Systematic Review and Meta-Analysis of the Clinical Utility of the ADOS-2 and the ADI-R in Diagnosing Autism Spectrum Disorders in Children

Lebersfeld, Jenna B.; Swanson, Marissa; Clesi, Christian D.; O’Kelley, Sarah

doi:10.1007/s10803-020-04839-z

Cited by 46 publications

(34 citation statements)

References 51 publications

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“…The sensitivity analysis using only the NICE guideline standard ASD clinical assessment data gave a sensitivity of 88% (77%, 95%) and a specificity of 81% (70%, 90%). These perform as well as recent published systematic review data from the ADI-R, which quote overall figures of 75% and 82%, respectively (Lebersfeld et al, 2021).…”

Section: Resultssupporting

confidence: 83%

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Adapting and validating the Autism Diagnostic Interview - Revised for use with deaf children and young people

Wright

Phillips

Allgar

et al. 2021

Autism

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A Delphi consensus methodology was used to adapt the Autism Diagnostic Interview–Revised for the assessment of deaf children with suspected autism spectrum disorder. Each Autism Diagnostic Interview–Revised item was considered by a panel of nine international experts in terms of relevance and acceptability. Modifications were proposed and agreed by the expert panel for 45% of items. The pre-specified criterion for agreement between experts was set at 80% for each item. A first validation of the revised version, adapted for deaf children (Autism Diagnostic Interview–Revised Deaf Adaptation), was undertaken with a UK sample of 78 parents/carers of deaf children with autism spectrum disorder and 126 parents/carers with deaf children without autism spectrum disorder. When compared to National Institute for Health and Care Excellence guideline standard clinical assessments, the Autism Diagnostic Interview–Revised Deaf Adaptation diagnostic algorithm cut-off/threshold scores achieved a sensitivity of 89% (79%–96%) and specificity of 81% (70%–89%) for autism spectrum disorder. The alpha coefficients for each algorithm symptom domain ranged from 0.80 to 0.91, suggesting that the items had high internal consistency. Our findings indicate that the Autism Diagnostic Interview–Revised Deaf Adaptation is likely to be a useful measure for the assessment of deaf children with suspected autism spectrum disorder, although further research is needed. Lay abstract Autism assessment processes need to improve for deaf children as they are currently being diagnosed later than their hearing counterparts and misdiagnosis can occur. We took one of the most commonly used parent developmental interviews for autism spectrum disorder the Autism Diagnostic Interview–Revised and adapted it using international expert advice. Modifications were proposed and agreed by the expert panel for 45% of items; the remaining 55% of items were unchanged. We then tested the revised version, adapted for deaf children (Autism Diagnostic Interview–Revised Deaf Adaptation), in a UK sample of 78 parents/carers of deaf children with autism spectrum disorder and 126 parents/carers with deaf children without autism spectrum disorder. When compared to National Institute for Health and Care Excellence guideline standard clinical assessments, the Autism Diagnostic Interview–Revised Deaf Adaptation diagnostic algorithm threshold scores could identify those deaf children with a definite diagnosis (true autism spectrum disorder positives) well (sensitivity of 89% (79%–96%)) and those deaf children who did not have autism spectrum disorder (true autism spectrum disorder negatives) well (specificity of 81% (70%–89%)). Our findings indicate that the Autism Diagnostic Interview–Revised Deaf Adaptation is likely to prove a useful measure for the assessment of deaf children with suspected autism spectrum disorder and that further research would be helpful.

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Section: Resultssupporting

confidence: 83%

“…b 'Verbal/signing' defined as functional use of three word/sign phrases (see Item 30 ADI-R Deaf Adaptation (2020)). quote overall figures of 75% and 82%, respectively (Lebersfeld et al, 2021).…”

Section: Validation Resultsmentioning

confidence: 99%

Adapting and validating the Autism Diagnostic Interview - Revised for use with deaf children and young people

