Replication study of <scp>ADOS</scp>‐2 Toddler Module cut‐off scores for autism spectrum disorder classification

Hong, John J; Singh, Vini; Kalb, Luke; Ashkar, Ahlam; Landa, Rebecca

doi:10.1002/aur.2496

Cited by 16 publications

(15 citation statements)

References 48 publications

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“… 17 There have been multiple studies demonstrating the clinical utility and accuracy of the ADOS-2 across national and international samples. 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 However, to our knowledge, there have only been 2 studies examining ADOS measurement bias at the item level, using item response theory (IRT), by sex and/or race. Specifically, Harrison et al 16 investigated the role of race, ethnicity, and sex on 10 items of the ADOS-Generic.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Race and Sex Bias in the Autism Diagnostic Observation Schedule (ADOS-2)

et al. 2022

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Key Points Question Is a reference standard measure of autism spectrum disorder (ASD), the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), systematically biased across sex and race? Findings In this cross-sectional study of 6269 children evaluated at an ASD specialty clinic in the US, 11% of ADOS-2 diagnostic items demonstrated bias for Black/African American vs White children and for female vs male children. The magnitude of bias was moderate to large for only 2 repetitive/restricted behavior interest items. Meaning Although the ADOS-2 demonstrated minimal bias overall, these findings suggest that further research is needed to address some evidence of underdetection of ASD symptoms in Black/African American children and female children.

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Section: Introductionmentioning

confidence: 99%

Analysis of Race and Sex Bias in the Autism Diagnostic Observation Schedule (ADOS-2)

et al. 2022

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“…Our findings show that TDAS ≥20 points yielded high accuracy (82.05%), sensitivity (82.86%), and specificity (80.39%) for ASD diagnosis. Compared to a recent study to find the optimal cut-off point for ADOS-2 in toddlers aged 12–30 months old in the US, the cut-off points were 12 and 10 based on Algorithms 1 and 2, respectively (Algorithm 1 for toddlers aged 12–20 months old or 21–30 months with <5 words and Algorithm 2 for toddlers aged 21–30 months old with ≥5 words) [ 30 ]. The sensitivity values were 98.31% and 95.65%, the specificity values were 75.41% and 84.78%, and the accuracy values were 93.60 and 91.30 for Algorithms 1 and 2, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Other than the TDAS score, our findings show that the age of the children was independently associated with ASD. As shown in a recent study in the US, cut-off points for toddlers were different between each age group [ 30 ]. However, the researchers did not attempt to find the optimal cut-off point for the subgroups due to the limited number of children in each age range.…”

Section: Discussionmentioning

confidence: 99%

The Optimal Cut-Off Point for Thai Diagnostic Autism Scale and Probability Prediction of Autism Spectrum Disorder Diagnosis in Suspected Children

et al. 2022

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The Thai Diagnostic Autism Scale (TDAS) was developed to diagnose autism spectrum disorder (ASD) under the context and characteristics of the Thai population. Although the tool has an excellent agreement, the interpretation of diagnostic results needs to rely on the optimal cut-off point to maximize efficiency and clarity. This study aims to find an optimal cut-off point for TDAS in the diagnosis of ASD and to compare its agreement with the DSM-5 ASD criteria. This study was conducted on 156 children aged 12–48 months old who were suspected of having ASD and had enrolled from hospitals in the four regions of Thailand in 2017–2018. The optimal cut-off point for TDAS was considered by using receiver operating characteristic (ROC) curves according to the DSM-5 ASD criteria. The areas under the curve (AUCs) for TDAS and ADOS-2 were also compared. Multivariable logistic regression was performed to create a predictive model for the probability of ASD. The AUC of TDAS was significantly higher than that of ADOS-2 (0.8748 vs. 0.7993; p = 0.033). The optimal cut-off point for TDAS was ≥20 points (accuracy = 82.05%, sensitivity = 82.86%, and specificity = 80.93%). Our findings show that TDAS with a cut-off point can yield higher diagnostic accuracy than ADOS-2 and TDAS domain. Diagnosis by using this cut-off point could be useful in practical assessments.

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“…The ADOS-2 has become more internationally accessible, driven by increased ASD awareness as well as the efforts to administer the ADOS-2 in different countries [ 13 ]. Currently, the ADOS-2 has been translated into more than 20 languages [ 14 ], and the clinical validity of the ADOS-2 has been well-established in various international samples [ 15 ]. Previous studies have underscored that ASD diagnostic instruments developed in Western countries can be properly translated and adapted in non-Western countries [ 13 , 16 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic validity of Autism Diagnostic Observation Schedule, second edition (K-ADOS-2) in the Korean population

Kim

Bong

et al. 2022

Molecular Autism

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Background Although the Korean version of the Autism Diagnostic Observation Schedule-2 (K-ADOS‐2) is widely being used to diagnose autism spectrum disorder (ASD) in South Korea, no previous study has examined the validity and reliability of all modules of K-ADOS-2 across a wide age range, particularly older children, adolescents, and adults. Method Data from 2,158 participants were included (mean age = 79.7 months; 73.6% male): 1473 participants with ASD and 685 participants without ASD (Toddler Module, n = 289; Module 1, n = 642; Module 2 n = 574; Module 3 n = 411; Module 4, n = 242). Participants completed a battery of tests, including the K-ADOS or K-ADOS-2 and other existing diagnostic instruments. Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, positive predictive value (PPV), negative predictive value (NPV), Cohen’s kappa (k), and agreement with existing diagnostic instruments were computed. Cronbach’s α values were also calculated. Results All developmental cells of the K-ADOS-2 showed sufficient ranges of sensitivity 85.4–100.0%; specificity, 80.4–96.8%; area under the ROC curve, .90-.97; PPV, 77.8–99.3%; NPV, 80.6–100.0%; and k values, .83–.92. The kappa agreements of developmental cells with existing diagnostic instruments ranged from .20 to .90. Cronbach’s α values ranged from .82 to .91 across all developmental cells. Limitation The best-estimate clinical diagnoses made in this study were not independent of the K-ADOS-2 scores. Some modules did not include balanced numbers of participants in terms of gender and diagnostic status. Conclusion The K-ADOS-2 is a valid and reliable instrument in diagnosing ASD in South Korea. Future studies exploring the effectiveness of the K-ADOS-2 in capturing restricted, repetitive behaviors and differentiating ASD from other developmental disabilities are needed.

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Replication study of ADOS‐2 Toddler Module cut‐off scores for autism spectrum disorder classification

Cited by 16 publications

References 48 publications

Analysis of Race and Sex Bias in the Autism Diagnostic Observation Schedule (ADOS-2)

Analysis of Race and Sex Bias in the Autism Diagnostic Observation Schedule (ADOS-2)

The Optimal Cut-Off Point for Thai Diagnostic Autism Scale and Probability Prediction of Autism Spectrum Disorder Diagnosis in Suspected Children

Diagnostic validity of Autism Diagnostic Observation Schedule, second edition (K-ADOS-2) in the Korean population

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