Autism spectrum disorder screening in preschools.

LAY ABSTRACT: With professional training and regular opportunities to observe children interacting with their peers, preschool teachers are in a good position to notice children's autism spectrum disorder symptomatology. Yet even when a preschool teacher suspects that a child may have autism spectrum disorder, fear of false alarm may hold the teacher back from alerting the parents, let alone suggesting them to consider clinical assessment for the child. A valid and convenient screening tool can help preschool teachers make more informed and hence more confident judgment. We set out to develop a screening tool that capitalizes on peer interaction as a naturalistic "stress test" to identify children more likely than their peers to have autism spectrum disorder. A total of 304 3- to 4-year-olds were observed at school with an 84-item preliminary checklist; data-driven item reduction yielded a 13-item Classroom Observation Scale. The Classroom Observation Scale scores correlated significantly with Autism Diagnostic Observation Schedule-2 scores. To validate the scale, another 322 2- to 4-year-olds were screened using the Classroom Observation Scale. The screen-positive children and randomly selected typically developing peers were assessed for autism spectrum disorder 1.5 years later. The Classroom Observation Scale as used by teachers and researchers near preschool onset predicted autism spectrum disorder diagnoses 1.5 years later. This user-friendly 13-item Classroom Observation Scale enables teachers and healthcare workers with little or no clinical training to identify, with reliable and valid results, preschoolers more likely than their peers to have autism spectrum disorder.

The Learning, Social and Emotion Adaptation Questionnaire-Short Form: A Measure of Adaptive Behavior for Primary School Students with Autism Spectrum Disorder.

Students with autism spectrum disorder (ASD) studying in mainstream classrooms have diverse adjustment difficulties in learning, social interaction, and emotion regulation. It is crucial to identify the areas these students find most challenging so that teachers can provide training and support accordingly. We therefore developed, examined, and provided norms for the Learning, Social and Emotion Adaptation Questionnaire-Short Form (LSEAQ-S), a teacher report instrument measuring 53 essential adaptive behaviors for mainstream primary school students in Hong Kong. Teachers completed the LSEAQ-S for three samples of 2,298, 2,690, and 3,305 students with ASD from 204 schools and a sample of 1,869 students without ASD from 112 schools. Our study showed that an 11-factor structure best describes the LSEAQ-S, which has high internal consistency and good convergent validity examined with the Social Responsiveness Scale-Second Edition (SRS-2). Normative data of the LSEAQ-S stratified by gender and grade (grades 1 to 3; grades 4 to 6) are presented. Gender and grade differences were found, with girls with ASD lagging behind their same-gender peers in related skills more than boys with ASD did, across both grade levels and especially in senior grades. The LSEAQ-S, together with its normative data, can reveal students' difficulties and needs, inform intervention priorities, and help monitor training progress. LAY SUMMARY: This study introduces the Learning, Social and Emotion Adaptation Questionnaire-Short Form (LSEAQ-S), a teacher report instrument developed in Hong Kong measuring school adaptation of students with autism spectrum disorder (ASD) in mainstream primary schools. The measure helps education personnel identify behaviors in which a student falls behind his/her peers and facilitate training and support targeting those behaviors. Autism Res 2021, 14: 959-972. © 2020 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals LLC.