Autism Classification System of Functioning: Social Communication (ACSF:SC) – Expansion, Testing, and Feasibility for Charting of Early Trajectories from Toddlers to School-Aged Children
Maternal, Child & Mental Health
The applicability of the ACSF to an expanded age-range to toddlers and school-aged children will better identify a child’s ‘social communication’ functioning and map their social communication trajecory throughout their childhood. The ACSF will enable parents, caregivers, and professionals to monitor the ‘social communication’ abilites and explore factors that impact on their functioning. This information can inform best practices in health services and intervention research. Also, having a function-focused classification system for young children and adolescents that is completed consistently (i.e., reliable) and accurately (i.e., valid) would enable families to have a ‘common language’ to use with professionals who provide services for their children (e.g., clinicians, therapists, teachers). In this context, this work will have a meaningful impact on interdisciplinary ASD services and facilitate partnerships between families, clinicians and researchers.
The Autism Classification System of Functioning: Social Communication (ACSF) describes 5-levels of social communication. Objectives: Initially developed for preschool children with ASD, this study developed and tested the reliability and validity of the ACSF with an expanded age (2-to-18 years). Methods: ACSF was adapted using qualitative methods from parent and clinician perspectives and analyzed by content analysis. An international online survey followed. ACSF intra- and inter-rater reliability testing with parents and professionals at 2 time points, and construct validity (testing convergent and discriminant validity with two measures), using correlation coefficients. Results: Parents (n=90) and professionals (n=41) were involved in reliability testing. Content validity from qualitative data supported the applicability, clarity and usability of the ACSF. Ratings were provided for children with ASD (2-15 years). Results showed good-to-very good intra-rater agreement for parents and professionals, and good inter-rater agreement. For construct validity testing, participants reported on 117 children with ASD (2-19 years). Significant correlations were reported between ACSF and the Social Communication and Interaction, Functional Communication, and Social Skills. Discriminant analyses showed weaker correlations between the ACSF and Externalizing and Attentional Problems. Conclusions: Our findings demonstrate that ACSF can be used as a reliable and valid social communication classification system in children with ASD 2-15 years of age. Challenges: Recruitment. Next Steps: The ACSF is being used internationally to track social communication abilities from diagnosis into school-age. This can empower caregivers and help in ongoing clinical, educational, and research contexts to assist with goal-setting and understanding barriers and facilitators that impact social communication. This can also help improve health services based on interventions and meaningful outcomes.
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