Study questions the necessity for ADOS in diagnosing ASD

A new study suggests that administering the Autism Diagnostic Observation Schedule (ADOS) may not be necessary in order for clinicians to accurately diagnose autism spectrum disorders (ASD). Developed for use in research studies, the ADOS is currently considered to be part of the “gold standard” diagnosis of ASD. 

The study, involving 349 children between 18 months and five years of age who did not have a prior ASD diagnosis, took place at eight sites—seven in the United States and one in Europe—that provided subspecialty assessments for children suspected to have ASD. William Barbaresi and colleagues asked developmental-behavioral pediatricians at each site to make an initial diagnosis based on clinical assessment. The ADOS was then administered, after which the pediatricians made a second diagnosis. 

The researchers also asked the pediatricians to describe their level of diagnostic certainty at the times of the first and second diagnoses. The researchers found that there was 90 percent agreement between clinical diagnoses alone and diagnoses including information from ADOS. In addition, they say that the clinicians’ diagnostic certainty was the best predictor of consistency between the two diagnoses. 

Noting that the ADOS adds to the time and expense of diagnosing ASD, the researchers conclude, “This study suggests that the ADOS is generally not required for diagnosis of ASD in young children by developmental-behavioral pediatricians and that [these clinicians] can identify children for whom the ADOS may be needed.

Citations

“Clinician diagnostic certainty and the role of the Autism Diagnostic Observation Schedule in autism spectrum disorder diagnosis in young children,” William Barbaresi, Jaclyn Cacia, Sandra Friedman, Jill Fussell, Robin Hansen, Johannes Hofer, Nancy Roizen, Ruth E. K. Stein, Douglas Vanderbilt, and Georgios Sideridis, JAMA Pediatrics, October 17, 2022 (online prior to print publication). Address: William Barbaresi, Division of Developmental Medicine, Boston Children’s Hospital, Harvard Medical School, Brookline, MA 02445, [email protected]. 

—and— 

“Clinical diagnoses of autism spectrum disorder mostly consistent with, without Autism Diagnostic Observation Schedule,” Medical Xpress, October 21, 2022.