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Can questions about social interaction correctly identify preschool aged children with autism?


  • Conflict of interest: None declared.

Correspondence: Professor Katrina Williams, Developmental Medicine The Royal Children's Hospital Melbourne, 50 Flemington Road, Parkville, Melbourne, VIC 3052, Australia. Fax: +9345 4848; email:



We developed a questionnaire to assess social development (SIQ) in preschool children. Social development is often not included in medical assessment, though it may assist in early identification of autism spectrum disorder (ASD).


Parents of 108 children with ASD, speech and language disorders, or ‘developmental concerns’, recruited from a clinical developmental assessment and community child health service, completed the SIQ, and also a Childhood Autism Rating Scale (CARS) assessment. Receiver Operator Characteristic (ROC) curves were generated to assess the performance of different questionnaire score thresholds in correctly identifying children with a CARS score of 30 or more. Logistic regression models were used to identify the questions which had the most predictive value for a CARS score of 30 or more.


An SIQ score of 14 or more correctly identified children with a CARS ≥30 with a sensitivity of 85%, specificity 85%, positive likelihood ratio (LR) 8.3 and negative LR 0.2. Two questions were identified as most predictive of ASD.


The SIQ may assist clinicians in assessing social development and in making decisions about referral for autism assessment. Evaluation of the SIQ at the point of entry to a clinical service is needed.