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Evaluation of the Ghuman-Folstein Screen for Social Interaction (SSI)

Leone, Sarah Lyn
http://rave.ohiolink.edu/etdc/view?acc_num=osu1259081774

Abstract Details

2009, Doctor of Philosophy, Ohio State University, Psychology.
The current diagnostic model of autism spectrum disorders (ASD) is characterized by qualitative impairments in social interaction and communication, and the presence of restricted or repetitive behaviors. There are very early signs of social-communication delays that indicate risk for ASD. Several screening instruments have been developed to detect risk for ASD, but few have focused on very young children. The Ghuman-Folstein Screen for Social Interaction (SSI) is a 54-item instrument developed to detect problems with social interactions in very young children. Initial evaluation of the SSI revealed promising reliability estimates, and preliminary support for construct validity. The current study goals included (a) evaluating the SSI’s psychometric properties with a large heterogeneous sample of young children with and without ASD, and (b) shortening the instrument. The SSI was completed in developmental and pediatric clinics by caregivers of children with autism or PDD-NOS, non-ASD developmental or psychiatric disorders, and for typically-developing children. The sample consisted of 450 children between the ages of 24 and 61 months (mean 43.4 months; SD = 10.6). Diagnostic validity analyses were conducted separately for younger (24-42 months) and older participants (43-61 months). In order to evaluate the tool’s factor validity, SSI ratings (n=207) were submitted to exploratory factor analysis (EFA). The relationship of SSI scores to ASD diagnostic measures, age, and developmental level was examined. Diagnostic validity was assessed by comparing SSI scores across different groups. In order to determine optimal sensitivity and specificity, Receiver Operative Characteristic (ROC) curves were used in a number of comparisons between different diagnostic groups with the original and shortened scales. A subset of participants from ASD and non-ASD clinical groups was matched on age and developmental level. Results of the EFA indicated that a four-factor solution best fit the data. The factors had good internal consistency and were labeled Connection to Caregiver, Interaction/Imagination, Social Approach/Interest, and Agreeable Nature. The SSI showed moderate convergence with other ASD diagnostic measures, and little relation to age and developmental level. The SSI and its subscales significantly differentiated diagnostic groups. The Interaction/Imagination subscale produced the highest level of group discrimination, and the Agreeable Nature subscale produced the lowest. Binary logistic regression and item mean scores were used to identify critical items, resulting in the 26-item SSI-T (“Toddler” version, for younger children), and the 21-item SSI-P (“Preschool” version, for older children). In the ROC curve analyses, all sensitivity and specificity levels met or exceeded .79, and .64, respectively, even in the comparisons that controlled for age, developmental level, and verbal ability. The SSI-T and SSI-PS performed better than the full 54-item scale, with less than half the number of items. Scoring recommendations were made based on the ROC results. The SSI is a unique parent-completed Level 2 screen that measures social-communication behaviors in very young children with ASD. This study suggest that the SSI may be a useful screen to discriminate very young children with significant social interaction delays associated with ASD from those with non-ASD developmental delays.
Luc Lecavalier, PhD (Advisor)
Michael Aman, PhD (Committee Member)
David Hammer, PhD (Committee Member)
135 p.
Psychology
autism; autism spectrum disorders; screen; SSI; early detection

Recommended Citations

Citations

  • Leone, S. L. (2009). Evaluation of the Ghuman-Folstein Screen for Social Interaction (SSI) [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1259081774

    APA Style (7th edition)

  • Leone, Sarah. Evaluation of the Ghuman-Folstein Screen for Social Interaction (SSI). 2009. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1259081774.

    MLA Style (8th edition)

  • Leone, Sarah. "Evaluation of the Ghuman-Folstein Screen for Social Interaction (SSI)." Doctoral dissertation, Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1259081774

    Chicago Manual of Style (17th edition)

osu1259081774
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© 2009, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.