Comparison between diagnostic instruments for identifying high-functioning children with autism.
For high-functioning autism the ADI catches more cases than the ABC, yet neither beats careful clinical eyes.
01Research in Context
What this study did
The team compared two paper checklists used to spot autism in bright, verbal kids.
They gave both the Autism Diagnostic Interview (ADI) and the Autism Behavior Checklist (ABC) to the children who already had a diagnosis.
Parents answered questions, and clinicians scored each tool to see which one caught the most cases.
What they found
The ABC missed most current diagnoses unless parents added old memories.
The ADI missed only three kids, and two of those were borderline on the ABC.
In short, the ADI was safer, but neither tool was perfect.
How this fits with other research
Fombonne (1992) saw the same ADI edge two years earlier, but in teens with severe delays.
Schaaf et al. (2015) later showed that DSM-5 rules strip diagnosis from 25–50 % of high-functioning clients.
Together the papers warn: checklists shrink the autism label at both ends—bright kids and delayed kids can slip through.
Why it matters
If you test a smart, chatty child, do not trust the ABC alone.
Add the ADI and still watch real-life play and social cues.
Keep notes on adaptive gaps too; later studies show IQ can hide daily-skills deficits that matter for funding and goals.
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02At a glance
03Original abstract
Two instruments for identifying autism in children and adolescents with intellectual abilities in the normal range were compared. Diagnostic tools consisted of the Autism Behavior Checklist (ABC) and the Autism Diagnostic Interview (ADI). The sample was composed of 18 children who were all diagnosed as having either infantile autism or infantile autism, residual state based on DSM-III criteria by a clinical team using observations, parental interviews, and interactions with the children. Only 4 of the children met diagnostic cutoffs for autism on the current ABC but all met criteria for diagnosis on the ABC using parental recall of the child's behavior at 3-5 years of age. The ADI had somewhat greater specificity in that 3 children did not meet criteria for diagnosis although 2 of these children also received ABC scores based on parental recollection that were in the borderline range.
Journal of autism and developmental disorders, 1994 · doi:10.1007/BF02172227