The Brief Observation of Symptoms of Autism: Validation study in a Latin American sample
Authors: Granana Nora , Astorino Francisco , Richaudeau Alba , Costa Lucas , Fernandez de Carrera Elena , Nanclares Valeria , Sohl Kristin ,   ECHO PROTECTEA BOSA CONSORTIUM
Published: December 2024

Autism spectrum disorder presents as a multifaceted condition characterized by pronounced impairments in social communication and behavioral patterns. Diagnosis hinges upon the expertise of clinicians, comprehensive developmental history, and observation of specific behavioral markers. However, in low-income countries, access to screening tools and standardized diagnostic tests for autism spectrum disorder remains profoundly limited. Moreover, the COVID-19 pandemic has exacerbated these challenges, rendering diagnostic protocols impractical. In response to these barriers, the Brief Observation of Symptoms of Autism instrument was developed to facilitate assessments via telehealth during the pandemic. This study aims to validate the use of the Brief Observation of Symptoms of Autism within two Latin American countries, Argentina, and Chile. A cohort of 313 spanning various age groups underwent examination. Psychometric properties of each Brief Observation of Symptoms of Autism module were scrutinized, including sensitivity and specificity against the recommended University of California at Los Angeles cutoffs. Receiver operating characteristic curve analysis yielded credible sensitivity and specificity scores for each module. Confirmatory factor analysis supported a favorable fit across modules, employing a 2-factor model distinguishing Social Affect and Restricted, Repetitive Behaviors. Preliminary findings affirm the validity of the Brief Observation of Symptoms of Autism as an effective diagnostic tool within the Latin American population. Furthermore, its potential extends beyond the pandemic, promising support in the future. Lay abstract Autism spectrum disorder is a complex condition associated with significant impairments in social communication and behavioral functioning. Diagnosis is dependent on clinician expertise, gathering of developmental history, and observation of specific behaviors. The suggested protocols include tools rendered invalid during the pandemic, which created significant barriers for diagnostic assessments. Furthermore, there are additional barriers in low-income countries in access to screening tools and standardized diagnostic tests for autism spectrum disorders that were only exacerbated during COVID-19. The Brief Observation of Symptoms of Autism instrument was developed to improve access to diagnostic assessment via telehealth during this time. The current study sought to validate the use of the Brief Observation of Symptoms of Autism within two Latin American countries. A sample of 313 children and adults from Argentina and Chile were examined. Results showed valid sensitivity and specificity scores with good fit across modules using two factors (i.e. Social Affect and Restricted, Repetitive Behaviors). Preliminary results of the current study demonstrated that the Brief Observation of Symptoms of Autism is a valid instrument for Latin American population and shows promise to be used beyond the pandemic to ease the diagnostic process. This is a collaborative work with BRINCAR Parent Association, who defined the need in our country to run the validation of Brief Observation of Symptoms of Autism and gave us support as the stakeholders at Lancet Commission.