You can ask actual clinicians in the field, but based on my knowledge, the most commonly used measures in the US are ADOS and ADI. The Stanford Binet only measures IQ and thus doesn't really capture the whole ASD spectrum (as many people with ASD do not have an intellectual disability). It may be appropriate to test Intellectual disability in ASD but not as a measure of ASD severity since it does not tap into behavioral and social issues. 

You can ask actual clinicians in the field, but based on my knowledge, the most commonly used measures in the US are ADOS and ADI. The Stanford Binet only measures IQ and thus doesn't really capture the whole ASD spectrum (as many people with ASD do not have an intellectual disability). It may be appropriate to test Intellectual disability in ASD but not as a measure of ASD severity since it does not tap into behavioral and social issues. 

the CARS also is useful

Thank you dear Rita, I agree with you that  the Stanford Binet doesn't really capture the whole aspects of ASD, but clinicians do use it as a measure of severity rather than a measure for diagnosis. I do not know why!!!.

They defend that many other measures for diagnosis of ASD severity do not capture both behavioral and social aspects. In addition, they argue that the scores of the mostly used measures for assessment of ASD severity are highly correlated with Stanford Binet scale.

Dear Prof. Rosa Fabio, CARS can accurately distinguish the behavioral symptoms of ASD from other developmental disorders and typical development, but is it appropriate to accurately differentiate between different severity levels of ASD?

In my (admittedly humble) clinical experience, ADI-R is very useful because it covers nearly all imaginable clinical presentations of ASD, has good reliability and is widely used.

I don't think it's very useful to primarily rely on IQ tests to assess severity because intelligence is just one of the factors that affect one's functionality, you need a more comprehensive tool.

Thank you dear Vladimir. Also ADI-R is a useful tool for diagnosing autism and distinguishing autism from other developmental disorders. But I am looking for a tool that is used for persons who are already diagnosed with Autism for the purpose of specifying the severity level of the disorder.

I would be very cautious about using IQ for this purpose Ahmad.  IQ tests were never designed to determine the severity of any clinical disorders -- you can look at the history of using IQ measures to diagnose reading disabilities for an example of the negative impact the use of such measures can have on research.  

Two good measures for adults with autism are the Ritvo Autism Asperger Diagnostic Scale (Ritvo et al, 2011, Journal of Autism and Developmental Disorders, 41, 1076–89. doi:10.1007/s10803-010-1133-5), and the Social Responsiveness Scale by Constantino.  There is an updated SRS survey, and these surveys were originally designed for children.

In an adult sample I am currently recruiting, scores for Vocabulary (WASI) and the RAADS are completely unrelated (r =-.08). 

Thank you Dear M.E Stothers, It seems that IQ is not an appropriate option. Thanks also for the suggested tools but I want a tool for children.

Dear Mr Alban Burke, thank you so much for your help. I totally agree with you that no single instrument would be sufficient to assess severity of autism, since different tools assess different aspects. I just want to include a representative sample for different levels of severity for autism in my research. I think the DSM V criteria regarding the level of support needed can satisfy my need, because I am interested in the degree to which children may exhaust their parents while raising these children..

Ahmad, the SRS-2 has been validated on over 7,000 children.  See:

Frazier, Ratcliff, Gruber, Zhang, Law, & Constantino (2014).  Confirmatory factor analytic structure and measurement invariance of quantitative autistic traits measured by the Social Responsiveness Scale-2, Autism, 18 (1), 31-44. 

Thanks M.E. Stothers, please note that SRS-2 measures severity of social impairment, but ignores behavioral symptoms of autism.

To the best of my knowledge Stanford Binet Scale is an IQ test so I can't see how this would reflect Autism severity.

CARS is designed to assess severity and improvement following treatment. ADOS 2 has also a severity score so can be repeated for comparison purposes following intervention.

I guess I'm not sure what you mean by behavioural symptoms, Ahmad.  The SRS-2 has items that do address restricted/repetitive behaviors, repetitive mannerisms, and insistence on sameness as well as social responsiveness items.  Do you mean quantifying behavioural observations?  ...  if so, the ADOS is the gold standard, but the CARS is a very good measure is simpler to learn and administer.  .

Margot 

Thank you so much dear M. E Stothers. Exactly, SRS-2 is also compatible to some extent with DSM5 criteria.

yes quantifying behavioral observations is important since they are so stressful for parents and caregivers. 

