Diagnosing autism spectrum disorders in pre-school children using two standardised assessment instruments: the ADI-R and the ADOS.
Running both the ADI-R interview and ADOS play test together gives a more accurate autism diagnosis in preschoolers.
01Research in Context
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.
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.
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.
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.
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02At a glance
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