Journal of Autism and Developmental Disorders

, Volume 49, Issue 9, pp 3732–3752 | Cite as

Developing a Diagnostic Algorithm for the Music-Based Scale for Autism Diagnostics (MUSAD) Assessing Adults with Intellectual Disability

  • Thomas BergmannEmail author
  • Manuel Heinrich
  • Matthias Ziegler
  • Isabel Dziobek
  • Albert Diefenbacher
  • Tanja Sappok
Original Paper


Initial studies have presented the Music-based Scale for Autism Diagnostics (MUSAD) as a promising DSM-5-based observational tool to identify autism spectrum disorder (ASD) in adults with intellectual disability (ID). The current study is the first to address its clinical utility in a new sample of 124 adults with ID (60.5% diagnosed with ASD). The derived diagnostic algorithm differentiated well between individuals with and without ASD (sensitivity 79%, specificity 74%, area under the curve = 0.81). Inter-rater reliability, assessed by the scorings of four independent experts in 22 consensus cases, was excellent (ICC = 0.92). Substantial correlations with scores from other ASD-specific measures indicated convergent validity. The MUSAD yields accurate and reliable scores, supporting comprehensive ASD diagnostics in adults with ID.


Autism spectrum disorder Diagnostic Intellectual disability Adults Music 



We are grateful to the participants, their families and their caregivers for supporting the study. We wish to thank Heika Kaiser for performing the psychometric evaluations (SCQ, PDD-MRS, ADOS, and ADI-R) and our hospital staff for supporting our research projects. In particular, we would like to thank Agnes Burghardt and Silke Reimer for scoring several MUSAD assessments and Joana Birkner for performing the data collection and for her support in the data analysis.

Authors’ Contribution

TB initiated the study, participated in its design and coordination, and drafted the manuscript. MH performed the statistical analysis, participated in the interpretation of data, and helped to draft the manuscript. MZ supervised the performance of the statistical procedures and helped to draft the Methods section. ID participated in the design of the study and helped to streamline the manuscript. AD collaborated on study coordination and critically reviewed the manuscript. TS participated in the design of the study and the interpretation of the results and drafted the Discussion section. All authors have read and approved the final manuscript.


This research was supported in part by Stiftung Irene, gemeinnützige Stiftung zum Wohle autistischer Menschen, Hamburg, Germany. The foundation has had no influence on the design of the study, the writing of the manuscript, or the publication process.

Compliance with Ethical Standards

Conflict of interest

None of the authors or other persons involved in this study have any interests that might be interpreted as influencing the research.

Ethical Approval

All data were acquired in a routine patient-care setting according to the legal requirements of the local hospital law. All procedures were performed in accordance with the Ethical Standards of the Institutional Research Committee and with the 1964 Declaration of Helsinki and its later amendments, or with comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study or from their legal guardians.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Evangelisches Krankenhaus Königin Elisabeth HerzbergeBerlinGermany
  2. 2.Division of Clinical-Psychological Intervention, Department of Education and PsychologyFreie Universität BerlinBerlinGermany
  3. 3.Faculty of Life Sciences/Department of PsychologyHumboldt-Universität zu BerlinBerlinGermany
  4. 4.Berlin School of Mind and BrainHumboldt-Universität zu BerlinBerlinGermany

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