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Interrelationship Between Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview-Revised (ADI-R), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) Classification in Children and Adolescents with Mental Retardation
Abstract
The interrelationship between the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule-Generic (ADOS-G) and clinical classification was studied in 184 children and adolescents with Mental Retardation (MR). The agreement between the ADI-R and ADOS-G was fair, with a substantial difference between younger and older children (5-8 vs. 8+ years). Compared with the Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM-IV-TR) classification of Autistic Disorder (AD) and Pervasive Developmental Disorder (PDD), both instruments measure AD or PDD validly and reliably. Even in low-functioning children the interrelationship between the instruments and the clinical classification was satisfactory. The combination of ADI-R and ADOS-G identifies AD or PDD, as described in the DSM-IV-TR, most appropriately. Both instruments seem to be of great value in the diagnostic process of PDD in children and adolescents with MR.
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There is low agreement between diagnoses based on anamnestic interviews (ADI-R) and those based on behavioral observations, particularly for older and atypical cases.
“Additionally, there is some evidence that there is low agreement between diagnoses based on anamnestic interviews (ADI-R) and those based on behavioral observations, particularly for older and atypical cases, and for better performance of the behavioral observation ([22, 30, 34–40].”
From Autism spectrum disorder in ICD-11—a critical reflection of its possible impact on clinical practice and research (2024) · cites this paper as [34]
A primary challenge of using ADI-R and ADOS to classify ASD is that their results are not always consistent, and no standard method exists to resolve discordance when one suggests ASD and the other does not.
“One of the primary challenges of using ADI-R and ADOS scores to classify children with ASD is that results of the ADI-R and ADOS are not always consistent with each other and there is not a standard method to resolve discordance when one instrument suggests the presence of an ASD and the other instrument does not suggest presence of an ASD (de Bildt et al. 2004; Le Couter et al. 2008).”
From Using standardized diagnostic instruments to classify children with autism in the study to explore early development (2015) · cites this paper as de Bildt et al. 2004
Previous studies have found that the probability of ADOS agreement with diagnostic criteria is inversely related to the child's level of functioning.
“Previous studies have found the probability of ADOS agreement with diagnostic criteria is inversely related to level of functioning for the child (de Bildt et al. 2004)”
From Using standardized diagnostic instruments to classify children with autism in the study to explore early development (2015) · cites this paper as de Bildt et al. 2004
Discordant ADI-R and ADOS results were found in 17.6% of children administered a comprehensive developmental evaluation in SEED, supporting previous findings.
“We found discordant ADI-R and ADOS results in 17.6 % of children administered a comprehensive developmental evaluation in SEED, which supports previous findings (de Bildt te al. 2004; Le Couter et al. 2008).”
From Using standardized diagnostic instruments to classify children with autism in the study to explore early development (2015) · cites this paper as de Bildt te al. 2004
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Metadata
- Authors
- de Bildt, A., Sytema, S., Ketelaars, C., Kraijer, D., Mulder, E., Volkmar, F., & Minderaa, R.
- Affiliations
- University of Groningen (NL)
- Vanboeijen (NL)
- Yale University (US)
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2004-04
- Volume
- 34
- Issue
- 2
- Pages
- 129-137
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- OpenAlex
- W2131502071
- Cited by
- 278
- References
- 29
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 8 · 2021: 15 · 2020: 11 · 2019: 11 · 2018: 14 · 2017: 14 · 2016: 13 · 2015: 13 · 2014: 23 · 2013: 16 · 2012: 25
- FWCI
- 6.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Keywords
- autism spectrum disorder, pervasive developmental disorders, intellectual disability, autism diagnosis, ADI-R, diagnostic agreement, children and adolescents, low-functioning autism
- MeSH terms
- Adolescent, Adult, Age Factors, Autistic Disorder, Child, Child, Preschool, Female, Humans, Intellectual Disability, Netherlands, Surveys and Questionnaires, Sensitivity and Specificity, Time Factors, Reproducibility of Results, Odds Ratio, Diagnostic and Statistical Manual of Mental Disorders
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