Skip to main content
Log in

Brief Report: Excluding the ADI-R Behavioral Domain Improves Diagnostic Agreement in Toddlers

  • Brief Report
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Past research shows poor agreement between the Autism Diagnostic Interview-Revised (ADI-R) and other diagnostic measures in toddlers. Our goal was to examine whether exclusion of the ADI-R behavioral domain results in improved diagnostic agreement. Toddlers aged 16–37 months (= 26 months) received an evaluation because they failed the Modified Checklist for Autism in Toddlers (n = 142). Evaluations included the ADI-R, Autism Diagnostic Observation Schedule, Childhood Autism Rating Scale, and clinical judgment. Results found poor to fair agreement between the ADI-R and other measures; agreement improved when the ADI-R behavioral domain was excluded. These findings suggest that stereotyped interests and behaviors are not as relevant to the ADI-R as other diagnostic criteria when evaluating toddlers for autism spectrum disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  • American Academy of Pediatrics. (2001). The pediatrician’s role in the diagnosis and management of autism spectrum disorder in children. Pediatrics, 107, 1221–1226.

    Article  Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistics manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.

  • Bishop, D., & Norbury, C. (2002). Exploring the borderlands of autistic disorder and specific language impairment: a study using standardized diagnostic instruments. Journal of Child Psychology and Psychiatry, 43, 917–929.

    Article  PubMed  Google Scholar 

  • Cicchetti, D. V. (1988). When diagnostic agreement is high, but reliability is low: Some paradoxes occurring in joint independent neuropsychology assessments. Journal of Clinical and Experimental Neuropsychology, 10, 605–622.

    Article  PubMed  Google Scholar 

  • Cicchetti, D. V. (2001). The precision of reliability and validity estimates re-visited: Distinguishing between clinical and statistical significance of sample size requirements. Journal of Clinical and Experimental Neuropsychology, 23, 695–700.

    Article  PubMed  Google Scholar 

  • Cox, A., Klein, K., Charman, T., Baird, G., Baron-Cohen, S., Sweetenham, J., Drew, A., & Wheelwright, S. (1999). Autism spectrum disorders at 20 and 42 months of age: Stability of clinical and ADI-R diagnosis. Journal of Child Psychology and Psychiatry, 40, 719–732.

    Article  PubMed  Google Scholar 

  • De Bildt, A., Sytema, S., Katelaars, C., Kraijer, D., Mulder, E., Volkmar, F., & Minderaa, R. (2004). Interrelationship between Autism Diagnostic Observation Schedule-Generic, Autism Diagnostic Interview-Revised, and the Diagnostic and Statistical Manual of Mental Disorders Classification in Children and Adolescents with Mental Retardation. Journal of Autism, and Developmental Disorders, 34, 129–137.

    Article  Google Scholar 

  • Filipek, P., Accardo, P., Ashwal, S., Baranek, G., Cook, E., Dawson, G., Gordon, B., Gravel, J., Johnson, C., Kallen, R., Levy, S., Minshew, N., Ozonoff, S., Prizant, B., Rapin, I., Rogers, S., Stone, W., Teplin, S., Tuchman, R., & Volkmar, F. (2000). Practice parameter: Screening and diagnosis of autism. Neurology, 55, 468–477.

    PubMed  Google Scholar 

  • Gotham, K., Risi, S., Pickles, A., & Lord, C. (2007). The Autism Diagnostic Observation Schedule: Revised algorithms for improved diagnostic validity. Journal of Autism and Developmental Disorders, 37, 613–627.

    Article  PubMed  Google Scholar 

  • Lord, C. (1995). Follow-up of two year olds referred for possible autism. Journal of Child Psychology and Psychiatry, 36, 1365–1382.

    Article  PubMed  Google Scholar 

  • Lord, C., & Richler, J. (2006). Early diagnosis of children with autism spectrum disorders. In T. Charman & W. Stone (Eds.), Social & communication development in Autism Spectrum Disorders: Early identification, diagnosis, & intervention (pp. 35–59). New York: Guilford Press.

