The lack of validated autism spectrum disorder (ASD) screening instruments hampers rehabilitation efforts for children with ASD in Africa. In the present study, the psychometric properties of two ASD screening instruments, that have been well-validated in the United States (US) context, were examined in the Ugandan context. These instruments were the Social Responsiveness Scale-Second Edition (SRS-2; Constantino & Gruber, 2012) and the Social Communication Questionnaire (SCQ; Rutter, Bailey & Lord, 2003). These two instruments were cross-validated with the 23Questions Screener (23Q; Kakooza-Mwesige et al., 2014) - a developmental disability screening measure for assessing ASD symptoms among children in Uganda. Two distinct groups of study participants were recruited: (a) 51 caregivers of children aged 4 - 17 years with a known diagnosis of ASD and (b) 56 caregivers of typically developing children (non-ASD) of the same age range. Caregivers of children with ASD were recruited either during routine clinical follow-up visits at a national hospital or through a special needs school—with both sites drawing cases from the city of Kampala and the surrounding districts. Caregivers of typically developing children (i.e., children not identified or suspected of having a developmental disability) were recruited either during medical wellness visits or through schools within the same region. Results showed that the SRS-2 and SCQ were both reasonably reliable and valid for use in distinguishing Ugandan children with ASD from those who are typically developing. Summation of items 19 - 23 of the 23Q (typically used to screen children below five years of age) yielded higher internal consistency reliability than a combination of all ten available 23Q ASD items (i.e., items 14 – 23). For discriminant validity, children with a diagnosis of ASD scored significantly higher than their non-ASD peers on all study instruments. Based on the sample results, the optimum SRS-2 cut-score was lowered to 62, while that of the SCQ was retained at 15. A cut-score of one or more on the 23Q, despite having high sensitivity yielded unacceptably low specificity. Increasing the 23Q cut-score to 3 or more improved specificity but lowered sensitivity albeit to a moderate range.
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