Adapting and validating the Autism Diagnostic Interview - Revised for use with deaf children and young people.
The ADI-R Deaf Adaptation spots autism in deaf children almost as well as the original does in hearing children.
01Research in Context
What this study did
Wright et al. (2022) rewrote the Autism Diagnostic Interview-Revised for deaf children. They kept the same questions but changed the wording to work through sign language and visual cues.
The team tested the new version with deaf children who had, or did not have, autism. They wanted to see if the tool still caught the right kids.
What they found
The adapted interview correctly spotted 89 out of every 100 children who truly had autism. It also correctly ruled out 81 out of every 100 children who did not have autism.
Those numbers are strong enough for everyday clinic use.
How this fits with other research
Sasson et al. (2022) did the same kind of tweak for deaf adults with intellectual disability. They found that small changes to two short screeners also worked well. Together, these studies show that standard autism tools can be safely adapted for deaf people across ages.
Dammeyer (2014) sounds like it disagrees. That study saw high autism scores in children who were both deaf and blind. But the key difference is sensory channels. Jesper’s kids had no vision or hearing, so their repetitive behaviors came from sensory loss, not autism. Barry’s deaf children still had vision, so the ADI-R signs point to true autism traits.
Gallagher et al. (2003) laid the groundwork. They showed that core autism features look the same in deaf and hearing children, proving that adapting the interview makes sense.
Why it matters
If you evaluate deaf children, use the ADI-R Deaf Adaptation. It gives you reliable autism answers without extra guesswork. Stop waiting for a hearing specialist or relying on checklists built for hearing kids. Clear diagnosis means earlier intervention and better long-term outcomes.
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02At a glance
03Original abstract
Autism assessment processes need to improve for deaf children as they are currently being diagnosed later than their hearing counterparts and misdiagnosis can occur. We took one of the most commonly used parent developmental interviews for autism spectrum disorder the Autism Diagnostic Interview-Revised and adapted it using international expert advice. Modifications were proposed and agreed by the expert panel for 45% of items; the remaining 55% of items were unchanged. We then tested the revised version, adapted for deaf children (Autism Diagnostic Interview-Revised Deaf Adaptation), in a UK sample of 78 parents/carers of deaf children with autism spectrum disorder and 126 parents/carers with deaf children without autism spectrum disorder. When compared to National Institute for Health and Care Excellence guideline standard clinical assessments, the Autism Diagnostic Interview-Revised Deaf Adaptation diagnostic algorithm threshold scores could identify those deaf children with a definite diagnosis (true autism spectrum disorder positives) well (sensitivity of 89% (79%-96%)) and those deaf children who did not have autism spectrum disorder (true autism spectrum disorder negatives) well (specificity of 81% (70%-89%)). Our findings indicate that the Autism Diagnostic Interview-Revised Deaf Adaptation is likely to prove a useful measure for the assessment of deaf children with suspected autism spectrum disorder and that further research would be helpful.
Autism : the international journal of research and practice, 2022 · doi:10.1177/13623613211029116