Assessment & Research

New autism diagnostic interview-revised algorithms for toddlers and young preschoolers from 12 to 47 months of age.

Kim et al. (2012) · Journal of autism and developmental disorders 2012
★ The Verdict

Switch to the toddler ADI-R algorithm for kids 12-47 months to cut missed diagnoses.

✓ Read this if BCBAs who conduct or supervise autism assessments for toddlers in clinic or early-intervention settings.
✗ Skip if Practitioners who only serve school-age clients or rely solely on ADOS teams.

01Research in Context

01

What this study did

The team built new scoring rules for the Autism Diagnostic Interview-Revised.

They wanted a version that works for toddlers and young preschoolers aged 12 to 47 months.

Kids with autism, typical kids, and kids with other delays all took part.

02

What they found

The new toddler rules caught more autism cases and made fewer false alarms.

Sensitivity and specificity both improved compared with the old algorithm.

03

How this fits with other research

Lancioni et al. (2006) warned that the original ADI-R often missed toddlers. They saw that many little ones had not yet shown repetitive behaviors.

Kim et al. (2012) fixed the gap. They lowered the behavior count needed and added age-based cut-offs.

Saemundsen et al. (2003) showed ADI-R and CARS only agreed about two-thirds of the time. The toddler update narrows that gap by making the interview more sensitive early on.

Hedley et al. (2015) found the 10-minute ADEC play screen also caught most ASD toddlers. The new ADI-R rules give you a second, deeper tool when you need a full diagnosis.

04

Why it matters

If you assess toddlers, ask your team which ADI-R algorithm they use. The toddler version gives cleaner answers and saves families from repeat visits. Swap the disk or update the software, then trust the lower cut-offs for kids under four.

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→ Action — try this Monday

Email your assessment team to confirm the toddler ADI-R algorithm is installed and select the 12-47 month option before your next intake.

02At a glance

Intervention
not applicable
Design
other
Sample size
829
Population
autism spectrum disorder, neurotypical, mixed clinical
Finding
positive

03Original abstract

Autism Diagnostic Interview-Revised (Rutter et al. in Autism diagnostic interview-revised. Western Psychological Services, Los Angeles, 2003) diagnostic algorithms specific to toddlers and young preschoolers were created using 829 assessments of children aged from 12 to 47 months with ASD, nonspectrum disorders, and typical development. The participants were divided into three more homogeneous groups by language level and age. Items that best differentiated the diagnostic groups were selected and arranged into domains based on multifactor item-response analyses. Using the new algorithms for toddlers and preschool children, we were able to improve sensitivity and specificity compared to the previously developed algorithm.

Journal of autism and developmental disorders, 2012 · doi:10.1007/s10803-011-1213-1