scholarly journals Is the Combination of ADOS and ADI-R Necessary to Classify ASD? Rethinking the “Gold Standard” in Diagnosing ASD

2021 ◽  
Vol 12 ◽  
Author(s):  
Inge Kamp-Becker ◽  
Johannes Tauscher ◽  
Nicole Wolff ◽  
Charlotte Küpper ◽  
Luise Poustka ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Autism Diagnostic Observation Schedule ◽  
Autism Spectrum ◽  
Diagnostic Interview ◽  
Clinical Samples ◽  
Diagnostic Process ◽  
Clinical Expertise ◽  
Physical And Mental Health ◽  
Diagnostic Features ◽  
Using Data

Diagnosing autism spectrum disorder (ASD) requires extensive clinical expertise and training as well as a focus on differential diagnoses. The diagnostic process is particularly complex given symptom overlap with other mental disorders and high rates of co-occurring physical and mental health concerns. The aim of this study was to conduct a data-driven selection of the most relevant diagnostic information collected from a behavior observation and an anamnestic interview in two clinical samples of children/younger adolescents and adolescents/adults with suspected ASD. Via random forests, the present study discovered patterns of symptoms in the diagnostic data of 2310 participants (46% ASD, 54% non-ASD, age range 4–72 years) using data from the combined Autism Diagnostic Observation Schedule (ADOS) and Autism Diagnostic Interview—Revised (ADI-R) and ADOS data alone. Classifiers built on reduced subsets of diagnostic features yield satisfactory sensitivity and specificity values. For adolescents/adults specificity values were lower compared to those for children/younger adolescents. The models including ADOS and ADI-R data were mainly built on ADOS items and in the adolescent/adult sample the classifier including only ADOS items performed even better than the classifier including information from both instruments. Results suggest that reduced subsets of ADOS and ADI-R items may suffice to effectively differentiate ASD from other mental disorders. The imbalance of ADOS and ADI-R items included in the models leads to the assumption that, particularly in adolescents and adults, the ADI-R may play a lesser role than current behavior observations.

scholarly journals Differentiation of autism spectrum disorder and mood or anxiety disorder

Autism ◽  
2021 ◽  
pp. 136236132110396
Author(s):  
Sarah Wittkopf ◽  
Sanna Stroth ◽  
Anika Langmann ◽  
Nicole Wolff ◽  
Veit Roessner ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Autism Diagnostic Observation Schedule ◽  
Autism Spectrum ◽  
Diagnostic Interview ◽  
Spectrum Disorder ◽  
Diagnostic Process ◽  
Mood And Anxiety Disorders ◽  
Autism Diagnostic Interview

Autism spectrum disorder shares many symptoms with other mental health disorders, and comorbid disorders such as mood and anxiety disorders are common, making the diagnostic process challenging. We aimed to explore the diagnostic accuracy of two standard autism spectrum disorder diagnostic instruments and to identify those behavioral items that best differentiate between autism spectrum disorder and mood and anxiety disorder in a naturalistic sample of patients utilizing autism spectrum disorder specialist services. The study included data of 847 participants (5–65 years of age, n = 586 with autism spectrum disorder, n = 261 with mood and anxiety disorder) all evaluated with the Autism Diagnostic Observation Schedule in the context of the diagnostic process. Data of the Autism Diagnostic Interview–Revised were available for 428 participants (5–51 years of age, n = 367 with autism spectrum disorder, n = 61 with mood and anxiety disorder). By means of binominal logistic regressions and an ensemble feature selection, we identified a subset of items that best differentiated between autism spectrum disorder and mood and anxiety disorder. Overall, the results indicate that a combination of communicational deficits and unusual and/or inappropriate social overtures differentiates autism spectrum disorder and mood and anxiety disorder. Aspects of social cognition are also relevant. Limitations of the current study and implications for research and practice are discussed. Lay abstract Symptoms of mood and anxiety disorders overlap with symptoms of autism spectrum disorder, making the diagnostic process challenging. This study found that a combination of communicational deficits and unusual and/or inappropriate social overtures facilitates differentiation between autism spectrum disorder and mood and anxiety disorders. Furthermore, the results confirm the essential need of a behavioral observation with the Autism Diagnostic Observation Schedule in combination with a full Autism Diagnostic Interview–Revised to support diagnostic decisions.

