International Meeting for Autism Research: Diagnosis of Autism Utilizing the ADOS and ADI-R: Are There Factors to Account for Discrepancies?

Diagnosis of Autism Utilizing the ADOS and ADI-R: Are There Factors to Account for Discrepancies?

Friday, May 13, 2011
Elizabeth Ballroom E-F and Lirenta Foyer Level 2 (Manchester Grand Hyatt)
3:00 PM
C. L. Grantham1, M. W. Gower2, M. K. McCalla2, A. N. Harris2, S. E. O'Kelley3 and K. C. Guest4, (1)University of Alabama at Birmingham, Athens, AL, (2)University of Alabama at Birmingham, Birmingham, AL, (3)UAB Civitan-Sparks Clinics, Birmingham, AL, United States, (4)Psychology, University of Alabama at Birmingham, Birmingham, AL
Background:  Past experimental findings show that using a combination of both the ADOS and the ADI-R is more effective when making a clinical diagnosis than using a single instrument (Risi et al, 2006).  There is often a higher sensitivity on the ADOS when compared to the ADI-R regarding final clinical diagnosis (Gray, 2008).  The present study seeks to identify specific factors that may account for the lower sensitivity in the ADI-R.  The ADI-R manual recommends that the informant be a parent or caregiver who has known the child through their preschool years, but this is not always possible as some children have been placed in a setting that does not provide this type of informant. Thus the relationship between type of caregiver and ADI-R reports and scores will be explored.  Given the diversity of children and families seen in typical practice, it is important to explore and understand the impact of "real world" variables on these assessment tools to assist clinicians in better understanding how to utilize these results.  Additional factors related to the respondent/caregiver, such as their age, race, and level of education will be examined along with child factors, such as age and race.  The study will also examine the number of children in the home, and the number of children in the home with developmental disabilities as additional factors contributing to the discrepancies in ADOS and ADI-R reports.

Objectives:  To improve the understanding of any discrepancies between the two “gold standard measurements” (Lord et al., 2000; Lord et al., 2001) used for diagnosing autism and the factors that may influence these discrepancies. 

Methods:  Both the ADOS and the ADI-R were performed as part of an autism evaluation at an interdisciplinary autism clinic.  The final diagnosis was made based on team discussion of clinical impressions and scores on related tests.  

Results:   Based on initial data analysis (N = 131; mean age = 5.3 years), it has been determined that there is a discrepancy between the ADI-R and ADOS in 15% of the cases, and it is predicted that respondent and child characteristics will be related to these discrepancies in the larger sample.  Research is still being completed for this study.   

Conclusions: The results of this study will potentially produce a clarified understanding of any discrepancies between the two “gold standard measurements” (Lord et al., 2000; Lord et al., 2001) used for diagnosing autism.  The factors that may influence these discrepancies, such as maternal education level or number of children in the home with developmental disabilities,  would be clinically useful in determining which test to put more emphasis on for diagnosis when these discrepancies are present, particularly if any known mitigating factors are present.

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