SLPCohortAutism : the international journal of research and practice2025

Associations between emotion and behavior codes and ADOS-2 scores in a sample of children referred for autism evaluation.

Rebecca W Lieb, Luther G Kalb, Rachel Reetzke and 7 others

PMID 40684358

WHAT IT FOUND

Overactivity and disruptive behavior observed during ADOS-2 testing were associated with higher autism symptom scores in children with ASD.

Anxiety was associated with higher social communication scores only in children without an ASD diagnosis. All associations were small in magnitude.

Key findings

01The presence of overactivity was associated with higher Social Affect and Restricted and Repetitive Behavior scores for children with ASD, and this association was stronger than for children without ASD.

02Disruptive behavior was associated with higher Social Affect and Restricted and Repetitive Behavior scores for children with ASD, but this association did not differ significantly between those with and without ASD.

03Anxiety during testing was associated with higher Social Affect scores for children without ASD, but not for those with ASD.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The sample was drawn from a single outpatient specialty clinic in an urban Mid-Atlantic area, limiting generalizability. The study did not have access to co-occurring diagnoses (e.g., ADHD, anxiety disorders), so it is unclear if the observed behaviors were due to these conditions or autism itself. The analysis dichotomized E codes (present vs. absent), losing information about the severity of the behaviors. Data were cross-sectional and based on a single observation session with a stranger, which may not reflect the child's behavior in other settings.

Declared interests

The authors declared no potential conflicts of interest.

The easy way to misread this

Do not interpret the significant associations between E codes and ADOS-2 scores as large or clinically decisive effects. The study explicitly notes that all effect sizes were small, and the presence of these behaviors does not invalidate the ADOS-2 or confirm a specific diagnosis.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →