Assessment & Research

Assessing Autism Spectrum Disorder in Intellectually Able Adults with the Personality Assessment Inventory: Normative Data and a Novel Supplemental Indicator.

Harrison et al. (2020) · Journal of autism and developmental disorders 2020
★ The Verdict

A new PAI math rule spots autism in smart, undiagnosed adults with 88 % accuracy.

✓ Read this if BCBAs doing adult intake or mental-health assessments in outpatient clinics.
✗ Skip if RBTs who only work with toddlers or use solely play-based assessments.

01Research in Context

01

What this study did

The team built a new math rule inside the Personality Assessment Inventory (PAI). The rule spots autism in bright adults who never got a diagnosis.

They tested the adults with ASD and 67 matched controls. All had IQs in the normal range.

Cross-validation checked the rule twice. It held up both times.

02

What they found

The PAI rule got 88 % of true autism cases right. It kept false positives under 15 %.

One extra score, the "Alone-Time" scale, made the rule even sharper.

03

How this fits with other research

Waldron et al. (2023) pushed screening further. They mined health records with NLP and caught 95 % of autistic young adults. Sievers et al. (2020) gives you a clinic form; A et al. gives you a computer script. Use both and you cover the office and the database.

Barton et al. (2019) did the same kind of work, only in toddlers. They proved a 5-item checklist can flag autism early. B et al. shows the same "short tool works" rule holds for grown-ups.

Deschrijver et al. (2017) looked at brain waves and found motor-planning glitches. Their EEG marker and the PAI rule measure different things, yet both spot high-functioning autism. Together they give you two windows: mind style and brain timing.

04

Why it matters

Many bright adults mask autism and leave your office mis-labeled as anxious or moody. The new PAI function gives you a 15-minute paper-and-pencil screen you can score before intake ends. If the score is high, you move to full ADOS or refer to a specialist. No extra kit, no extra cost. Pair it with the NLP chart review from Waldron et al. (2023) and you can spot missed cases even before they walk in.

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→ Action — try this Monday

Add the PAI discriminant score to your adult intake packet; flag scores above cutoff for follow-up ASD evaluation.

02At a glance

Intervention
not applicable
Design
other
Population
autism spectrum disorder
Finding
positive

03Original abstract

Differential diagnosis of autism spectrum disorder (ASD) among intellectually-able adults often presents a clinical challenge, particularly when individuals present in crisis without diagnostic history. The Personality Assessment Inventory (PAI) is a multiscale personality and psychopathology instrument utilized across clinical settings, but to date there are no published normative data for use of the PAI with adults with ASD. This study provides normative PAI data for adults diagnosed with ASD, with effect size comparisons to the PAI clinical standardization sample and an inpatient sample. Additionally, a discriminant function was developed and cross-validated for identification of ASD-like symptomatology in a clinical population, which demonstrates promise as a screening tool to aid in the identification of individuals in need of specialized ASD assessment.

Journal of autism and developmental disorders, 2020 · doi:10.1007/s10803-020-04450-2