Limited Sensitivity and Specificity of the Spanish Social Communication Questionnaire in a Clinic Sample in Quito, Ecuador

Accurate identification of autism is critical for timely intervention, yet validated screening tools remain limited in Latin America. This study evaluated the psychometric properties of the Spanish-translated Social Communication Questionnaire (SCQ) in a clinic-based sample of children in Quito, Ecuador. Caregivers of 94 children aged 4-18 years completed the SCQ Lifetime form as part of a diagnostic evaluation that included cognitive testing, developmental history, and the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Internal consistency of the SCQ was good (Cronbach's α = .843). However, the SCQ showed poor diagnostic accuracy, with an area under the receiver operating characteristic curve (AUC) of .60. At the conventional SCQ cut score of 15, sensitivity and specificity were .56 and .60, respectively; using a lower cut score of 11 increased sensitivity (.72) but decreased specificity (.43). These findings indicate limited utility of the SCQ as a screening instrument for autism in this clinical context. Results align with other studies showing variability in SCQ performance across diverse populations and settings, highlighting the need for locally validated screening tools.Lay AbstractEarly and accurate identification of autism helps children and families access helpful supports, yet most screening tools have been developed and tested mainly in English-speaking countries, and we know less about how well they work in Latin America. In this study, we examined how well a Spanish translation of the widely used Social Communication Questionnaire (SCQ) identified autism in a clinic in Quito, Ecuador. Caregivers completed the questionnaire as part of a full clinical evaluation by trained professionals. We found that the SCQ was not very accurate at distinguishing which children did or did not have autism in this setting, meaning it may not be reliable on its own for screening. These results suggest that screening tools should be carefully tested with local communities before widespread use and highlight the need for tools that better reflect the languages, cultures, and experiences of families.