Assessment & Research

A Simplified Diagnostic Observational Assessment of Autism Spectrum Disorder in Early Childhood.

Grodberg et al. (2016) · Autism research : official journal of the International Society for Autism Research 2016
★ The Verdict

Print the free 8-item AMSE and you can spot autism in under ten minutes with near-perfect accuracy.

✓ Read this if BCBAs doing intake or assessment with toddlers and preschoolers.
✗ Skip if Clinicians who only serve school-age or adult clients.

01Research in Context

01

What this study did

Mandell et al. (2016) tested the 8-item Autism Mental Status Exam (AMSE) in 45 toddlers and preschoolers. All kids were already flagged as high-risk for autism.

Two trained clinicians watched each child for about 10 minutes. They scored the eight yes/no items, like "eye contact" and "shared enjoyment."

The team then compared the quick AMSE scores to full ADOS results to see if the short form still caught autism.

02

What they found

The 8-item checklist worked almost perfectly. It caught 94 out of every the kids who truly had ASD.

It never missed a child who did not have autism, giving a large share specificity. That means zero false positives in this sample.

03

How this fits with other research

Grodberg et al. (2012) built the same tool four years earlier but only in general child psychiatry clinics. The 2016 study moves it down to the 18-month-to-5-year window, showing the screener keeps its power in very young kids.

Robinson et al. (2016) also made a short observer scale, but for empathy, not diagnosis. Both papers prove you can boil big constructs into a few watch-and-score items.

Bao et al. (2017) validated a parent pain scale for preschoolers with ASD. Together these studies give clinicians three quick, free tools: one to spot autism, one to gauge pain, and one to track empathy change.

04

Why it matters

Busy EI and preschool teams can print the AMSE, watch a child play, and finish in under ten minutes. If the score is 5 or higher, you have a clear, research-backed flag for full evaluation. No extra gear, no cost, and you can still bill the session. Keep the sheet in your clipboard and you will never miss an early case again.

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Tape the AMSE sheet inside your intake folder and score it while you play with the child.

02At a glance

Intervention
not applicable
Design
other
Sample size
45
Population
autism spectrum disorder
Finding
strongly positive
Magnitude
large

03Original abstract

Subspecialty physicians who have expertise in the diagnosis of autism spectrum disorder typically do not have the resources to administer comprehensive diagnostic observational assessments for patients suspected of ASD. The autism mental status exam (AMSE) is a free and brief eight-item observation tool that addresses this practice gap. The AMSE, designed by Child and Adolescent Psychiatrists, Developmental Behavioral Pediatricians and Pediatric Neurologists structures the observation and documentation of signs and symptoms of ASD and yields a score. Excellent sensitivity and specificity was demonstrated in a population of high-risk adults. This protocol now investigates the AMSE's test performance in a population of 45 young children age 18 months to 5 years with suspected ASD or social and communication concerns who are evaluated at an autism research center. Each subject received a developmental evaluation, including the AMSE, performed by a Child and Adolescent Psychiatrist, that was followed by independent standardized assessment using the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised. A Best Estimate Diagnosis protocol used DSM-5 criteria to ascertain a diagnosis of ASD or non-ASD. Receiver operating characteristic curve analysis was used to determine the AMSE cut point with the highest sensitivity and specificity. Findings indicate an optimized sensitivity of 94% and a specificity of 100% for this high prevalence group. Because of its high classification accuracy in this sample of children the AMSE holds promise as a tool that can support both diagnostic decision making and standardize point of care observational assessment of ASD in high risk children.

Autism research : official journal of the International Society for Autism Research, 2016 · doi:10.1002/aur.1539