    Google Scholar 

  • Lord, C., Risi, S., DiLavore, P., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63, 694–701.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P., & Risi, S. (1999). Autism diagnostic observation schedule—WPS edition. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Lord, C., Pickles, A., McLennan, J., Rutter, M., Bregman, J., Folston, S., Fombonne, E., Libya, M., & Minshew, N. (1997). Diagnosing autism: Analysis of data from the Autism Diagnostic Interview. Journal of Autism and Developmental Disorders, 27, 501–517.

    Article  PubMed  Google Scholar 

  • Moore, V., & Goodson, S. (2003). How well does early diagnosis of autism stand the test of time? Follow-up study of children assessed for autism at age 2 and development of an early diagnostic service. Autism, 7, 47–63.

    PubMed  Google Scholar 

  • Mullen, E. (1995). Mullen Scales of Early Learning. American Guidance Service.

  • Richler, J., Bishop, S. L., Klienke, J. R., & Lord, C. (2007). Restricted and repetitive behaviors in young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 73–85.

    Article  PubMed  Google Scholar 

  • Risi, S., Lord, C., Gotham, K., Corsello, C., Chrysler, C., Szatmari, P., Cook, E., Leventhal, B., & Pickles, A. (2006). Combining information from multiple sources in the diagnosis of autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1094–1103.

    Article  PubMed  Google Scholar 

  • Robins, D., Fein, D., & Barton, M. (1999). The modified-checklist for autism in toddlers. Self-published.

  • Robins, D., Fein, D., Barton, M., & Green, J. (2001). The Modified Checklist for Autism in Toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31, 131–144.

    Article  PubMed  Google Scholar 

  • Rogers, S. (1998). Empirically supported comprehensive treatments for young children with autism. Journal of Clinical Child Psychology, 27, 168–179.

    Article  PubMed  Google Scholar 

  • Rogers, S. (2001). Diagnosis of autism before the age of 3. International Review of Research in Mental Retardation, 23, 1–31.

    Article  Google Scholar 

  • Saemundsen, E., Magnusson, P., Smari, J., & Sigurdardottir, S. (2003). Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale: Convergence and discrepancy in diagnosing autism. Journal of Autism and Developmental Disorders, 33, 319–328.

    Article  PubMed  Google Scholar 

  • Schloper, E., Reichler, R. J., & Renner, B. R. (1988). The Childhood Autism Rating Scale. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Stone, W., Hoffman, E., Lewis, S., & Ousley, O. (1994). Early recognition of autism. Archives of Pediatric and Adolescent Medicine, 148, 174–179.

    Google Scholar 

  • Stone, W., Lee, E., & Ashford, L. (1999). Can autism be diagnosed accurately in children under 3 years?. Journal of Child Psychology and Psychiatry, 40, 219–226.

    Article  PubMed  Google Scholar 

  • Ventola, P., Kleinman, J., Pandey, J., Barton, M., Allen, S., Green, J., Robins, D., & Fein, D. (2006). Agreement among four diagnostic instruments for autism spectrum disorders in toddlers. Journal of Autism and Developmental Disorders, 36, 839–847.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported in-part by the University of Connecticut’s Research Foundation Faculty Grant, National Alliance of Autism Research, National Institute of Child Health and Human Development (5 R01 HD039961), Maternal and Child Health Bureau (R40 MC 00270). We are grateful to the children and families who participated in the study and our clinical and community collaborators for their continued support. We also thank the research teams at Georgia State University and the University of Connecticut for their dedication to the screening and early diagnosis study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lisa D. Wiggins.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wiggins, L.D., Robins, D.L. Brief Report: Excluding the ADI-R Behavioral Domain Improves Diagnostic Agreement in Toddlers . J Autism Dev Disord 38, 972–976 (2008). https://doi.org/10.1007/s10803-007-0456-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-007-0456-3

Keywords

Navigation