NEW RESEARCH
A Replication of the Autism Diagnostic Observation Schedule (ADOS) Revised Algorithms

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ABSTRACT

Objective:

To replicate the factor structure and predictive validity of revised Autism Diagnostic Observation Schedule algorithms in an independent dataset (N = 1,282).

Method:

Algorithm revisions were replicated using data from children ages 18 months to 16 years collected at 11 North American sites participating in the Collaborative Programs for Excellence in Autism and the Studies to Advance Autism Research and Treatment.

Results:

Sensitivities and specificities approximated or exceeded those of the old algorithms except for young children with phrase speech and a clinical diagnosis of pervasive developmental disorders not otherwise specified.

Conclusions:

Revised algorithms increase comparability between modules and improve the predictive validity of the Autism Diagnostic Observation Schedule forautism cases compared to the original algorithms.

Section snippets

Participants

Analyses were conducted on data provided by the CPEA, a network of 10 sites funded by the National Institute of Child Health and Human Development and the National Institute of Deafness and Other Communication Disorders, and the STAART program, an NIH-funded network of eight research centers (some of which overlap with CPEA sites) throughout the United States and Canada. This dataset represents 1,259 different participants from 11 different sites, excluding children from Michigan (who were

Comparability of Revision and Replication Samples

The Michigan 2007 sample included more data from children with clinical diagnoses of PDD-NOS than did the CPEA/STAART dataset for all developmental cells (Michigan 2007 N = 439; CPEA/STAART N = 98). In the 2007 sample, the majority of children with nonspectrum diagnoses had been specifically recruited from populations with Down syndrome, fetal alcohol syndrome, and non-ASD language delays to provide a control group against which to assess the predictive validity of the ADOS and ADI-R. In

DISCUSSION

Recently proposed improvements to the algorithm1 resulted in increased comparability across ADOS modules; now each algorithm includes 14 items of similar content. The revised algorithms also better represent observed diagnostic features of ASD in that social, communication, and RRBs contribute to both a measure classification and DSM-IV diagnosis of autism. Predictive value of the ADOS for autism cases generally increased under the revised algorithms in this large independent multisite sample.

REFERENCES (18)

  • DR Walker et al.

    Specifying PDD-NOS: a comparison of PDD-NOS, Asperger syndrome, and autism

    J Am Acad Child Adolesc Psychiatry.

    (2004)
  • B Siegel et al.

    The use of signal detection theory to assess DSM-III-R criteria for autistic disorder

    J Am Acad Child Adolesc Psychiatry.

    (1989)
  • K Gotham et al.

    The Autism Diagnostic Observation Schedule (ADOS): revised algorithms for improved diagnostic validity

    J Autism Dev Disord.

    (2007)
  • C Lord et al.

    The Autism Diagnostic Observation Schedule-Generic: a standard measure of social and communication deficits associated with the spectrum of autism

    J Autism Dev Disord.

    (2000)
  • RM Joseph et al.

    Cognitive profiles and social-communicative functioning in children with autism spectrum disorders

    J Child Psychol Psychiatry.

    (2002)
  • A de Bildt et al.

    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

    J Autism Dev Disord.

    (2004)
  • C Lord et al.

    Autism Diagnostic Observation Schedule Manual

    (1999)
  • JN Constantino et al.

    The factor structure of autistic traits

    J Child Psychol Psychiatry.

    (2004)
  • L Lecavalier et al.

    Validity of the autism Diagnostic Interview-Revised

    Am J Ment Retard.

    (2006)
There are more references available in the full text version of this article.

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Article Plus (online-only) materials for this article appear on the Journal's Web site: www.jaacap.com.

This study was supported by NIMHRO1 MH066469 and NIMH R25MH067723.

We gratefully acknowledge the help of Shanping Qiu, Kathryn Larson, and Mary Yonkovit. We thank the families in all CPEA/STAART sites.

This article is the subject of an editorial by Dr. Charles Zeanah in this issue.

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