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The Diagnostic Interview for Social and Communication Disorders: background, inter‐rater reliability and clinical use
Open accessAbstract
Background: The Diagnostic Interview for Social and Communication Disorders (DISCO) is a schedule for the diagnosis of autistic spectrum and related disorders and assessment of individual needs. It enables information to be recorded systematically for a wide range of behaviours and developmental skills and is suitable for use with all ages and levels of ability. In addition to helping the clinician to obtain a profile of each individual's pattern of development and behaviour, the DISCO also enables identification of specific features found in autistic spectrum disorders that are relevant for use with established diagnostic systems. Method: This paper describes the historical background of the DISCO, outlines its structure and reports the results of an inter‐rater reliability study with parents of 82 children aged 3 to 11 years with autistic spectrum disorder, learning disability, language disorder or typical development. Results: Inter‐rater reliability for the items in the interview was high (kappa coefficient or intra‐class correlation at .75 or higher). This level of agreement was achieved for over 80% of the interview items.
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“Two psychiatrists (HK and TM) confirmed the diagnosis using the Diagnostic Interview for Social and Communication Disorders.26”
From Oxytocin efficacy is modulated by dosage and oxytocin receptor genotype in young adults with high-functioning autism: a 24-week randomized clinical trial (2016) · cites this paper as [26]
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Leekam, S. R., Nieto, C., Libby, S. J., Wing, L., & Gould, J. (2007) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0218-7 · Cited by 1,140
“algorithms used by the ADI-R (Lord et al., 1994) and the DISCO ( Wing et al., 2002 ), the ‘marked’ rating was selected for the data analysis.”
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“In Sweden, in few cases, the Diagnostic Interview for Social and Communication Disorders (DISCO-10) [50] was used instead of the ADI-R.”
MethodAutism Spectrum Disorder: Classification, diagnosis and therapy
Sharma, S., Gonda, X., & Tarazi, F. I. (2018) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2018.05.007 · Cited by 745
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“This measure selects items from the Diagnostic Interview for Social and Communication Disorder (DISCO; Wing et al., 2002) that match most closely with corresponding items from the original RBQ.”
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de Vries, A. L. C., Noens, I. L. J., Cohen‐Kettenis, P. T., van Berckelaer‐Onnes, I. A., & DORELEIJERS, T. A. H. (2010) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-010-0935-9 · Cited by 518
“Inter-rater reliability for the items in the DISCO interview were high, with a kappa coefficient or intra-class correlation at .75 or higher achieved for over 80% of the interview items ( Wing et al. 2002 ).”
MethodAbnormal melatonin synthesis in autism spectrum disorders
Melke, J., Goubran Botros, H., Chaste, P., Betancur, C., Nygren, G., Anckarsäter, H., Rastam, M., Ståhlberg, O., Gillberg, I. C., Delorme, R., et al. (2008) · Molecular Psychiatry · doi:10.1038/sj.mp.4002016 · Cited by 511
Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome
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“In contrast, more elaborate clinical, interview-based, diagnostic schedules, such as the Kiddie-SADS (Kiddie-Schedule for Affective Disorders and Schizophrenia) [37], and the DISCO [30] may provide precise clinical diagnoses, but are less useful in non-clinical research.”
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Self-citationSkuse, D., Warrington, R., Bishop, D., Chowdhury, U., Lau, J., Mandy, W., & Place, M. (2004) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200405000-00008 · Cited by 342
“The validity of content for the assessment of autistic disorders was determined by comparing the 3di with published material on the most discriminating domains of behavior that are typical of autistic children (e.g., Leekam et al., 2002; Lord et al., 1994, 1997).”
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“The DISCO-10 has excellent inter-rater and test-retest reliability, and is highly valid for assigning diagnoses in the autism spectrum (Wing et al., 2002).”
