Exploring diagnostic validity of the autism diagnostic observation schedule‐2 in South Korean toddlers and preschoolers

Lee, Kyung Sook; Chung, Suk Jin; Thomas, Hannah; Park, Jinah; Kim, So Hyun

doi:10.1002/aur.2125

Cited by 10 publications

(26 citation statements)

References 37 publications

(68 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The current study, having a large independent clinical sample, replicates previous findings on the clinical validity of ADOS‐2 Toddler module (Lee et al, 2019; Luyster et al, 2009). The optimal cut‐off scores determined in our sample (see Tables 2 and 3) are exactly the same as those identified by Luyster et al (2009).…”

Section: Discussionsupporting

confidence: 88%

“…The clinical validity of ADOS‐2 Modules 1–4 have been well established, both in the United States and international samples (Bal & Lord, 2015; de Bildt et al, 2011; Gotham et al, 2007; Gotham et al, 2009; Hus & Lord, 2014; Medda et al, 2019; Pugliese et al, 2015; Zander et al, 2016). However, there have been only two studies examining the clinical validity of the ADOS‐2 Toddler Module (Lee et al, 2019; Luyster et al, 2009). Luyster et al's study included a multisite evaluation of the ADOS‐2 Toddler Module with 182 children (age range 12–30 months), of whom 59 had ASD, 43 had non‐spectrum developmental delay, and 104 were typically developing.…”

Section: Introductionmentioning

confidence: 99%

“…Their chosen cut‐off yielded 88%–91% sensitivity and 91%–94% specificity. Lee et al (2019) investigated validity of a Korean version of the ADOS‐2 Toddler Module with 56 toddlers (24 with ASD, 18 with non‐spectrum disorders, and 14 typically developing). With the lower cut‐off (mild‐to‐moderate concern), Lee et al (2019) identified sensitivity of 94%–100% and specificity of 82%–94%.…”

Section: Introductionmentioning

confidence: 99%

“…Lee et al (2019) investigated validity of a Korean version of the ADOS‐2 Toddler Module with 56 toddlers (24 with ASD, 18 with non‐spectrum disorders, and 14 typically developing). With the lower cut‐off (mild‐to‐moderate concern), Lee et al (2019) identified sensitivity of 94%–100% and specificity of 82%–94%. With the higher cut‐off (moderate‐to‐severe concern), Lee et al (2019) identified sensitivity of 50%–83% and specificity of 100%.…”

Section: Introductionmentioning

confidence: 99%

“…With the lower cut‐off (mild‐to‐moderate concern), Lee et al (2019) identified sensitivity of 94%–100% and specificity of 82%–94%. With the higher cut‐off (moderate‐to‐severe concern), Lee et al (2019) identified sensitivity of 50%–83% and specificity of 100%. Their small sample size prohibited generation of guidelines for defining cut‐off scores to optimize sensitivity and specificity.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Replication study of ADOS‐2 Toddler Module cut‐off scores for autism spectrum disorder classification

et al. 2021

View full text Add to dashboard Cite

The Autism Diagnostic Observation Schedule, Second Edition (ADOS‐2) has been regarded as the gold standard assessment of autism spectrum disorder (ASD). While clinical validity of ADOS‐2 Modules 1–4 have been extensively studied, there has been very limited research examining the clinical validity of ADOS‐2 Toddler Module. The goal of this study was to examine alignment of the ADOS‐2 Toddler Module classification with clinicians' determination of ASD, with assessing cut‐off scores for diagnosing ASD in toddlers. A total of 412 toddlers ages 12–30 months who received ADOS‐2 Toddler Module as well as a best estimate clinical (BEC) diagnosis, were included in this study. ADOS‐2 Toddler Module cut‐off scores were determined using the appropriate algorithms (Algorithm 1 for toddlers aged 12–20 months and those aged 21–30 months with <5 words, Algorithm 2 for toddlers aged 21–30 months with 5 words or more). Receiver operating characteristic (ROC) curves were used to assess cut‐off scores that optimized sensitivity and specificity when compared against BEC diagnosis. The selected cut‐off scores were examined using frequency tables to compare ADOS‐2 classification against BEC diagnosis. For Algorithm 1, classification statistics were optimized at the cut‐off score of 12 with an area under the curve (AUC) of 0.92. For Algorithm 2, classification statistics were optimized at the cut‐off score of 10 with an AUC of 0.96. The ADOS‐2 Toddler Module classification is strongly aligned with BEC diagnosis. The optimal cut‐off scores identified in the current study reflect the same results configured by the prior study. Lay Summary ADOS‐2 Toddler Module has been widely used for the ASD assessment, but there have been limited research on its clinical validity. This study is the first replication of the ADOS‐2 Toddler Module with a large independent sample. We examined alignment of the ADOS‐2 Toddler Module classification with clinicians' determination of ASD, with assessing cut‐off scores, and confirmed the clinical validity of ADOS‐2 Toddler Module. Cut‐off scores of ADOS‐2 Toddler Module cited in the manual yielded best clinical utility for diagnosing ASD in toddlers.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Replication study of ADOS‐2 Toddler Module cut‐off scores for autism spectrum disorder classification