POMDP-Based Coding of Child–Robot Interaction within a Robot-Assisted ASD Diagnostic Protocol

2018 ◽  
Vol 15 (02) ◽  
pp. 1850011 ◽  
Author(s):  
Frano Petric ◽  
Damjan Miklić ◽  
Zdenko Kovačić
Keyword(s):  
Humanoid Robots ◽  
Autism Diagnostic Observation Schedule ◽  
Autism Spectrum ◽  
Diagnostic Process ◽  
Sequential Decision ◽  
Robot Assisted ◽  
Robot Interaction ◽  
Fine Grained ◽  
Markov Decision ◽  
Partially Observable

The existing procedures for autism spectrum disorder (ASD) diagnosis are often time consuming and tiresome both for highly-trained human evaluators and children, which may be alleviated by using humanoid robots in the diagnostic process. Hence, this paper proposes a framework for robot-assisted ASD evaluation based on partially observable Markov decision process (POMDP) modeling, specifically POMDPs with mixed observability (MOMDPs). POMDP is broadly used for modeling optimal sequential decision making tasks under uncertainty. Spurred by the widely accepted autism diagnostic observation schedule (ADOS), we emulate ADOS through four tasks, whose models incorporate observations of multiple social cues such as eye contact, gestures and utterances. Relying only on those observations, the robot provides an assessment of the child’s ASD-relevant functioning level (which is partially observable) within a particular task and provides human evaluators with readable information by partitioning its belief space. Finally, we evaluate the proposed MOMDP task models and demonstrate that chaining the tasks provides fine-grained outcome quantification, which could also increase the appeal of robot-assisted diagnostic protocols in the future.

scholarly journals Psychiatric comorbidity and intellectual disability

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Keyes
Keyword(s):  
Intellectual Disability ◽  
Mental Disorders ◽  
Capital Punishment ◽  
Representative Sample ◽  
Psychiatric Comorbidity ◽  
Sample Selection ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Clinical Samples ◽  
Axis I

Abstract Most research on the prevalence, distribution, and psychiatric comorbidity of intellectual disability (ID) relies on clinical samples, limiting the generalizability and utility of ID assessment in a legal context. This study assessed ID prevalence in a population-representative sample of U.S. adolescents, and examined associations of ID with socio-demographic factors and mental disorders. Data were drawn from the National Comorbidity Survey Adolescent Supplement (N = 6256). ID was defined as: 1) IQ ≤ 76, measured using the Kaufman Brief Intelligence Test; and 2) an adaptive behavior score ≤76, measured using a validated scale. The Composite International Diagnostic Interview assessed fifteen lifetime mental disorders. The Sheehan disability scale assessed disorder severity. We used logistic regression models to estimate differences in lifetime disorders for adolescents with and without ID. ID prevalence was 3.2%, and was more common among those with specific phobia (OR = 1.66, 95% C.I. 1.02, 2.68), bipolar disorder (OR = 7.24, 95% C.I. 2.10-24.99), after adjusted for demographic and clinical covariates. Among those with Axis I psychiatric disorder, adolescents with ID and mental disorders were significantly more likely to exhibit severe impairment than those without ID, across a broad range of disorders. These findings highlight how sample selection and overlap between ID and psychopathology symptoms might bias understanding of the mental health consequences of ID. For example, associations between ID and behavior disorders widely reported in clinical samples were not observed in a population-representative sample after adjustment for socio-demographic confounders. Valid assessment and understanding of these constructs may prove influential in the legal system by influencing treatment referrals and capital punishment decisions.

