach’s alpha = .97). Also the test-retest reliability (second measurement after 1 week) is good (N = 43, Wilcoxon Signed Rank test, M1 = 93.19 vs. M2 = 95.63, r = .91, p = .001).

A Principal Component Analysis conveyed three clusters (56% explained variance) (see Figure 1): 1) language, gestures, pretending and symbolic play; 2) pointing and giving; 3) gaze shifting and following attention (gaze and points).

*Research 2:

The ESBCQ was shortened and ameliorated, to make it more user friendly. This resulted in the ESBCQ-2 (Buruma & Blijd-Hoogewys, 2014). This is based on additional item analyzes (Differential Item Analyses) and clinical expertise. The ESBCQ-2 contains 58 items. The completion time is 10-15 minutes. Preliminary results are promising.


The ESCBQ(-2) is a new questionnaire with good psychometric properties. The three clusters found coincide with what is expected from literature. More research is underway, focusing on the use of the ESCBQ as a ‘diagnostic’ tool.