Recent studies suggest that many children with milder autism spectrum disorder (ASD) are undiagnosed, untreated, and being educated in mainstream classes without support and that school teachers might be the best persons to identify a child’s social deviance. At present, only a few screening measures using teacher ratings of ASD have been validated. The aim of this study was to examine the utility of teacher ratings on the Social Responsiveness Scale (SRS), a quantitative measure of ASD. We recruited 130 participants aged 4 to 17 years from local schools or local pediatric outpatient clinics specializing in neurodevelopmental disorders that included 70 children with ASD. We found that the teacher-report SRS can be reliably and validly applied to children as a screening tool or for other research purposes, and it also has cross-cultural comparability. Although parent-teacher agreement was satisfactory overall, a discrepancy existed for children with ASD, especially for girls with ASD. To improve sensitivity in children at higher risk, especially girls, we cannot overstate the importance of using standardized norms specific to gender, informant, and culture. 1. Introduction The current professional consensus is that early diagnosis and subsequent early treatment of autism spectrum disorder (ASD) can facilitate development and learning [1, 2], reduce the need for treatment later in life [3, 4], and improve longterm prognosis in adulthood [5, 6]. However, not all families with children with ASD necessarily get timely access to treatment and other support. Delayed identification and diagnosis of ASD have been associated with subtypes of ASD [7–10], cognitive level [10, 11], gender [11, 12], and demographic factors such as low socioeconomic status [8, 10]. Diagnosis of ASD tends to be delayed in children having both milder autistic symptoms and above-average general cognitive ability, especially in girls. For example, reported age at first diagnosis of Asperger, syndrome ranges from 7 to 11 years [9, 10, 12, 13]. In a Japanese nationwide survey of adults with high-functioning ASD, the median age at first diagnosis was 10.3 years [6]. Recent epidemiological studies [14, 15] have revealed that most mainstreamed children with ASD were undiagnosed and untreated. Although most of these children might have had few diagnosable symptoms during preschool to draw the attention of primary health professionals, school teachers should be the best persons to identify any overt social deviance [16, 17]. At present, many quantitative behavioral measures of ASD have been
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