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“22 In the IDCR a random sample of 30 carers of individuals who scored high on the ADOS-Mod1 ( 5 7) and a random sample of 30 carers of individuals who scored low on the ADOS-Mod1 ( 5 7) were invited to take part in an interview by a senior research psychologist (J.S.) using the DISCO and ADI-R, to test the accuracy of…”
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“The Diagnostic Interview for Social and Communication disorders (DISCO) (16) was also conducted.”
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“Further research could investigate the utility of questionnaire measures of this kind within the diagnostic process; for example, they may provide a supplement to clinical interviews such as the DISCO which also asks about specific separate behaviours.”
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“[12] employed a well-validated diagnostic tool for ASD, the Diagnostic Interview for Social and Communication Disorder (DISCO 10) [44].”
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“It takes three hours to administer (Wing 2002).”
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“The procedure for conducting the parent interview and details of the coding scheme and the items included for DISCO 9 are described in full in Wing et al. (2002).”
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“The size of the two datasets was 82 and 115 respectively, and both are related to clinical diagnoses using DISCO-9 [27].”
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“This evaluation included the Asperger Syndrome Screening Questionnaire (ASSQ) [13], the Diagnostic Interview for Social and Communication Disorders (DISCO) [14, 15 ], and the Autism Diagnostic Observation Schedule (ADOS), module 4 [16].”
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“Assessment of the child’s type of ASD at follow-up was based on parent interview using the Diagnostic Interview of Social and Communication Disorders (DISCO-10; Nygren et al., 2009; Wing et al., 2002), administrated by medical doctor, psychologist, or speech-language pathologist, in combination with other compiled cli…”
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“A systematic enquiry was additionally made of early development using items based on the Diagnostic Interview for Social and Communication Disorders (with permission) (DISCO; Wing et al., 2002) that supplemented the ADI items on language acquisition.”
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Comparison of ICD-10 and Gillberg’s Criteria for Asperger Syndrome
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Self-citationAspects of bacteriology and endocrinology of cows with pyometra and retained fetal membranes
Olson, J. D., Ball, L. K., Mortimer, R. G., Farin, P. W., Adney, W. S., & Huffman, E. M. (1984) · American Journal of Veterinary Research · doi:10.2460/ajvr.1984.45.11.2251 · Cited by 158
Dyadic orienting and joint attention in preschool children with autism
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“In addition to the current study, a parent interview study ( Wing, Libby, Leekam, Gould & Larcombe, 2002; Leekam, Libby, Wing, Gould, & Taylor, 2002) and an experimental study (Leekam, Lopez, & Moore, 2000) were conducted.”
BackgroundSelf-citationAutism and Learning Disability
O’Brien, G., & Pearson, J. (2004) · Autism · doi:10.1177/1362361304042718 · Cited by 174
Autism, ethnicity and maternal immigration
Keen, D. V., Reid, F. D., & Arnone, D. (2010) · British Journal of Psychiatry · doi:10.1192/bjp.bp.109.065490 · Cited by 153
Simonoff, E. A., Kent, R. G., Stringer, D., Lord, C., Briskman, J., Lukito, S., Pickles, A. R., Charman, T., & Baird, G. (2019) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2019.11.020 · Cited by 156
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Diagnostic Instruments in Autistic Spectrum Disorders
Lord, C., & Corsello, C. (2005) · Handbook of Autism and Pervasive Developmental Disorders · doi:10.1002/9780470939352.ch2 · Cited by 156
Auditory Characteristics of Children with Autism
Tharpe, A. M., Bess, F. H., Sladen, D. P., Schissel, H., Couch, S., & Schery, T. K. (2006) · Ear and Hearing · doi:10.1097/01.aud.0000224981.60575.d8 · Cited by 144
“Conclusions: Children with autism demonstrated essentially equivalent results on a battery of physiological auditory tests as those obtained from typically developing children.”
ResultMiniscalco, C., Nygren, G., Hagberg, B., Kadesjö, B., & Gillberg, C. (2006) · Developmental Medicine & Child Neurology · doi:10.1017/s0012162206000788 · Cited by 144
“…from autistic disorder were underwent further in-depth examination including an interview with the parent by using the Diagnostic Interview for Social and Communication disorders (DISCO-10), a semistructured interview covering developmental skills and the broad autism spectrum (Wing et al. 2002).”
