Performance of the Autism Spectrum Rating Scale and Social Responsiveness Scale in Identifying Autism Spectrum Disorder Among Cases of Intellectual Disability
The Autism Spectrum Rating Scale (ASRS) and the Social Responsiveness Scale (SRS) have been widely used for screening autism spectrum disorder (ASD) in the general population during epidemiological studies, but studies of individuals with intellectual disability (ID) are quite limited. Therefore, we recruited the parents/caregivers of 204 ASD cases, 71 ID cases aged 6–18 years from special education schools, and 402 typically developing (TD) children in the same age span from a community-based population to complete the ASRS and SRS. The results showed that the ID group scored significantly lower on total and subscale scores than the ASD group on both scales (P < 0.05) but higher than TD children (P < 0.05). Receiver operating characteristic analyses demonstrated a similar fair performance in discriminating ASD from ID with the ASRS (area under the curve (AUC) = 0.709, sensitivity = 77.0%, specificity = 52.1%, positive predictive value (PPV) = 82.2%) and the SRS (AUC = 0.742, sensitivity = 59.8%, specificity = 77.5%, PPV = 88.4%). The results showed that individuals with ID had clear autistic traits and discriminating ASD from ID cases was quite challenging, while assessment tools such as ASRS and SRS, help to some degree.
KeywordsAutism spectrum disorder Intellectual disability Screening accuracy Autism Spectrum Rating Scale Social Responsiveness Scale
This study was supported by the National Health and Family Planning Commission of China (201302002; ClinicalTrials.gov Number NCT 02200679). We thank all participants and their parents, as well as teachers at the Dong Li Feng Mei Health School (Mr. Ning Rao) and Qi Zhi School (Miss Xiaoqing Zhu) of Shanghai, who helped us greatly. Moreover, we thank all the physicians who helped during the evaluations.
Compliance with Ethical Standards
Conflict of interest
All authors claim that there are no conflicts of interest.
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