Journal of Autism and Developmental Disorders

, Volume 48, Issue 5, pp 1780–1791 | Cite as

Identifying Autism with a Brief and Low-Cost Screening Instrument—OERA: Construct Validity, Invariance Testing, and Agreement Between Judges

  • Cristiane S. Paula
  • Graccielle Rodrigues Cunha
  • Daniela Bordini
  • Decio Brunoni
  • Ana Claudia Moya
  • Cleonice Alves Bosa
  • Jair J. Mari
  • Hugo Cogo-Moreira
Original Paper


Simple and low-cost observational-tools to detect symptoms of Autism Spectrum Disorder (ASD) are still necessary. The OERA is a new assessment tool to screen children eliciting observable behaviors with no substantial knowledge on ASD required. The sample was 99 children aged 3–10: 76 with ASD and 23 without ASD (11/23 had intellectual disability). The 13 remained items exhibited high interrater agreement and high reliability loaded onto a single latent trait. Such model showed excellent fit indices evaluated via confirmatory factor analysis and no item showed differential function in terms of age/sex/IQ. A cutoff of five points or higher resulted in the highest sensitivity (92.75) and specificity (90.91) percentages. OERA is a brief, stable, low-cost standardized observational-screening to identify ASD children.


Autism Screening Construct validity Sensitivity Specificity Public health 



This study was funded by the State of São Paulo Funding Agency-FAPESP under a special agreement with Maria Cecília Souto Vidigal Foundation [Grant No. 2012/51584-0], and by the National Research Council—CNPQ [Grant No. 401468/2010-0]. CSP and JJM are researchers from the National Research Council (CNPQ).

Author Contributions

CSP conceived of the study, participated in its design, coordination, data collection, interpretation of data, and drafted the manuscript; GRC was one of the expert clinicians responsible for the ASD diagnosis, helped in the statistical analysis, and helped to draft the manuscript; DB was one of the expert clinicians responsible for the ASD diagnosis; participated in the study design, and helped to draft the manuscript; DB was one of the expert clinicians responsible for the ASD diagnosis, and helped to coordinate the data collection; ACM helped to coordinate the data collection, and participated in the interpretation of data; CAB was responsible for the ADI-R evaluations, and helped to draft the manuscript; JJM participated in the coordination of the study, and helped to draft the manuscript; HCM performed statistical analysis, and helped to draft the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the two institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Cristiane S. Paula
    • 1
    • 2
  • Graccielle Rodrigues Cunha
    • 2
  • Daniela Bordini
    • 2
  • Decio Brunoni
    • 1
    • 3
  • Ana Claudia Moya
    • 2
  • Cleonice Alves Bosa
    • 4
  • Jair J. Mari
    • 2
  • Hugo Cogo-Moreira
    • 2
  1. 1.Development Disorders ProgramMackenzie UniversitySão PauloBrazil
  2. 2.Departament of PsychiatryFederal University of Sao Paulo (UNIFESP)São PauloBrazil
  3. 3.Departament of GeneticsFederal University of Sao Paulo (UNIFESP)São PauloBrazil
  4. 4.Deparment of PsychologyUniversidade Federal do Rio Grande do SulPorto AlegreBrazil

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