MethodAbnormal EEG lateralization in boys with autism
Stroganova, T. A., Nygren, G., Tsetlin, M. M., Posikera, I. N., Gillberg, C., Elam, M., & Orekhova, E. V. (2007) · Clinical Neurophysiology · doi:10.1016/j.clinph.2007.05.005 · Cited by 170
Clabaugh, C., Mahajan, K., Jain, S., Pakkar, R., Becerra, D., Shi, Z., Deng, E., Lee, R., Ragusa, G., & Matarić, M. J. (2019) · Frontiers in Robotics and AI · doi:10.3389/frobt.2019.00110 · Cited by 156
“Common measures used for the ASD diagnoses were the Autism Diagnostic Interview-Revised (Wing et al., 2002; Tadevosyan-Leyfer et al., 2003), Autism Diagnostic Observation Schedule (Lord et al., 2000; Gotham et al., 2008), and Child Autism Rating Scale (Van Bourgondien et al., 1992).”
MethodFernell, E., Hedvall, Å., Westerlund, J., Carlsson, L. H., Eriksson, M. A., Olsson, M. B., Holm, A., Norrelgen, F., Kjellmer, L., & Gillberg, C. (2011) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2011.08.002 · Cited by 141
Autism spectrum traits in children and adolescents with obsessive-compulsive disorder (OCD)
Ivarsson, T., & Melin, K. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.10.003 · Cited by 148
“Possibly, using a semistructured interview like the Diagnostic Interview of Social- and Communication disorders (DISCO) (Wing et al., 2002), where problems in different social- and communicative situations are elicited might give more reliable estimates.”
MethodTowards understanding the under-recognition of girls and women on the autism spectrum
Gould, J. (2017) · Autism · doi:10.1177/1362361317706174 · Cited by 136
“The Diagnostic Interview for Social and Communication Disorders (DISCO) (Wing et al., 2002) is a semi-structured interview which enables a clinician to systematically collect information which not only can lead to a diagnostic label but, more importantly, can also give a detailed profile of the person.”
BackgroundSelf-citationKanfiszer, L., Davies, F., & Collins, S. (2017) · Autism · doi:10.1177/1362361316687987 · Cited by 143
“…to have been diagnosed with an ASD, formally, aged ⩾18 years, using the Autism Diagnostic Observation Schedule (ADOS; Lord et al., 1989, 2000), Diagnostic Interview for Social and Communication Disorders (DISCO; Wing et al., 2002) or Autism Diagnostic Interview – Revised (ADI-R; Lord et al., 1994).”
BackgroundMethodAgeing in people with autistic spectrum disorder
Mukaetova‐Ladinska, E. B., Perry, E. K., Baron, M. G., Povey, C., & on behalf of the Autism Ageing Writing Group (2011) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2711 · Cited by 134
“The Diagnostic Interview for Social and Communication Disorders (DISCO) (Wing et al., 2002) has been designed and evaluated for use with people in the autism spectrum of any age, from infancy to old age.”
MethodMortality in Autism: A Prospective Longitudinal Community-Based Study
Gillberg, C., Billstedt, E., Sundh, V., & Gillberg, I. C. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0883-4 · Cited by 129
“In the follow-up study the Diagnostic Interview for Social and COmmuniation disorders (The DISCO, Wing et al. 2002) was used.”
Honey, E. J., Leekam, S. R., Turner, M., & McConachie, H. (2006) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0253-4 · Cited by 129
“Inter-rater reliability of DISCO items is high with j coefficients of 0.75 or higher in over 80% of the items ( Wing, Leekam, Libby, Gould, & Larcombe, 2002 ).”
InfluentialSelf-citationJung, M., Kosaka, H., Saito, D. N., Ishitobi, M., Morita, T., Inohara, K., Asano, M., Arai, S., Munesue, T., Tomoda, A., et al. (2014) · Molecular Autism · doi:10.1186/2040-2392-5-35 · Cited by 128
“It also contains items on early development, and a section on activities of daily life, thereby giving the interviewer an idea of the individual’s level of functioning in several different areas, not only social functioning and communication [35].”
