Journal of Autism and Developmental Disorders

, Volume 30, Issue 4, pp 269–278

Toward a Developmental Operational Definition of Autism

  • Jane E. Gillham
  • Alice S. Carter
  • Fred R. Volkmar
  • Sara S. Sparrow
Article

Abstract

Traditional approaches to diagnosing autism emphasize delays in communication and socialization. Traditional diagnostic schemes typically list symptoms (e.g., lack of eye contact), but provide little guidance on how to incorporate information about developmental level in making a diagnosis. Because standardized measures of adaptive behavior can provide information about children's communication, socialization, and other behavior relative to their age, they may be useful tools for diagnosing autism. This study investigated the ability of the Vineland Adaptive Behavior Scales to identify children with autism. Vineland scores and measures of intellectual functioning were obtained for children with autism, PDDNOS, and other developmental disorders (DD). Discriminant function analyses indicated that the autism and combined nonautism (PDDNOS and DD) groups could be differentiated on the basis of socialization, daily living skills, and serious maladaptive behaviors. Socialization alone accounted for 48% of the variance in diagnosis. Using regression analyses derived from a large normative sample, adaptive behavior scores were predicted from chronological age (CA) and mental age (MA). Socialization scores in the autism group were substantially below the level predicted from CA or MA. An index derived from the ratio of actual to predicted socialization scores correctly classified 86% of both autism and nonautism cases. Findings suggest that comparison of obtained Vineland socialization scores to those predicted by CA or MA may be useful in clarifying the diagnosis of autism.