et al. 2021

View full text Add to dashboard Cite

show abstract

Cultural differences in social communication and interaction: A gap in autism research

et al. 2021

View full text Add to dashboard Cite

Social communication and interaction deficits are a diagnostic criteria of autism and integral to practitioner and researcher conceptualization. Culture is an influential factor in expectations for, and demonstration of, social communication and interaction skills, but there is limited research published in autism journals on this topic. This paucity of autism research examining cultural factors related to social communication and interaction may contribute to known identification disparities for racial and ethnic populations minoritized by systemic factors and research bias. We call for increased commitment from researchers to recruit racially and ethnically minoritized participants, prioritize investigating cultural expectations and perceptions of social communication and interaction, and evaluate measures related to social communication for cultural and linguistic responsivity. Lay Summary A diagnosis of autism requires the presence of deficits in social communication and interaction. Examples of these behaviors and skills include holding a back‐and‐forth conversation, the use of nonverbal communicative behaviors (e.g., gestures), and developing and maintaining social relationships. Culture influences the expectations for, and presentation of, these behaviors. However, research on this topic is lacking. Conducting more research related to culture and social communication could help reduce the disparities in autism identification across racially and ethnically minoritized populations.

show abstract

Replication study for ADOS‐2 cut‐offs to assist evaluation of autism spectrum disorder

et al. 2022

View full text Add to dashboard Cite

The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) has been widely used for ASD assessment. While prior studies investigated sensitivity and specificity of ADOS-2 Modules 1-3, there has been limited research addressing algorithm cut-off scores to optimize ADOS-2 classification. The goal of this study was to assess algorithm cut-off scores for diagnosing ASD with Modules 1-3, and to evaluate alignment of the ADOS-2 classification with the best estimate clinical diagnosis. Participants included 3144 children aged 31 months or older who received ADOS-2 Modules 1-3, as well as the best estimate clinical diagnosis. Five classification statistics were reported for each module: sensitivity, specificity, positive predictive value, negative predictive value, and accuracy (i.e., Receiver Operator Classification Statistic), and these statistics were calculated for the optimal cut-off score. Frequency tables were used to compare ADOS-2 classification and the best estimate clinical diagnosis. Half of the sample received Module 3, 21% received Module 2, and 29% received Module 1. The overall prevalence of ASD was 60%; the male-to-female ratio was 4:1, and half of the sample was non-White. Across all modules, the autism spectrum cut-off score from the ADOS-2 manual resulted in high sensitivity (95%+) and low specificity (63%-73%). The autism cut-off score resulted in better specificity (76%-86%) with favorable sensitivity (81%-94%). The optimal cut-off scores for all modules based on the current sample were within the autism spectrum classification range except Module 2 Algorithm 2. In the No ASD group, 29% had false positives (ADOS-2 autism spectrum classification or autism classification). The ADOS-2 autism spectrum classification did not indicate directionality for diagnostic outcome (ASD 56% vs. No ASD 44%). While cut-off scores of ADOS-2 Modules 1-3 in the manual yielded good clinical utility in ASD assessment, false positives and low predictability of the autism spectrum classification remain challenging for clinicians. Lay summary: ADOS-2 Modules 1-3 have been widely used for ASD assessment, but there has been limited research on algorithm cut-off scores to optimize ADOS-2 clinical performance. Using a large independent sample, we examined alignment of the ADOS-2 classification with clinicians' best estimate clinical diagnosis, assessing algorithm cut-off scores. Cut-off scores of ADOS-2 Modules 1-3 in the manual yielded good clinical utility in ASD classification. The optimal cutoff scores based on the current sample were generally within the autism spectrum classification range.

show abstract

Exploring diagnostic validity of the autism diagnostic observation schedule‐2 in South Korean toddlers and preschoolers

Cited by 10 publications

References 37 publications

Replication study of ADOS‐2 Toddler Module cut‐off scores for autism spectrum disorder classification

Replication study of ADOS‐2 Toddler Module cut‐off scores for autism spectrum disorder classification

Cultural differences in social communication and interaction: A gap in autism research

Replication study for ADOS‐2 cut‐offs to assist evaluation of autism spectrum disorder

Contact Info

Product

Resources

About