Three-item Direct Observation Screen (TIDOS) for autism spectrum disorder

Abstract

We compared ratings on the Three-Item Direct Observation Screen test for autism spectrum disorders completed by pediatric residents with the Social Communication Questionnaire parent reports as an augmentative tool for improving autism spectrum disorder screening performance. We examined three groups of children (18–60 months) comparable in age (18–24 month, 24–36 month, 36–60 preschool subgroups) and gender distribution: n = 86 with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) autism spectrum disorders; n = 76 with developmental delay without autism spectrum disorders; and n = 97 with typical development. The Three-Item Direct Observation Screen test included the following (a) Joint Attention, (b) Eye Contact, and (c) Responsiveness to Name. The parent Social Communication Questionnaire ratings had a sensitivity of .73 and specificity of .70 for diagnosis of autism spectrum disorders. The Three-Item Direct Observation Screen test item Joint Attention had a sensitivity of .82 and specificity of .90, Eye Contact had a sensitivity of .89 and specificity of .91, and Responsiveness to Name had a sensitivity of .67 and specificity of .87. In the Three-Item Direct Observation Screen test, having at least one of the three items positive had a sensitivity of .95 and specificity of .85. Age, diagnosis of autism spectrum disorder, and developmental level were important factors affecting sensitivity and specificity. The results indicate that augmentation of autism spectrum disorder screening by observational items completed by trained pediatric-oriented professionals can be a highly effective tool in improving screening performance. If supported by future population studies, the results suggest that primary care practitioners will be able to be trained to use this direct procedure to augment screening for autism spectrum disorders in the community.

A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low‐ and middle‐income countries

“…For the screening and detection of ASD specifically, we identified three tools, namely the Modified Checklist for Autism in Toddlers, Revised with Follow‐up (Robins et al, ), the PAAS, (Perera et al, , ) and the TIDOS (Oner et al, ). To identify children with, or at risk of DD, we selected seven tools for use in LMIC, namely: the Guide for Monitoring Child Development (GMCD; Ertem et al, ); Malawi Developmental Assessment Tool (MDAT; Gladstone et al, ); Rapid Neurodevelopmental Assessment Tool (RNDA; Khan et al, , , ); TQSI (Durkin et al, , , ; Thorburn et al, ); Caregiver‐Reported Early Development Index (CREDI; McCoy et al, ); INTERGROWTH‐21st Neurodevelopment Assessment (Fernandes et al, ), and the 12‐month screener (Biasini et al, ).…”

“…There are a number of screening tools used for DD from LMIC (35 tools), but ASD tools for LMIC remain limited (only six identified in our review). Tools used to screen for ASD in LMIC are often derived from existing tools: for example, the HIVA screening tool used in Iran (Samadi & McConkey, 2014 includes items from the GARS-2 and the M-CHAT screening tools, while the Three-Item Direct Observation Screen (TIDOS; Oner et al, 2013) used in Turkey to screen for ASD in young children, combines the parent-report items from the Social Communication Questionnaire (SCQ; Allen et al, 2007;Chandler et al, 2007;Oosterling et al, 2010;Snow & Lecavalier, 2008) with three observational items. The 23-item screener used in Uganda (Kakooza-Mwesige et al, 2014) is an adaptation of the Ten Questions Screening Instrument (TQSI; Durkin et al, 1995), including an additional 13 items to identify children with ASD and to increase screening capability for visual, hearing, and seizure impairments.…”

“…For the screening and detection of ASD specifically, we identified three tools, namely the Modified Checklist for Autism in Toddlers, Revised with Follow-up (Robins et al, 2014), the PAAS, (Perera et al, 2009(Perera et al, , 2017 and the TIDOS (Oner et al, 2013). To identify children with, or at risk of DD, we selected seven tools for use in LMIC Tools that appear to be free (i.e., no purchase cost involved or tool described as low-cost), received a checkmark with an asterisk (√*).…”

Genetic testing in children with autism spectrum disorders

“…Most of the subjects were derived from a previously described Three-item Direct Observation Screen (TIDOS) study. 15 Written consents were obtained from all parents for participation in the study. The diagnosis of an ASD was made through application of a structured Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.…”

“…Distinction between AD and PDD-NOS was based on presence of full versus subthreshold symptom number in the affected ASD domains according to well recognized DSM-IV -TR rules. Also the Social Communication Questionnaire (SCQ), and the TIDOS 15 measures were used. Although 116 charts was identified, 96 children (with pervasive developmental disorder not otherwise specified (PDD-NOS), n=23; and autistic disorder (AD), n=73) had genetic testing completed.…”