BackgroundHarrop, C., McConachie, H., Emsley, R., Leadbitter, K., & Green, J. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1986-5 · Cited by 140
“1999) and the Diagnostic Interview for Social and Communication Disorders (DISCO; Wing et al. 2002).”
MethodAllely, C. S. (2019) · Advances in Autism · doi:10.1108/aia-09-2018-0036 · Cited by 123
Personality disorders and autism spectrum disorders: what are the connections?
Lugnegård, T., Hallerbäck, M. U., & Gillberg, C. (2012) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2011.05.014 · Cited by 120
Melville, C. A., Cooper, S., Morrison, J., Smiley, E., Allan, L., Jackson, A., Finlayson, J., & Mantry, D. (2008) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-008-0549-7 · Cited by 121
“Whilst the use of a standardised diagnostic instrument, such as the ADI-R (Lord et al. 1994) or DISCO ( Wing et al. 2002 ) might have added to the inter-rater reliability, there is no evidence that these improve diagnostic validity compared to a gold-standard”
Autistic Spectrum Disorder: A Child Population Profile
Keen, D., & Ward, S. (2004) · Autism · doi:10.1177/1362361304040637 · Cited by 120
Smith, R. S., & Sharp, J. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1633-6 · Cited by 120
Dover, C. J., & Couteur, A. S. L. (2007) · Archives of Disease in Childhood · doi:10.1136/adc.2005.086280 · Cited by 124
The Autism-Spectrum Quotient (AQ) Children’s Version in Japan: A Cross-Cultural Comparison
Wakabayashi, A., Baron-Cohen, S., Uchiyama, T., Yoshida, Y., Tojo, Y., Kuroda, M., & Wheelwright, S. (2007) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0181-3 · Cited by 117
“All of the psychiatrists in this study were trained in diagnosis of autistic disorders under Dr. Wing, and were qualified to use the Diagnostic Interview for Social and Communication Disorders (DISCO) (Leekam, Libby, Wing, Gould, & Taylor, 2002; Wing, Leekam, Libby, Gould, & Larcombe, 2002 ).”
MethodSensory subtypes and anxiety in older children and adolescents with autism spectrum disorder
Uljarević, M., Lane, A., Kelly, A., & Leekam, S. (2016) · Autism Research · doi:10.1002/aur.1602 · Cited by 108
“A short questionnaire based on language items extracted from the diagnostic interview for social and communication disorders [DISCO; Wing et al., 2002] and previously used in questionnaire studies [Honey, Leekam, Turner, & McConachie, 2007; Lidstone et al., 2014] provided an estimate of expressive…”
MethodSelf-citationKosaka, H., Okamoto, Y., Munesue, T., Yamasue, H., Inohara, K., Fujioka, T., Anme, T., Orisaka, M., Ishitobi, M., Jung, M., et al. (2016) · Translational Psychiatry · doi:10.1038/tp.2016.152 · Cited by 117
Kappa Coefficients for Missing Data
de Raadt, A., Warrens, M. J., Bosker, R., & Kiers, H. A. L. (2019) · Educational and Psychological Measurement · doi:10.1177/0013164418823249 · Cited by 116
A Comparison of Reliability Coefficients for Ordinal Rating Scales
de Raadt, A., Warrens, M. J., Bosker, R., & Kiers, H. A. L. (2021) · Journal of Classification · doi:10.1007/s00357-021-09386-5 · Cited by 146
Barrett, S. L., Uljarević, M., Baker, E. K., Richdale, A. L., Jones, C. R. G., & Leekam, S. R. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2514-6 · Cited by 113
“The Repetitive Behaviour Questionnaire-2 (RBQ-2; Leekam et al. 2007b) is a twenty item questionnaire, with items directly derived from a standardised clinical interview tool, the Diagnostic Interview for Social and Communication Disorders (DISCO; Wing et al. 2002).”