I agree with you regarding ADOS, it also takes long time.

Kind regards, Ahmad.

"Is it appropriate to depend on the Stanford Binet Scale as an indication for severity level of ASD?"

Absolutely not!  Autism, even with severe symptoms, can occur at any IQ level.  Also, SB should not be used in any condition with a language deficit to measure general IQ.  In the congenitally deaf, non-verbal IQs are normal, but verbal IQs, including SB, are quite low.  Use of a verbal IQ test may be justified if one wanted to predict school attainment, for example, but it is not a measure of general intelligence in these populations.   

Dear Ahmad, I think quick and simple ways to measure ASD severity in Jordan are CARS-2 (present revised version of CARS) and Social Communication Questionnaire (SCQ). They are cheap and can be administered by nurses/ educational psychologists, not only by mental health specialists as clinical psychologists and child psychiatrists. In addition they are quite cross-cultural, differently from more accurate and complex scales as ADI-R/ ADOS, mostly used in high resources western countries. I also agree with all those highlighting the need of not confounding IQ with ASD symptoms, because ASD may occurr at any IQ. I hope this will be helpful.

Best

Paolo

Thank you Mr Gordon

Yes, it is helpful Paolo Feo, thank you.

I agree with the previous posts stating that the IQ measure is absolutely inappropriate to measure the severity of ASD. It is a measure of ability level and not of ASD. I use the GARS together with extensive observation and parents', teachers' interviews to estimate (rather than measure) the severity of the symptoms. The ability to use language for communication, the intensity of the stereotyped behaviors and their impact on general functioning as well as the problems in social interaction would be my target points when estimating. I don't believe that use of one or more tests alone is sufficient in assessing the severity of ASD symptoms. 

Thank you so much dear Aleksandra Jelonek-Turk. Unsurprisingly, I totally agree with this principle. I also support using the three levels of severity identified by the DSM-5 criteria  "with extensive observation and parents', teachers' interviews to estimate (rather than measure) the severity of the symptoms". Hope you the best. Kind regards. Ahmad.

This is a question that comes up frequently where I work.  I am actually surprised that no one has mentioned to assess adaptive behaviour which can be assessed at any level of cognitive functioning (not just intellectual disability).  You can have a child or adult with ASD with Average range intellectual functioning y and still have impairments that he or she is moderately affected (Level 2) because they need more assistance than most to go through life.  Measures of adaptive behaviour are very helpful to outline deficits of daily living.

Ahmad, you should know there is much debate about using the DSM 5 Levels, most notably by Dr. Catherine Lord who was on the ASD committee when the DSM 5 was written (she discussed this at the Autism 2014 conference in Toronto, Canada).  Instruments you could use (at least in North America) are the Adaptive Behavior Assessment System (ABAS-2) and the Vineland.  I don't know what is used abroad.

As well, I would never discount any of the other tools (IQ, achievement and memory) in addition to the ADOS-2 and the ADI-R, because they also form the corpus of understanding the impact of impairments on an individual. 

Thank you so much dear Hadley Koltun. yes, there is a great debate on DSM-5 criteria. I also agree with you that behavioral symptoms are the most important symptoms. But I will use DSM-5 criteria because of their focus on "the level of support" needed by parents or caregivers. This is an issue of interest in my research which focuses on psychological response for parents who are raising a child with ASD. Since the more support needed for the child, the more negative psychological responses are expected in parents. 

Yes, your diagnosis should always be based on DSM5 but that will merely get you a listing of symptoms (and some idea of their severity).  However, the individuals you assess may have other impairments which are not directly assessed by the DSM5 criteria (such as co morbid conditions or disorders).  Using an adaptive behaviour scale will help you obtain a level of support needed.  There are both parent and teacher scales you can use for this.  Good luck.

also the Vineland Adaptive Behavior Scales... you might want to look at this article by a Canadian group who have studied ASD in very young children.  

"Our results also emphasize the importance of considering age and developmental level when describing ability profiles in children with ASD. Higher functioning children may have significant challenges with everyday skills relative to their cognitive abilities, and require specialized educational supports despite having average IQ scores. In contrast, adaptive behaviour can be a relative strength for those with cognitive delays, and there may be value in focusing on the acquisition of functional skills, especially in individuals with very low IQ."...

