101 SCOPE study design 5 of ASD. Observations of the clinician are categorized and a score is assigned for each domain of ASD symptoms. Although the ADOS-2 has thus long been considered the “golden standard” in intervention studies, the instrument has its limitations. For example, the ADOS-2 can identify changes in ASD symptoms over a couple of years (3) but due to the narrow range of scores used for each item, the ability to detect subtle changes in behaviour over a shorter time frame might be limited. Also, the ADOS has not been developed to quantify different degrees of autism severity, rather it has been developed to allow for a diagnostic algorithm (yes/no autism). The BOSCC might be more sensitive in detecting subtle changes and better suitable to quantify autism severity. However, since the BOSCC is a relatively new instrument, both instruments will be administered in this study (also enabling future in-depth instrument comparisons). Language. The child’s expressive level of language will be measured by the Dutch adaptation of the MacArthur Communicative Development Inventory: Toddler (N-CDI; Fenson et al., 1993, 2001), a parent report, at T1 and T3. Raw scores will be calculated as to indicate both language production and language comprehension. Also, level of expressive language will be measured by using the JERI. Based on the same twelve minute dyadic videotape child’s expressive language level and use will be rated from 1 (no expressive language) to 7 (fluent and frequent use of sentences) at T1, T2 and T3. Global level of adaptive functioning. For estimating global level of adaptive functioning, the Vineland Screener will be conducted at T1 and T3. The Vineland Screener is an adapted Dutch version of the Vineland Adaptive Behaviour Scales (VABS: Sparrow et al., 2005, Van Duin et al., 2009), consisting of 90 items, to be filled out by one parents/primary caregiver. It consists of the following scales: Communication domain, Daily Skills domain, Socialization domain and Motor Skills domain. Each of the items in the previous mentioned domains contains a statement of child adaptive behavior. Subscales will be calculated as to identify change in global level of adaptive functioning at starting point (T1) and at follow up (T3). Parents themselves rate whether the child mostly (2), sometimes/partly (1) or never (0) performs the behavior or action independently. Parental well-being. Parental well-being is measured by the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS; Tennant et al., 2007) and Parenting Stress Questionnaire (PSQ, in Dutch Opvoedingsbelastingsvragenlijst, OBVL; Vermulst et al., 2012). The WEMWBS is a reliable instrument that measures mental well-being. It consists of 14 items, measured on a 5-point Likert type scale and will be completed by both parents/primary caregivers. Additionally, the PSQ is used to determine parental experiences with their child, how they interact with their child and how parents feel about their own health. The PSQ is a well validated and reliable questionnaire that consists of 34 items on a 4-point scale ranging from ‘not true’ to ‘very true’. For both instruments, total scores will be calculated during all measurement points.
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