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The Autism Diagnostic Observation Schedule: Revised Algorithms for Improved Diagnostic Validity

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Abstract

Autism Diagnostic Observation Schedule (ADOS) Modules 1–3 item and domain total distributions were reviewed for 1,630 assessments of children aged 14 months to 16 years with an autism spectrum disorder (ASD) or with heterogeneous non-spectrum disorders. Children were divided by language level and age to yield more homogeneous cells. Items were chosen that best differentiated between diagnoses and were arranged into domains on the basis of multi-factor item-response analysis. Reflecting recent research, the revised algorithm now consists of two new domains, Social Affect and Restricted, Repetitive Behaviors (RRB), combined to one score to which thresholds are applied, resulting in generally improved predictive value.

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References

  • Bayley, N. (1993). Bayley scales of infant development (2nd ed.). San Antonio: The Psychological Corporation.

    Google Scholar 

  • Binder, D. A. (1983). On the variances of asymptotically normal estimators from complex surveys. International Statistical Review, 51, 279–292.

    Article  Google Scholar 

  • Bishop, D. V., & Norbury, C. F. (2002). Exploring the borderlands of autistic disorder and specific language impairment: a study using standardized diagnostic instruments. Journal of Child Psychology and Psychiatry & Allied Disciplines, 43(7), 917–929.

    Google Scholar 

  • Bishop, S. L., Richler, J., & Lord, C. (2006). Restricted and repetitive behaviors and non-verbal IQ in children with autism spectrum disorders. Journal of Child Neuropsychology, 12, 247–267.

    Article  Google Scholar 

  • Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.

    Google Scholar 

  • Cohen, I. L., Schmidt-Lackner, S., Romanczyk, R., & Sudhalter, V. (2003). The PDD behavior inventory: A rating scale for assessing response to intervention in children with pervasive developmental disorder. Journal of Autism and Developmental Disorders, 33(1), 31–45.

    Article  PubMed  Google Scholar 

  • Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., et al., (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the social responsiveness scale with the autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 33(4), 427–433.

    Article  PubMed  Google Scholar 

  • Constantino, J. N., Gruber, C. P., Davis, S., Hayes, S., Passanante, N., & Przybeck, T. (2004). The factor structure of autistic traits. Journal of Child Psychology and Psychiatry, 45 (4), 719–726.

    Article  PubMed  Google Scholar 

  • Critchley, H., Daly, E., Phillips, M., Brammer, M., Bullmore, E., Williams, S., Van Amelsvoort, T., Robertson, D., David, A., & Murphy, D. (2000). Explicit and implicit neural mechanisms for processing of social information from facial expressions: a functional magnetic resonance imaging study. Human Brain Mapping, 9(2), 93–105.

    Article  PubMed  Google Scholar 

  • Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.

    Article  Google Scholar 

  • de Bildt, A., Sytema, S., Ketelaars, C., Kraijer, D., Mulder, E., Volkmar, F., & Minderaa, R. (2004). Interrelationship between autism diagnostic observation schedule-generic (ADOS-G), autism diagnostic interview-revised (ADI-R), and the diagnostic and statistical manual of mental disorders (DSM-IV-TR) classification in children and adolescents with mental retardation. Journal of Autism and Developmental Disorders, 34(2), 129–137.

    Article  PubMed  Google Scholar 

  • Elliot, C. D. (1990). Differential abilities scale (DAS). San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Gilmour, J., Hill, B., Place, M., & Skuse, D. H. (2004). Social communication deficits in conduct disorder: a clinical and community survey. Journal of Child Psychology and Psychiatry, 45(5), 967–978.

    Article  PubMed  Google Scholar 

  • Joseph, R. M., Tager-Flusberg, H., & Lord, C. (2002). Cognitive profiles and social-communicativefunctioning in children with autism spectrum disorder. Journal of Child Psychology and Psychiatry and Allied Disciplines, 43(6), 807–821.

    Google Scholar 

  • Klein-Tasman, B., Risi, S., & Lord, C. (in press). The effect of language and task demands on the diagnostic effectiveness of the Autism Diagnostic Observation Schedule (ADOS): The impact of module choice. Journal of Autism and Developmental Disorders.