ADHD in adults

2018 ◽  
Author(s):  
Sandra Kooij ◽  
Philip Asherson ◽  
Michael Rösler
Keyword(s):  
Clinical Picture ◽  
Adult Adhd ◽  
Autism Spectrum ◽  
Diagnostic Interview ◽  
Diagnostic Assessment ◽  
Diagnostic Process ◽  
Collateral Information ◽  
Dsm 5 ◽  
Spectrum Disorders ◽  
Instructions For Use

In this chapter, the diagnostic assessment of ADHD in adults is described, starting with the clinical picture, such as the symptoms and the areas of impairment. To start the diagnostic process, screening instruments may be used. During diagnostic assessment, collateral information and neuropsychological tests have their role. The assessment of frequently occurring comorbidity with other psychiatric disorders, such as mood, anxiety, sleep, personality, and autism spectrum disorders, as well as addiction, is necessary to complete the clinical picture. Also, differential diagnosis is part of the diagnostic process. Finally, the Diagnostic Interview for ADHD in adults (DIVA 2.0), and the Conners Adult ADHD Diagnostic Interview (CAADID) are described and discussed. Instructions for use of the DIVA are given. The adjustments in the DSM-5 criteria for ADHD, and the next edition of DIVA based on the DSM-5 criteria, DIVA-5, are described.

scholarly journals Quantifying and exploring camouflaging in men and women with autism

Autism ◽  
2016 ◽  
Vol 21 (6) ◽  
pp. 690-702 ◽  
Author(s):  
Meng-Chuan Lai ◽  
Michael V Lombardo ◽  
Amber NV Ruigrok ◽  
Bhismadev Chakrabarti ◽  
Bonnie Auyeung ◽  
...  
Keyword(s):  
Social Cognitive ◽  
Autism Diagnostic Observation Schedule ◽  
Autism Spectrum ◽  
Cognitive Effort ◽  
Detection Sensitivity ◽  
Autism Spectrum Quotient ◽  
Adults With Autism ◽  
Men And Women ◽  
Emotion And Memory ◽  
Using Data

Autobiographical descriptions and clinician observations suggest that some individuals with autism, particularly females, ‘camouflage’ their social communication difficulties, which may require considerable cognitive effort and lead to increased stress, anxiety and depression. Using data from 60 age- and IQ-matched men and women with autism (without intellectual disability), we operationalized camouflaging in adults with autism for the first time as the quantitative discrepancy between the person’s ‘external’ behavioural presentation in social–interpersonal contexts (measured by the Autism Diagnostic Observation Schedule) and the person’s ‘internal’ status (dispositional traits measured by the Autism Spectrum Quotient and social cognitive capability measured by the ‘Reading the Mind in the Eyes’ Test). We found that the operationalized camouflaging measure was not significantly correlated with age or IQ. On average, women with autism had higher camouflaging scores than men with autism (Cohen’s d = 0.98), with substantial variability in both groups. Greater camouflaging was associated with more depressive symptoms in men and better signal-detection sensitivity in women with autism. The neuroanatomical association with camouflaging score was largely sex/gender-dependent and significant only in women: from reverse inference, the most correlated cognitive terms were about emotion and memory. The underlying constructs, measurement, mechanisms, consequences and heterogeneity of camouflaging in autism warrant further investigation.

Underestimation of autism spectrum disorders according to DSM-5 criteria: A pilot study

2017 ◽  
Vol 41 (S1) ◽  
pp. S459-S460
Author(s):  
R. Ferrara ◽  
M. Esposito
Keyword(s):  
Autism Diagnostic Observation Schedule ◽  
Autism Spectrum ◽  
Diagnostic Interview ◽  
Two Dimensions ◽  
Three Dimensions ◽  
Dsm 5 ◽  
Autism Diagnostic Interview ◽  
Treatment Centre ◽  
Dsm Iv ◽  
Competing Interest

IntroductionRecent studies on autism concern the number of individuals diagnosed with pervasive developmental disorder (PDD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 autism spectrum disorder (ASD). ASD is diagnosed using the impairments in two dimensions:– the social and communication dimension;– the restricted and repetitive interests and behaviors (RRIB) dimension whereas PDD is diagnosed using impairments in three dimensions.All the studies indicate between 50 and 75% of individuals will maintain diagnoses.ObjectivesThe aim of the study is to quantify how many individuals with previous PDD diagnoses under DSM-IV-TR criteria would maintain a diagnosis of ASD under DSM-5 criteria.MethodsOur sample consists of 23 cases (21 males, 2 female) related to the treatment Centre “Una breccia nel muro” of Rome and Salerno. All the cases previous received a PDD diagnose according to DSM-IV TR criteria. The mean age of cases was 7.7 years. All the cases were diagnosed by our team according to DSM-5 criteria, clinicians also used to make diagnoses: the Autism Diagnostic Observation Schedule-2, the Autism Diagnostic Interview-Revised.ResultsEighty-seven percent of cases with PDD were classified as ASD using DSM-5 criteria. Thirteen percent of cases, that previous received an Asperger diagnose, did not meet the ASD criteria (Fig. 1).ConclusionsDSM-5 criteria may easily exclude cases with high functioning from ASD because they tend to be atypical for ASD according to this study.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Utredning av autismespekterforstyrrelser i BUP – hvor godt samsvar er det mellom instrumenter og endelig klinisk diagnose?

