Rapid quantitative assessment of autistic social impairment by classroom teachers

Objective: Teachers routinely observe children in the naturalistic social contexts of their classrooms and provide extremely important input in the evaluation of numerous psychiatric syndromes. Their precision in ascertaining and quantifying autistic symptomatology has not previously been established. In this study, we compared teachers' ratings of autistic symptomatology with those derived from parents, expert clinicians, and trained raters. Method: A total of 577 subjects (ages 4-18 years) with (n = 406) and without (n = 171) pervasive developmental disorders (PDDs) were assessed by one parent and one current teacher using the Social Responsiveness Scale, a quantitative measure of autistic traits. PDD subjects were assessed by expert clinicians, the Autism Diagnostic Interview-Revised, and/or the Autism Diagnostic Observation Schedule. All of the assessments were conducted during the period 1996-2006. Results: Teacher Social Responsiveness Scale reports exhibited strong correlations with parent reports (0.72); use of quantitative ratings from both informants resulted in extremely high sensitivity and specificity for clinical and research diagnoses of PDDs (area under receiver operating characteristics curve =.95). Conclusions: Rapid quantitative assessments by teachers and parents constitute a cost-effective method for measuring and tracking the severity of autistic symptomatology in both educational and clinical settings.