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The Autism Diagnostic Observation Schedule, Module 4: Revised Algorithm and Standardized Severity Scores

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Abstract

The recently published Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) includes revised diagnostic algorithms and standardized severity scores for modules used to assess younger children. A revised algorithm and severity scores are not yet available for Module 4, used with verbally fluent adults. The current study revises the Module 4 algorithm and calibrates raw overall and domain totals to provide metrics of autism spectrum disorder (ASD) symptom severity. Sensitivity and specificity of the revised Module 4 algorithm exceeded 80 % in the overall sample. Module 4 calibrated severity scores provide quantitative estimates of ASD symptom severity that are relatively independent of participant characteristics. These efforts increase comparability of ADOS scores across modules and should facilitate efforts to examine symptom trajectories from toddler to adulthood.

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Acknowledgments

This research was supported by a Dennis Weatherstone Predoctoral Fellowship to VH and Simons Foundation and National Institute of Mental Health grant R01MH081873 to CL. We thank Andrew Pickles for his statistical consultation. We are also grateful to the families, as well as SSC principal investigators (A. Beaudet, R. Bernier, E. Cook, E. Fombonne, D. Geschwind, D. Grice, A. Klin, D. Ledbetter, C. Martin, D. Martin, R. Maxim, J. Miles, O. Ousley, B. Peterson, J. Piggot, C. Saulnier, M. State, W. Stone, J. Sutcliffe, C. Walsh, E. Wijsman).We appreciate obtaining access to phenotypic data on SFARI Base. Approved researchers can obtain the SSC dataset described in this study by applying at https://base.sfari.org.

Conflict of interest

CL receives royalties for the ADI-R and ADOS-2; profits from this study were donated to charity.

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Author notes

  1. Catherine Lord

    Present address: Center for Autism and the Developing Brain, New York Presbyterian Hospital & Weill Cornell Medical College, White Plains, NY, USA

Authors and Affiliations

  1. Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA

    Vanessa Hus & Catherine Lord

  2. University of Michigan Autism and Communication Disorders Center, Ann Arbor, MI, USA

    Vanessa Hus & Catherine Lord

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  1. Vanessa Hus
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Correspondence to Vanessa Hus.

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Hus, V., Lord, C. The Autism Diagnostic Observation Schedule, Module 4: Revised Algorithm and Standardized Severity Scores. J Autism Dev Disord 44, 1996–2012 (2014). https://doi.org/10.1007/s10803-014-2080-3

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  • DOI: https://doi.org/10.1007/s10803-014-2080-3

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