Assessment & Research

Diagnosing autism spectrum disorders in pre-school children using two standardised assessment instruments: the ADI-R and the ADOS.

Le Couteur et al. (2008) · Journal of autism and developmental disorders 2008
★ The Verdict

Running both the ADI-R interview and ADOS play test together gives a more accurate autism diagnosis in preschoolers.

✓ Read this if BCBAs who conduct or interpret autism assessments in clinic or school intake teams.
✗ Skip if RBTs who only run skill-acquisition programs and never sit in on evaluations.

01Research in Context

01

What this study did

The team gave the preschoolers both the ADI-R parent interview and the ADOS play-based observation.

All children were already referred for possible autism.

They compared the two tools to see how often they agreed on the diagnosis.

02

What they found

The tests agreed on 84 percent of cases when calling autism "core" or "non-core."

Using both tools together caught more true cases than either tool alone.

The pair gave a clearer yes-or-no answer for three- to five-year-olds.

03

How this fits with other research

Bennett et al. (2008) saw the revised ADOS over-identify autism in Hispanic kids with mild social delays.

The samples differ, so the two studies do not truly clash; both say "know your population."

Hong et al. (2021) later confirmed ADOS-the Toddler Module cut-offs work in even younger kids, extending the tool downward.

Hus et al. (2014) then added calibrated domain scores, giving us finer Social-Affect and RRB numbers built on the same ADOS base.

04

Why it matters

If you assess preschoolers, schedule the ADI-R interview and the ADOS observation on the same day.

The ten-minute rule of thumb: one parent story plus one structured play equals higher confidence.

When scores disagree, re-check language level and cultural context before you decide.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Book the ADI-R and ADOS for the same assessment block and note agreement on your intake form.

02At a glance

Intervention
not applicable
Design
other
Population
autism spectrum disorder
Finding
positive

03Original abstract

The reliable diagnosis of Autism/Autism Spectrum Disorder in pre-school children is important for access to early intervention and for accurate ascertainment for research. This paper explores the combined use of two standardised assessment instruments--the Autism Diagnostic Interview Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS)--in a large sample of pre-school children. The children were recruited to research studies, and a 'best estimate' clinical diagnosis reached. The findings show good agreement between the instruments especially for children with core Autism. The instruments appear to have a complementary effect in aiding diagnosis and confirm the importance of a multidisciplinary assessment process with access to information from different sources and settings. The presence of repetitive behaviours during the ADOS appeared of diagnostic significance.

Journal of autism and developmental disorders, 2008 · doi:10.1007/s10803-007-0403-3