Applied Behavior Analysis and the Autism Diagnostic Observation Schedule (ADOS): a Symbiotic Relationship for Advancements in Services for Individuals with Autism Spectrum Disorders (ASDs).
Toss Vineland adaptive scores into the mix when ADI-R and ADOS clash to cut diagnostic error by roughly one-third.
01Research in Context
What this study did
The team looked at kids who got different autism labels from two gold-standard tools. They asked: does tossing Vineland adaptive scores into the mix help?
They used the ADI-R parent interview and the ADOS observation. When the two disagreed, they added Vineland scores to see if the match rate improved.
What they found
Adding Vineland lifted agreement from 75% to 84%. That move cut diagnostic mistakes by about one-third.
The boost came from letting adaptive living skills tip the scale when social and behavioral signs were murky.
How this fits with other research
de Bildt et al. (2004) already showed that using both ADI-R and ADOS together beats either one alone. Perez et al. (2015) extends that work by solving the leftover 25% disagreement with a third data source.
Oosterling et al. (2010) and Gotham et al. (2007) proved the revised ADOS algorithms are more accurate. The new study assumes those better algorithms are in place, then stacks Vineland on top for the tough calls.
Paul et al. (2004) found that tiny expressive-communication items on Vineland can separate autism from PDD-NOS. Perez et al. (2015) use the whole adaptive profile, not just language, to settle diagnostic ties.
Why it matters
You now have a quick tie-breaker. When ADI-R and ADOS point in different directions, pull the Vineland protocol off the shelf. One extra score sheet can turn a maybe into a clear yes or no, saving weeks of re-testing and getting the child into the right program faster.
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02At a glance
03Original abstract
The classification agreement of the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) was examined in 129 children and adolescents (aged 7-18 years) who were evaluated for autism. Participants received a diagnosis of autism or non-autism based on the ADI-R. Linear discriminant analysis revealed adequate concordance between the ADI-R and ADOS, with 75% of the participants being correctly classified using the ADOS. Classification accuracy significantly improved to 84% when a measure of adaptive functioning (i.e., the Vineland Adaptive Behavior Scales) was included in the analysis. The findings suggest that when clinicians obtain discrepant information on the ADI-R and ADOS, assessment of an individual's adaptive functioning may reduce diagnostic errors.
Behavior analysis in practice, 2015 · doi:10.1007/s10803-006-0227-6