The Utility of the Spence Children's Anxiety Scale (SCAS) in Screening for Anxiety Disorders in Children and Youth with Autism Spectrum Disorders

Background:  The experience of anxiety is often an associated feature of Autism Spectrum Disorders (ASD) and children and young people with ASD are at increased risk for comorbid anxiety disorders. As these difficulties can significantly exacerbate overall disability levels in the ASD population, there is a need accurately to screen and identify individuals with clinical levels of anxiety in the community in order to enable them to receive appropriate assessment and intervention. However, as existing anxiety scales have been primarily developed for children and youth without ASD, it is important that the usefulness of these measures is evaluated in the ASD population

Objectives:  This study will assess the utility of the Spence Children’s Anxiety Scale (SCAS) as an accurate early indicator of significant anxiety difficulties and in screening for anxiety disorders in children and youths with ASD. 

Methods:  30 caregivers of 6-17 year old children and young people with an established professional diagnosis of ASD completed the brief Parent Report version of the SCAS and also participated in an in-depth, follow-up clinical diagnostic interview for anxiety using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL). Inter-rater reliability for the administration and scoring of the K-SADS-PL was also established. Caregivers also completed the Developmental Behaviour Checklist (DBC) and the Scales of Independent Behaviour-Revised (SIB-R) in order to provide information on their child’s adaptive functioning and on other behavioural or emotional difficulties. 

Results:  Data collection has been completed and data is currently being analyzed. The frequencies of children meeting full as well as subthreshold DSM-IV-TR anxiety criteria will be calculated. Specificity, sensitivity, reliability coefficients and positive and negative predictive values will be calculated for the SCAS total and subscale scores and compared to values reported from limited literature on the use of other non-ASD specific tools in screening for anxiety disorders in ASD. The utility of SCAS in higher and lower functioning children with ASD (defined as SIB-R standard scores > or < 70 respectively) is also examined. 

Conclusions:  Preliminary inspection of the results suggests that the SCAS Parent Report is likely to be a useful screening tool that can effectively identify children and youths with ASD with high anxiety symptomatology who may benefit from further assessment for a possible clinical diagnosis of anxiety disorders.