Flanagan et al., 2015, Stability and change in the cognitive and adaptive behaviour scores of preschoolers with ASD.  JADD, in press.

Thank you so much for your valuable ideas and suggestions (Hadley Koltun & M.E. Stothers).

We can use CARS ( current verison is version 2 ) . In India we have a tool called ISAA. You can get the PDF version of tool online at http://wcdsc.ap.nic.in/documents/autism.pdf

Thanks Mr John, do you have any references about the psychometric properties for ISAA. 

To assess severity I would neither rely on an intelligence tests (Binet) nor on a categorial measure such as the ADOS. If i get it right, you are not aiming at clinically diagnosing ASD but find a research tool to assess the severity of the diagnoses. Hence, "Yes" - "no instruments won't be useful, and an intelligence test however correlated, will not tell you the severity of autism symptoms but of cognitive deficits.

I would suggest to use an autism quotient measure.

Thank you dear Elisabeth Soechting for your suggestion.

the Stanford Binet test is a good measure of intelligence, many autistics can be high functioning and can have high I.Q,The test is useful to design remedial programmes to deal with children with autism but cannot be used as a measure for diagnosis of severity of the disorder itself. the test was not designed for this purpose either.

Thank you dear Linda Dhakul...

As has been pointed out, whether for research or for practice, one has to distinguish between intellectual functioning levels and the features of autism despite correlations. Moreover, when answering parental questions about level of severity in their children, I have found it useful to point out that the condition of autism is a spectrum of strengths and weaknesses in relevant areas such as the level of social interaction, verbal communication, and need for structured settings and routines as well as level of intellectual ability. Children may be stronger in one area than in others and this will be most relevant to ways of supporting the child and his or her family.  

Thanks Prof. Bartolo

Maybe, the following reference is helpful that lists instruments "used to characterise ASD, comorbid psychopathology and cognitive and adaptive ability for patient diagnostic and characterisation purposes across Europe."

Ashwood, K. L., Buitelaar, J., Murphy, D., Spooren, W., & Charman, T. (2014). European clinical network: autism spectrum disorder assessments and patient characterisation. European Child & Adolescent Psychiatry. doi:10.1007/s00787-014-0648-2

Thank you so much Dr Reinhold Rauh

Using an IQ-test to assess the severity of autism is even stranger than so far acknowledged since it is not a characteristic of autism 'proper'.

Apart from a general instrument which can count of sufficient consensus from 'the scientific community' it matters why one is interested in the severity of autism. If it is to assess the treatability of a particular person one should not only look at Axis-I characteristics but also at the other axises, particularly Axis-II. The first two can be viewed to an extent as dimensions: the 'severity' can be low but be accompanied by severe ego-problems among which executive functioning, cognitive switching and central coherence (and intelligence!). These hamper treatability in spite of a low severity of 'the autism proper' (axis-I). Conversely the autism may be very severe and yet a good working relationship can be built on the basis of strong ego-functions.

Thinking about the demands on the physical environment as I'm trying to do, sensory aspects count heavily and some which are absent or less prominent in the axis-I definition might be added or emphasized, such as disturbances in perception or an impaired sense of time. (See http://goo.gl/7zNCmv)

So, the indented use of a severity measure is decisive.             

Thank you so much Dr Flip Schrameijer. In my study, I want to correlate parental stress with autism severity in children, so, I decided to use the three levels of severity which are based on the level of needed support as described by DSM-V criteria. 

I see what you mean. Assuming establishing this correlation is your main plan, I would suggest to take other factors into account. Severity as derived from the DSM criteria it itself is an elusive category: what does it really mean? And how interesting is it to know to what extent parents of children with more severe autism have higher sress-levels?  To me it's beginning to get interesting if more is revealed about the mechanisms. What is the contribution to parental stress by things such as the lack of experienced contact, the level of attention needed, the time or money which is demanded, and so on. I suspect factors such as these are decisive, so if you find a correlation this might be spurious and in fact be one of these factors with which the 'dsm severity' happens to be correlated. Chances are, if I'm right, you won't find a correlation because their is no consistent and sufficient relationship between this severity and the factors which really matter.

But I'm speculating, probably you have a much better model. I hope to notice the end-result of your endeavor once it's published.      

