Validation of an outcome measure of early social-communication for young children with ASD

Abstract
The majority of validated social-communication measures for children with autism spectrum disorder (ASD)
were designed to behaviorally phenotype or diagnose this core symptom domain and not to detect change
over time. The lack of validated outcome measures has somewhat stifled intervention research efforts as well
as early interventionists’ ability to monitor the effects of their programs on children’s social-communicative
outcomes. It has become difficult to sort out whether non-significant treatment effects are a result of truly
ineffective interventions, or rather poorly validated measures for this population. We know that the early,
foundational social-communication and language skills of children with ASD predict their functioning into
adolescence and even adulthood, with functional use of language by age 5 being one of the best predictors of
long-term prognosis. As such, clinicians have begun to focus their efforts on improving children’s social-
communication and language skills using both developmental and behavioral interventions as well as
pharmaceutical treatments. In reviewing these treatment trials, it is clear there is a range of intervention
success and even more clear that we lack a consistent set of outcome measures for the social-communication
symptom domain. Our group has been working to validate measures of key social-communication and
language skills and are able to draw from a wealth of prior psychometric data to adapt and validate a brief
observational measure that can be easily used within clinical trials as well as within routine care and practice.
We propose to adapt and psychometrically validate a measure of social-communication and language skills for
young children, ages 12 – 60 months, preliminarily or formally diagnosed with ASD. Specifically, we plan to
validate the Early Communication Indicator for Autism Spectrum Disorder (ECI-ASD) using a robust and
representative multisite sample of well-characterized children with ASD (n = 400). The current version of the
ECI is norm-referenced and allows for progress monitoring, which means the measure can be used in a
formative, data-driven fashion to monitor children’s intervention progress and make changes if children are not
improving, but it also can provide summative outcome data. In addition, the current measure can be scored live
using a mobile app. Currently, no other current social-communication measure specifically designed for
children with ASD easily allows for ongoing intervention progress monitoring, data visualization, and live
scoring, which will make the adapted ECI-ASD a unique outcome measurement tool. Further, the ECI-ASD will
provide the ability to enter data into an online platform to compare the progress of children with ASD to
normative data and this represents a sorely needed and clear innovation above current measurement
approaches. The expected deliverable is a novel outcome measure of key social-communication and language
skills that is psychometrically sound, minimally burdensome to administer and score, and sensitive to the
incremental change expected for young children with ASD.

Grant Number: 5R01HD100364-06
NIH Institute/Center: NIH
Principal Investigator: Brian Boyd