Childhood Autism Spectrum Test

Autism screening test for children

Medical diagnostic method

Childhood Autism Spectrum Test

Synonyms|

* Childhood Asperger Syndrome Test
* Social and Communication Development Questionnaire

LOINC| 62740-6

The Childhood Autism Spectrum Test, abbreviated as CAST and formerly titled the Childhood Asperger Syndrome Test, is a tool to screen for autism spectrum disorder in children aged 4–11 years, in a non-clinical setting.[1] It is also called the Social and Communication Development Questionnaire.[2] Higher scores on this screening test correlate with a higher likelihood of a child being on the autism spectrum. [3]

## Development

[edit]

The questionnaire was developed by the Autism Research Centre at the University of Cambridge, by Fiona J Scott, Simon Baron-Cohen, Patrick Bolton, and Carol Brayne.[1]

### Pilot study

[edit]

The pilot study utilized data gathered from the CAST completed by parents of 37 neurotypical children and parents of 13 children with an Asperger syndrome diagnosis to determine cut-off scores for this questionnaire. Results revealed that the scores from children with Asperger Syndrome were significantly higher (range 15-31) than the scores of typically developing children (range 0-13). This pilot study helped establish a cut off score of 15 for the CAST, indicating that a child may likely be on the autism spectrum with scores of 15+.[1]

### Main study

[edit]

There was a low response rate on the CAST questionnaire considering it was sent out to parents of 1,150 primary school aged children but only 199 responses were received. Of those who responded, 174 families accepted to complete the Social Communication Questionnaire (SCQ), a comparison screening tool. The SCQ was based on the Autism Diagnostic Interview-Revised (ADI-R) which was also being utilized for this research study. The results showed that the CAST, compared to other screening tools, may help identify children at risk for autism spectrum disorders in a non-clinical group.[1]

### Additional research

[edit]

"Research is ongoing to establish accurate sensitivity data,[4] validity, reliability,[5] to replicate current findings in a larger and geographically more diverse sample, and to study the epidemiological issues in greater detail." [1] The PhenX Toolkit uses CAST as its child protocol for symptoms of autism spectrum disorders.[2]

## Format

[edit]

The CAST questionnaire contains 39 yes-or-no questions about the child's social behaviors and communication tendencies. It also contains a separate special needs section that asks about other comorbid disorders that the child might have.[6]

## Autism Screening

[edit]

Pediatricians may begin initial screening for autism spectrum disorder (ASD) for their patients at 18 months and 24 months. Special attention may be given to patients who may be at a higher risk for an ASD diagnosis based on family, birth, and developmental history.[7]

The Social Communication Questionnaire (SCQ) is another autism screening tool for children aged 4 years and up. This questionnaire consists of 40 yes or no questions to be filled out by a child's main caregiver based on observed verbal and social skills over the last three months.[8] There is a scoring rubric at the end of the questionnaire that aids a professional clinician to come up with a score based on responses. There is a higher possibility of a child being on the autism spectrum with a score of 15+.[3]

It is important to note that higher scores on autism screening questionnaires do not automatically lead to a diagnosis of autism. Diagnosis is based on monitoring a child's behavior and development by a professional and meeting standardized criteria found in the American Psychiatric Association's Diagnostic and Statistical Manual, Fifth Edition (DSM-5). [9]

## Recommended Interventions

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The earlier ASD is diagnosed, the earlier treatment can be started to target social, communication, and behavioral skills.[7] Treatment options are based on where a child may fall on the autism spectrum and areas of deficits that may need more attention than others. Appropriate interventions may include a multidisciplinary approach with professionals in different fields, such as behavior analysts, physical therapists, and occupational therapists. [10]

## See also

[edit]

