Anxiety Disorders Interview Schedule–Autism Addendum: Reliability and Validity in Children With Autism Spectrum Disorder
Open accessAbstract
Assessing anxiety in autism spectrum disorder (ASD) is inherently challenging due to overlapping (e.g., social avoidance) and ambiguous symptoms (e.g., fears of change). An ASD addendum to the Anxiety Disorders Interview Schedule-Child/Parent, Parent Version (ADIS/ASA) was developed to provide a systematic approach for differentiating traditional anxiety disorders from symptoms of ASD and more ambiguous, ASD-related anxiety symptoms. Interrater reliability and convergent and discriminant validity were examined in a sample of 69 youth with ASD (8-13 years, 75% male, IQ = 68-143) seeking treatment for anxiety. The parents of participants completed the ADIS/ASA and a battery of behavioral measures. A second rater independently observed and scored recordings of the original interviews. Findings suggest reliable measurement of comorbid (intraclass correlation = 0.85-0.98, κ = 0.67-0.91) as well as ambiguous anxiety-like symptoms (intraclass correlation = 0.87-95, κ = 0.77-0.90) in children with ASD. Convergent and discriminant validity were supported for the traditional anxiety symptoms on the ADIS/ASA, whereas convergent and discriminant validity were partially supported for the ambiguous anxiety-like symptoms. Results provide evidence for the reliability and validity of the ADIS/ASA as a measure of traditional anxiety categories in youth with ASD, with partial support for the validity of the ambiguous anxiety-like categories. Unlike other measures, the ADIS/ASA differentiates comorbid anxiety disorders from overlapping and ambiguous anxiety-like symptoms in ASD, allowing for more precise measurement and clinical conceptualization. Ambiguous anxiety-like symptoms appear phenomenologically distinct from comorbid anxiety disorders and may reflect either symptoms of ASD or a novel variant of anxiety in ASD.
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The ADIS/ASA is the only anxiety measure for this population that strategically teases apart anxiety and ASD symptoms and measures both DSM-5 anxiety disorders and clinically impairing anxiety presentations unique to ASD.
“The ADIS/ASA is the only anxiety measure for this population that strategically teases apart anxiety and ASD symptoms and measures both DSM-5 anxiety disorders and clinically impairing anxiety presentations unique to ASD.”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [23]
The Introduction and Discussion describe the ADIS/ASA as distinguishing anxiety disorders from overlapping ASD symptoms and separately assessing ambiguous anxiety-like behaviors. But the Method (Measures) identifies the underlying interview as assessing DSM-IV disorders, not DSM-5 disorders; the Discussion also says the ambiguous behaviors may be aspects of ASD rather than anxiety and may not be unique to ASD. (LLM, conf=0.88)
Experimental — accuracy not yet measuredInstruments that are currently widely used in clinical settings to screen for anxiety disorders in the general adult population can probably be considered valid also for autistic adults, with the caveat that autism-specific presentations of anxiety may be missed.
“Thus, instruments that are currently widely used in clinical settings to screen for anxiety disorders in the general adult population can probably be considered valid also for autistic adults, with the caveat that autism-specific presentations of anxiety may be missed”
From Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools. (2020) · cites this paper as Kerns et al., 2017
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Experimental — accuracy not yet measuredAn addendum to the ADIS for autistic children has previously been developed and has demonstrated reliability and validity.
“An addendum to the ADIS for autistic children has previously been developed and has demonstrated reliability and validity (Kerns et al., 2017).”
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- Authors
- Kerns, C. M., Renno, P., Kendall, P. C., Wood, J. J., & Storch, E. A.
- Affiliations
- Drexel University (US)
- University of California, Los Angeles (US)
- Temple University (US)
- University of South Florida (US)
- Corresponding author
- Kerns, Connor Morrow
- Venue
- Journal of Clinical Child & Adolescent Psychology
- Publisher
- Informa UK Limited
- Published
- 2016-12-07
- Volume
- 46
- Issue
- 1
- Pages
- 88-100
- ISSN
- 1537-4416 (ISSN-L)
- 1537-4424
- PMC
- PMC5441235
- OpenAlex
- W2560791324
- Cited by
- 170
- References
- 45
- Citations by year
- 2026: 9 · 2025: 22 · 2024: 22 · 2023: 14 · 2022: 21 · 2021: 21 · 2020: 20 · 2019: 18 · 2018: 12 · 2017: 11
- FWCI
- 8.70
- Type
- journal article
- Language
- en
- Update notices
- correction (2019-05-24)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Child & Adolescent Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Commons - University of South Florida (University of South Florida) (submittedVersion)
- Funders
- Autism Science Foundation
- National Institute of Child Health and Human Development (R01 HD080097)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- autism spectrum disorder, anxiety disorders, anxiety comorbidity, social avoidance, inter-rater reliability, convergent validity, discriminant validity, children and adolescents
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Anxiety, Anxiety Disorders, Child, Female, Humans, Male, Parents, Psychometrics, Severity of Illness Index, Reproducibility of Results
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