2021 ◽  
Vol 58 (10) ◽  
Author(s):  
Hans Jørgen Berntsen ◽  
◽  
Beate Ørbeck ◽  
Kristin Romvig Øvergaard ◽  
◽  
...  
Keyword(s):  
Classification Accuracy ◽  
Positive Likelihood Ratio ◽  
Autism Diagnostic Observation Schedule ◽  
Autism Spectrum ◽  
Diagnostic Interview ◽  
Lower Sensitivity ◽  
Acceptable Accuracy ◽  
Reliability Sensitivity ◽  
Sensitivity Specificity ◽  
Autism Diagnostic Observation

Background: The Developmental, Dimensional and Diagnostic Interview (3Di) and the Autism Diagnostic Observation Schedule (ADOS-2) may be useful when assessing autism spectrum disorder (ASD), but the accuracy of the Norwegian 3Di is not known. Method: We investigated the classification accuracy of the 3Di and the ADOS-2 in identifying clinically diagnosed ASD in 130 participants (mean age 11 years). Results: We found acceptable accuracy in identifying ASD with both the 3Di and ADOS-2 (sensitivities/specificities > 70 %), and highest accuracy (positive likelihood ratio = 17.12) when combining the two instruments, but this gave lower sensitivity (54 %). Conclusions: The 3Di is useful when assessing ASD, and most accurate when combined with information from the ADOS-2. Clinicians should be aware that some children with ASD may be missed by requiring endorsement from both instruments. Keywords: Autism Diagnostic Observation Schedule, inter-rater reliability, sensitivity, specificity, Developmental, Dimensional and Diagnostic Interview

scholarly journals Predicting the diagnosis of autism in adults using the Autism-Spectrum Quotient (AQ) questionnaire

2016 ◽  
Vol 46 (12) ◽  
pp. 2595-2604 ◽  
Author(s):  
K. L. Ashwood ◽  
N. Gillan ◽  
J. Horder ◽  
H. Hayward ◽  
E. Woodhouse ◽  
...  
Keyword(s):  
Predictive Value ◽  
Autistic Traits ◽  
High Sensitivity ◽  
Autism Diagnostic Observation Schedule ◽  
International Classification Of Diseases ◽  
Autism Spectrum ◽  
Diagnostic Interview ◽  
Self Report ◽  
Autism Spectrum Quotient ◽  
Co Morbidity

BackgroundMany adults with autism spectrum disorder (ASD) remain undiagnosed. Specialist assessment clinics enable the detection of these cases, but such services are often overstretched. It has been proposed that unnecessary referrals to these services could be reduced by prioritizing individuals who score highly on the Autism-Spectrum Quotient (AQ), a self-report questionnaire measure of autistic traits. However, the ability of the AQ to predict who will go on to receive a diagnosis of ASD in adults is unclear.MethodWe studied 476 adults, seen consecutively at a national ASD diagnostic referral service for suspected ASD. We tested AQ scores as predictors of ASD diagnosis made by expert clinicians according to International Classification of Diseases (ICD)-10 criteria, informed by the Autism Diagnostic Observation Schedule-Generic (ADOS-G) and Autism Diagnostic Interview-Revised (ADI-R) assessments.ResultsOf the participants, 73% received a clinical diagnosis of ASD. Self-report AQ scores did not significantly predict receipt of a diagnosis. While AQ scores provided high sensitivity of 0.77 [95% confidence interval (CI) 0.72–0.82] and positive predictive value of 0.76 (95% CI 0.70–0.80), the specificity of 0.29 (95% CI 0.20–0.38) and negative predictive value of 0.36 (95% CI 0.22–0.40) were low. Thus, 64% of those who scored below the AQ cut-off were ‘false negatives’ who did in fact have ASD. Co-morbidity data revealed that generalized anxiety disorder may ‘mimic’ ASD and inflate AQ scores, leading to false positives.ConclusionsThe AQ's utility for screening referrals was limited in this sample. Recommendations supporting the AQ's role in the assessment of adult ASD, e.g. UK NICE guidelines, may need to be reconsidered.

