Diagnostic Accuracy of the ADOS-2 in Children With Psychiatric Conditions

The Autism Diagnostic Observation Schedule (2nd edition, ADOS-2) shows excellent diagnostic accuracy when used with children suspected of having either autism or language/intellectual delays; however, its accuracy has been lower in children with psychiatric conditions. The purpose of this study was...

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Bibliographic Details
Published inCanadian journal of speech-language pathology and audiology Vol. 47; no. 3; p. 95
Main Authors Feehan, Angela, Napora, Shannon, Weis, Karen, Johnston, Danielle, Davis, Keya Clegg, McKinnon, Sharron, Zwaigenbaum, Lonnie
Format Journal Article
LanguageEnglish
Published Ottawa Canadian Association of Speech, Language Pathologists and Audiologist (Assn 01.01.2023
Subjects
Accuracy
Anxiety
Attention deficit hyperactivity disorder
Autism
Child & adolescent psychiatry
Children
Children & youth
Delayed language acquisition
Medical diagnosis
Patients
Pediatrics
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Summary:The Autism Diagnostic Observation Schedule (2nd edition, ADOS-2) shows excellent diagnostic accuracy when used with children suspected of having either autism or language/intellectual delays; however, its accuracy has been lower in children with psychiatric conditions. The purpose of this study was to determine the diagnostic accuracy of the ADOS-2 in pediatric psychiatry patients and to explore factors related to misclassification. Retrospective chart reviews for 84 consecutive autism query referrals in a local child psychiatry program were completed. Patient charts were reviewed for demographic and diagnostic information as well as scores on the ADOS-2 and the Children's Communication Checklist-2. Forty-four of 84 children were ultimately diagnosed with autism. Sensitivity of the ADOS-2 was 93% and specificity was 58%. Positive and negative predictive values were 71% and 89%, respectively. Thus, a negative result on the ADOS-2 was more informative than a positive result. The positive likelihood ratio showed a small difference, and the negative likelihood ratio showed a large difference. Overall, the ADOS-2 produced high rates of false positives in this pediatric psychiatry population. False positives were not related to the total number of psychiatric diagnoses children had received, but children diagnosed with attention-deficit/hyperactivity disorder and anxiety disorders were more likely to receive a false positive result.
ISSN:1913-200X
1913-2018