Diagnosing autism: analyses of data from the Autism Diagnostic Interview.
The ADI-R stays the gold standard, but short parent forms can stand in when stakes and symptoms are low.
01Research in Context
What this study did
Lord et al. (1997) tested how well the Autism Diagnostic Interview-Revised (ADI-R) spots autism.
They looked at whether its questions match the DSM-IV checklist.
Kids with autism, intellectual disability, and other delays took part.
What they found
The full interview plus developmental history gave a clear yes-or-no answer across all language levels.
Items that asked about early social and communication past worked best.
How this fits with other research
Ferreri et al. (2011) later showed two 15-minute parent checklists match the 2-hour ADI-R over 90% of the time.
This looks like a clash, but the studies asked different questions. C et al. aimed for top accuracy in tricky cases; J et al. wanted a fast screen for typical clinics.
Chen et al. (2001) kept the same interview style but trimmed it for bright, verbal adults with Asperger Syndrome and still hit excellent reliability.
Ventola et al. (2007) used the ADI-R to separate autism from general developmental delay after a failed M-CHAT, proving the tool helps in differential diagnosis.
Why it matters
Use the whole ADI-R when you need court-level certainty or the case is complex. Reach for a brief parent scale when time is short and the child shows clear red flags. Keep developmental history in the mix; it sharpens every score.
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02At a glance
03Original abstract
Results from ROC curves of items from two scales, the Autism Diagnostic Interview (ADI) and Autism Diagnostic Interview-Revised (ADI-R), operationalizing DSM-IV criteria for autism are presented for 319 autistic and 113 other subjects from 8 international autism centers. Analyses indicate that multiple items were necessary to attain adequate sensitivity and specificity if samples with varying levels of language were considered separately. Although considering only current behavior was generally sufficient when a combination cutoff and additive model was employed, predictive power was highest when history was taken into account. A single set of criteria, as operationalized by individually structured questions in the ADI/ADI-R, was effective in differentiating autism from mental handicap and language impairment in subjects with a range of chronological ages and developmental levels.
Journal of autism and developmental disorders, 1997 · doi:10.1023/a:1025873925661