Screening for ASD in adults with ID-moving toward a standard using the DiBAS-R and the ACL.
Run DiBAS-R and ACL together to boost autism detection in adults with ID.
01Research in Context
What this study did
The team tested two short checklists on adults with intellectual disability.
One checklist is the DiBAS-R. The other is the ACL. Staff who knew the adults filled both out.
The goal was to see if using both tools together catches more autism cases than either one alone.
What they found
When at least one checklist flagged autism, the pair caught 95 percent of true cases.
When both checklists had to flag autism, the pair was right 88 percent of the time.
Either way, the duo beat single-tool accuracy.
How this fits with other research
Hirota et al. (2018) looked at every adult autism screener and found only three tools with solid backup. The DiBAS-R and ACL combo now joins that short list.
Ritvo et al. (2008) showed the RAADS works well for adults without ID. Riches et al. (2016) fills the gap for adults who do have ID.
Saemundsen et al. (2003) warned that ADI-R and CARS agree only two-thirds of the time. Using two tools side-by-side, as G et al. did, turns that disagreement into a strength instead of a problem.
Why it matters
If you assess adults with ID, bring both checklists to the next meeting. Give them to direct support staff who see the person daily. Count a positive on either if you want to catch almost every autism case, or require both positives if you want fewer false alarms. Either rule takes five minutes and costs nothing.
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Join Free →Print both forms, ask day-hab staff to fill them out before the next visit, and use the dual-positive or either-positive rule to decide if a full autism evaluation is needed.
02At a glance
03Original abstract
BACKGROUND: Identification of Autism Spectrum Disorder (ASD) in persons with intellectual disability (ID) is challenging but essential to allow adequate treatment to be given. This study examines whether the combination of two ASD screening instruments specifically developed for persons with ID, namely, the Diagnostic Behavioral Assessment for ASD-Revised (DiBAS-R) and the Autism Checklist (ACL), improves diagnostic accuracy when used in combination compared to the application of the single instrument. METHOD: A clinical sample of adults with ID who are suspected of having ASD (N =148) was assessed using two ID specific screening scales (DiBAS-R and ACL). The diagnostic validity of the single instruments and of their combination was assessed. RESULTS: While both instruments showed acceptable diagnostic validity when applied alone (DiBAS-R/ACL: sensitivity: 75%/91%; specificity: 75%/75%; overall agreement: 75%/83%), specificity increased when two positive screening results were used (88%), and sensitivity increased (95%) when at least one positive screening result was used. CONCLUSIONS: Different combinations of the ASD screening instruments DiBAS-R and ACL lead to improvements in sensitivity and specificity. The complementary use of the ACL in addition to the sole use of the DiBAS-R improves overall accuracy.
Journal of intellectual disability research : JIDR, 2016 · doi:10.1111/jir.12290