CanChild Announces Autism Classification System

Researchers from the CanChild Centre for Childhood Disability Research at McMaster University have created a groundbreaking new tool to help categorize ‘levels’ of social communication skills among children with Autism Spectrum Disorder (ASD). Their paper has recently been published electronically in Developmental Medicine and Child Neurology, the leading international child development and disability journal.

The Autism Classification System of Functioning: Social Communication (ACSF:SC), provides a standardized and simplified way for clinicians, therapists, teachers, and parents to talk about what a child’s social communication abilities are – what they CAN do rather than what they cannot.

However, as lead author and CanChild Scientist Dr. Briano Di Rezze points out, the ACSF:SC is not a test.

“There are plenty of useful diagnostic tools and assessments to be used with children with ASD, but the ACSF:SC is different – it isn’t a test”, says Di Rezze, who is also an Assistant Professor in the School of Rehabilitation Science. “Currently we hear terms like ‘high-functioning or ‘low-functioning’ to describe children with ASD. However there is no common interpretation of what those terms mean, which makes them unreliable because clinicians, therapists, and parents aren’t using them in the same way.”

In a study that surveyed parents and professionals alike, Di Rezze, alongside Dr. Peter Rosenbaum, Professor of Pediatrics, and Dr. Lonnie Zwaigenbaum of the University of Alberta, were able to identify social communication as the common element that could best characterize and describe different levels of ability for children with ASD.

The Autism Classification team, which also included Professors Mary Law and Paul Stratford of McMaster’s School of Rehabilitation Science, and colleagues from the University of Wyoming (Dr. Mary Jo Cooley Hidecker) and the University of Toronto (Dr. Peter Szatmari), then focused on social communication as the basis for the classification system. The McMaster investigators are also part of the recently launched MacART (McMaster Autism Research Team) initiative.

Supported by a CIHR grant as well as a recent Hamilton Academic Health Sciences Organization (HAHSO) grant, research was done with parents of children with ASD, Hamilton-area preschool teachers who work with children with ASD, and professional colleagues at McMaster Children’s Hospital, the Ron Joyce Children’s Health Centre, and McMaster’s Autism program. The tool was then tested for reliability and validity with parents of children with ASD and professionals across the country.

After years of research in partnership with families and ASD professionals, the result has been a reliable and validated way to classify preschool children with ASD according to their social communication functional abilities. Through the use of ‘word pictures’ that describe 5 levels of social communication, users of the tool are asked to determine a child’s ability within two conditions: when they are performing at their best, known as their Capacity, and what they usually do, known as their Typical Performance.

This information can then be used by all members of the child’s care team to help understand and potentially improve a child’s social communication function in everyday life.

The ACSF:SC is an analogue of several functional classification systems created over the past 20 years by CanChild researchers and their colleagues in Sweden and the US. The first and best known of these classifications is the Gross Motor Function Classification System (GMFCS), now used all over the world in 40 or more languages, and cited in the research literature well over 4000 times.

As Dr. Peter Rosenbaum, one of the original developers of the GMFCS and co-founder of CanChild explains, the ACSF:SC has the potential to be as influential as the GMFCS has been.

“We hope that the ACSF:SC has the same transformative impact in the field of ASD as the GMFCS has been reported to have in the field of cerebral palsy. Its applicability in communication with families, and in clinical services, research, and policy-making, will be very exciting.”

The tool with an attached User’s Guide is available as a free download through the CanChild for clinical practice, academic research, educational, and for personal uses.