Autism diagnosis Vineland socialization scores 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.Google Scholar
  2. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., Rev.) Washington, DC: Author.Google Scholar
  3. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.) Washington, DC: Author.Google Scholar
  4. Ando, H., Yoshimura, I., & Wakabayashi, S. (1980). Effects of age on adaptive behavior levels in autistic and mentally retarded children. Journal of Autism and Developmental Disorders, 10, 173–183.Google Scholar
  5. Baily, A., Phillips, W., & Rutter, M. (1996). Autism: Towards an integration of clinical, genetic, neuropsychological, and neurological perspectives. Journal of Child Psychology and Psychiatry, 37, 89–126.Google Scholar
  6. Bishop, D. V. M. (1989). Autism, Asperger's syndrome and semantic-pragmatic disorder: Where are the boundaries? British Journal of Disorders of Communication, 24, 107–121.Google Scholar
  7. Bryson, S. E., Clark, B. S., & Smith, I. M. (1988). First report of a Canadian epidemiological study of autistic syndromes. Journal of Child Psychology and Psychiatry, 29, 433–445.Google Scholar
  8. Burd, L., Fisher, W., & Kerbeshian, J. (1987). A prevalence study of pervasive developmental disorders in North Dakota. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 700–703.Google Scholar
  9. Carter, A. S., Gillham, J. E., Sparrow, S. S., & Volkmar, F. R. (1996). Adaptive behavior in autism. Child and Adolescent Psychiatry Clinics of North America, 5, 945–961.Google Scholar
  10. Carter, A. S., Volkmar, F. R., Sparrow, S. S. Wang, J. J., Lord, C., Dawson, G., Fombonne, E., Loveland, K., Mesibov, G., & Shopler, E. (1998). The Vineland Adaptive Behavior Scales: Supplementary norms for individuals with autism. Journal of Autism and Developmental Disorders, 28, 287–302.Google Scholar
  11. DiLavore, P. C., Lord, C., & Rutter, M. (1995). Pre-linguistic autism diagnostic observation schedule. Journal of Autism and Developmental Disorders, 25, 355–379.Google Scholar
  12. Dykens, E. M., Hodapp, R. M., Walsh, K., & Nash, L. J. (1992). Adaptive and maladaptive behavior in Prader-Willi syndrome. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 1131–1136.Google Scholar
  13. Finucci, J. M., Isaacs, S. D., Whitehouse, C. C. & Childs, B. (1982). Empirical validation of reading and spelling quotients. Developmental Medicine and Child Neurology, 24, 733–744.Google Scholar
  14. Finucci, J. M., Whitehouse, C. C. Isaacs, S. & Childs, B. (1982). Derivation and validation of a quantitative definition of specific reading disability for adults. Developmental Medicine and Child Neurology, 24, 733–744.Google Scholar
  15. Fombonne, E., & du Mazaubrun, C. (1992). Prevalence of infantile autism in four French regions. Social Psychiatry and Psychiatric Epidemiology, 27, 203–210.Google Scholar
  16. Freeman, B. J., Ritvo, E. R., Yokota, A., Childs, J. & Pollard, J. (1988). WISC-R and Vineland Adaptive Behavior Scale scores in autistic children. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 428–429.Google Scholar
  17. Greenspan, S. I. (1990). Comprehensive clinical approaches to infants and their families: Psychodynamic and developmental perspectives. In S. J. Meishels & J. P. Shonkoff (Eds). Handbook of early intervention (pp. 150–172). New York: Cambridge University Press.Google Scholar
  18. Jacobson, J. W., & Ackerman, L. J. (1990). Differences in adaptive functioning among people with autism or mental retardation. Journal of Autism and Developmental Disorders, 20, 205–219.Google Scholar
  19. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.Google Scholar
  20. Kaufman, A. S., & Kaufman, N. L. (1983). Kaufman Assessment Battery for Children. Circle Pines, MN: American Guidance Service.Google Scholar
  21. Klin, A., Lang, J., Cicchetti, D. V. & Volkmar, F. R. (in press). Reliability of clinicians in diagnosing autism: Results of the DSMIV field trial. Journal of Autism and Developmental Disorders, 30, 163–167.Google Scholar
  22. Klin, A., Mayes, L. C., Volkmar, F. R., & Cohen, D. J. (1995). Multiplex developmental disorder. Journal of Developmental and Behavioral Pediatrics, 16, S7-S11.Google Scholar
  23. Kraemer, H. C. (1988). Assessment of 2 × 2 associations and generalization of signal detection methodology. American Statistician, 42, 37–49.Google Scholar
  24. Krug, D. A., Arick, J., & Almond, P. (1980). Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior. Journal of Child Psychology and Psychiatry, 21, 221–229.Google Scholar
  25. Lord, C. (1997). Diagnostic instruments in autism spectrum disorders. In D. J. Cohen & F. R. Volkmar (Eds.), Handbook of autism and pervasive developmental disorders (2nd ed., pp. 195–225). New York: Wiley.Google Scholar
