Examining the Role of Race, Ethnicity, and Gender on Social and Behavioral Ratings Within the Autism Diagnostic Observation Schedule
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The Autism Diagnostic Observation Schedule (ADOS) is widely used to assess symptoms of autism spectrum disorder (ASD). Given well-documented differences in social behaviors across cultures, this study examined whether item-level biases exist in ADOS scores across sociodemographic groups (race, ethnicity, and gender). We examined a subset of ten ADOS items among participants (N = 2458). Holding level of overall ADOS behavioral symptoms constant, we found significant item level bias (measurement noninvariance) for race and ethnicity on three ADOS items. Item-level bias was not apparent across gender. Although the magnitude of bias was small, our findings highlight the need to reevaluate norms and operational definitions used in assessments to increase ASD diagnostic accuracy among culturally-diverse groups.
KeywordsAutism spectrum disorder Cross-cultural Social norms ADOS Measurement bias Race Ethnicity
Ashley J. Harrison’s work on this project was supported by a NIMH T32 fellowship to (5T32MH019927_20). The authors would like to express their appreciation to the following students for their help with this project and manuscript, Margaret Naughton, Rebecca Miller, and Alejandra Perez-Ramirez and the families that participated in the Simons Simplex Collection data set.
AJH and RNJ conceived of the study and designed the study. AJH requested SSC data access. RNJ and DCT performed the statistical analysis and the provided the written interpretation of the data analyses. AJH and KAL helped interpret the data and aided in contextualizing the findings in the cross-cultural literature. All authors drafted and revised the manuscript.
Compliance with Ethical Standards
Conflict of interests
All the authors declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all participants included in the study.
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