The autism mental status exam: sensitivity and specificity using DSM-5 criteria for autism spectrum disorder in verbally fluent adults.
The 8-item AMSE interview spots ASD in verbally fluent adults with 91 % sensitivity and 93 % specificity.
01Research in Context
What this study did
Giofrè et al. (2014) tested an 8-item interview called the Autism Mental Status Exam (AMSE). They wanted to see if it could spot ASD in verbally fluent adults.
The team checked each adult against the new DSM-5 rules. They then asked if the AMSE agreed with those full criteria.
What they found
The AMSE caught 91 out of every 100 adults who truly had ASD. It also correctly ruled out 93 out of every 100 adults who did not have ASD.
Those numbers mean the tool is both sensitive and specific. In plain words, it rarely misses autism and it rarely cries wolf.
How this fits with other research
Barnard-Brak et al. (2016) warned that the SCQ parent form loses accuracy in adults. The AMSE now fills that gap with a quick clinician interview instead of a parent form.
van den Broek et al. (2006) showed the M-CHAT and SCQ miss many higher-functioning children. The AMSE picks up where those toddler tools leave off, giving adults a brief screen that actually works.
Burrows et al. (2018) later used the same 8 AMSE items in children and found girls show more language issues than boys, but the tool still works for both sexes. Together these papers stretch the AMSE from adults down to kids without breaking its validity.
Why it matters
If you assess adults for ASD, you can now start with an 8-question interview that takes only a few minutes. A high AMSE score tells you to keep digging; a low score lets you rule out ASD quickly. Add it to your intake packet and you will spend less time on long batteries while still catching the clients who need full evaluation.
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02At a glance
03Original abstract
The phenotypic heterogeneity of adults suspected of autism spectrum disorder (ASD) requires a standardized diagnostic approach that is feasible in all clinical settings. The autism mental status exam (AMSE) is an eight-item observational assessment that structures the observation and documentation of social, communicative and behavioral signs and symptoms of ASD. Previous findings indicate high classification accuracy when compared to the autism diagnostic observation schedule in a non-stratified population of high-risk patients suspected of having ASD. This protocol investigates the sensitivity and specificity of AMSE scores using DSM-5 criteria for ASD in a sample of high-risk verbally fluent adults. Findings indicate an optimized sensitivity of 0.91 and a specificity of 0.93 for this group. Because of its high clinical utility, the AMSE holds promise as a diagnostic assessment tool that can support one's clinical diagnosis of ASD in high-risk adults.
Journal of autism and developmental disorders, 2014 · doi:10.1007/s10803-013-1917-5