Evaluating the Autism Spectrum Rating Scale Parent and Teacher Reports (6 to 18 years) to Predict an Autism Diagnosis in a Clinical Sample

Rating scales are widely used in autism spectrum disorder (ASD) evaluations to provide information about developmental history and behavior across settings. Despite frequent use, limited research has examined the diagnostic utility of the Autism Spectrum Rating Scale (ASRS) in clinical settings. This study evaluated the ability of the ASRS to predict ASD diagnoses in a clinical sample. We conducted a chart review of 2,200 youth ages 8-18 years (M = 10, SD = 3) who completed comprehensive autism evaluations and either received an ASD diagnosis (n = 1101) or did not (n = 1119). We analyzed parent and teacher ASRS forms using t-tests and receiver operating characteristic analyses. The DSM subscale scores were significantly higher in the ASD group, though effect sizes were small. Teacher ratings performed slightly better than parent ratings, but overall diagnostic accuracy was poor (AUC = 0.62). Findings suggest the ASRS may aid screening but has limited diagnostic utility in high base-rate clinical settings.