Thank you so much dr Flip Schrameijer. Yes, severity of autism in children is only one factor that may contribute to parental stress. For sure, I will consider different other predictors for parental stress in my study, including what you have suggested. I will be happy to share the end-result of the study with you once it's published.  

I have been retired for many years, and honestly am not an expert in autism, although I did do some diagnostic work as a clinical neuropsychologist.  I think that a more comprehensive battery would be best, that would illuminate strengths and weaknesses in intellectual and functional areas. Autistic Spectrum Disorder (ADS) is a multifaceted entity, and intellectual functioning is only one area that needs to be evaluated in assessing severity. Therefore I would strongly recommend against using the Stanford Binet as a sole determinant of severity.

I tend to prefer the Wechsler Scales to the Stanford Binet for intellectual functioning, perhaps due to my training, but also the general usage by many professionals, unless cultural sensitivity is an issue.  

Perhaps combining the best validated autism scales would be good, along with this, although I know the more tests, the more noise you introduce and need a larger sample.

My main contribution for you here here is from my years of study and work in developmental disabilities.  That is, the use of an adaptive behavior scale. Adaptive behavior, that is, what functional skills an individual has to function in their environment and the community is just as important as intellectual proficiency, although they are often correlated in individuals with more general developmental disabilities.  In the case of Autistic Spectrum Disorders, adaptive behavior skills become much more important, as coping abilities may be affected by factors other than intellect alone.

There is one originally developed by Henry Leland, Ph.D. et. al., but is not often used, as the psychometric properties are not as well validated as other scales.  However, it is the one I was trained on from Dr. Leland, and can be useful in a clinical setting if one is well-acquainted with it's strengths and weaknesses.

From S. Netherton, D. Holmes, & C. E. Walker, (Eds.), Comprehensive Textbook of Child and Adolescent Disorders. New York: Oxford University Press, in press: "The American Association on Mental Retardation (AMMR) Adaptive Behavior Scale (ABS): The ABS has two forms which address survival skills and maladaptive behaviors in individuals living in residential and community settings (ABS-RC:2; Nihira, Leland, & Lambert, 1993) or school age children (ABS-S:2; Lamber, Nahira, & Leland, 1993). It is limited in scope and should be used with caution. A new scoring method has recently been devised that can generate scores consistent with the 10 adaptive behavior areas suggested in the 1992 definition of mental retardation (Bryant, Taylor, & Pedrotty-Rivera, 1996). The results of this assessment can be readily translated into objectives for intervention."

Another option is the Vineland, as described by these same authors: "Vineland Adaptive Behavior Scales (VABS) (Sparrow, Balla, & Cicchetti, 1984): The VABS is a revision of the Vineland Social Maturity Scale (Doll, 1953) and assesses the social competence of individuals with and without disabilities from birth to age 19. It is an indirect assessment in that the respondent is not the individual in question but someone familiar with the individual's behavior. The VABS measures four domains: Communication, Daily Living Skills, Socialization, and Motor Skills. An Adaptive Behavior Composite is a combination of the scores from the four domains. A Maladaptive Behavior domain is also available with two of the three forms of administration. Each of the domains and the Composite has a mean of 100 and a standard deviation of 15. Three types of administration are available: the Survey Form (297 items), the Expanded Form (577 items, 297 of which are from the Survey Form), and the Classroom Edition (244 items for children age 3-13). The Survey and Expanded Forms were standardized on a representative sample of the 1980 U.S. census data including 3,000 individuals ranging in age from newborn to 18 years, 11 months. There are norms for individuals with mental retardation, children with behavior disorders, and individuals with physical handicaps. The Classroom Edition was standardized on a representative sample of the 1980 U.S. census data including 3,0000 students, ages 3 to 12 years, 11 months. Caution is advised when using this scale with children under the age of two because children with more significant delays frequently attain standard scores that appear to be in the low average range of ability. In this case more weight should be placed on the age equivalents that can be derived."