MethodA Systematic Examination of Catatonia‐like Clinical Pictures in Autism Spectrum Disorders
Wing, L., & Shah, A. (2006) · International review of neurobiology · doi:10.1016/s0074-7742(05)72002-x · Cited by 112
Self-citationBeacher, F. D. C. C., Minati, L., Baron‐Cohen, S., Lombardo, M. V., Lai, M., Gray, M. A., Harrison, N. A., & Critchley, H. (2011) · American Journal of Neuroradiology · doi:10.3174/ajnr.a2880 · Cited by 117
The impact of robotic intervention on joint attention in children with autism spectrum disorders
Kumazaki, H., Yoshikawa, Y., Yoshimura, Y., Ikeda, T., Hasegawa, C., Saito, D. N., Tomiyama, S., An, K., Shimaya, J., Ishiguro, H., et al. (2018) · Molecular Autism · doi:10.1186/s13229-018-0230-8 · Cited by 111
“The children with ASD were diagnosed using the Autism Diagnostic Observational Schedule-Generic (ADOS-G) [35], the Diagnostic Interview for Social and Communication Disorders (DISCO) [36], and the DSM-5 criteria at the time of recruitment for this study.”
MethodValidation of the Autism Spectrum Screening Questionnaire in a Total Population Sample
Posserud, M.-B. R., Lundervold, A. J., & Gillberg, C. (2008) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-008-0609-z · Cited by 116
“) assessed 48 of the 56 ASD screen positive children in the third phase with the Diagnostic Interview for Social and Communication Disorders (DISCO, tenth revision) (Wing et al. 2002).”
DuBois, D., Lymer, E., Gibson, B. E., Desarkar, P., & Nalder, E. J. (2017) · Brain Sciences · doi:10.3390/brainsci7080108 · Cited by 108
“As previously mentioned, several questionnaires (GSQ, DISCO, SBS and SR-AS) were developed specifically for individuals with ASD.”
MethodInfluentialSmaller insula and inferior frontal volumes in young adults with pervasive developmental disorders
Kosaka, H., Omori, M., Munesue, T., Ishitobi, M., Matsumura, Y., Takahashi, T., Narita, K., Murata, T., Saito, D. N., Uchiyama, H. T., et al. (2010) · NeuroImage · doi:10.1016/j.neuroimage.2010.01.085 · Cited by 107
“Author T.M. was trained in the diagnosis of PDD under Dr. Tokio Uchiyama and was qualified to use the DISCO (DISCO Japanese edition, 2007).”
Influential
Metadata
- Authors
- Wing, L., Leekam, S. R., Libby, S. J., Gould, J., & Larcombe, M.
- Affiliations
- Durham University (GB)
- University of East Anglia (GB)
- University of Plymouth (GB)
- Corresponding author
- Wing, Lorna
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2002-03
- Volume
- 43
- Issue
- 3
- Pages
- 307-325
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2118415569
- Cited by
- 694
- References
- 37
- Citations by year
- 2026: 21 · 2025: 26 · 2024: 21 · 2023: 18 · 2022: 35 · 2021: 43 · 2020: 35 · 2019: 41 · 2018: 36 · 2017: 31 · 2016: 43 · 2015: 34 · 2014: 37 · 2013: 39 · 2012: 44
- FWCI
- 4.51
- Type
- journal article
- Language
- en
- Open access
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Durham Research Online (Durham University) (acceptedVersion)
- Durham Research Online (Durham University) (submittedVersion, cc-by)
- Funders
- University of Kent
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- disco, autism spectrum disorder, inter-rater reliability, diagnostic interview, learning disabilities, language disorders, parent interviews, developmental assessment, children
- MeSH terms
- Adolescent, Age Factors, Autistic Disorder, Child, Communication Disorders, Female, Humans, Interview, Psychological, Male, Sensitivity and Specificity, Social Behavior Disorders, Reproducibility of Results, Observer Variation
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