  26. Lord, C., Pickles, A., McLennan, J., Rutter, M. et al. (1997). Diagnosing autism: Analyses from data from the Autism Diagnostic Interview. Journal of Autism and Developmental Disorders, 27, 501–517.Google Scholar
  27. Lord, C., Rutter, M. & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.Google Scholar
  28. Lord, C., & Schopler, E. (1987). Neurobiological implications of sex differences in autism. In E. Schopler & G. Mesibov (Eds.), Neurobiological issues in autism (pp. 191–212). New York: Plenum Press.Google Scholar
  29. Loveland, K. A., & Kelley, M. L. (1988). Development of adaptive behavior in adolescents and young adults with autism and Down Syndrome. American Journal of Mental Retardation, 93, 84–92.Google Scholar
  30. Loveland, K. A., & Kelley, M. L. (1991). Development of adaptive behavior in preschoolers with Autism or Down Syndrome. American Journal of Mental Retardation, 96, 13–20.Google Scholar
  31. Matson, J. L., Baglio, C. S., Smiroldo, B. B., & Hamilton, M. (1996). Characteristics of autism as assessed by the Diagnostic Assessment for the Severely Handicapped-II (DASH-II). Research in Developmental Disabilities, 17, 135–143.Google Scholar
  32. Rodrigue, J. R., Morgan, S. B., & Gefken, G. R. (1991). A comparative evaluation of adaptive behavior in children and adolescents with autism, Down syndrome, and normal development. Journal of Autism and Developmental Disorders, 21, 187–198.Google Scholar
  33. Schatz, J., & Hamdan-Allen, G. (1995). Effects of age and IQ on adaptive behavior domains for children with autism. Journal of Autism and Developmental Disorders, 25, 51–60.Google Scholar
  34. Schopler, E., Reichler, R. J., & Renner, B. R. (1988). The Child Autism Rating Scale (CARS). Los Angeles, CA: Western Psychiatric Services.Google Scholar
  35. Siegel, B., Vukicevic, J., Elliott, G. R. & Kraemer, H. C. (1989). The use of signal detection theory to assess DSM-III-R criteria for autistic disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 542–548.Google Scholar
  36. Sloan, J. L., & Marcus, L. (1981). Some findings on the use of the Adaptive Behavior Scale with autistic children. Journal of Autism and Developmental Disorders, 11, 191–199.Google Scholar
  37. Sparrow, S. S., Balla, D. & Cicchetti, D. V. (1984). Vineland Adaptive Behavior Scales (Survey Form). Circle Pines, MN: American Guidance Service.Google Scholar
  38. Sroufe, L. A., & Rutter, M. (1984). The domain of developmental psychopathology. Child Development, 55, 17–29.Google Scholar
  39. Sverd, J., Sheth, R., Fuss, J., & Levine, J. (1995). Prevalence of pervasive developmental disorder in a sample of psychiatrically hospitalized children and adolescents. Child Psychiatry and Human Development, 25, 221–240.Google Scholar
  40. Volkmar, F. R., Carter, A., Sparrow, S. S., & Cicchetti, D. V. (1993). Quantifying social development in autism. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 627–632.Google Scholar
  41. Volkmar, F. R. & Cohen, D. J. (1988). Diagnosis of pervasive developmental disorders. In B. Lahey & A. Kazdin (Eds.), Advances in clinical child psychology (Vol. 11, pp. 249–284). New York: Plenum Press.Google Scholar
  42. Volkmar, F. R., Klin, A., Siegel, B., Szatmari, P., Lord, C., Campbell, M., Freeman, B. J., Cicchetti, D. V., Rutter, M., Kline, W., Buitelar, J., Hattab, Y., Fombonne, E., Fuentes, J., Werry, J., Stone, W., Kerbeshian, J., Hoshino, Y., Bregman, J., Loveland, K., Szymanski, L., & Towbin, K. (1994). Field trial for autistic disorder in DSM-IV. American Journal of Psychiatry, 151, 1361–1367.Google Scholar
  43. Volkmar, F. R., Sparrow, S. S., Goudreau, D., Cicchetti, D. V., Paul, R. & Cohen, D. J. (1987). Social deficits in autism: An operational approach using the Vineland Adaptive Behavior Scales. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 156–161.Google Scholar
  44. Wechsler, D. (1991). Manual for the Wechsler Intelligence Scale for Children-Third Edition (WISC-III). San Antonio, TX: Psychological Corp.Google Scholar
  45. World Health Organization. (1993). The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: Author.Google Scholar
  46. Yule, W., & Rutter, M. (1985). Reading and other learning difficulties. In M. Rutter & L. Hersov (Eds.), Child and adolescent psychiatry: Modern approaches (2nd ed., pp. 444–464). Blackwell: Oxford.Google Scholar

Copyright information

© Plenum Publishing Corporation 2000

Authors and Affiliations

  • Jane E. Gillham
    • 1
  • Alice S. Carter
    • 2
    • 3
  • Fred R. Volkmar
    • 3
  • Sara S. Sparrow
    • 3
  1. 1.University of Pennsylvania, Philadelphia, and Swarthmore CollegeUSA
  2. 2.University of Massachusetts—Boston
  3. 3.Yale Child Study CenterYale UniversityNew Haven

Personalised recommendations