* List of diagnostic classification and rating scales used in psychiatry

## References

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1. ^ a b c d e Scott FJ, Baron-Cohen S, Bolton P, Brayne C (December 2002). "The CAST (Childhood Asperger Syndrome Test): preliminary development of a UK screen for mainstream primary-school-age children" (PDF). Autism. 6 (4): 9–31\. doi:10.1177/1362361302006001003. PMID 11918111. S2CID 24938030.9-31&rft.date=2002-12&rft_id=https://api.semanticscholar.org/CorpusID:24938030#id-name=S2CID&rft_id=info:pmid/11918111&rft_id=info:doi/10.1177/1362361302006001003&rft.aulast=Scott&rft.aufirst=Fiona+J.&rft.au=Baron-Cohen,+Simon&rft.au=Bolton,+Patrick&rft.au=Brayne,+Carol&rft_id=https://www.researchgate.net/publication/11446786&rfr_id=info:sid/en.wikipedia.org:Childhood+Autism+Spectrum+Test" class="Z3988">
2. ^ a b "Protocol Overview: Symptoms of Autism Spectrum Disorders - Child". PhenX Toolkit, Ver 19.0. 17 January 2017.
3. ^ a b "Social Communication Questionnaire (SCQ)". CHOP Research Institute. Retrieved 2025-03-18.
4. ^ Williams J, Scott F, Stott C, Allison C, Bolton P, Baron-Cohen S, Brayne C (February 2005). "The CAST (Childhood Asperger Syndrome Test): test accuracy". Autism. 9 (1): 45–68\. CiteSeerX 10.1.1.655.3016. doi:10.1177/1362361305049029. PMID 15618262.45-68&rft.date=2005-02&rft_id=https://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.655.3016#id-name=CiteSeerX&rft_id=info:pmid/15618262&rft_id=info:doi/10.1177/1362361305049029&rft.aulast=Williams&rft.aufirst=Jo&rft.au=Scott,+Fiona&rft.au=Stott,+Carol&rft.au=Allison,+Carrie&rft.au=Bolton,+Patrick&rft.au=Baron-Cohen,+Simon&rft.au=Brayne,+Carol&rft_id=https://doi.org/10.1177%2F1362361305049029&rfr_id=info:sid/en.wikipedia.org:Childhood+Autism+Spectrum+Test" class="Z3988">
5. ^ Williams J, Allison C, Scott F, Stott C, Bolton P, Baron-Cohen S, Brayne C (July 2006). "The Childhood Asperger Syndrome Test (CAST): test-retest reliability". Autism. 10 (4): 415–27\. doi:10.1177/1362361306066612. PMID 16908483. S2CID 19886611.415-27&rft.date=2006-07&rft_id=https://api.semanticscholar.org/CorpusID:19886611#id-name=S2CID&rft_id=info:pmid/16908483&rft_id=info:doi/10.1177/1362361306066612&rft.aulast=Williams&rft.aufirst=Jo&rft.au=Allison,+Carrie&rft.au=Scott,+Fiona&rft.au=Stott,+Carol&rft.au=Bolton,+Patrick&rft.au=Baron-Cohen,+Simon&rft.au=Brayne,+Carol&rfr_id=info:sid/en.wikipedia.org:Childhood+Autism+Spectrum+Test" class="Z3988">
6. ^ "Childhood Autism Spectrum Test (CAST)". Psychology Tools. 2008-10-06. Retrieved 2025-03-24.
7. ^ a b CDC (2024-07-19). "Clinical Screening for Autism Spectrum Disorder". Autism Spectrum Disorder (ASD). Retrieved 2025-03-18.
8. ^ "ASD Screening Tools | AAP Toolkits | American Academy of Pediatrics". publications.aap.org. Retrieved 2025-03-18.
9. ^ CDC (2024-05-15). "Clinical Testing and Diagnosis for Autism Spectrum Disorder". Autism Spectrum Disorder (ASD). Retrieved 2025-03-24.
10. ^ CDC (2024-07-18). "Treatment and Intervention for Autism Spectrum Disorder". Autism Spectrum Disorder (ASD). Retrieved 2025-03-18.

## External links

[edit]

* CAST questionnaire - PDF format
* CAST questionnaire - Online format

* v
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Autism

Main|

* Causes
* Diagnosis
* Epidemiology
* Epigenetics
* Heritability
* History
* Memory
* Pathophysiology
* Sex and gender
* Societal and cultural aspects
* Therapies

Diagnoses|

* Pervasive developmental disorder
* Autistic disorder
* Asperger syndrome
* Pervasive developmental disorder not otherwise specified
* Childhood disintegrative disorder
* High-functioning autism

Associated conditions
and phenomena|

* Alexithymia
* Autism and LGBTQ identities
* Autistic burnout
* Autistic catatonia
* Autistic masking
* Autistic meltdown
* Echolalia
* Echopraxia
* Emotional dysregulation
* Hyperlexia
* Infodumping
* Late talker
* Monotropism
* Nonverbal autism
* Pathological demand avoidance
* Pronoun reversal
* Savant syndrome
* Special interests
* Stimming
* Sensory overload

Comorbid conditions|

* Avoidant/restrictive food intake disorder
* Attention deficit hyperactivity disorder
* Anxiety disorder
* obsessive–compulsive disorder
* Developmental coordination disorder
* Epilepsy
* Intellectual disability
* Sensory processing disorder
* Global developmental delay
* Developmental verbal dyspraxia

Associated syndromes|

* 22q13 deletion syndrome
* Angelman syndrome
* CHARGE syndrome
* Cohen syndrome
* Cornelia de Lange syndrome
* DiGeorge syndrome
* Down syndrome
* Fetal valproate spectrum disorder
* Fragile X syndrome
* MECP2 duplication syndrome
* Neurofibromatosis type I
* Noonan syndrome
* Multiple hamartoma syndrome
* Rett syndrome
* Smith–Lemli–Opitz syndrome
* Timothy syndrome
* Tuberous sclerosis
* Williams syndrome

Related issues|

* Autism rights movement
* Critical autism studies
* Discrimination
* Double empathy problem
* Employment
* Multiple complex developmental disorder
* Neurodiversity
* TEACCH program
* Twice exceptional
* Violence and autism

Controversies|

* Facilitated communication
* Lancet MMR autism fraud
* MMR vaccine
* Rapid prompting method
* Thiomersal
* Chelation
* Combating Autism Act
* Autistic supremacism

Diagnostic scales|

* Autism Diagnostic Interview
* Autism Diagnostic Observation Schedule
* Childhood Autism Rating Scale
* Gilliam Asperger's disorder scale

