Background The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) module four assessment for diagnosing autism spectrum disorder in adults has shown good sensitivity and specificity in research settings. Method This study aimed to evaluate the predictive accuracy of the ADOS-2 module four by investigating the components of the assessment, in relation to diagnostic outcome in a clinical setting. Data from 88 service users referred to a Specialist Adult Autism Service was explored. Results ADOS-2 scores failed to predict the diagnostic outcome (overall sensitivity = 92%, specificity = 57%). Interestingly, scores from the ‘restricted interests’ component of the ADOS-2 have the potential to predict diagnostic outcome, despite this domain not been included in the scoring algorithm. Conclusions Based on our findings, we recommend clinicians are cautious when interpreting results of the ADOS-2 assessment.

Purpose The Adult Asperger Assessment (AAA), comprising the Autism Questionnaire, the Empathy Quiotient and the Relatives Questionnaire is a commonly used screening tool designed to identify adults who may benefit from a further clinical assessment for autism spectrum disorder. The purpose of this paper is to investigate the usefulness of this screening measure in a clinical setting. Design/methodology/approach This retrospective cohort study comprised of 192 service users referred for diagnostic assessment of Autism by a specialist service of the National Health Service. The authors evaluated the diagnostic accuracy of the AAA by investigating if the Autism Questionnaire, the Empathy Quiotient and the Relatives Questionnaire were able to predict the diagnostic outcome of Autism in a clinical setting. Findings Scores from the Relatives Questionnaire can accurately predict diagnostic outcome. No evidence of accuracy for the Autism Questionnaire or the Empathy Quotient was apparent. Based on the findings, the authors recommend clinicians are cautious when interpreting results of the AAA. Research limitations/implications It should be acknowledged that the results may not be generalisable to whole populations. Also, the authors used the full item versions of the scales; therefore, the findings are most applicable to studies which did similar. Originality/value This study highlights the need for investigation into the lack of validation of commonly used screening measures in autistic populations.

Stephanie Wetherhill is a Support Worker, based at The Disabilities Trust, The Brain Injury Rehabilitation Trust, Leeds, UK. AbstractPurpose -The purpose of this paper is to review evidence for the importance of the wider society to combat mental health, long-term effects of TBI and the stigma and discrimination within the western society in particular. Design/methodology/approach -In favour of the neurobehavioural framework, studies included in this review are those conducted under such settings. Findings -Literature shows evidence of significant progress made under the neurobehavioural framework particularly, and, other intense rehabilitation schemes. Community rehabilitation is important for meeting emotional needs and furthering progress in this area, along side physical difficulties. Research limitations/implications -Access to all journal search engines was not possible in this case and thus there may be more research which may be useful in this paper. It is not based on any strict empirical evidence, however -it is based on experience and work in the field. More empirical research is needed in this area. Practical implications -Implications of this paper are to stress the importance of social rehabilitation, the documentation of behaviour and rehabilitation outcomes including measurements of success. Social implications -Social implications are infinite. Increasing the knowledge of TBI is necessary to allow survivors to live in the community with dignity, understanding and support. Awareness of such social disabilities may increase tolerance and patience among those least experienced in this aspect of disability. Communities may become more accepting and thus accommodate more for those living with TBI and ABI. Originality/value -There is less research on the qualitative data within services for rehabilitation in this field. A population whereby TBI/ABI symptoms and specific mental health sequelae coexist is less common and therefore can provide unique insight into the importance of community during rehabilitation.