Wright

Phillips

Allgar

et al. 2021

Autism

View full text Add to dashboard Cite

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“…Despite having some options for remote assessment, many groups expressed interest in continuing to administer the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2; Lord, Rutter, et al, 2012 ; Lord, Luyster, et al, 2012 ) with modifications, likely due to its widespread use and number of clinicians trained to administer it. The ADOS-2 also boasts a strong empirical base (Lebersfeld et al, 2021 ), the ability to assess individuals across the age span, and had previously been required by many insurance providers to ensure coverage of medical services. However, standard administration of the ADOS-2 was not possible during the pandemic, and the adaptations needed altered the social environment when administered in-person while wearing face masks or using barrier shields.…”

Section: Telehealth Asd Assessment Measuresmentioning

confidence: 99%

The Brief Observation of Symptoms of Autism (BOSA): Development of a New Adapted Assessment Measure for Remote Telehealth Administration Through COVID-19 and Beyond

Dow

Holbrook

Toolan

et al. 2021

J Autism Dev Disord

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Interest in telehealth assessment for autism has increased due to COVID-19 and subsequent expansion of remote psychological services, though options that are easy for clinicians to adopt and available through the lifespan are limited. The Brief Observation of Symptoms of Autism (BOSA) provides a social context with standardized materials and activities that can be coded by clinicians trained in the Autism Diagnostic Observation Schedule. The current project examined psychometric properties to determine optimal use for each BOSA version. Three hundred and seven participants with 453 BOSAs were included to determine best performing items for algorithms, validity, sensitivity, specificity, recommended cut-offs, and proposed ranges of concern. While preliminary, the BOSA provides a promising new option for telehealth-administered assessment for autism.

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“…While health professionals generally consider standardised diagnostic tools to be helpful (e.g. Rogers et al, 2015), in practice, the sensitivity and specificity of these measures vary (Dorlack et al, 2018;Lebersfeld et al, 2021). There are also some populations, such as those with psychiatric conditions, in which these measures yield false positives (Maddox et al, 2017), and a subset of children with neurodevelopmental conditions that share features of autism, such as Attention Deficit Hyperactivity Disorder, meet autism spectrum cutoffs on the ADOS-2 and the ADI-R despite not meeting full diagnostic criteria for autism (Grzadzinski et al, 2016).…”

Section: Use Of Standardised Assessments Of Asd Symptomsmentioning

confidence: 99%

An investigation of adherence to best practice guidelines for autism diagnosis in New Zealand

Taylor

Eggleston

Thabrew

et al. 2021

Autism

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Recent studies of autism diagnosis in New Zealand have revealed inconsistent implementation of best practice standards in autism assessment and high rates of parental dissatisfaction with the diagnostic process. These findings have arisen despite the development and dissemination of the New Zealand Autism Spectrum Disorder Guideline (the Guideline). In this study, we investigated current diagnostic processes, and adherence to the Guideline in New Zealand, for an opportunity sample of 117 health professionals who practice across a wide range of diagnostic services, health professionals and geographic regions in New Zealand. The results show considerable variability in practice, and suggest specific areas for improvement. These include the robustness of diagnostic evaluations conducted in private settings, the provision of specialist assessment services for youth and adults presenting for autism diagnosis, and the uniformity of post-diagnostic supports and services. These findings have implications for further implementation of the Guideline in New Zealand. Lay abstract Many clinicians in New Zealand do not follow guidelines for best practice in autism diagnosis. In this study, we investigated the processes that health professionals in New Zealand follow when diagnosing autistic children and adults. We asked 117 health professionals from a range of services and regions in New Zealand, how they identify and diagnose autism. We found that there are differences in the way that clinicians in New Zealand diagnose autism. We identified areas in which autism diagnosis in New Zealand could be improved, for example, by establishing more services to diagnose autism in adolescents and adults, and providing more consistent support after a person is diagnosed with autism. These findings will help to improve autism diagnosis in New Zealand.

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Systematic Review and Meta-Analysis of the Clinical Utility of the ADOS-2 and the ADI-R in Diagnosing Autism Spectrum Disorders in Children

Cited by 46 publications

References 51 publications

Adapting and validating the Autism Diagnostic Interview - Revised for use with deaf children and young people

Adapting and validating the Autism Diagnostic Interview - Revised for use with deaf children and young people

The Brief Observation of Symptoms of Autism (BOSA): Development of a New Adapted Assessment Measure for Remote Telehealth Administration Through COVID-19 and Beyond

An investigation of adherence to best practice guidelines for autism diagnosis in New Zealand

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