The Parent’s Observations of Social Interactions (POSI), is a 7-item screening instrument for Autism Spectrum Disorders (ASD).  The POSI was created as one part of a comprehensive screening instrument designed for pediatric primary care. Items for the POSI were chosen by a team of experts who reviewed existing assessment instruments and relevant research literature. Initial validation was conducted in two sub-studies, 1) in a sub-specialty setting and 2) in separate mixed sub-specialty/primary care settings.  In the first sample, parents of 213 children aged 18-48 months who presented to a developmental clinic for diagnostic evaluation completed a clinical intake questionnaire that included the POSI and the Modified Checklist for Autism in Toddlers (M-CHAT) checklist. POSI and M-CHAT scores were compared to results of the full clinical evaluation to derive scoring thresholds and assess reliability and validity.  In the second sample, 235 parents of children aged 16-36 months were enrolled from a combination of primary care and subspecialty settings.  They completed the POSI, M-CHAT, and a report of their child’s diagnoses.  POSI and M-CHAT scores were compared to reported diagnoses to assess validity. In the first study, the POSI demonstrated adequate internal reliability (Cronbach alpha 0.83).  Sensitivity (89%) was higher than that of the MCHAT (71%) (p<0.05) and specificity (54%) was not significantly different from that of the MCHAT (62%). In the second study, the POSI demonstrated adequate internal reliability (alpha=0.86). Sensitivity (83%) compared favorably to the MCHAT (50%), although specificity was lower (75% v 84%).

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