Assessment & Research

Evaluation of the criterion and convergent validity of the Diagnostic Interview for Social and Communication Disorders in young and low-functioning children.

Maljaars et al. (2012) · Autism : the international journal of research and practice 2012
★ The Verdict

DISCO-11 is solid for preschoolers with mild ID, but expect it to over-diagnose autism in kids with severe delay.

✓ Read this if BCBAs who diagnose autism in clinic or school teams.
✗ Skip if Practitioners who only run skill-building programs and never sit on diagnosis teams.

01Research in Context

01

What this study did

The team tested the DISCO-11 interview on preschoolers.

Kids had autism, intellectual disability, or typical development.

They checked if DISCO-11 ICD-10 rules gave the right diagnosis.

02

What they found

DISCO-11 worked well for children with mild delay or average IQ.

It over-called autism in kids with moderate or severe ID.

Expect false positives when cognitive scores are very low.

03

How this fits with other research

Hong et al. (2021) and Liu et al. (2026) show ADOS-2 also needs different cut-offs for delayed kids.

Bennett et al. (2008) found the revised ADOS over-labels autism in Hispanic children with mild social problems.

All three papers agree: lower the diagnostic bar when language or IQ is low, or you will get false positives.

Le Couteur et al. (2008) already showed that using two tools together boosts accuracy, so pair DISCO-11 with an observation measure.

04

Why it matters

If you give DISCO-11 to a preschooler with severe ID, double-check the result.

Add an ADOS-2 and watch play skills yourself.

This combo keeps you from telling a family the child has autism when the real issue is profound cognitive delay.

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If the child’s IQ or adaptive scores are below 50, schedule an ADOS-2 before you sign off on the DISCO-11 result.

02At a glance

Intervention
not applicable
Design
other
Sample size
115
Population
autism spectrum disorder, intellectual disability, neurotypical
Finding
positive

03Original abstract

The Diagnostic Interview for Social and Communication Disorders (DISCO; Wing, 2006) is a standardized, semi-structured and interviewer-based schedule for diagnosis of autism spectrum disorder (ASD). The objective of this study was to evaluate the criterion and convergent validity of the DISCO-11 ICD-10 algorithm in young and low-functioning children. The DISCO-11, Autism Diagnostic Observation Schedule (ADOS), and Social Communication Questionnaire (SCQ) were administered to a Dutch sample of 115 children comprising 52 children with ASD (both with and without intellectual disability), 26 children with intellectual disability (non-ASD), and 37 typically developing children. Results indicated high sensitivity and specificity for DISCO-11 classifications in differentiating ASD from non-ASD according to the clinical classification in children with mild intellectual disability or average intelligence. Among children with a moderate or severe intellectual disability the sensitivity was equally high, but the specificity was significantly lower. The agreement between DISCO-11 and ADOS classifications was substantial, between DISCO-11 and SCQ moderate. The correlations between raw scores of the DISCO and ADOS algorithm or SCQ were both high. In conclusion, the DISCO-11 differentiates accurately between autistic disorder and non-ASD in young children with an average intelligence or mild intellectual disability, but is over inclusive in the lower levels of intellectual disability.

Autism : the international journal of research and practice, 2012 · doi:10.1177/1362361311402857