scholarly journals Standardized Diagnostic Instruments for Autism Spectrum Disorders: the Use of ADOS-2 and ADI-R

2021 ◽  
Vol 19 (1) ◽  
pp. 12-24
Author(s):  
A.B. Sorokin ◽  
E.Yu. Davydova ◽  
L.V. Samarina ◽  
E.E. Ermolaeva ◽  
K.Yu. Antokhina ◽  
...  
Keyword(s):  
Autism Spectrum Disorders ◽  
Autism Diagnostic Observation Schedule ◽  
Autism Spectrum ◽  
Diagnostic Interview ◽  
Russian Language ◽  
Diagnostic Methods ◽  
Expert Assessment ◽  
Diagnostic Instruments ◽  
Spectrum Disorders ◽  
Standardized Diagnostic

Standardized diagnostic methods for autism spectrum disorders (ASD) have been internationally used by professionals for diagnosis validation, diagnostic classification for intervention planning, structured collection of behavioral and developmental data as well as stand-alone diagnostic instruments. Recently, two of such instruments — Autism Diagnostic Observation Schedule ADOS-2 and Autism Diagnostic Interview ADI-R — became available in Russian. The article briefly describes both instruments and presents expert assessment of potential and possible limitations of Russian-language ADOS-2 and ADI-R. Preliminary ADOS-2 psychometric data attests to sufficient sensitivity and positive predictive value to be used as an observation instrument. More research is needed to confirm its differential diagnostic ability.

scholarly journals Diagnostic Evaluation of Autism Spectrum Disorders, A Health Professional Survey

2021 ◽  
pp. 357-364
Author(s):  
Khadija Saleem ◽  
Muhammad Sikander Ghayas Khan ◽  
Aayeshah Firdous ◽  
Iqra Naseer ◽  
Amna Rashid ◽  
...  
Keyword(s):  
Rating Scale ◽  
Occupational Therapists ◽  
Autism Diagnostic Observation Schedule ◽  
Autism Spectrum ◽  
Diagnostic Interview ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Dsm V ◽  
International University ◽  
Consensus Diagnosis

Background: Since the prevalence and awareness AutismSpectrum Disorders (ASD) is growing day by day, it is crucial to correctly allocate diagnosis of ASD. According to the guidelines, there should be a multi-agency strategy group for diagnosis of ASD. Aim: To find out the diagnostic practices of ASD among different Health Professionals. Place and Duration of Study: Riphah International University, Lahore campus. The study was conducted from October 2017 till March 2018. Methodology: Data was collected from 116 professionals which included Speech-Language Pathologists, Pediatricians, Psychiatrists, Psychologists and Occupational Therapists by using questionnaire. A cross-sectional survey was carried out by using the technique of convenient sampling. Researcher collected the data from Riphah International University in person and some professionals were sent questionnaires online. Results: Majority of professionals provide diagnostic service i.e. 84.4% as a part of multidisciplinary team whereas 15.6% are sole practitioners for giving diagnosis; 51.1% collaborate with other professionals to make a consensus diagnosis and the most frequently used tool by professionals for diagnosing ASD is Childhood Autism Rating Scale CARS (76.7%) and Diagnostic and Statistical Manual of Mental Disorders V/IV (DSM V OR IV) criteria (67.8%). Conclusion: The professionals in the current study are using multidisciplinary approach for diagnosing ASD and a small number are sole practitioners. The most frequently used tool for diagnosing ASD are CARS and DSM V OR IV criteria. However, very few practitioners use the diagnostic tool Autism Diagnostic Observation Schedule ADOS and Autism Diagnostic Interview-Revised ADI-R. The professionals who provide diagnosis of ASD are Speech and language Pathologists, Psychologists, pediatricians, psychiatrists and Occupational therapists.

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