Formal Psychological Assessment for Autism Spectrum Disorder Diagnosis: A New Methodology to Build An Adaptive Testing System

Abstract

Background:Early identification of Autism Spectrum Disorder (ASD) is of paramount importance in establishing effective interventions. Currently, the accepted gold standard for ASD diagnosis is the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2).Methods:In our research study, we applied a novel approach to the ADOS-2 known as the Formal Psychological Assessment (FPA). The innovation of this methodology comes from the construction of a matrix that allows (1) the identification of the existing relations among items in terms of clinical symptoms and (2) an adaptive assessment of an individual.Objective:The aim of this study was to use a practical application of the FPA on the ADOS-2 and show its potential for psychological assessment of individuals with ASD. Particularly, this research raises some important considerations regarding the evaluation of this population and the authors propose future work to improve the quality of clinical assessment.Results:Our results suggest potential for the application of this new methodology to the ADOS-2 to support clinicians using diagnostic procedures.Conclusion:The use of FPA allows analysis of each item of ADOS’s modules based on the presence/absence of clinical elements. This system allows the identification of the critical areas for each individual and reduces the number of items required for the test.

Qualitative Differences in Attribution of Mental States to Other People in Autism and Schizophrenia: What are the Tools for Differential Diagnosis?

“…The standard diagnostic test for autism is the Autism Diagnostic Observation Schedule-Version 2 (ADOS-2; Lord et al, 2012), but despite its widespread use, it is worth noting that ADOS-2 is not specific enough when used in adolescents or adults with psychotic onset (Frith & Happé, 2005;Keller & Bari, 2019;Pino et al, 2018). Social withdrawal and social communication difficulties in ASD usually overlap with negative SSD symptoms or catatonic behaviour, thereby leading to diagnostic errors (Bastiaansen et al, 2011;Frith & Happé, 2005).…”

“…In addition, several ToM tests are based on language abilities. According to the literature, ToM skills and development of language are related (Apperly et al, 2009 ; Astington & Jenkins, 1999 ; Milligan et al, 2007 ; Pino et al, 2018 ; Sivaratnam et al, 2012 ). Several studies highlighted that individuals with ASD and SSD exhibit atypical cognitive, language and social functioning (Mazza et al, 2008 ; Solomon et al, 2011 ).…”

On the Implementation of Computerized Adaptive Observations for Psychological Assessment

“…In fact, higher error parameters yield lower reliability for the collected answers. In all the previous applications of FPA (e.g., Donadello et al, 2017;Pino et al, 2018;Serra et al, 2015Serra et al, , 2017, a single response pattern per person was sufficient to fit the BLIM and, consequently, to validate the instrument from a probabilistic point of view because the instruments used comprised self-report questionnaires. As aforementioned, using a single scoring in observation could reduce response patterns' accuracy because several distortions and false positives or negatives can occur.…”

“…Until now, the logic of adaptivity in observations is mainly related to training behavior detection (e.g., the Train-to-Code software; Ray & Ray, 2008), and the detection of behaviors for clinical purposes lacks sufficient research. In this sense, Pino et al (2018) first showed how some modules of the latest Autism Diagnostic Observation Schedule version (C. Lord, Luyster, et al, 2012;C. Lord, Rutter, et al, 2012) have good implementation potential in a computerized adaptive assessment system.…”