Cited by 227Autism Spectrum Disorder ResearchReliability and Agreement in MeasurementBehavioral and Psychological Studies

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Brief Report: Interrater Reliability of Clinical Diagnosis and DSM-IV Criteria for Autistic Disorder: Results of the DSM-IV Autism Field Trial

Klin, Ami, Lang, Jason, Cicchetti, Domenic V., Volkmar, Fred R.·2000·Journal of Autism and Developmental Disorders

DOI 10.1023/a:1005415823867

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“Clinical judgment by experienced clinicians is considered to be the gold standard for an ASD diagnosis.[21,22] Only those cases were labeled as ASD in whom there was a consensus between the two authors regarding the diagnosis.”
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Loman, M. M., Vogt, E. M., Miller, L., Landsman, R. A., Duong, P. H., Kasten, J., DeFrancisco, D., Koop, J. I., & Heffelfinger, A. K. (2020) · Child Neuropsychology · doi:10.1080/09297049.2020.1830962 · Cited by 23
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“Clinical judgment by experienced clinicians is seen as crucial in the diagnostic process and considered the gold standard for diagnosis [12].”
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Observation-centered Approach to ASD Assessment in Tanzania
Harrison, A. J., Zimak, E. H., Sheinkopf, S. J., Manji, K. P., & Morrow, E. M. (2014) · Intellectual and developmental disabilities · doi:10.1352/1934-9556-52.5.330 · Cited by 22
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“Autism diagnosis for both adults and children can be a complex and protracted process due to heterogeneity of symptoms, the necessity of interpreting behaviours that may be ambiguous, and a lack of clinical biomarkers (Klin et al., 2000; Vllasaliu et al., 2016).”
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“AlthoughASD, a neurodevelopmental disorder with nomedical markers, is becoming more commonly diagnosed [1–3], the diagnostic procedure forASDhas been identified as problematic, both in terms of inter-rater reliability [4] but also in terms of time needed to reach a diagnosis [5].”
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“The heterogeneity and comorbidity are in part due to inadequate inclusion criteria in existing diagnostic assessment procedures and inexplicit boundaries between different diagnoses in this domain ( Klin et al. 2000 ) which results in substantial overlap among the various autistic disorders (Eisenmajer et al. 1996; Sz…”
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“The current gold standard for ASD diagnosis is considered to be clinical judgment,[5,6] along with various screening tests and questionnaires such as CARS and M-CHAT.”
Method
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“[15] Only trained clinicians can detect autistic features in children under the age of two, but they do not often get to see such young children.[12,16] However, large number of children and infants are also seen by other professionals such as special educators, psychologists, and community health workers, who may nee…”
Background
Hierarchical POMDP Framework for a Robot-Assisted ASD Diagnostic Protocol
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Klusek, J., Will, E., Moser, C., Hills, K. J., Thurman, A. J., Abbeduto, L., & Roberts, J. E. (2023) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-023-01044-1 · Cited by 10
“The judgment of experienced clinicians has been consistently shown to increase the accuracy of ASD diagnoses (Klin et al., 2000; Le Couteur et al., 2008; Lord et al., 2006), and expert clinical opinion is particularly essential when clinical presentations are complex, such as when intellectual disability must be consi…”
Background
The Balancing Act in Consistent Wine Tasting and Wine Appreciation: Part II: Consistency in Wine Tasting and Appreciation: An Empirical-Objective Perspective
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“One area in which this occurs is in the diagnosis of autism (e.g. Klin et al., 2000).”
BackgroundSelf-citation
Cronbach’s Alpha
Johnson, E. (2021) · Springer eBooks · doi:10.1007/978-3-319-91280-6_307 · Cited by 9
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Rodman, J., Gilbert, K. A., Grove, A. B., Cunningham, M. L., Levenson, S., & Wajsblat, L. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0880-7 · Cited by 8
“While numerous measures are available for assessing ASD, clinical judgment remains the gold standard for ASD diagnosis ( Klin et al. 2000; Ventola et al. 2006).”
Background
The Evolution of Autism as a Diagnostic Concept: From Kanner to DSM-5: A commentary
Volkmar, F. R., & Reichow, B. (2014) · Autism and child psychopathology series · doi:10.1007/978-3-319-06796-4_15 · Cited by 7
“Nearly half reported that they had evaluated more than 25 patients with autism; other raters were less experienced, providing an opportunity to assess possible moderators of both rater and item reliability (Klin et al. 2000).”
BackgroundMethodSelf-citation
Diagnosis of autistic disorder: Problems and new directions
Young, R. L., & Brewer, N. (2002) · International review of research in mental retardation · doi:10.1016/s0074-7750(02)80007-6 · Cited by 7
