Advertisement

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

  • Katherine Gotham
  • Susan Risi
  • Andrew Pickles
  • Catherine Lord
Original Paper

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.

Keywords

Autism Autism spectrum disorders PDD-NOS Diagnosis 

Notes

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.

References

  1. Bayley, N. (1993). Bayley scales of infant development (2nd ed.). San Antonio: The Psychological Corporation.Google Scholar
  2. Binder, D. A. (1983). On the variances of asymptotically normal estimators from complex surveys. International Statistical Review, 51, 279–292.CrossRefGoogle Scholar
  3. 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
  4. 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.CrossRefGoogle Scholar
  5. 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
  6. 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.PubMedCrossRefGoogle Scholar
  7. 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.PubMedCrossRefGoogle Scholar
  8. 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.PubMedCrossRefGoogle Scholar
  9. 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.PubMedCrossRefGoogle Scholar
  10. Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.CrossRefGoogle Scholar
  11. 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.PubMedCrossRefGoogle Scholar
  12. Elliot, C. D. (1990). Differential abilities scale (DAS). San Antonio, TX: Psychological Corporation.Google Scholar
  13. 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.PubMedCrossRefGoogle Scholar
  14. 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
  15. 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.Google Scholar
  16. 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.PubMedCrossRefGoogle Scholar
  17. 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.PubMedCrossRefGoogle Scholar
  18. 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.PubMedCrossRefGoogle Scholar
  19. Lord, C., Rutter, M., DiLavore, P., & Risi, S. (1999). Autism diagnostic observation schedule: Manual. Los Angeles: Western Psychological Services.Google Scholar
  20. Mullen, E. (1995). Mullen scales of early learning (AGS ed.). Circle Pines, MN: American Guidance Service.Google Scholar
  21. Muthen, L. K., Muthen, B. O. (1998). M-plus user’s guide. Los Angeles, CA: Muthen and Muthen.Google Scholar
  22. 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.PubMedCrossRefGoogle Scholar
  23. 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.PubMedCrossRefGoogle Scholar
  24. 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.PubMedCrossRefGoogle Scholar
  25. 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.CrossRefGoogle Scholar
  26. Rutter, M., Le Couteur, A., & Lord, C. (2003). Autism diagnostic interview-revised—WPS (WPS ed.). Los Angeles: Western Psychological Services.Google Scholar
  27. 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.PubMedCrossRefGoogle Scholar
  28. 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.PubMedCrossRefGoogle Scholar
  29. Skrondal, A., & Rabe-Hesketh, S. (2004). Generalized latent variable modeling. Boca Raton, FL: Chapman & Hall/CRC Press.Google Scholar
  30. Sparrow, S. S., Balla, D. A., & Cicchetti, D. V. (1984). Vineland adaptive behavior scales. Circle Pines, MN: American Guidance Service.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Katherine Gotham
    • 1
  • Susan Risi
    • 1
  • Andrew Pickles
    • 2
  • Catherine Lord
    • 1
  1. 1.University of Michigan Autism and Communication Disorders CenterAnn ArborUSA
  2. 2.Division of Epidemiology and Health Science University of Manchester ManchesterUnited Kingdom

Personalised recommendations