Currently submitted to: Journal of Medical Internet Research
Date Submitted: Nov 2, 2026
Open Peer Review Period: Nov 2, 2026 - Dec 28, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Assessing Autism Spectrum Disorder and Other Neurodevelopmental Conditions in Preschoolers Through the Strengths and Difficulties Questionnaire (SDQ) With Remote Data Collection: A Retrospective Observational Study
ABSTRACT
Background:
Screening is now worldwide recognised as essential for early detection of neurodevelopmental divergences, and telemedicine is increasingly proving to be a valuable resource in this area. Our retrospective observational study aimed to assess the ability of the Strengths and Difficulties Questionnaire (SDQ 2-4) as a measure to distinguish autism spectrum disorder from other neurodevelopmental disorders in clinical and typically developing populations of preschoolers by remote data collection.
Objective:
This study aimed to assess the validity of the digitally administered Strengths and Difficulties Questionnaire for ages 2–4 (SDQ 2–4), delivered remotely through a clinical web-based platform, as a screening tool for identifying neurodevelopmental conditions in preschoolers. Specifically, it examined the ability of the SDQ 2–4 to differentiate children with autism spectrum disorder (ASD) from those with other neurodevelopmental conditions, including developmental language disorder (DLD) and developmental delay (DD), as well as from typically developing children.
Methods:
Data from 343 preschoolers, including 93 children with autism spectrum disorder (ASD), 28 neurotypical children (NT), 167 children with developmental language disorder (DLD), and 55 children with developmental delay (DD), were collected through the MEDea Information and Clinical Assessment on-Line (MedicalBIT) platform.
Results:
Our results showed higher scores on all SDQ 2-4 scales for the ASD group vs the NT group, except for a scale scored in reverse (Prosocial Behaviour Scales) that had lower scores in children with ASD than NT children. Total Problems, Peer Problems, Hyperactivity, and Prosocial Behaviour Scales could more significantly differentiate the ASD group from the NT group. When comparing ASD group with other neurodevelopmental conditions (DLD, DD), the most significant results were found for the Total Problems, Peer Problems and Prosocial Behaviour Scales.
Conclusions:
We concluded that these scales were more effective in differentiating children with autism spectrum disorder from children with developmental language disorder and from children with developmental delay, as well as from neurotypical children. We proved the SDQ 2–4 to be a valid short screening tool for use in preschoolers, to differentiate between ASD and other conditions by remote data collection.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.