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Bölte, S., & Poustka, F. (2003) · Neuroembryology and Aging · doi:10.1159/000079404 · Cited by 5
Diagnosis for autism spectrum disorder children using T1-based gray matter and arterial spin labeling-based cerebral blood flow network metrics
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Screening and Diagnostic Instruments for Identification of Autism Spectrum Disorders in Children, Adolescents, and Young Adults: A Selective Review
Charak, D., & Stella, J. (2002) · Assessment for Effective Intervention · doi:10.1177/073724770202700103 · Cited by 6
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Play in Relation to Autism Traits in Young Children at Elevated Likelihood for Autism Spectrum Disorder
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No data?
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“Validation sample For the validation sample (n=37), an ASD best-estimate diagnosis was based on all-information-available from data gathered across two research visits.(28) The following information was obtained during each visit: parental report of developmental milestones, parental endorsement of ASDrelated concerns…”
BackgroundMethod
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Goh, T. J., Diederich, J., Song, I., & Sung, M. (2013) · Studies in computational intelligence · doi:10.1007/978-3-642-38550-6_13 · Cited by 4
Computational analysis of language use in autism
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“ASD diagnosis was determined through best-estimate clinical (BEC) judgment (Klin et al., 2000; Spitzer and Siegel, 1990).”
Method
Investigating the borders of autism spectrum disorder: lessons from the former diagnosis of pervasive developmental disorder not otherwise specified
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Melville, C. A. (2010) · Enlighten: Theses (The University of Glasgow) · Cited by 3
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'I want to be me' : learning from teenagers diagnosed with autism using collaborative, participatory research
Mogensen, L. L. (2010) · Cited by 2
Autism in preschoolers: Assessment, diagnostic and gender aspects
Andersson, G. W. (2013) · Cited by 2
Evidence-Based Instruction for Children with Asperger Syndrome
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Concordancia entre observadores de videos de pacientes con sospecha diagnóstica de autismo y psicosis infantiles
Jordán-Quintero, M. I., Corredor, C. A., Cepeda-Torres, J. F., Chaparro, C. P., & Arenas, V. C. S. (2017) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2017.08.003 · Cited by 1
Investigating the Predictive Validity of the Quantitative Checklist for Autism in Toddlers and the Autism Diagnostic Observation Schedule-2 in Children at Elevated Likelihood for Autism
Schaubroeck, S., Demurie, E., Ali, J. B., Bölte, S., Boterberg, S., Buitelaar, J. K., Charman, T., Falck‐Ytter, T., Hunnius, S., Johnson, M. H., et al. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06585-y · Cited by 1
“The CBE outcome was defined by the diagnostic criteria of DSM-5 (APA, 2013), following assessment at 36 months. consensus judgment, which is considered to be the gold standard for diagnosing autism (Klin et al., 2000; Ventola et al., 2006).”
Social assistive robotics as an enabling technology for the inclusion of children with ASD in school settings: a systematic literature review
Caro-Via, S., Horna-Saldaña, C. J., Canaleta, X., & Herrero-Martín, J. (2026) · Journal of Enabling Technologies · doi:10.1108/jet-01-2026-0003 · Cited by 1
Det tidlige sprog hos børn med autisme – en afgørende udviklingsfaktor
Brynskov, C., & Eigsti, I. (2010) · Psyke & Logos · doi:10.7146/pl.v31i2.8469 · Cited by 1
“…diagnosen infantil autisme lever op til de samme overordnede kriterier – og diagnosticeringen af forstyrrelsen i øvrigt har en høj grad af såvel reliabilitet som tidsmæssig stabilitet (Klin et al., 2000; Lord, 1995) – er der således tale om børn med vidt forskellige udviklingsforløb og prognoser.”
Background
Inter-rater reliability in videos of patients with a suspected diagnosis of autism and child psychosis
Jordán-Quintero, M. I., Corredor, C. A., Cepeda-Torres, J. F., Chaparro, C. P., & Arenas, V. C. S. (2019) · Revista Colombiana de Psiquiatría (English ed ) · doi:10.1016/j.rcpeng.2019.03.003 · Cited by 1
Assessment of Sonographic Carotid Parameters in Autism Spectrum Disorder: A Comparative Case Control Study
Yetkin, D. İ., Sizer, E., Gökhaner, Y. T., Büyükdemirci, E., & Atlı, A. (2023) · Developmental Neurorehabilitation · doi:10.1080/17518423.2023.2181417 · Cited by 1
“Clinical judgment by experienced clinicians is considered to be the “gold standard” for the autism diagnosis.(15,16) In the present study, 37 children between the ages of 2 and 18 years of age were diagnosed with ASD by a child and adolescent psychiatrist (ES) with 6 years of experience, according to the diagnostic cr…”
Method
Linguagem nos transtornos do espectro autístico: relações entre uso, forma e conteúdo
Miilher, L. P. (2009) · doi:10.11606/d.5.2009.tde-29092009-145336 · Cited by 1
DSM-5 Autism Criteria Applied to Toddlers with DSM-IV-TR Autism
Jashar, D. T. (2014) · OpenCommons - UConn (University of Connecticut) · Cited by 1