The final adaptive behavior scale, which looks promising, as it is newer, and developed through the newest name for the old AAMR (which was associated with the ABS), is the American Association on Intellectual and Developmental Disabilities (AAIDD).  It was also developed at the  at The Ohio State University's Nisonger Center, which is a premier research center regarding developmental syndromes. Their Diagnostic Behavior Scale (DABS) "measures these three domains:

Conceptual skills: literacy; self-direction; and concepts of number, money, and time

Social skills: interpersonal skills, social responsibility, self-esteem, gullibility, naïveté (i.e., wariness), social problem solving, following rules, obeying laws, and avoiding being victimized

Practical skills: activities of daily living (personal care), occupational skills, use of money, safety, health care, travel/transportation, schedules/routines, and use of the telephone"  

Their reference article can be viewed at this link: http://nisonger.osu.edu/dabs.  It appears to have good concurrent validity with respect to sensitivity and specificity in identifying individuals with Intellectual Disorders, per an article by Balboni G1, Tassé MJ2, Schalock RL3, Borthwick-Duffy SA4, Spreat S5, Thissen D6, Widaman KF7, Zhang D8, Navas P2. at this link: http://www.ncbi.nlm.nih.gov/pubmed/25105569.

What I don't see with the DABS is a measure of maladaptive behavior, which I feel would be important in evaluating severity of autism.  Perhaps some of the other autism severity measures cover this issue.

Finally, there is the issue of how much help the individual requires to function, which ties in with parental stress as mentioned by Flip Schrameijer above. The AAIDD also offers a scale for this, which you can get more information at http://aaidd.org/publications/supports-intensity-scale#.VUAIp84UpFI.

To summarize then, no, I do not believe it would be appropriate to use the Stanford Binet as a stand-alone measure for severity of ASDs.  ASD is a multi-dimensional diagnosis, and the severity needs to include all aspects of an individual's functioning, both in terms of strengths and weaknesses.  I realize that for both research and clinical purposes, the number of assessment tools needs to be streamlined. My advice would be to use a well-validated measure of intellectual functioning, a measure of adaptive behavior skills, a well-validated autism severity scale or two, (ensuring that one of these includes maladaptive behaviors), and perhaps a needs assessment such as the Supports Intensity Scale.

In further reading of your purpose, I thought you might find the following article helpful, which, only coincidentally comes from the Nisonger Center as well: 

The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders

L. Lecavalier, S. Leone & J. Wiltz

http://nisonger.osu.edu/papers/lecavalierleonewiltz_2006.pdf

I hope this comes in time to be of some help to you. I, too would be interested in the results of your study. Best wishes.

 Dear Dr Saneda, please accept my sincere thanks and deep appreciation for your interesting and valuable contribution, best regards.  

It's not appropriate since intellectual ability isn't included in the diagnostic criteria for Autism. It even goes so far as to be specifically excluded.

We have validated ADOS in our setup and seems to be working well

could you please provide more details about it "Joseph Karisa Gona"

In trying to come up with culturally acceptable screening and diagnostic measures for ASD, we validated the SCQ and ADOS to determine their applicability at the Kenyan Coast.

Best wishes in your Kenyan versions.

Attached is the CLINICIAN-RATED SEVERITY OF

AUTISM SPECTRUM AND SOCIAL COMMUNICATION DISORDERS by APA

https://www.researchgate.net/publication/280997107_ASSESSMENT_OF_A_LONG-TERM_DEVELOPMENTAL_RELATIONSHIP-BASED_APPROACH_IN_CHILDREN_WITH_AUTISM_SPECTRUM_DISORDER_%28.%29

Article Assessment of a long-term developmental relationship-based a...

I think you can find a good answer in this article

I hope can be a good answer to your question

Article From the Emotional Integration to the Cognitive Construction...

I'm currently using ADOS (Swahili version ) for diagnosing autism. It's working

Hi Amad, in the end what scale did you choose to describe and measure severity. I am a pediatric anesthesiologist and am conducting a research on evaluating effects of anesthetic agents on children with autism. As an attempt to differentiate between different groups I also want to use severity of the disorder but am a bit lost how to approach that.

Autism,

I did not able to understand any definition of it. It needs to be well define first

Hi Ammar check this ou, DAWBA offers an effetive validated Autimus Diagnostic tool

The agreement between the referrer, practitioner and research diagnosis of autistic spectrum conditions among children attending child and adolescent mental health services February 2019 · European Child & Adolescent Psychiatry DOI: · 10.1007/s00787-019-01290-z License · CC BY 4.0

I do ADOS as well, but that usually does not pick up Hifgh functioning utistic adolsecent, so this tool is greatA

Christine, the ADOS-2 is effective in discriminating High Functioning ASD from other conditions (although there are some false negatives even among experienced users).