Impairments in social communication are the hallmark of autism spectrum disorder (
ASD). Operationalizing ‘severity’ in ASDhas been challenging; thus, stratifying by functioning has not been possible. The purpose of this study is to describe the development of the Autism Classification System of Functioning: Social Communication ( ACSF: SC) and to evaluate its consistency within and between parent and professional ratings. Method
ACSF: SCdevelopment based on focus groups and surveys involving parents, educators, and clinicians familiar with preschoolers with ASD; and (2) evaluation of the intra‐ and interrater agreement of the ACSF: SCusing weighted kappa ( кw). Results
Seventy‐six participants were involved in the development process. Core characteristics of social communication were ascertained: communicative intent; communicative skills and reciprocity; and impact of environment. Five
ACSF: SClevels were created and content‐validated across participants. Best capacity and typical performance agreement ratings varied as follows: intrarater agreement on 41 children was кw=0.61 to 0.69 for parents, and кw=0.71 to 0.95 for professionals; interrater agreement between professionals was кw=0.47 to 0.61, and between parents and professionals was кw=0.33 to 0.53. Interpretation
Perspectives from parents and professionals informed
ACSF: SCdevelopment, providing common descriptions of the levels of everyday communicative abilities of children with ASDto complement the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Rater agreement demonstrates that the ACSF: SCcan be used with acceptable consistency compared with other functional classification systems.