Performance of Children with Autism on Selected Measures of Reading Achievement and Cognitive-Linguistic Ability
Turner, V. (2010) · UA Campus Repository (The University of Arizona) · Cited by 1
Autism Severity and Comorbid Symptoms in Children with ASD
Jang, J. (2014) · Louisiana State University · doi:10.31390/gradschool_theses.543 · Cited by 1
Construct Validity of the Autism Spectrum Disorders-Child Version (ASD-C) and the Child Behavior Checklist (CBCL)
Sheffield, K. (2014) · Louisiana State University · doi:10.31390/gradschool_dissertations.3219 · Cited by 1
The moderating effect of gender on the relationship between socialization and internalizing problems in early childhood
Adams, H. L. (2013) · Louisiana State University · doi:10.31390/gradschool_theses.1021 · Cited by 1
“Researchers (Klin et al., 2000) found that the criteria were beneficial in providing structure and guidance for diagnosing by persons with less experience with ASDs, and are thus preferable over clinical judgment alone for less experienced professionals (e.g., psychologists who do not focus on…”
Background
Reliability and concordance of the Childhood Autism Rating Scale and DSM-IV in adults with severe and profound mental retardation
Minshawi, N. F. (2004) · doi:10.31390/gradschool_theses.1609 · Cited by 1
“The studies by Volkmar et al. (1994) and Klin et al. (2000), coupled with poor direct-care staff interrater data reported here, is in line with the current study’s findings on lack of agreement between raters with varying levels of experience and education.”
Result
DSM-IV
Volkmar, F. R. (2012) · Springer eBooks · doi:10.1007/978-1-4419-1698-3_1444 · Cited by 1
Self-citation
Evaluating Evidence-Based Instruction for Children with Asperger Syndrome
DuCharme, R. W. (2013) · Issues in children's and families' lives · doi:10.1007/978-1-4614-7016-8_6
Exploring the diagnostic ability of the ADOS in special needs schools in the greater eThekwini area : a blinded study.
Wilford, A. (2012) · ResearchSpace (University of KwaZulu-Natal)
Treatment effectiveness in preschool autism: A look at affective variables
Tsakiris, E. A. (2009) · University Libraries (University of Maryland)
Autism nosology
Reber, M. E. (2012) · Cambridge University Press eBooks · doi:10.1017/cbo9780511978616.002
Relationship Between Sensory Sensitivities and Cognitive and Adaptive Abilities in Children with Autism Spectrum Disorders
Pendergast, L. L. (2014) · OpenCommons - UConn (University of Connecticut)
Characteristics of visual function in Asperger’s syndrome and the autism spectrum
Whiskens, A. (2010) · Aston Publications Explorer (Aston University) · doi:10.48780/publications.aston.ac.uk.00009546
Neurokognitive Defizite bei Autismus und Aufmerksamkeitsdefizit-/Hyperaktivitätssyndrom
Bruning, N. (2006) · PUB – Publications at Bielefeld University (Bielefeld University)
Interexaminer Agreement of Histopathologic Features in Pediatric Brain Tumors: A Biostatistical Perspective
Cicchetti, D. V. (2008) · Pediatric and Developmental Pathology · doi:10.2350/07-10-0357.1
“’’ In some areas of inquiry, such as the diagnosis of childhood autism, where there again is no confirmatory laboratory diagnosis available, the diagnosis by very experienced clinical examiners is used as the best available estimate of ‘‘diagnostic truth’’ [5].”
MethodSelf-citation
Are There Behavioral Differences between Children with High Functioning Autism and Children with Asperger’s Disorder?
Kříž, D. (2011) · CommonKnowledge Research Repository (Pacific University Oregon)
for Autism in Toddlers Screening for autism in older and younger toddlers with the Modified Checklist
Chawarska, K., Volkmar, F. R., Green, J., Barton, M. L., FEIN, D. A., Pandey, J., Verbalis, A. D., Robins, D. L., Boorstein, H., Klin, A., et al. (2008)
Self-citation
The relationship of cognitive profile to differential diagnosis of high-functioning autism and Asperger's Syndrome
McQuinn, S. W. (n.d.) · ProQuest Demo Repository
EARLY DIAGNOSIS OF AUTISM SPECTRUM DISORDER VIA A TRANSDISCIPLINARY CLINIC
Thaxter, P. J. (2015) · Digital Commons-DePaul (DePaul University)
Empirically Based Phenotypic Profiles of Children with Pervasive Developmental Disorders: Interpretation in the Light of the DSM-5 Kirstin Greaves-LordMart L. J. M. EussenFrank C. Verhulst • Ruud B. MinderaaWilliam MandyJames J. HudziakMark Peter Steenhuis • Pieter F. de NijsCatharina A. Hartman
Minderaa, R. B., Steenhuis, M. P., Hartman, C. A., Mandy, W., Hudziak, J. J., & Burlington, S. P. (2013)
Section I: Diagnosis And Classification
Volkmar, F. R., Paul, R., Klin, A. J., & Cohen, D. J. (2005) · doi:10.1002/9780470939345.part1
Self-citation
Use of M-CHAT-R/F-A to Screen for ASD in Albania
Brennan, L. (2016) · OpenCommons at University of Connecticut (University of Connecticut)
Comparisons: BASC-2 Parent and Teacher Reports for Children on the DSM-5 Autism Spectrum
Ellison, K. S. (2015)
Using Generalizability Theory to Investigate Sources of Variance of the Autism Diagnostic Observation Schedule-2 with Trainees
Parriott, D. R. (2016) · Digital Scholarship - UNLV (University of Nevada Reno) · doi:10.34917/9112162
Exploration of comorbid psychopathology symptoms in infants and toddlers with autism spectrum disorders
Konst, M. J. (2013) · Louisiana State University · doi:10.31390/gradschool_theses.3270

