Psychometric analysis of the Systematic Observation of Red Flags for autism spectrum disorder in toddlers.

Dow, Deanna; Guthrie, Whitney; Stronach, Sheri T; Wetherby, Amy M

doi:10.1177/1362361316636760

Cited by 62Autism Spectrum Disorder ResearchChild Nutrition and Feeding IssuesBehavioral and Psychological Studies

Psychometric analysis of the Systematic Observation of Red Flags for autism spectrum disorder in toddlers.

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Dow, Deanna, Guthrie, Whitney, Stronach, Sheri T, Wetherby, Amy M·2017·Autism

DOI 10.1177/1362361316636760PMC PMC5734914

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Abstract

The purpose of this study was to examine the utility of the Systematic Observation of Red Flags as an observational level-two screening measure to detect risk for autism spectrum disorder in toddlers when used with a video-recorded administration of the Communication and Symbolic Behavior Scales. Psychometric properties of the Systematic Observation of Red Flags were examined in a sample of 247 toddlers of 16- to 24 months old: 130 with autism spectrum disorder, 61 with developmental delays, and 56 typically developing. Individual items were examined for performance to create an algorithm with improved sensitivity and specificity, yielding a total Composite score and Domain scores for Social Communication and Restricted Repetitive Behaviors. Codes indicating clear symptom presence were collapsed to yield a count of the number of Red Flags for the overall scale and each symptom domain. Results indicated significant group differences with large effects for the Composite, both Domain scores, and Red Flags score, and good discrimination (area under the curve = 0.84–0.87) between autism spectrum disorder and nonspectrum groups for the Composite, Social Communication Domain, and Social Communication Red Flags score. The Systematic Observation of Red Flags provides an observational screening measure for 16- to 24-month-olds with good discrimination, sensitivity, and specificity. A cutoff of 20 on the Composite is recommended to optimally detect autism spectrum disorder risk.

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Increased use of telehealth approaches could reflect the movement toward recovery by enabling remote evaluation and identification of children with ASD.
“This could reflect increased use of telehealth approaches that enabled remote evaluation and identification of children with ASD (12–16).”
From Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020 (2023) · cites this paper as [15]

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Additional file 4 of Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario
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Additional file 3 of Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario
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Additional file 1 of Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario
Kamali, M., Sivapalan, S., Kata, A., Kim, N., Shanmugalingam, N., Duku, E., Zwaigenbaum, L., & Georgiades, S. (2022) · Figshare · doi:10.6084/m9.figshare.19498158
Additional file 2 of Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario
Kamali, M., Sivapalan, S., Kata, A., Kim, N., Shanmugalingam, N., Duku, E., Zwaigenbaum, L., & Georgiades, S. (2022) · Figshare · doi:10.6084/m9.figshare.19498161
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Observation of Social Communication Red Flags in Young Children with Autism Spectrum Disorder, Developmental Delay, and Typical Development Using Two Observation Methods
(2013) · DigiNole (Florida State University)

Authors: Dow, D., Guthrie, W., Stronach, S. T., & Wetherby, A. M.
Affiliations: Florida State University (US)
University of Minnesota (US)
Corresponding author: Dow, Deanna
ORCID: Dow, Deanna
Stronach, Sheri T
Wetherby, Amy M
Venue: Autism
Publisher: SAGE Publications
Published: 2016-07-09
Volume: 21
Issue: 3
Pages: 301-309
ISSN: 1362-3613 (ISSN-L)
1461-7005
DOI: 10.1177/1362361316636760
PMC: PMC5734914
OpenAlex: W2343483041
Cited by: 62
References: 31
Citations by year: 2026: 6 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 12 · 2021: 7 · 2020: 6 · 2019: 5 · 2018: 6 · 2017: 1 · 2016: 1
FWCI: 2.76
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Autism (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: Centers for Disease Control and Prevention (U01DD000304)
National Institute on Deafness and Other Communication Disorders (R01DC007462)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD065272, R01HD078410)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Keywords: autism spectrum disorder, toddlers, red flags, social communication, restricted and repetitive behaviors, developmental delay, screening cut-off values, sensitivity and specificity
MeSH terms: Autism Spectrum Disorder, Child Behavior, Child, Preschool, Humans, Infant, Psychological Tests, Psychometrics, Risk Factors, Sensitivity and Specificity, Video Recording, Reproducibility of Results

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