Content Validity Testing of the Autism Classification System of Functioning: Social Communication (ACSF:SC) with Toddlers and School-Aged Children with Autism

Poster Presentation
Saturday, May 4, 2019: 11:30 AM-1:30 PM
Room: 710 (Palais des congres de Montreal)
B. Di Rezze1, P. Rosenbaum2, S. J. Gentles1, C. Roncadin3, L. Zwaigenbaum4, M. J. C. Hidecker5, S. Georgiades1, O. Hlyva1 and H. Viveiros6, (1)McMaster University, Hamilton, ON, Canada, (2)CanChild Centre, McMaster University, Hamilton, ON, Canada, (3)Autism Spectrum Disorder Service, McMaster Children's Hospital - Hamilton Health Sciences, Hamilton, ON, Canada, (4)University of Alberta, Edmonton, AB, Canada, (5)Communication Disorders, University of Wyoming, Laramie, WY, (6)Pediatrics, McMaster University, Hamilton, ON, Canada

The Autism Classification System of Functioning: Social Communication (ACSF:SC) is a strengths-based system that classifies 5 levels of social communication abilities of children with ASD. To date, the ACSF:SC has been developed and used with preschoolers (3-6 years), with whom it has undergone psychometric testing, the findings of which have been published (Di Rezze et al. 2016). The current study examines applicability, clarity and utility of the ACSF:SC across the full childhood age range, by consulting with parents of children with ASD and clinicians working closely with toddlers (24-36 months) and school-aged children (>6 years) with ASD.


To assess the content validity of the ACSF:SC with children ages 24-36 months, and over 6 years old, in order to test the usefulness of the ACSF:SC and examine its performance across this expanded age range.


Qualitative methods were used to test ACSF:SC age expansions from the perspectives of parents and clinicians. We developed a user guide and conducted cognitive interviews and focus groups with parents of children (both toddler and school-aged) and clinicians working with children in this age range. Transcripts from interviews and focus groups were analyzed using qualitative content analysis.

Results: Ten parents and seventeen clinicians working with toddlers or school-aged children with ASD participated, and recommendations were provided for three categories: applicability, clarity and usability of the tool. Applicability captured respondents’ observations on developmental appropriateness of the level descriptions, and their ability to “see” (recognize) an individual child fitting into one particular ACSF:SC level. Most found the ACSF:SC relevant, but in the toddler group we learned that it was important to consider the educational and emotional needs of parents of newly diagnosed children. Clarity captured respondents’ understanding of the ACSF:SC, its explicit and underlying constructs, level descriptions and distinctions. Feedback on usability helped us to identify areas that needed to be more user-friendly.


Through a variety of content validation processes, these results indicated that ACSF:SC constructs are seen to be applicable to both toddlers and school-aged children with ASD, as well as being understood by most parents. Several recommendations need to be considered before proceeding with its final revisions and field testing – both of which are currently underway. Next steps will involve revising the ACSF:SC and sharing it with international stakeholders (n=50), whose perspectives are currently being collected and analysed through an online survey on ACSF:SC revisions, based on this work. This work will be completed prior to this conference and integrated into the presentation.