The Use of Signal Detection Theory to Assess DSM-III-R Criteria for Autistic Disorder

Siegel, Bryna; Vukičević, Jelena Pavičić; Elliott, Glen R.; Kraemer, Helena C.

doi:10.1097/00004583-198907000-00013

Cited by 72 publications

(25 citation statements)

References 5 publications

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“…Exploratory multifactor item response analysis was performed to compare the factor structure of revised algorithm items by cell to those of the Michigan 2007 sample. Receiver operating characteristic (ROC) curves 14 were calculated, and the sensitivity and specificity of the existing and revised ADOS algorithms were contrasted by developmental cells within the replication dataset and compared to the revised algorithms in the Michigan 2007 sample.…”

Section: Design and Analysismentioning

confidence: 99%

A Replication of the Autism Diagnostic Observation Schedule (ADOS) Revised Algorithms

Gotham

Risi

Dawson

et al. 2008

Journal of the American Academy of Child & Adolescent Psych

240

189

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Objective-To replicate the factor structure and predictive validity of revised Autism Diagnostic Observation Schedule algorithms in an independent dataset (N = 1,282).Method-Algorithm revisions were replicated using data from children ages 18 months to 16 years collected at 11 North American sites participating in the Collaborative Programs for Excellence in Autism and the Studies to Advance Autism Research and Treatment.Results-Sensitivities and specificities approximated or exceeded those of the old algorithms except for young children with phrase speech and a clinical diagnosis of pervasive developmental disorders not otherwise specified.Conclusions-Revised algorithms increase comparability between modules and improve the predictive validity of the Autism Diagnostic Observation Schedule for autism cases compared to the original algorithms. Particular attention was paid to the factor structure and predictive validity of the revised algorithms in this large independent dataset. NIH Public AccessThe ADOS is a semistructured, standardized assessment designed for use with individuals referred for possible autism spectrum disorders (ASDs). Four ADOS modules accommodate various developmental and language levels. In each, a protocol of activities or social presses is administered in approximately 45 minutes, and then items are scored on a 4-point scale, with 0 indicating "no abnormality of type specified" and 3 indicating "moderate to severe abnormality." To receive an ADOS classification of autism or ASD, an individual's scores on the original diagnostic algorithms must meet separate cutoffs in the Communication and Social domains, and a summation of the two. If any or all of these thresholds are not met, then a nonspectrum classification is assigned. Item scores of 2 and 3 are collapsed in the algorithms to reduce the impact of individual items.ADOS algorithm revisions were prompted by questions of effects of impairment level on current totals. Gotham and colleagues 1 noted that module 1 totals in the Michigan 2007 sample exhibited a restricted range due to scoring communication items in nonverbal children. Joseph and colleagues 3 reported correlations between ADOS social domain totals and level of cognitive impairment for preschool children. De Bildt and colleagues 4 found that ADOS classifications appeared to be least valid for children with mild, compared to moderate or profound, mental retardation. Thus, algorithm revisions were undertaken to improve sensitivity and specificity while possibly reducing age and IQ effects of the ADOS.Another goal of the Michigan 2007 revisions was to modify the existing ADOS domain structure of distinct domains and cutoffs for Social and Communication items, based on several studies that found a single factor best described social and communication domain items.5 -7 In response to findings that observation of repetitive behaviors may make an independent contribution to diagnostic stability, 8 restricted, repetitive behavior (RRB) items were included in the total to which...

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Section: Design and Analysismentioning

confidence: 99%

A Replication of the Autism Diagnostic Observation Schedule (ADOS) Revised Algorithms

Gotham

Risi

Dawson

et al. 2008

Journal of the American Academy of Child & Adolescent Psych

240

189

View full text Add to dashboard Cite

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“…For example, receiver operating characteristic curves, 123 signal detection, 124,125 and latent class analysis 126,127 methods may be used to answer questions about affective and other psychiatric symptoms associated with cognitive impairment. Examples of the use of receiver operating characteristic curves to answer clinical questions include prediction of relapse of late-life depression 128 and detection of MCI.…”

Section: Directions For Future Researchmentioning

confidence: 99%

Perspectives on Depression, Mild Cognitive Impairment, and Cognitive Decline

Steffens¹,

Otey

Alexopoulos³

et al. 2006

Arch Gen Psychiatry

238

217

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“…Siegel a nd his gro up have used th e signa l det ecti on stat istica l proced ure to e mpirica lly identify a set of optim a lly efficie nt di agnosti c crite ria for th e autistic di sorder given a developm entall y disabled differential di agn osti c grou p (17,18). This pro cedure takes into conside ra tion sa m ple size, pr eval en ce of th e di sord e r in th e sample and preval en ce of each crite ria in th e "diagnosis positive" group (17) .…”

Section: Signal Detectionmentioning

confidence: 99%

“…This pro cedure takes into conside ra tion sa m ple size, pr eval en ce of th e di sord e r in th e sample and preval en ce of each crite ria in th e "diagnosis positive" group (17) . This procedure simultaneously optimizes sensitivity a nd spec ificity a nd iden tifi es t he single crite rion with th e highest total pr edi ctiv e valu e. In other words, t his p roced ur e att empts to determin e how well a single sign or symptom performs in iden tifying a syndrome in contrast to identifying all th e elements of th at syndrom e. In th e cas e of autism, th ey wanted to det ermine whi ch of th e 16 diagnosti c crite ria of DSM-III we re most frequently evalua te d as central to the diagnosis.…”

Section: Signal Detectionmentioning

confidence: 99%

“…Th e fou r stud ies reviewed all found th e most di scriminating va r iab le to be it ems assessing fea t ures of the soci al domain as opposed to lan gu age or stereotyped beh aviour ( 17,18,19,21) . A qu es tion as king a bou t socia l relatedness ("marked lack of awareness of t he existe nce or feelings of others" or " looks through ' peopl e" ) would seem most appropriate.…”

Section: Screening For Auti Smmentioning

confidence: 99%

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