Authors: Klin, A., Lang, J., Cicchetti, D. V., & Volkmar, F. R.
Affiliations: Yale University (US)
Corresponding author: Klin, Ami
ORCID: Lang, Jason
Volkmar, Fred R.
Venue: Journal of Autism and Developmental Disorders
Publisher: Springer Science and Business Media LLC
Published: 2000-04
Volume: 30
Issue: 2
Pages: 163-167
ISSN: 0162-3257 (ISSN-L)
1573-3432
DOI: 10.1023/a:1005415823867
OpenAlex: W1536735458
Cited by: 225
References: 22
Citations by year: 2026: 1 · 2025: 2 · 2024: 3 · 2023: 7 · 2022: 3 · 2021: 16 · 2020: 13 · 2019: 4 · 2018: 7 · 2017: 9 · 2016: 11 · 2015: 12 · 2014: 12 · 2013: 13 · 2012: 15
FWCI: 2.88
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Journal of Autism and Developmental Disorders (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Keywords: inter-rater reliability, autistic disorder, DSM-IV diagnostic criteria, autism diagnosis, diagnosis
MeSH terms: Adolescent, Adult, Autistic Disorder, Child, Child Development Disorders, Pervasive, Child, Preschool, Diagnosis, Differential, Female, Humans, Male, Psychiatric Status Rating Scales, Psychometrics, Reproducibility of Results, Observer Variation

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Brief Report: Interrater Reliability of Clinical Diagnosis and DSM-IV Criteria for Autistic Disorder: Results of the DSM-IV Autism Field Trial

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