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Agreement Among Four Diagnostic Instruments for Autism Spectrum Disorders in Toddlers

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Abstract

Autistic spectrum disorders (ASD) can be difficult to diagnose in toddlers. This study compared diagnostic measures (ADOS-G, ADI-R, CARS, and clinical judgment using DSM-IV criteria) applied to toddlers. Results indicated that the ADOS-G, CARS, and clinical judgment agreed with each other but not with the ADI-R. Many of the children classified with ASD by the other measures were not classified with autism by the ADI-R because they did not display enough repetitive behaviors and stereotyped interests. These results indicate that young children with ASD may not display repetitive behaviors and stereotyped interests, and for toddlers, the ADI-R would have a higher sensitivity if revised to include a diagnosis of PDD-NOS, for which the requirement of repetitive behaviors is less stringent.

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Notes

  1. Since the majority of children received the ADI-R and because the ADI-R and Toddler Form use identical scoring algorithms, for ease of reading, the authors will jointly refer to these instruments as ADI-R.

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Acknowledgments

This research was supported by the University of Connecticut’s Research Foundation Faculty Grant, National Alliance of Autism Research, National Institute of Child Health and Human Development (5 R01 HD039961), Maternal and Child Health Bureau (R40 MC 00270). We are very grateful to the children and families who participated in this research, as well as the doctors and early intervention sites that screened the children. We would also like to acknowledge the invaluable assistance of the undergraduate research assistants.

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Correspondence to Pamela E. Ventola.

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Ventola, P.E., Kleinman, J., Pandey, J. et al. Agreement Among Four Diagnostic Instruments for Autism Spectrum Disorders in Toddlers. J Autism Dev Disord 36, 839–847 (2006). https://doi.org/10.1007/s10803-006-0128-8

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