Screening scales|

* Autism-spectrum quotient
* Childhood Autism Spectrum Test
* Ritvo Autism and Asperger Diagnostic Scale

Lists|

* Autism-related topics
* Fictional characters
* Schools

Accommodations|

* Autism-friendly
* Curb cut effect
* Inclusive design
* Neurodiversity and labor rights
* Sensory friendly
* Supported employment
* Universal design

* Category

* v
* t
* e

Autism resources

* Autism
* outline
* history

Awareness|

* Autism-friendly
* Autism Sunday
* Communication Shutdown
* World Autism Awareness Day

Culture|

* Autistic art
* Autism in popular culture
* Fictional characters
* Films about autism
* Circle of Friends
* Neurodiversity

Accommodations|

* Sensory friendly
* KultureCity

Therapies

| Psychotropic medication (antipsychotics)|

* Aripiprazole
* Risperidone

|

Behavioral|

*     * Discrete trial training (Lovaas)
* Picture exchange communication system (PECS)
* Pivotal response treatment
* Positive behavior support
* Early Start Denver Model (ESDM)
* Cognitive behavioral therapy (CBT)
* Social skills training

Developmental|

* Floortime (PLAY Project)

Controversial|

* Applied behavior analysis (ABA)
* Auditory integration training
* Aversion therapy (Judge Rotenberg Center)
* Chelation of mercury
* Facilitated communication
* Gluten-free, casein-free diet
* Hug machine
* Hyperbaric oxygen therapy
* Holding therapy
* Relationship development intervention
* Secretin
* Sensory integration therapy
* Son-Rise
* Vitamin B12

Related|

* ADHD medication
* Melatonin
* Occupational therapy
* Social Stories
* Speech therapy
* Selective serotonin reuptake inhibitors
* Structured teaching (TEACCH)

Centers

| Research|

| United States|

* Association for Science in Autism Treatment
* Autism Research Institute
* Autism Science Foundation
* Kennedy Krieger Institute
* National Alliance for Autism Research
* Simons Foundation Autism Research Initiative
* Yale Child Study Center

|

United Kingdom|

* Autism Research Centre (UK)

* Conditions and research areas
* Researchers

Therapy|

| United States|

* Center for Autism and Related Disorders (CARD)
* MIND Institute

|

Schools|

* Alpine Learning Group
* Eden II School for Autistic Children
* ESPA College (UK)
* Exceptional Minds (USA)
* New England Center for Children
* Pathlight School (Singapore)
* Rebecca School
* Sunfield Children's Home (UK)
* TreeHouse School (UK)
* Western Autistic School (Australia)

Organizations

| International|

* Autism rights movement
* Wrong Planet

|

Americas|

| United States|

* Autism Network International
* Autism Science Foundation
* Autistic Self Advocacy Network
* Autism Society of America
* Autism Speaks
* Centro Ponceño de Autismo
* Daniel Jordan Fiddle Foundation
* Generation Rescue
* Interactive Autism Network
* Interagency Autism Coordinating Committee
* LENA Foundation
* National Alliance for Autism Research
* National Council on Severe Autism
* National Database for Autism Research
* The Autism Community in Action

|

* Centro Ann Sullivan (Peru)
* Domus Instituto de Autismo (Mexico)

Asia|

* Action for Autism (India)
* Autism Resource Centre (Singapore)

Caribbean|

* Autistic Society of Trinidad and Tobago (Trinidad and Tobago)
* Maia Chung Autism and Disabilities Foundation (Jamaica)

Europe|

| UK|

* Autism Anglia
* The Autism Directory
* Autism Awareness Campaign UK
* Autism Cymru
* Autism Plus
* Autistica
* National Autistic Society
* Sacar

|

* Specialisterne (Denmark)
* Aspies For Freedom

Oceania|

* Luke Priddis Foundation (Australia)

Literature

| Non-fiction|

* The Accidental Teacher: Life Lessons from My Silent Son
* Animals in Translation
* Aspergirls: Empowering Females with Asperger's Syndrome
* Autism's False Prophets
* Extreme Love: Autism
* Freaks, Geeks, and Asperger Syndrome: A User Guide to Adolescence
* In a Different Key
* Life, Animated
* Like Colour to the Blind
* Look Me in the Eye
* Mother Warriors
* My Autobiography
* NeuroTribes
* Nobody Nowhere
* The Reason I Jump
* Somebody Somewhere
* Son-Rise: The Miracle Continues
* Strange Son
* Switched On
* Unstrange Minds

|

Fiction|

* The Curious Incident of the Dog in the Night-Time
* Dear John
* House Rules
* Mockingbird
* Saving Max
* Speed of Dark
* The Winter Journey
* With the Light

For younger people|

* Everybody Is Different: A Book for Young People Who Have Brothers or Sisters With Autism
* Ian's Walk: A Story about Autism
* Marcelo in the Real World
* Rage: A Love Story
* Rules

Journals|

* Autism
* Autism in Adulthood
* Autism Research
* Journal of Autism and Developmental Disorders
* Molecular Autism
* Research in Autism Spectrum Disorders

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