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What is the association between ADI-R scores and final diagnosis of autism in an all IQ adult autism diagnostic service?

What is the association between ADI-R scores and final diagnosis of autism in an all IQ adult... PurposeThe diagnosis of autism in adults often involves the use of tools recommended by NICE guidance but which are validated in children. The purpose of the paper is to establish the strength of the association between the Autism Diagnostic Interview-Revised (ADI-R) scores and the final clinical outcome in an all intellectual quotients adult autism diagnostic service and to establish if this in any way relates with gender and intellectual ability.Design/methodology/approachThe sample includes referrals to Leeds Autism Diagnostic Service in 2015 that received a clinical outcome. Sensitivity, specificity and positive and negative predictive values were calculated to evaluate ADI-R and final clinical outcomes. Logistic regression model was used to predict the effect of the scores in all the domains of ADI-R and the two-way interactions with gender and intellectual ability.FindingsADI-R has a high sensitivity and low specificity and is useful to rule out the presence of autism, but if used alone, it can over diagnose. Restricted stereotyped behaviours are the strongest predictor for autism and suggests that the threshold should be increased to enhance its specificity.Research limitations/implicationsThis is a single site study with small effect size, so results may not be replicable. It supports the combined use of ADI-R and Autism Diagnostic Observation Schedule and suggests increasing ADI-R cut-offs to increase the specificity.Practical implicationsThe clinical team may consider piloting a modified ADI-R as suggested by the results.Originality/valueTo the authors’ knowledge this is the only study of ADI-R in an adult population of all intellectual abilities. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Advances in Autism Emerald Publishing

What is the association between ADI-R scores and final diagnosis of autism in an all IQ adult autism diagnostic service?

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Publisher
Emerald Publishing
Copyright
Copyright © Emerald Group Publishing Limited
ISSN
2056-3868
DOI
10.1108/AIA-05-2017-0012
Publisher site
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Abstract

PurposeThe diagnosis of autism in adults often involves the use of tools recommended by NICE guidance but which are validated in children. The purpose of the paper is to establish the strength of the association between the Autism Diagnostic Interview-Revised (ADI-R) scores and the final clinical outcome in an all intellectual quotients adult autism diagnostic service and to establish if this in any way relates with gender and intellectual ability.Design/methodology/approachThe sample includes referrals to Leeds Autism Diagnostic Service in 2015 that received a clinical outcome. Sensitivity, specificity and positive and negative predictive values were calculated to evaluate ADI-R and final clinical outcomes. Logistic regression model was used to predict the effect of the scores in all the domains of ADI-R and the two-way interactions with gender and intellectual ability.FindingsADI-R has a high sensitivity and low specificity and is useful to rule out the presence of autism, but if used alone, it can over diagnose. Restricted stereotyped behaviours are the strongest predictor for autism and suggests that the threshold should be increased to enhance its specificity.Research limitations/implicationsThis is a single site study with small effect size, so results may not be replicable. It supports the combined use of ADI-R and Autism Diagnostic Observation Schedule and suggests increasing ADI-R cut-offs to increase the specificity.Practical implicationsThe clinical team may consider piloting a modified ADI-R as suggested by the results.Originality/valueTo the authors’ knowledge this is the only study of ADI-R in an adult population of all intellectual abilities.

Journal

Advances in Autism – Emerald Publishing

Published: Oct 2, 2017

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