The purpose of this study was to examine the utility of the Systematic Observation of Red Flags (SORF; Dow et al., 2016) as a level 2 screener for autism spectrum disorder (ASD) in toddlers during a naturalistic video‐recorded home observation. Psychometric properties of the SORF were examined in a sample of 228 toddlers—84 with ASD, 82 with developmental delay (DD), and 62 with typical development (TD). Trained undergraduate research assistants blind to diagnosis rated 22 red flags (RF) of ASD associated with DSM‐5 diagnostic criteria using a 4‐point scale. The following scores were computed: a total score summing all items, domain scores summing social communication and restricted, repetitive behavior items, and number of RF counting items with scores of 2 or 3 indicating clear symptom presence. The performance of the total, domain, and RF scores and individual items were examined. A composite score was formed with six items with the best psychometric performance: poor eye gaze directed to faces, limited showing and pointing, limited coordination of nonverbal communication, less interest in people than objects, repetitive use of objects, and excessive interest in particular objects, actions, or activities. The 6‐item composite provides a brief measure with optimal performance, while the RF may be instrumental for clinicians who are interested in characterizing the range of observed symptoms. The SORF shows promise as a practical alternative to currently available screening methods for implementation by nonexperts with the potential to increase feasibility and reduce common obstacles to access to care. Autism Res 2020, 13: 122–133. © The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc.

中文翻译：

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使用 18-24 个月时的危险信号系统观察 (SORF) 在自然家庭环境中筛查自闭症谱系障碍。


本研究的目的是检验红旗系统观察（SORF；Dow 等人，2016）在自然视频记录的家庭观察过程中作为幼儿自闭症谱系障碍（ASD）2 级筛查的实用性。 SORF 的心理测量特性在 228 名幼儿样本中进行了检查，其中 84 名患有自闭症谱系障碍 (ASD)，82 名患有发育迟缓 (DD)，62 名患有典型发育 (TD)。训练有素的本科生研究助理对诊断视而不见，使用 4 点量表对与 DSM-5 诊断标准相关的 22 个 ASD 危险信号 (RF) 进行了评分。计算以下分数：所有项目的总分，社交沟通和受限、重复行为项目的领域分数，以及分数为 2 或 3 表明存在明显症状的 RF 计数项目的数量。检查了总分、领域分、RF 分以及单个项目的表现。综合得分由心理测量表现最佳的六个项目组成：眼睛注视面部的能力较差、展示和指向能力有限、非语言交流的协调能力有限、对人的兴趣少于对物体的兴趣、重复使用物体以及对特定物体过度感兴趣、行动或活动。 6 项组合提供了具有最佳性能的简短测量，而 RF 可能对有兴趣表征观察到的症状范围的临床医生有所帮助。 SORF 有望作为当前可用筛查方法的实用替代方案，由非专家实施，有可能提高可行性并减少获得护理的常见障碍。自闭症研究2020，13：122–133 。 © 作者。 自闭症研究由国际自闭症研究协会出版，由 Wiley periodicals, Inc. 出版。