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Social Responsiveness Scale, Second Edition (SRS-2)

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Caitline Christenson

on 23 February 2016

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Transcript of Social Responsiveness Scale, Second Edition (SRS-2)

Social Responsiveness Scale, Second Edition (SRS-2)
Purpose
Identifies and characterizes subtle autism spectrum conditions
Measures subtle variations in symptoms (over time or response to intervention
Quantifies the severity (mild-severe)
General Organization
65 items on each form
2.5 years through adulthood
Likert-Scale
What is SRS-2?
SRS-2 identifies social impairment associated with Autism Spectrum Disorder (ASD) and quantifies its severity.
Sensitive enough to detect even subtle symptoms but specific enough to differentiate clinical groups, the SRS-2 can be used to monitor symptoms throughout the life span.
SRS Background
Developed by John N. Canstantino, MD & Christian P. Gruber, PhD
Norm Group
Current, nationally representative norms
Total of 4,709 ratings of 1,963 individuals:
474 ratings of 247 preschool children
2,025 ratings of 1,014 school-age children
2,210 ratings of 702 adults
First Edition Published in 2005
Second Edition Published in 2012
effort to precisely define and characterize children with autism and other autism spectrum disorders
similarly focused on assisting in differential diagnosis in the presence of comorbid conditions
Introduced Preschool and Adult forms
Age range for use
Preschool (ages 2.5-4.5 years)
School-age (ages 4-18 years)
Adult (ages 19 years and older)
Adult Self-report (ages 19 years and older)
Four Forms
Adult
(Relative or Other)
-Ages 19+
-Completed by relative or friend

Adult Self Report (optional)
-Ages 19+
-Completed by individual being assessed
School Age
-Ages 4-18
-Completed by parent and/or teacher
Preschool Form
-Ages 2.5-4.5
-Completed by parent and/or teacher
Likert-Scale
1= Not True
2= Sometimes True
3= Often True
4=Almost Always True
*4-point scale eliminates the "middle of the road" scoring
Scoring the SRS-2
Scoring and graphing- 5 to 10 minutes to complete
Auto Score forms provide quick hand scoring; Computer scoring also available

Step 1:
Enter the darkened response value for each item in the box in the same row as that item
Step 2
Total the item response values in each column to find the five Treatment subscale raw scores.
Step 3
Calculate the raw score for the Social Communication and Interaction (SCI) by totaling the scores of the first four Treatment subscales (Awr, Cog, Com, & Mot)
Step 4
Calculate the SRS-2 Total raw score by adding the raw scores for all five Treatment subscales
Step 5
Transfer all raw scores to Profile Sheet

*Make sure to use correct profile sheet (gender and rater)
Step 6
Convert
raw scores
to
T-scores
(M=50, SD=10)
Social Awareness (Awr)
: Ability to pick up on social cues
Social Cognition (Cog)
: Ability to interpret social cues
Social Communication (Com)
: Includes expressive social communication
Social Motivation (Mot)
: Extent of motivation to engage in social- interpersonal behavior
Restricted Interests and Repetitive Behavior (RRB)
: Includes stereotypical behaviors or highly restricted interests
Five Treatment Subscales
Application
T-Score Classifications
59T and Below - Within Normal Limits
60T to 65T - Mild Range
66T to 75T - Moderate Range
76T or Higher - Severe Range
Typical scores for children with DSM-5 ASD diagnoses (moderate and clinical severity )
SRS- 2 Total Score
:
sum of all 65 questions
serves as an index as to the severity of social deficits in the autism spectrum
These sub-scales are designed to facilitate the evaluation of behaviorally-oriented treatment goals
Should be used within the context of a comprehensive evaluation
Interpretation requires professional training and experience
SRS-2 Administered
Approximately 15-20 minutes to complete
Appropriate rating form depending on age
Auto Score protocols:
rating and scoring on the same form
Materials Needed
Familiar with social interactions in common venues (home, school, etc)
Known for at least a month
8th grade reading level

Selecting a Rater
Instructions
Complete all items
Cannot be scored if too many items are missing
Brief clarification if necessary
Once completed inspect for unusual response patterns
What is Autism Spectrum Disorder (ASD)?
A. Persistent deficits in social communication and social interaction across multiple contexts, manifested by the following:
Deficits in social-emotion reciprocity
Deficits in nonverbal communicative behaviors used for social interaction
Deficits in developing, maintaining and understanding relationships
B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least 2 of the following:
Stereotyped or repetitive motor movements, use of objects, or speech
Insistence on sameness, inflexible adherence to routines, or ritualized patterns
Highly restricted, fixated interest that are abnormal in intensity
Hyper or hyperactivity to sensory input or unusual interests in sensory aspects of environment
C. Symptoms present in early developmental period
D. Symptoms cause clinically significant impairment in social, occupational or other area of functioning
E. Not explained by Intellectual Disability
DSM-V Diagnostic Criteria
Is the SRS-2 aligned with the DSM-5?
Two sub-scales align with DSM-5 criteria for ASD and Social Communication Disorder (new in DSM-5)
YES!
SCI: Social Communication and Interaction (sum of 4 treatment sub-scales)
RRB: Restricted Interests and Repetitive Behaviors
59T and below - Within normal limits
Scores in this range are generally not associated with clinically significant autism spectrum disorders. Children with very mild autistic syndromes may show scores in the upper end of the normal range if they are well adjusted and their adaptive functioning is relatively intact.
66T to 75T - Moderate Range
Scores in this range indicate deficiencies in reciprocal social behavior that are clinically significant and lead to substantial interference with everyday social interactions. Such scores are typical for children with autism spectrum disorders of moderate severity ...
Pros
Efficient : short and easy to give
Strong interrater agreement = multiple raters gives "whole" picture
Aids in diagnosis as well as treatment planning
Indicates individual's strengths and weaknesses
Can be used to progress monitor : over time and response to intervention
Expanded age range- monitor symptoms throughout the lifespan
Allows for comparison to new DSM 5 ASD diagnostic criteria

Cons
The new SRS-2 provides preschool and adult forms but majority of independent research has been limited to school-age form : additional research needed to provide information on preschool and adult forms
Test questions at 8th grade reading level; This could be too high for some parents and for some ASD-affected individuals (Self-report form) with language deficits
Some of the items are "judgemental" - somewhat subjective
Some of the questions are culturally biased and/or could be due to a language discrepancy

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