Evaluation of clinical assessments of social abilities for use in autism clinical trials by the autism biomarkers consortium for clinical trials.
Susan Faja, Maura Sabatos-DeVito, Aksheya Sridhar and 18 others
PMID 36929131WHAT IT FOUND
Eight social assessments all accurately separated autistic from neurotypical children, but many were burdened by cost, time, or demographic biases.
The Vineland discriminated best but was most sensitive to age, IQ, race, and income. Diagnostic tools were weakly correlated with other measures.
Key findings
01All eight instruments successfully discriminated between children with ASD and neurotypical children, with excellent accuracy scores.
02The Vineland Adaptive Behavior Scales provided the best balance of discrimination and full range of behavior, but was the most sensitive to demographic factors like age, cognitive ability, race, household income, and parent education.
03Diagnostic instruments (ADOS and ADI-R) were the most resource-intensive to administer and showed only weak correlations with other measures in the battery.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample did not include children with significant intellectual disability (IQ below 60) or known genetic conditions, limiting generalizability to the broader clinical population. Sensitivity to change over time in response to an intervention was not examined. The same clinician completed both the ADOS-2 and CGI-S, meaning scores were not independent. The study did not formally assess common co-occurring conditions like anxiety or ADHD. Participants were volunteers for a rigorous longitudinal study, which may not represent typical clinical settings.
Declared interests
Funding was provided by the NIH (Extramural) and non-U.S. government sources. The authors are part of the Autism Biomarkers Consortium for Clinical Trials.
The easy way to misread this
Do not assume these instruments are validated for tracking treatment progress or detecting change over time, as sensitivity to change was explicitly not tested in this study.