  • Klin, A., Jones, W., Schultz, R., Volkmar, F., & Cohen, D. (2002). Visual fixation patterns during viewing of naturalistic social situations as predictors of social competence in individuals with autism Archives of General Psychiatry, 59(9), 809–816.

    Article  PubMed  Google Scholar 

  • Lord, C., Risi, S., DiLavore, P., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from two to nine. Archives of General Psychiatry, 63(6), 694–701.

    Article  PubMed  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000). The Autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P., & Risi, S. (1999). Autism diagnostic observation schedule: Manual. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Mullen, E. (1995). Mullen scales of early learning (AGS ed.). Circle Pines, MN: American Guidance Service.

    Google Scholar 

  • Muthen, L. K., Muthen, B. O. (1998). M-plus user’s guide. Los Angeles, CA: Muthen and Muthen.

    Google Scholar 

  • Noterdaeme, M., Mildenberger, K., Sitter, S., & Amorosa, H. (2002). Parent information and direct observation in the diagnosis of pervasive and specific developmental disorders. Autism, 6(2), 159–168.

    Article  PubMed  Google Scholar 

  • Risi, S., Lord, C., Gotham, K., Corsello, C., Chrysler, C., Szatmari, P., Cook, E., Leventhal, B., & Pickles, A. (2006). Combining information from multiple sources in the diagnosis of autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1094–1103.

    Article  PubMed  Google Scholar 

  • Robertson, J. M., Tanguay, P. E., L’Ecuyer, S., Sims, A., & Waltrip, C. (1999). Domains of social communication handicap in autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 38(6), 738–745.

    Article  PubMed  Google Scholar 

  • Rogers, S. J., Hepburn, S. L., & Wehner, E. A. (2004). Parent reports of sensory functioning in toddlers with autism and those with other developmental disorders. Journal of Autism and Developmental Disorders, 33(6), 631–642.

    Article  Google Scholar 

  • Rutter, M., Le Couteur, A., & Lord, C. (2003). Autism diagnostic interview-revised—WPS (WPS ed.). Los Angeles: Western Psychological Services.

    Google Scholar 

  • Schultz, R. T., Gauthier, I., Klin, A., Fulbright, R. K., Anderson, A. W., Volkmar, F., Skudlarski, P., Lacadie, C., Cohen, D. J., & Gore, J. C. (2000). Abnormal ventral temporal cortical activity during face discrimination among individuals with autism and Asperger syndrome. Archives of General Psychiatry, 57, 331–340.

    Article  PubMed  Google Scholar 

  • Siegel, B., Vukicevic, J., Elliott, G., & Kraemer, H. (1989). The use of signal detection theory to assess DSM-III-R criteria for autistic disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 542–548.

    Article  PubMed  Google Scholar 

  • Skrondal, A., & Rabe-Hesketh, S. (2004). Generalized latent variable modeling. Boca Raton, FL: Chapman & Hall/CRC Press.

    Google Scholar 

  • Sparrow, S. S., Balla, D. A., & Cicchetti, D. V. (1984). Vineland adaptive behavior scales. Circle Pines, MN: American Guidance Service.

    Google Scholar 

Download references

Acknowledgments

We gratefully acknowledge the help of Bennett Leventhal, Edwin Cook, Christina Corsello, Amy Esler, Somer Bishop, Danielle Guerin, Kathryn Larson, Jackie Preston Opatik, and Mary Yonkovit, as well as the families that participated in this research. This study was funded by the National Institute of Mental Health (Validity of Diagnostic Measures for Autism Spectrum Disorders: NIMH RO1 MH066469). Some authors (C.L., S.R.) receive royalties for the ADOS; profits related to this study were donated to charity.

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Correspondence to Katherine Gotham.

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Gotham, K., Risi, S., Pickles, A. et al. The Autism Diagnostic Observation Schedule: Revised Algorithms for Improved Diagnostic Validity. J Autism Dev Disord 37, 613–627 (2007). https://doi.org/10.1007/s10803-006-0280-1

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  • DOI: https://doi.org/10.1007/s10803-006-0280-1

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