Identifying children with autism spectrum disorders in Iran using the Autism Diagnostic Interview-Revised.
Recalculated ADI-R cut-offs make the interview valid for Iranian kids, but still pair it with ADOS and watch for under-five sensitivity drops.
01Research in Context
What this study did
Samadi et al. (2021) tested the Autism Diagnostic Interview-Revised in Iran. They wanted to know if the Western-made tool still spots autism after cultural tweaks.
Doctors interviewed parents of Iranian children with autism, intellectual disability, and typical development. They recalculated the cut-off scores for social and repetitive-behavior domains.
What they found
The new Iranian cut-offs cleanly split kids with autism from the other two groups. Sensitivity and specificity stayed strong after the adjustment.
The tool now works for Iranian families without losing its core power.
How this fits with other research
Tassé et al. (2013) did the same job in Japan and also found good reliability, but they warned the ADI-R misses more cases in children under five. Iran did not report an age drop-off, so clinicians should still stay alert with toddlers.
de Bildt et al. (2013) compared several cut-off sets in over a thousand Dutch kids. They showed that stricter original rules give the fewest false positives, while looser rules catch more kids but also over-diagnose. Iran’s recalibration lands closer to the strict side, keeping false positives low.
Noterdaeme et al. (2002) and Zander et al. (2015) both proved that adding the ADOS observation boosts accuracy. Iran validated the ADI-R alone, so teams there should still pair it with ADOS whenever possible.
Why it matters
If you assess Iranian children, use the new domain cut-offs instead of the Western manual. The same logic applies anywhere: check if your local sample needs its own thresholds, especially when families describe behaviors differently. Always combine the parent interview with direct observation for the clearest picture.
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02At a glance
03Original abstract
The diagnosis of autism spectrum disorder is a challenging task. Most of the current assessment scales have been developed in the West. The present study examines the applicability of one of the most used scales (the Autism Diagnostic Interview-Revised) in a Middle-Eastern culture. Two studies were undertaken. In the first, the Autism Diagnostic Interview-Revised ratings given to 420 children with autism spectrum disorder, aged 4-11 years, and 110 typically developing children were contrasted. In Study 2, the Autism Diagnostic Interview-Revised ratings of 720 children with autism spectrum disorder were compared with those of 172 children with intellectual disabilities to find out whether the Autism Diagnostic Interview-Revised scale would discriminate between these two types of developmental disabilities. The studies confirmed the acceptability of the scale to Iranian parents and assessors. However, the summary scores used to determine whether a child was likely to have autism spectrum disorder were recalculated on the two domains of social communication and repetitive behaviours, which were identified in the statistical analyses that are recommended for the evaluation of assessment scales. Thus the translated scale with the modified domain scoring proved very suitable for identifying Iranian children with autism spectrum disorder. Having a common tool such as Autism Diagnostic Interview-Revised will strengthen the opportunities to undertake cross-cultural research into the impact of autism spectrum disorder on the child and families.
Autism : the international journal of research and practice, 2021 · doi:10.1177/1362361320974558