Development of a Screening Score for Rapid Diagnosis of Autism Spectrum Disorders Risk in Children Aged Three to Four

Abstract

The article is devoted to a detailed description of the procedure and results of a scree­ning scale elaboration for rapid diagnosis of autism risk in Russian 3–4-year-olds. The study sample consisted of 926 children, of whom 383 were clinically diagnosed with ASD (autism spectrum disorder), 200 with DD (developmental delay), and 343 were from the Norm group. Using mathematical modeling methods, a 20-point scale of autism was constructed. The factor validity, reliability and effectiveness of the developed scale have been confirmed. The accuracy of the scale was 88.91% (sensitivity 92.1%, specificity 87.2%). The scale is based on 40 symptoms of autism, representing 4 vectors of its manifestation, 3 of which correspond to the main symptoms of autism according to DSM-5: "Emotional disorders", "Sensory disorders", "Communication disorders", but another dimension was also obtained called "Hyperactivity"/Disinhibition", which is unique for ASD models. The multigroup confirmatory factor analysis of structural and measurement equivalence confirmed the 4-vector structure of ASD for a sample of children with ASD, its structural and measurement invariance with respect to children with ASD differing in gender and age: boys and girls, 3- and 4-year-olds. However, for children without ASD, the existence of such a structure was not confirmed. Therefore, the selected scales reflect the autism vectors specific to children with ASD, according to which children with ASD differ from other children to the greatest extent.