Use of a Video Scoring Anchor for Rapid Serial Assessment of Social Communication in Toddlers

The overall goal of this behavioral assessment is to obtain a calibrated, quantitative measurement of reciprocal, social behavior in toddlers, which indexes levels of autistic traits while also being sensitive to change overtime. This brief tool facilitates accurate behavioral assessment by untrained raters with routine experience observing a given child's naturalistic social interactions. This method could help answer key questions in the field of child development.

By measuring the earliest manifestations of reciprocal social behavior in childhood and social communication deficits that are characteristic of autism spectrum disorders. A main advantage of this method is that it allows calibrated developmentally sensitive ratings through brief, user friendly measures that are appropriate for use by untrained raters. We first had the idea to overcome the challenge of rating toddlers after realizing that a video tape reference of a single child could provide an understandable, ecologically valid representation of social communication.

The implications of this technique extend toward diagnosis and treatment planning of autism because this measure can detect early signs of risk, as well as responses to interaction. While this method can provide insight into early signs of autism risk, it can also be applied to study developmental trajectories of social communication in typically developing toddlers. Begin by creating a new project to house with a questionnaire in the online data collection tool, REDCap'by logging in and clicking new project'in the ribbon at the top of the page.

Then, enter study specific text into the fields Project title'in purpose of the project. For the prompt, start project from scratch or begin with a template. Select the radio button, upload a REDCap project XML file.

Then, in the window, choose the online_vrRSB file'and click open'Next, scroll to the bottom of the page and click create project'to open a project setup page, which provides a work flow for incorporating surveys into a REDCap project. In the box labeled main project settings, click enable"next to the option use surveys in this project? in order to allow the vrRSB to be accessible within the project.

Then proceed to the next box labeled, Design your data collection instruments and enable your surveys. Select online designer"to open a screen with a table of instruments within the project. In the row that contains the vrRSB, click on enable a survey, which will show a set up my survey"tab.

Finally, scroll to the bottom of the page and click save changes"to complete the enabling of the vrRSB in a REDCap project. To modify instructions within the vrRSB text, click the vrRSB listing. Click on the pencil in the upper left of the specific text boxes to edit existing texts.

Provide study specific information on the welcome page. Click add fields"to allow entry of additional participating characteristics and edit the instructions proceeding the video referenced items by inserting a study contact person in the event of technical difficulties with the video. Hit save"after each modification.

Next, obtain an online link for the survey by returning to project home and clicking on manage survey participants in the click tasks box. Within the public survey link page, click the button next to the URL to copy the survey link. Finally, email the link to study participants by selecting the participant list"tab.

Click add participants"to insert emails and then click compose survey invitations"button to generate an introductory email. Escort the participant to the testing room and have them sit at the computer. Present them with the question there while providing information about the purpose of the study and duration.

Ensure that the participant knows how to access the video. Remind the participant to attend the entire three minute video clip, which they may watch more than once. Finally, after the participate watches the video clip, have them complete questions one through 13 followed by the remaining non-video referenced items.

To view an individual's scores, begin by clicking add edit records"under data collection"in the sidebar menu. Then, in the following screen, under choose an existing participant identification number, select the participant from the drop down menu to pull up the record home page for that participant. To access total and subscale scores for that participant, click status"in the row for vrRSB scores.

Then, to view vrRSB scores for all participants in a given study, return to the project home page and click create report"Enter a name for the report in the text box. Then, next to the option, add all fields from selected instruments, select vrRSB scores from the dropdown menu to obtain total and subscale scores. For item level data, select vrRSB.

To keep only a subset of available fields in the report, click the red x to the right of unwanted fields so they are excluded. Next, scroll to the bottom of the page and click save report"Accept the option to return to my reports and exports"which will display a table, including a row with a newly created report. Then click view report"to see scores for all participants.

Click the my reports and exports"tab to return to the table of viewing options for the report. Finally, click export data and select the format of choice. Then click the export data button at the lower right.

In the follow up screen, click on the icon confirming the data format. These results indicated that both the video reference scores and the RSB total score demonstrated the continuous unimodal distribution at 18 and 24 months across the general population sample. Note that on these measures, higher scores indicate a greater burden of autistic traits.

Therefore, higher scores indicate relative deficits in social ability, while lower scores indicate greater social ability. Scores on the video referenced items show measurable differences in social communication across time points. In particular, overall scores at 24 months are lower than scores at 18 months.

Because higher scores indicate relative deficits in social communication, this observed drop in scores corresponds to expected advancement at early ages in typical development. Good six month test, re-test reliability was observed for the video reference score, and strong test, re-test reliability was observed for RSB Total Score. Lastly, initial testing in children with ASD confirms higher scores, indicating decreased, reciprocal social behavior in social communication, as expected for this population.

Once mastered, this assessment can be completed in approximately 15 minutes, if it is performed properly. While attempting this procedure, it's important to remember that children who are being assessed be of the appropriate age range, and also that the counselors have sufficient experience with witnessing the children's social interactions. Following this procedure in person behavioral assessments can be performed by a researcher or clinician.

To answer questions regarding the presence of an ASD diagnosis, or the relationship of reciprocal social behavior to the development of other key abilities, like language. After it's development, the measure allowed child psychiatrists to show that by toddler-hood, reciprocal social behavior and social communication were measurable, heritable aspects of early social human development that correlated well with autistic traits measured at age three years. After watching this video, you should have a good understanding of how to use the video reference rating of reciprocal social behavior, including an online version that allows automated scoring.