Describing the Profile of Diagnostic Features in Autistic Adults Using an Abbreviated Version of the Diagnostic Interview for Social and Communication Disorders (DISCO-Abbreviated).

The adult and child samples were not directly compared statistically, so differences should be read as descriptive patterns rather than tested group contrasts. All participants were diagnosed using ICD-10/DSM-IV-TR criteria, while the analysis used DSM-5 algorithm thresholds, so diagnostic rules may not match the original clinical diagnoses. The abbreviated interview was developed and tested mainly with children, and the adults included in its test samples had been diagnosed in childhood or adolescence, so it may not capture features more typical of adults diagnosed later. All adults received their first diagnosis as adults, but diagnoses were made by different clinicians and were independent of the research interview, so the study does not show how the interview changed clinical diagnosis. The child comparison sample had a diagnosis of Autistic Disorder or Childhood Autism, while the adult sample also included Asperger Syndrome, which may account for some profile differences. Adults were often self-informants, and informants were not available for all participants; the study could not formally compare self-report and other-report profiles because the groups were small. IQ was not assessed, although none were registered with intellectual disability and all had verbal ability to self-report, so the sample represents higher ability adults only. The female sample was too small for meaningful comparison with males, so possible gender differences in presentation were not examined. The study used existing anonymised datasets and a small adult sample, so it cannot establish how common these profiles are in all autistic adults.

Funder named: Economic and Social Research Council.

Do not conclude that adults with good non-verbal communication skills are not autistic. The paper used an abbreviated interview developed mainly with children, and adults still showed strong social-communication and restricted behaviour features. DSM-5 non-verbal criteria may miss some adults, but the study does not show autism is absent.