Measuring outcomes for autistic children following social communication interventions is an ongoing challenge given the heterogeneous changes, which can be subtle. We tested and compared the overall and item‐level intervention effects of the Brief Observation of Social Communication Change (BOSCC), Autism Diagnostic Observation Schedule (ADOS‐2) algorithm, and ADOS‐2 Calibrated Severity Scores (CSS) with autistic children aged 2–5 years from the Preschool Autism Communication Trial (PACT). The BOSCC was applied to Module 1 ADOS assessments (ADOS‐BOSCC). Among the 117 children using single or no words (Module 1), the ADOS‐BOSCC, ADOS algorithm, and ADOS CSS each detected small non‐significant intervention effects. However, on the ADOS algorithm, there was a medium significant intervention effect for children with “few to no words” at baseline, while children with “some words” showed little intervention effect. For the full PACT sample (including ADOS Module 2, total n=152), ADOS metrics evidenced significant small (CSS) and medium (algorithm) overall intervention effects. None of the Module 1 item‐level intervention effects reached significance, with largest changes observed for Gesture (ADOS‐BOSCC and ADOS), Facial Expressions (ADOS), and Intonation (ADOS). Significant ADOS Module 2 item‐level effects were observed for Mannerisms and Repetitive Interests and Stereotyped Behaviors. Despite strong psychometric properties, the ADOS‐BOSCC was not more sensitive to behavioral changes than the ADOS among Module 1 children. Our results suggest the ADOS can be a sensitive outcome measure. Item‐level intervention effect plots have the potential to indicate intervention “signatures of change,” a concept that may be useful in future trials and systematic reviews.

中文翻译：

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自闭症诊断观察时间表和社会和交流变化的简短观察用于测量父母介导的早期自闭症干预结果的效用

鉴于各种变化（可能是微妙的），在社交交流干预之后，对自闭症儿童的结局进行衡量是一项持续的挑战。我们测试并比较了2岁自闭症儿童的社交交流变化简短观察（BOSCC），自闭症诊断观察时间表（ADOS-2）算法和ADOS-2校正严重程度评分（CSS）的总体和项目级干预效果距学龄前自闭症传播试验（PACT）– 5年。BOSCC已应用于模块1 ADOS评估（ADOS-BOSCC）。在117个使用单个单词或不使用单词的孩子（模块1）中，ADOS-BOSCC，ADOS算法和ADOS CSS均检测到很小的无显着干预效果。但是，在ADOS算法上，基线时“少到无字”的孩子会有中等程度的干预效果，带有“某些单词”的儿童几乎没有干预效果。对于完整的PACT示例（包括ADOS模块2），总计n = 152），ADOS指标证明总体干预效果显着小（CSS）和中（算法）。第1单元项目级别的干预效果均未达到显着水平，在手势（ADOS-BOSCC和ADOS），面部表情（ADOS）和语调（ADOS）方面观察到最大的变化。观察到ADOS模块2项级别的重大影响，表现为举止，重复兴趣和刻板印象行为。尽管具有很强的心理测验特性，但在模块1的孩子中，ADOS-BOSCC对行为改变的敏感度并不比ADOS更敏感。我们的结果表明，ADOS可能是一种敏感的结果指标。项目级干预效果图有可能表明干预“变化的特征”，这一概念可能在将来的试验和系统评价中很有用。