Developing a classification system of social communication functioning of preschool children with autism spectrum disorder

Briano Di Rezze, Peter Rosenbaum, Lonnie Zwaigenbaum, Mary Jo Cooley Hidecker, Paul Stratford, Martha Cousins, Chantal Camden, Mary Law

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Aim: Impairments in social communication are the hallmark of autism spectrum disorder (ASD). Operationalizing ‘severity’ in ASD has been challenging; thus, stratifying by functioning has not been possible. The purpose of this study is to describe the development of the Autism Classification System of Functioning: Social Communication (ACSF:SC) and to evaluate its consistency within and between parent and professional ratings. Method: (1) ACSF:SC development based on focus groups and surveys involving parents, educators, and clinicians familiar with preschoolers with ASD; and (2) evaluation of the intra- and interrater agreement of the ACSF:SC using weighted kappa (кw). Results: Seventy-six participants were involved in the development process. Core characteristics of social communication were ascertained: communicative intent; communicative skills and reciprocity; and impact of environment. Five ACSF:SC levels were created and content-validated across participants. Best capacity and typical performance agreement ratings varied as follows: intrarater agreement on 41 children was кw=0.61 to 0.69 for parents, and кw=0.71 to 0.95 for professionals; interrater agreement between professionals was кw=0.47 to 0.61, and between parents and professionals was кw=0.33 to 0.53. Interpretation: Perspectives from parents and professionals informed ACSF:SC development, providing common descriptions of the levels of everyday communicative abilities of children with ASD to complement the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Rater agreement demonstrates that the ACSF:SC can be used with acceptable consistency compared with other functional classification systems.

Original languageEnglish
Pages (from-to)942-948
Number of pages7
JournalDevelopmental Medicine and Child Neurology
Issue number9
StatePublished - Sep 1 2016

Bibliographical note

Publisher Copyright:
© 2016 Mac Keith Press

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Clinical Neurology


Dive into the research topics of 'Developing a classification system of social communication functioning of preschool children with autism spectrum disorder'. Together they form a unique fingerprint.

Cite this