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Autism Spectrum Disorder in the DSM-5: Diagnostic Sensitivity and Specificity in Early Childhood

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Abstract

Changes to the DSM-5 Autism Spectrum Disorder (ASD) criteria raised concerns among parents and practitioners that the criteria may exclude some children with Pervasive Developmental Disorder (PDD). Few studies have examined DSM-5 sensitivity and specificity in children less than 5 years of age. This study evaluated 185 children aged 20–55 months with DSM-IV PDD or developmental delay. Autism Diagnostic Interview—Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) data was assigned to DSM-5 subdomains. Children displaying the required symptomatology were classified with DSM-5 ASD. DSM-IV clinical diagnoses were compared to DSM-5 classifications. Using combined ADI-R/ADOS information, sensitivity was .84 and specificity was .54. Comorbid behaviour and emotional problems were significantly lower in children with PDD that did not meet DSM-5 criteria.

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Acknowledgments

This study utilised data collected as part of a project funded by the National Health and Medical Research Council of Australia, awarded to A/Prof Kylie Gray and Prof Bruce Tonge. The authors thank the families who participated in the project and the research team who assisted with data collection—Deborah Sweeney, Dr Helen Jeges, Caroline Keating, Dr Erin Mooney, and Dr Sally Herring. A preliminary version of the paper was orally presented at the Australasian Society for Autism Research (ASfAR) Conference, Bundoora, Australia in December 2014.

Author Contributions

JAC contributed to the coordination of the study, completed statistical analyses with JT and drafted the manuscript; KMG designed and coordinated the study, acquired the original data, and participated in the writing of the manuscript; JT performed the statistical analyses; BJT participated in the data collection and design of the study, and reviewed the manuscript. All authors read and approved the final manuscript.

Funding

The collection of the data used in this study was funded by the National Health and Medical Research Council of Australia (Project Number 236834), awarded to Kylie M. Gray and Bruce J. Tonge.

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Authors and Affiliations

  1. Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, VIC, Australia

    Jessica A. Christiansz, Kylie M. Gray, John Taffe & Bruce J. Tonge

  2. Centre for Developmental Psychiatry and Psychology, Early in Life Mental Health Services, Monash Medical Centre, 246 Clayton Rd, Clayton, VIC, 31768, Australia

    Kylie M. Gray

Authors
  1. Jessica A. Christiansz
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  2. Kylie M. Gray
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  3. John Taffe
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  4. Bruce J. Tonge
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Correspondence to Kylie M. Gray.

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The authors declare that they have no conflict of interest.

Ethical Approval

This study was granted approval from the Monash University Human Research Ethics Committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained at the time of assessment from all parents of participants included in the study.

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Christiansz, J.A., Gray, K.M., Taffe, J. et al. Autism Spectrum Disorder in the DSM-5: Diagnostic Sensitivity and Specificity in Early Childhood. J Autism Dev Disord 46, 2054–2063 (2016). https://doi.org/10.1007/s10803-016-2734-4

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