Grant: Operating Grant

Autism spectrum disorders (ASDs) are a huge challenge in the field of childhood developmental disability. The wide 'spectrum' of these conditions means that people's functional capacities and limitations vary enormously. Thus, it makes little sense to talk about ASDs as if they were a single disorder. A challenge in the field of ASDs is how to categorize children's functional difficulties meaningfully. There are many tools that assess the functional status of children with ASD, but no valid and reliable functional classification system exists with which to group children with apparently similar functional status. Such a system (the GMFCS), developed by the PI's group for Cerebral Palsy (CP), is used around the world. This makes it possible to talk about and study groups of children who are similar with respect to the characteristic(s) being classified. This kind of categorization allows clinicians to answer parents' key questions ("How bad is our child's condition?" "What does the future hold for our child?"). In CP, gross motor function is the GMFCS domain by which to group ability levels. The hallmark domain that impacts on function of children with ASD, identified in our pilot work, is social communication and a spectrum of levels of this ability must be categorized. This study will develop and evaluate an Autism Classification System of Functioning: Social Communication (ACSF:SC) modelled on the GMFCS. The ACSF:SC is NOT a new measure; rather it will provide a consistent, valid and reliable way to identify functionally similar children with ASDs. The ACSF:SC, complementary to clinical assessment and outcome tools, will enrich the field by facilitating communication among parents and professionals, and providing a way to stratify children for clinical and research purposes. We are purposely focusing first on preschool children. Once an ACSF:SC has been developed this research program will expand the work downward to infants and upward to older children.