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      Diagnosing Autism Spectrum Disorders in Adults: the Use of Autism Diagnostic Observation Schedule (ADOS) Module 4

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          Abstract

          Autism Diagnostic Observation Schedule (ADOS) module 4 was investigated in an independent sample of high-functioning adult males with an autism spectrum disorder (ASD) compared to three specific diagnostic groups: schizophrenia, psychopathy, and typical development. ADOS module 4 proves to be a reliable instrument with good predictive value. It can adequately discriminate ASD from psychopathy and typical development, but is less specific with respect to schizophrenia due to behavioral overlap between autistic and negative symptoms. However, these groups differ on some core items and explorative analyses indicate that a revision of the algorithm in line with Gotham et al. (J Autism Dev Disord 37: 613–627, 2007) could be beneficial for discriminating ASD from schizophrenia.

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          The positive and negative syndrome scale (PANSS) for schizophrenia.

          L Opler, Jennifer Kay, Paul Opler … (1986)
          The variable results of positive-negative research with schizophrenics underscore the importance of well-characterized, standardized measurement techniques. We report on the development and initial standardization of the Positive and Negative Syndrome Scale (PANSS) for typological and dimensional assessment. Based on two established psychiatric rating systems, the 30-item PANSS was conceived as an operationalized, drug-sensitive instrument that provides balanced representation of positive and negative symptoms and gauges their relationship to one another and to global psychopathology. It thus constitutes four scales measuring positive and negative syndromes, their differential, and general severity of illness. Study of 101 schizophrenics found the four scales to be normally distributed and supported their reliability and stability. Positive and negative scores were inversely correlated once their common association with general psychopathology was extracted, suggesting that they represent mutually exclusive constructs. Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
          Article 0 comments Cited 1800 times – based on 0 reviews     Review now
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            Autism from 2 to 9 years of age.

            Catherine Lord, Susan Risi, Pamela DiLavore … (2006)
            Autism represents an unusual pattern of development beginning in the infant and toddler years. To examine the stability of autism spectrum diagnoses made at ages 2 through 9 years and identify features that predicted later diagnosis. Prospective study of diagnostic classifications from standardized instruments including a parent interview (Autism Diagnostic Interview-Revised [ADI-R]), an observational scale (Pre-Linguistic Autism Diagnostic Observation Schedule/Autism Diagnostic Observation Schedule [ADOS]), and independent clinical diagnoses made at ages 2 and 9 years compared with a clinical research team's criterion standard diagnoses. Three inception cohorts: consecutive referrals for autism assessment to (1) state-funded community autism centers, (2) a private university autism clinic, and (3) case controls with developmental delay from community clinics. At 2 years of age, 192 autism referrals and 22 developmentally delayed case controls; 172 children seen at 9 years of age. Consensus best-estimate diagnoses at 9 years of age. Percentage agreement between best-estimate diagnoses at 2 and 9 years of age was 67, with a weighted kappa of 0.72. Diagnostic change was primarily accounted for by movement from pervasive developmental disorder not otherwise specified to autism. Each measure at age 2 years was strongly prognostic for autism at age 9 years, with odds ratios of 6.6 for parent interview, 6.8 for observation, and 12.8 for clinical judgment. Once verbal IQ (P = .001) was taken into account at age 2 years, the ADI-R repetitive domain (P = .02) and the ADOS social (P = .05) and repetitive domains (P = .005) significantly predicted autism at age 9 years. Diagnostic stability at age 9 years was very high for autism at age 2 years and less strong for pervasive developmental disorder not otherwise specified. Judgment of experienced clinicians, trained on standard instruments, consistently added to information available from parent interview and standardized observation.
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              Trajectory of development in adolescents and adults with autism.

              Alicia M. Seltzer, Leonard Abbeduto, J. Greenberg … (2003)
              This article seeks to elucidate the trajectory of development in adolescents and adults with autism. Prospective, retrospective, and cross-sectional studies are reviewed to reveal the manifestation of and changes in the core symptoms of autism in adolescence and adulthood. Comparing children with adolescents and adults, modest degrees of symptom abatement and improvement in skills have been documented in multiple studies, as are increases in verbal and decreases in performance IQ. Nevertheless, most individuals do not attain normative outcomes in adulthood and continue to manifest significant degrees of symptomatology and dependency. However, a small sub-group (about 15%) has more favorable adult outcomes. Copyright 2004 Wiley-Liss, Inc.
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                Author and article information

                Contributors
                : +31503638794 , j.bastiaansen@med.umcg.nl
                Journal
                Journal ID (nlm-ta): J Autism Dev Disord
                Title: Journal of Autism and Developmental Disorders
                Publisher: Springer US (Boston )
                ISSN (Print): 0162-3257
                ISSN (Electronic): 1573-3432
                Publication date (Electronic): 14 December 2010
                Publication date PMC-release: 14 December 2010
                Publication date (Print): September 2011
                Volume: 41
                Issue: 9
                Pages: 1256-1266
                Affiliations
                [1 ]Social Brain Lab, Department of Neuroscience, University Medical Center, Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands
                [2 ]Autism Team North Netherlands, Lentis, Laan Corpus den Hoorn 102-2, 9728 JR Groningen, the Netherlands
                [3 ]FPC Dr. S. van Mesdag, Forint, Helperlinie 2, 9722 AZ Groningen, the Netherlands
                [4 ]Jeugd en Autisme, Dimence, Burgemeester Roelenweg 9, 8021 EV Zwolle, the Netherlands
                [5 ]Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands
                [7 ]Psychosencluster, GGZ Drenthe, Dennenweg 9, 9404 LA Assen, the Netherlands
                [8 ]Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Meibergdreef 47, 1105 BA Amsterdam, the Netherlands
                Article
                Publisher ID: 1157
                DOI: 10.1007/s10803-010-1157-x
                PMC ID: 3156304
                PubMed ID: 21153873
                SO-VID: fb961164-2d22-4e9a-b331-255e0dfa9454
                Copyright © © The Author(s) 2010
                History
                Categories
                Subject: Original Paper
                Custom metadata
                issue-copyright-statement © Springer Science+Business Media, LLC 2011

                ScienceOpen disciplines: Neurology
                Keywords: adults,psychopathy,schizophrenia,diagnosis,ados,autism
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: adults, psychopathy, schizophrenia, diagnosis, ados, autism

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